NHLBI Working Group on Competencies for Overweight and
Obesity Identification, Prevention, and Treatment
6701 Rockledge Drive, Bethesda, MD 20892

May 3-4, 2005

Summary of Meeting and Recommendations

The Working Group on Competencies for Overweight and Obesity Identification, Prevention and Treatment met on May 3-4, 2005 and was chaired by Dr. Robert Kushner, Professor of Medicine at the Northwestern University Feinberg School of Medicine. Attendees included representatives from public and private medical and academic institutions, the Association of American Medical Colleges, and NIH Institutes, including the National Institute of Diabetes, Digestive and Kidney Diseases, National Cancer Institute, and the National Heart, Lung, and Blood Institute (NHLBI), which sponsored the Working Group meeting.

The goal of the meeting was to provide advice to the NHLBI and NIH as to whether an Obesity Academic Award program is needed and what components of a successful program would be. The NHLBI Think Tank on Obesity Research recommended such a program as one of the important strategies in the effort to counteract the epidemic of overweight and obesity. To meet this goal, the group was charged to discuss two major issues:

• The challenges that medical schools, residency programs and clinicians face in obesity training and practice; and,
• How to incorporate obesity training and care into medical education and practice in undergraduate, graduate, and continuing medical education programs.

Speakers with extensive experience in all aspects of medical curriculum development and delivery presented their perspectives on undergraduate and graduate education as well as continuing medical education. Perspectives of resident physicians, clinicians, academic deans, and the Association of American Medical Colleges were included. NHLBI resources and research on obesity, and the importance of incorporating evidence from sleep research in an obesity academic award, were also presented.

The Working Group concluded that an Obesity Academic Award program is needed and would make an important contribution, in tandem with ongoing research, to improving clinical care and addressing the national obesity epidemic. The Working Group recommended the following as objectives for an Obesity Academic Award:

Undergraduate Medical Education (UME)

• Medical school administrators (i.e., associate deans, course directors, and faculty) must recognize and support a competency-based obesity theme that is taught across the four-year UME curriculum. Thematic integration is one in which obesity identification, prevention, and treatment are incorporated into courses, lectures, case studies, small-group discussions, role plays, standardized patients, and problem-based learning and examinations in a wide variety of medical training topics, from basic-science courses such as pathology to clinical training experiences such as ambulatory care rotations. A multidisciplinary Task Force should be created to accomplish this integration.
• The medical school administrative leadership should have a centralized structure to modify curricula and should support a full-time coordinator, trained and committed faculty instructors, and clinicians experienced in obesity care. Ongoing faculty development sessions and role models are also needed.
• Obesity Academic Award awardees should collaborate with the American Association of Medical Colleges and the Liaison Committee for Medical Education to incorporate obesity education into competency requirements for accreditation.
• An Obesity Academic Award initiative should encourage collaboration among medical institutions by, for example, having medical institutions work with other local medical schools within their state to disseminate widely their programs and curricula.

Graduate Medical Education (GME)

• Medical institutions should have strong institutional support from GME deans and residency directors, implement faculty development by training faculty who can teach in multiple programs, and involve residents in the teaching process.
• Medical institutions planning for an obesity GME program should consider involving a network or group of at least three additional residency programs across institutions to develop, implement, and evaluate their program.
• Institutions who receive the academic awards should plan to share GME materials, to mentor faculty, and to design faculty development sessions, retreats, conferences, electives, Web-based resources, and standardized patient cases.
• Medical Institutions should collaborate with organizations such as the American College of Graduate Medical Education, who can modify competency requirements for GME disciplines.

Continuing Medical Education (CME)

• Strategies for CME should include training of faculty from a variety of disciplines in sufficient numbers to reinforce and institutionalize obesity training and care.
• Pre-implementation evaluation of providers’ needs should guide CME program development.
• CME and training programs should incorporate recommendations and conclusions of the Robert Wood Johnson Foundation’s expert panel on continuing provider education on obesity that are available at http://www.rwjf.org/files/research/CMEPanelReportSum.pdf
• Curricula for providers should include training in advocacy (community, healthcare systems, and regulatory bodies).

Cross-Cutting Issues

• All programs should integrate basic science and pathophysiology with clinical applications, which will also prepare the trainee to integrate future new information.
• For optimal impact, an Obesity Academic Award program should include a coordinating center to facilitate collaboration, specifically: communications among awardees and with organizations such as the AAMC, Liaison Committee on Medical Education and the American College of Graduate Medical Education; sharing and dissemination of activities, curricula, and test materials; and approaches to mentoring faculty.
• An Obesity Academic Award should include a strong evaluation plan to assess whether the program improved the competency levels (knowledge and skills) to identify, prevent, and treat obesity effectively.