Integrating Lifestyle Medicine into Residency Curricula

By: Tonya Cramer MD, MPH

LMRC Project Director

Assistant Professor LLUH

 

In the past few decades we have begun to accumulate the evidence from randomized clinical trials and large observational studies to substantiate reversal of chronic diseases using Lifestyle Medicine interventions. Unfortunately, the majority of the medical community is unaware of the significant body of research and the positive impact on health provided by Lifestyle Medicine. There is very little information on nutrition, physical activity, positive psychology and wellness, sleep or spirituality reviewed in graduate medical education. This undermines not only the health of individuals and communities, but of health care providers themselves. Given that physician burnout and health concerns are at record levels and hypertension, hyperlipidemia, diabetes and abnormal weight are likewise burdening the current healthcare system, this critical and health restoring information is essential in healthcare now.


The journey started in 2016 with a core group of dedicated residents and faculty with the vision to create an innovative, interactive, resident driven curriculum. Three core resident leaders from the ACLM Professionals in Training (PiT) team, Deepa Sannidhi, Regan Stiegmann, and Lucas Shanholtzer led as the managers of the project along with medical student, Silvia Caswell, as the meeting coordinator. These young professionals in conjunction with faculty and staff leadership from LLUH, ACLM and LMEd, progressed the LMRC to the point where a soft launch was implemented at ACLM 2017. Since that time, over 100 people and/or residency programs have expressed interest in the LMRC and have signed up to receive our LMRC Newsletter.


Subsequently, the Beta Version of the LMRC premiered in July 2018 at 4 institutions and 8 programs after a rigorous national application and selection process. Selected pilot sites are Florida State University College of Medicine’s Family Medicine Residency at Lee Health; Greenville Health System and University of South Carolina School of Medicine Greenville’s Family Medicine Residency as well as the Primary Care Sports Medicine Fellowship program; Loma Linda University’s Family Medicine, Preventive Medicine, Combined Family and Preventive Medicine Residencies and the Lifestyle Medicine Fellowship; and the University of Texas- Rio Grande Valley’s Preventive Medicine Residency. The curriculum is hosted on the ACLM learning management system, providing online access to the content.


Currently, the LMRC is a comprehensive, applicable and flexible curriculum designed for integrated implementation into medical residency programs and is driven by residency involvement at all levels. The LMRC contains 10 modules consistent with the American Board of Lifestyle Medicine certification competencies with 40 hours of in-person didactics and 60 hours of independent application activities that are designed to be presented and completed over a 2 to 3- year timeline depending on the needs of the residency program. The practical component provides support for the use of lifestyle medicine principles in the clinical setting with a requirement of 400 Lifestyle Medicine patient encounters and experience with groups and intensive therapeutic lifestyle change programming. Upon completion of all components of the curriculum, residents are qualified for the American Board of Lifestyle Medicine certification exam.

Version 1 of the LMRC is planned for national availability beginning in July of 2019. Version 1 will continue to be available on the ACLM online learning management system and will be adaptable to each individual residency program. The LMRC is appropriate for integration into any primary care specialty. While the current version does not specifically contain pediatric sections, pediatric information is incorporated and there are plans for content expansion in this area.


The progression of the LMRC would not have been possible without the support of Susan Benigas as the Executive Director of the ACLM and a generous grant from the Ardmore Institute of Health. Many of the original members continue their involvement as authors and curriculum contributors. The current LMRC board consists of Dr. Brenda Rea as the Executive Sponsor (LLUH), Dr. Tonya Cramer as the Project Director (LLUH), Dr. Karen Studer for Evaluation Oversight (LLUH), Dennis Muscato (Co-Director, LMEd), and Paulina Shetty (Director of Education, ACLM). Authorship of the presentations include work contributed by faculty and resident leaders in the field of Lifestyle Medicine from multiple institutions and training programs.


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