Benchmarking of provider competencies and current training for prevention and management of obesity among family medicine residency programs: a cross-sectional survey

Abstract

Background 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. Methods 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. Results 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. Conclusion 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.

Teaching module for obesity bias education: incorporating comprehensive competencies and innovative techniques

“…Recommendations for teaching obesity bias, include educating learners about the complexities and biological processes involved in weight issues, as well as removing personal blame for weight gain [ 10 , 20 ]. It has long been noted that there is a deficit in obesity education in primary care residencies, and it has been challenging to implement obesity medicine curricula to address these issues [ 21 , 22 ]. An already crowded didactic schedule, limited faculty knowledge about obesity, and negative attitudes about obesity as a disease have been highlighted as potential barriers to implementation of obesity curricula [ 17 ].…”

“…There is a paucity of validated teaching material for obesity bias, especially regarding implicit biases, and few programs have implemented any instruction around the subject of obesity bias [ 20 , 23 ]. Efficient and effective educational materials for students and residents could help overcome educational deficiencies [ 17 , 22 ].…”

Supporting faculty development for obesity education: A National Survey of United States family medicine residency programme directors

“…Compared to 2018, fewer programme directors in this survey assessed their residents as fairly or very prepared to provide high quality obesity care (74% vs. 58%, p = .016). 14 Residents in programmes with 1+ ABOM-certified faculty member were more likely to be very prepared to provide medical care compared to those without ABOM-certified faculty members (18% vs. 7.8% p = .047).…”

“…13 A 2018 study demonstrated that future family physicians are ill-prepared to provide comprehensive, team-based obesity care, with the majority of Family Medicine programme directors reporting their graduates to be unprepared to manage obesity. 14 The Obesity Medicine Education Collaborative (OMEC) published obesity competencies in 2019 to guide and assess educational outcomes, and efforts are ongoing to improve the quality of medical school training in the care of people with obesity. 15 These limitation in formal obesity education have led over 1700 US family physicians to seek additional expertise and board certification through the American Board of Obesity Medicine (ABOM) (American Board of Obesity Medicine, personal communication, August 26, 2022).…”

Canadian family medicine residency program survey of physical activity curriculum content

“…These discrepancies may be due to the curriculum expert's familiarity with PA content in their program. By contrast, in the United States, 52% of family medicine programs were prepared to incorporate PA to a great extent in obesity prevention and management training (Orjuela-Grimm, Butsch, Bhatt-Carreño, Smolarz, & Rao, 2021). Unique to our study is that many Canadian FM programs explained they teach specifically to the CFPC priority topic areas and that some residents learn the benefits of PA, how to assess PA, prescribe PA, refer for PA, and document PA information in EMRs.…”