Most Important Nutritional Competencies Every Future Physician Should Develop

Diet plays a major role in the development and management of chronic disease, yet there are no mandated nutrition competencies in the U.S. undergraduate medical education. Most residency programs include minimal formal nutrition requirements, some include none and they aren’t accessed on licensing or board exams. Consequently, many physicians report feeling underprepared to provide practical, evidence-based nutrition guidance to patients.

A recent paper published in the Journal of American Medical Association, Proposed Nutrition Competencies for Medical Students and Physician Trainees, calls for physicians to be knowledgeable in varied aspects of nutritional science and practice. The paper recommends establishing 36 nutritional competencies for medical professionals, ranging from fundamental science concepts to counseling patients in a culturally appropriate way.

Columbia University’s Institute of Human Nutrition (IHN) master's program addresses all 36 competencies in its curriculum. “We are well aware of the scarcity of nutritional education among medical professionals, so our program aims to fill this crucial gap,” says Kim Hekimian, PhD, Director of the IHN’s Master of Science in Nutrition program. “Our curriculum is designed to reflect all 36 competencies necessary for physicians’ success.”

Here are the most important and relevant competencies a physician must have.

Demonstrate knowledge of the functions of essential nutrients

Physicians must demonstrate knowledge of the functions of essential nutrients because this understanding forms the foundation of effective nutrition counseling and disease management. Knowing how vitamins, minerals, fatty acids, amino acids, and other key nutrients support metabolism, immunity, growth, and overall physiological function enables physicians to recognize deficiencies, interpret lab values, and make informed dietary recommendations.

The IHN curriculum addresses this competency through Biochemical and Physiological Bases of Nutrition courses as well as the Introduction to Public Health Nutrition course, educating future physicians on the basics of nutritional science. As part of their education, students study and develop a comprehensive understanding of nutritional biochemistry, biological functions of nutrients and macronutrients as well as their metabolites, and their relevance to nutrition at the cellular, organ, and systemic levels. A solid grasp of nutrient functions empowers IHN graduates to deliver comprehensive, evidence-based care in their future practice.

Demonstrate knowledge of the principles of a healthy, balanced diet, in accordance with national nutrition guidelines

Physicians must demonstrate knowledge of the principles of a healthy, balanced diet, aligned with national nutrition guidelines, because patients rely on their credible and practical advice that supports disease prevention and overall well-being. Understanding core dietary principles allows physicians to translate broad public health recommendations into individualized guidance that fits a patient’s health status, lifestyle, and preferences. This knowledge also equips physicians to identify unhealthy patterns, address misinformation, and reinforce evidence-based strategies for improving health outcomes.

The IHN program fulfills this competency through a set of classes that include Introduction to Public Health Nutrition, Physiology and Nutrition Through the Lifecycle, and Integrative Nutrition and Pathophysiology. Students also take Obesity: Etiology, Prevention and Treatment, to understand the underlying reasons for metabolic dysfunction and Introduction to Lifestyle Medicine which delves into sustainable, health-promoting food choices and counseling.

Provide evidence-based, culturally sensitive nutrition and food recommendations

Physicians must offer evidence-based, culturally sensitive nutrition and food recommendations because diet is a powerful tool in both preventing and treating many chronic diseases. Patients are more likely to understand, trust, and follow guidance when it’s presented to them in a way that respects their cultural traditions, food preferences and lived experiences.

To develop this competency, IHN students rely on Introduction to Public Health Nutrition, Biochemical and Physiological Bases of Nutrition and Introduction to Lifestyle Medicine, among others. Additionally, they also take the Structured Observations in Clinical Practice class, which helps them develop cultural insights and sensitives crucial for working with diverse patient populations.

When physicians integrate nutrition knowledge with an awareness of each patient’s cultural context, they can create realistic, personalized plans that improve adherence and support long-term well-being. This approach not only strengthens the physician–patient relationship but also enhances the effectiveness of medical care overall.

IHN alumni value the opportunity to study science and its practical applications. “I gained a strong foundation in the basic sciences and a humanistic view of nutrition and medicine,” says Jacob (JP) Paul, (MS ' 19). 

Demonstrate knowledge of public health nutrition, including the social determinants of health, and how it can reduce the burden of disease adn improve access to adequate, healthy food

Effective nutrition counseling depends not only on what advice is given but also on how well it aligns with a patient’s readiness and ability to make changes. When patients feel heard and respected, dietary counseling is more likely to lead to behavioral changes, as patients are more likely to successfully adopt healthier eating patterns. When physicians understand a patient’s motivations, barriers, and stage of change, they can tailor their guidance, set realistic goals, and provide the right level of support at the right time.Physicians must demonstrate knowledge of public health nutrition and the social determinants of health because these factors profoundly shape patients’ ability to access and maintain healthy diets. Understanding how issues like income, education, neighborhood food environments, cultural norms, and structural inequities influence nutrition allows physicians to better identify barriers their patients face and to offer realistic, compassionate guidance.

To address these important issues, the IHN program requires students to take Introduction to Public Health Nutrition and Epidemiology for Nutritionists, among other foundational nutrition classes. Students also have the opportunity to volunteer at the IHN Food Co-op by designing nutritious food menus, supporting local communities and organizing annual food drives.

Interprets information on nutrition facts panels, nutrition labels, and menus to make appropriate recommendations to support patients’ individual needs and food choices

Physicians must remain a trusted voice for patients in making thoughtful food choices because people’s eating habits have a major influence on their weight, metabolic health, and risk for chronic diseases such as diabetes, heart disease, and hypertension. By guiding patients through their everyday dietary decisions, physicians support the development of sustainable, lifelong patterns that promote overall well-being. This guidance is especially valuable in helping patients understand nutrition labels, nutrition facts panels and designing healthy menus and meals.

To master this competency, students build the fundamental knowledge of intake, digestion, absorption, transport, and metabolism in the Biochemical and Physiological Bases of Nutrition course. They move on to investigate the causes, management, prevention and treatment of obesity in the Obesity: Etiology, Prevention, and Treatment course. They also study Introduction to Public Health Nutrition to learn the variety of dietary patterns and develop skills in assessment, literature review, and program planning.

Students can put their knowledge to practice in real-world settings by volunteering their skills at Columbia Student Medical Outreach (CoSMO), a free clinic serving uninsured patients in Washington Heights and Northern Harlem.

Utilizes evidence-based models of behavior change to assess patients’ readiness in order to effectively counsel patients for how to modify their diet and food choices to improve health

Effective nutrition counseling depends not only on what advice is given but also on how well it aligns with a patient’s readiness and ability to make changes. When patients feel heard and respected, dietary counseling is more likely to lead to behavioral changes, as patients are more likely to successfully adopt healthier eating patterns. When physicians understand a patient’s motivations, barriers, and stage of change, they can tailor their guidance, set realistic goals, and provide the right level of support at the right time.

To bolster their counseling skills, IHN students can choose an elective course, Essentials of Nutrition Counseling and Medical Nutrition Therapy. During the first part of the class, students focus on building counseling techniques; in the second part, they apply these skills through assignments related to medical nutrition management.

Conclusion

To fill the gap in nutritional education, future physicians must develop a number of nutritional competencies. The leadership at Columbia IHN has incorporated all 36 competencies into their current Master of Science in Nutrition curriculum. Interested in learning more? Visit the MS in Human Nutrition home page.