Departments of Epidemiology and Pediatrics, Mailman School of Public Health, Columbia University, New York, NY, USA.
Departments of Surgery and Internal Medicine and Geriatrics, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA.
BMC Fam Pract. 2021 Jun 24;22(1):132. doi: 10.1186/s12875-021-01484-y.
U.S. physicians lack training in caring for patients with obesity. For family medicine, the newly developed Obesity Medicine Education Collaborative (OMEC) competencies provide an opportunity to compare current training with widely accepted standards. We aimed to evaluate the current state of obesity training in family medicine residency programs.
We conducted a study consisting of a cross-sectional survey of U.S. family medicine residency program leaders. A total of 735 directors (including associate/assistant directors) from 472 family medicine residency programs identified from the American Academy of Family Physicians public directory were invited via postal mail to complete an online survey in 2018.
Seventy-seven program leaders completed surveys (16% response rate). Sixty-four percent of programs offered training on prevention of obesity and 83% provided training on management of patients with obesity; however, 39% of programs surveyed reported not teaching an approach to obesity management that integrates clinical and community systems as partners, or doing so very little. Topics such as behavioral aspects of obesity (52%), physical activity (44%), and nutritional aspects of obesity (36%) were the most widely covered (to a great extent) by residency programs. In contrast, very few programs extensively covered pharmacological treatment of obesity (10%) and weight stigma and discrimination (14%). Most respondents perceived obesity-related training as very important; 65% of the respondents indicated that expanding obesity education was a high or medium priority for their programs. Lack of room in the curriculum and lack of faculty expertise were reported as the greatest barriers to obesity education during residency. Only 21% of the respondents perceived their residents as very prepared to manage patients with obesity at the end of the residency training.
Family medicine residency programs are currently incorporating recommended teaching to address OMEC competencies to a variable degree, with some topic areas moderately well represented and others poorly represented such as pharmacotherapy and weight stigma. Very few program directors report their family medicine residents are adequately prepared to manage patients with obesity at the completion of their training. The OMEC competencies could serve as a basis for systematic obesity training in family medicine residency programs.
美国医生在照顾肥胖患者方面缺乏培训。对于家庭医学来说，新开发的肥胖医学教育合作组织（OMEC）能力为比较当前培训与广泛接受的标准提供了机会。我们旨在评估家庭医学住院医师培训计划中肥胖培训的现状。
我们进行了一项研究，对美国家庭医学住院医师培训计划负责人进行了横断面调查。共有 735 名主任（包括副主任/助理主任）来自美国家庭医师学会公开目录中确定的 472 个家庭医学住院医师培训计划，通过邮寄邀请他们在 2018 年完成在线调查。
77 名计划负责人完成了调查（16%的回应率）。64%的项目提供肥胖预防培训，83%提供肥胖患者管理培训；然而，39%的调查项目报告称，他们没有教授一种将临床和社区系统作为合作伙伴整合到肥胖管理中的方法，或者很少这样做。行为方面的肥胖（52%）、体力活动（44%）和肥胖的营养方面（36%）是住院医师培训计划中涵盖最广（很大程度上）的话题。相比之下，很少有项目广泛涵盖肥胖的药物治疗（10%）和体重耻辱和歧视（14%）。大多数受访者认为肥胖相关培训非常重要；65%的受访者表示，扩大肥胖教育是他们计划的高或中优先级。在住院期间，课程中缺乏空间和缺乏教师专业知识被报告为肥胖教育的最大障碍。只有 21%的受访者认为他们的住院医师在住院培训结束时非常有准备管理肥胖患者。
家庭医学住院医师培训计划目前正在根据 OMEC 能力在不同程度上纳入推荐的教学内容，一些主题领域得到了较好的体现，而其他领域则较差，如药物治疗和体重耻辱。很少有项目主任报告说他们的家庭医学住院医师在完成培训后能够很好地管理肥胖患者。OMEC 能力可以作为家庭医学住院医师培训计划中系统肥胖培训的基础。
