Nutrition education in medical school: the case of international medical students in China

OBJECTIVE: To assess the knowledge on country-specific nutrition situation, perceptions of the nutrition curricula and factors influencing capacity to offer nutrition guidance among medical students studying internationally in China compared with their home-country counterparts. DESIGN: Cross-sectional study. SETTINGS: China, Ghana, India and Montenegro. PARTICIPANTS: International medical students in China and medical students studying in their home countries of Ghana, India and Montenegro. MAIN MEASURE: An online semistructured questionnaire was administered using WeChat for international students and Microsoft Forms for home-country medical students to assess students’ perceived knowledge and significance of nutrition, knowledge of country-specific nutrition situation, perceptions of the nutrition curricula and perceived capacity to offer nutrition counselling. RESULT: In all, 190 medical students responded to the survey: 110 international students studying in China and 80 home-country students from Ghana (40), India (20) and Montenegro (20). Home-country students rated the importance of nutrition in health and disease development higher than international students (p<0.05). International students reported not having any specific nutrition courses while home-country students had nutrition courses as part of their curriculum. Only 8.2% of international students and 13.8% of home-country students were able to correctly mention any specific national nutrition guidelines of their home countries. Home-country students were more likely to provide correct nutrition recommendations for infants (χ²(3)=26.349; p=0.001), pregnancy (χ²(3)=9.793; p=0.007), lactating mothers (χ²(3)=9.112; p=0.011), diabetes (χ²(3)=13.619; p=0.001), hypertension (χ²(3)=12.022; p=0.002), overweight/obesity (χ²(3)=8.896; p=0.012) and undernutrition (χ²(3)=7.670; p=0.022) compared with international students. Practical nutrition courses, hours of nutrition education and how often students were asked nutrition-related questions tended to affect and predict the adequacy of nutrition education received and the perceived confidence for nutrition counselling. CONCLUSION: International medical students in China are less familiar with the nutrition context in their respective home countries compared with their home-country counterparts. Medical schools in China that train significant numbers of international students need to support these students to become familiar with their respective countries’ nutrition contexts.