The Kitchen as a Classroom: Medical Students Get a Culinary Education
AAMC Reporter: November 2012
—By Barbara A. Gabriel, special to the Reporter
Many medical conditions require that patients follow specific dietary guidelines. But in some cases, doctors are not quite sure how to counsel patients about healthy eating. And such topics are not common in traditional medical school curricula. At a number of clinics, patients receive pamphlets on what to eat and not to eat for different medical conditions. But translating that into everyday practice is not always straightforward for patients, said Esther Joo, a second-year student at Tulane University School of Medicine.
“You tell a patient with diabetes to stay away from white flour and sugar. But he doesn’t know what it means to stay away from white flour in practice. And sugar is in everything,” said Joo.
In a novel approach, Tulane and at least one other medical school have created programs to help future doctors and community members develop a deeper understanding of healthy eating.
Tulane joined forces with the prestigious culinary school Johnson and Wales University to create a “culinary medicine” program, one of the first of its kind in the country. Timothy S. Harlan, M.D., an assistant professor of clinical medicine at Tulane, developed the program two years ago at the recommendation of Tulane’s dean, Benjamin P. Sachs, M.B.B.S.
Picking up the phone and cold-calling Karl J. Guggenmos, dean of culinary education at Johnson and Wales, Harlan shared Sachs’ idea to build a “teaching kitchen” to allow medical students and the larger community to learn about nutrition through hands-on cooking exercises.
In a city renowned for sweet and fatty foods, Harlan saw the irony of holding healthy cooking classes.
“New Orleans—indeed, all of Louisiana—is one of the most obese areas of the country,” Harlan observed. “Certainly there is a challenge to doing this, given the food culture in southern Louisiana. But that makes this the perfect place to start this project.”
Tulane’s teaching kitchen
Tulane’s joint effort with Johnson and Wales is multifaceted. In 2010, the schools signed a memorandum of understanding that laid out a variety of mutual goals, including establishing the teaching kitchen, a Tulane elective course in culinary medicine, internships at Tulane for Johnson and Wales students, and continuing medical education classes. The centerpiece of the program, the teaching kitchen, is still under construction, although classes already are taking place.
“We’re trying to use food and culinary skills as the touchstone for conversations about disease processes that occur as a result of lifestyle issues,” Harlan explained. Students and community members are encouraged to think about how what they put into their bodies affects their long-term health—and they are given the practical cooking skills to change their diet.
Community teaching-kitchen classes are taught by a Johnson and Wales graduate who is assisted by medical students. After a lecture on a nutritional topic such as proteins or fats, the class cooks recipes that reinforce the nutritional concepts. Afterward, those in the class are invited to eat the fruits of their labors and discuss what they learned.
Joo noted the teaching kitchen gives her and fellow medical students the opportunity to engage community members.
“It’s not an in-and-out, 20-minute thing, like most clinic visits,” Joo said. “We talk to people for two to three hours and get to know them. It’s more of an investment in the community because you are working so closely with people on something that is such a big part of their daily lives.”
Tulane’s elective course in culinary medicine follows the teaching kitchen’s lecture-cook-eat-discuss format. Taught by medical school faculty, assisted by Johnson and Wales interns, the course encourages medical students to draw on the connection between food and health. “At the end, the goal is to loop the lesson back to the basic biochemistry and physiology they are learning in other classes,” Harlan said. Students also discuss how they can use what they learn to counsel patients about healthy eating.
Joo added that her experience with patient education was severely inadequate before she became involved with the program. “My lack of success in that area is one of the reasons I’m so passionate about making sure this effort gets off the ground,” she said.
Taking the elective and volunteering in the teaching kitchen taught Joo to give her patients concrete examples of what it means to eat well, she added. “Now I can give them specific, step-by-step instructions so they can go to the grocery store and make a substantial change.”
After noticing her colleagues’ poor diets, Amy Cobb, a fourth-year student at Baylor College of Medicine, co-founded Cooking Healthy, Eating Fresh (CHEF), a six month elective for second-year medical students.
“I’ve never seen a group of people eat so many frozen dinners and fast food,” Cobb said. “One of the things we wanted to do was give second-year medical students the tools they need to be able to maintain healthy habits during the hectic part of their clinical training.”
Like Tulane’s culinary medicine elective, CHEF consists of a lecture, a hands-on cooking exercise, and a discussion.
“A lot of doctors tell their patients to eat healthy, but they have no practical advice to give. This should help physicians counsel better,” Cobb said.
Cobb herself maintains a healthy diet and tries to set an example for patients. “One luxury we have as medical students is more time to spend with patients to counsel them. I’ve made food and nutrition a topic of special interest. Especially with my diabetic patients, I get down to specifics and give them cooking tips.”
At Tulane, Harlan said patients are more likely to take advice from physicians like Cobb who walk the talk. “When physicians are healthy themselves—when they eat healthy, exercise, and share with their patients that they do so—their patients are more likely to listen to them,” he said.
“We’re trying to use food and culinary skills as the touchstone for conversations about disease processes that occur as a result of lifestyle issues.”
Timothy S. Harlan, M.D.