The future of education of health professionals – 1

Last week I spent a morning discussing omics, big data and AI with an audience of nutritionists and MDs in the context of the Masters in Human Nutrition and Metabolism, invited by Prof. Conceição Calhau. The discussion (and others recently) made me reflect about how we should be training health professionals, specifically nutritionists/dieticians.

Human nutrition is a particularly difficult area to study scientifically since it is hard to control all the variables in the time scales involved. However, the emergence of all sorts of gadgets that can help us monitor what we actually eat and do, combined with the rise of omics in describing physiological alterations, provide us with tools to study the effects of nutrition in our bodies. What we are learning is that one size diet does not fit all, as we respond to food in radically different ways. It does however create the problem: nutritionist already had a hard time figuring our all the variables at hand, including the fact that people lie about what they do and eat; the new patient is a now moving mountain of data that no common human being can process, and s/he demands a personalised nutritional plan. This is the typical scenario for AI to make its play! Multiple scientific publications describe computational integration of multiple data types, including the ever complex gut microbiome, and personalised diet prediction (check Segal’s lab for example). AI is already offered as part of the nutritional planning that is offered by companies offering consumer-directed microbiome analysis services. Inevitably computers are becoming MUCH better at predicting the best, individualised diet for a person… so this begs the question – why are we focusing nutritionist training in metabolism and dietary interventions when computer can already do it better than humans?

I am convinced that the education of the (near-)future medical professionals require far more soft skills than hard, technical knowledge, as these professional’s roles will be to convince, engage, involve, motivate, make accountable the patient in front of them, providing a human interaction experience that no machine can match. However, when I checked the BSc degrees in nutritional sciences in my region (6 differed degrees in as many Higher Education institutions just in Lisbon!!), I noticed that either they have one single semester learning Psychology, or had no psychology training. I also did not see any training on sales, marketing, empathy, motivation, etc.. It may be that all of these subjects are intensely studied in the majority of courses focusing on anatomy, metabolism, public health, etc…

I am also finding that many nutritionists/ dieticians are not familiar with the gazillion devices on the market, targeted directly at consumers and aiming at empowering individuals beyond the reach of traditional health professionals. If nothing else this would be a major commercial threat for a professional class where private practice plays a significant role. But these same devices could (and should!) become a major instrument in the hands of health professional. Yet knowledge of what is currently possible to measure with wearables and its limitations is at best dependent on the individual curiosity of the practitioner. Understanding that AI combined with a mobile phone can recognise and compute energy and nutrient consumption with encouraging accuracy TODAY contrasts with the prevailing notion among many professionals that this is will never work. I am convinced that nutritional planning will be increasingly leveraged by consumer-directed analytical products and services and that no nutrition professional can afford not being an expert in these technologies.

AI for nutrition is here, but it is not perfect yet – we are not on the brink of witnessing entire professional class becoming obsolete. I am certain that its adoption will be very gradual. For nutritionists/dieticians, as we are just learning how to deal with microbiomes, nutrigenomics and permanent monitoring of our bodies this means that some time is still at hand to learn new skills. I believe that the successful professionals of the future will be those that master these skills today. But health schools need to get their act together quickly and focus on training for the PRESENT of nutrition science, and not for its past.

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