Comprehensive integration of nutrition into medical training.

Nutrition must be integrated into the medical school curriculum to train physicians who can effectively provide nutrition care for the prevention and management of chronic diseases. This article describes the comprehensive nutrition curriculum developed at the University of Colorado School of Medicine. Two fundamental principles have guided the school's approach to medical nutrition education: 1) nutrition content must be broad in nature and be vertically integrated across the preclinical and clinical years and continued through postgraduate training, and 2) active adult learning (eg, "learning by doing") should be practiced whenever possible. From our experience, we have identified several key elements important for the successful integration of nutrition into the curriculum. First, identifying a core group of committed faculty to advocate for nutrition and serve as role models and having a physician nutrition specialist at the helm provides constant momentum for the advancement of nutrition education. Second, establishing a network of linkages with other elements of the existing curriculum creates the opportunity to add nutrition content without necessarily adding time. The third key element is an emphasis on incorporating nutrition in clinical training. Students must be routinely exposed to physicians practicing nutrition for nutrition to become part of standard patient care. This can be accomplished through multiple exposures to nutrition throughout the curriculum (ie, vertical integration). Finally, a coordinator is needed to monitor the many "fronts" of the integrated nutrition curriculum and to continue networking and program implementation.