Training Future Medics – Be Deliberately Different

There is strong evidence that physical activity is highly beneficial for living with and beyond cancer. Research has shown it can reduce side effects and improve quality of life at all stages of cancer treatment. There is also evidence physical activity can reduce reoccurrence and improve survival rates in some cancers . Despite the evidence, physical activity is not routinely available as part of cancer care in the UK.
During my Churchill fellowship, I explored how a culture where physical activity is embedded within cancer care has been achieved in North America. Although the project focused on cancer care, the findings were applicable across the health care system, as someone with a long term health condition is twice as likely to be inactive.

The way our medical professionals are trained is a key cultural factor which impacts the perceived importance of physical activity, and how professionals promote it to their patients. This then impacts the patients own perception and ultimately helps change their behaviour.
During the project, I visited the first medical school in the USA to fully integrate lifestyle medicine into all 4 years of the medical school curriculum. The University of South Carolina (USC) School of Medicine Greenville has a unique philosophy to be ‘deliberately different’ and has placed the implementation of lifestyle medicine at the forefront of its approach. The USC Medicine Greenville believes that when you train physicians differently, they will treat patients differently.

The approach recognises the societal impact of chronic diseases which could be prevented via lifestyle modifications, such as increased physical activity. Despite this, most medical schools teach physicians about pharmaceutical approaches to treat the symptoms of ill health, rather than learning how to prevent and manage conditions holistically.

USC Greenville’s curriculum is designed to equip future physicians with the knowledge and skills to promote lifestyle changes, and recognises that strong patient-doctor relationships are key. Although qualified physicians will disperse across the country after finishing medical school, it was clear that the universities innovative approach had a wider impact on the city of Greenville’s public health. The strong emphasis the medical school places on physical activity has caused a ripple effect to normalise the promotion of physical activity across the local health system. The impact of the medical school’s philosophy is demonstrated through various programmes and initiatives across the city, including a community based ‘exercise is medicine’ programme which health professionals refer to and a ‘walk with a Doc’ programme, where patients can speak informally to doctors whilst out walking. The city has also invested in its parks and green space to further encourage healthy lifestyles and mental well being.

Greenville provides an example of how changing way that health professionals are trained can create a legacy of improved health across a population. With the continued rise in chronic disease, its crucial that we start thinking deliberately different to help people move more and improve our nation’s health.

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Patel, A. V., Friedenreich, C. M., Moore, S. C., Hayes, S. C., Silver, J. K., Campbell, K. L., … & Matthews, C. E. (2019). American College of Sports Medicine roundtable report on physical activity, sedentary behavior, and cancer prevention and control. Medicine and science in sports and exercise, 51(11), 2391

Reid, H., Ridout, A. J., Tomaz, S. A., Kelly, P., & Jones, N. (2022). Benefits outweigh the risks: a consensus statement on the risks of physical activity for people living with long-term conditions. British journal of sports medicine, 56(8), 427-438.

Albert, F. A., Crowe, M. J., Malau-Aduli, A. E., & Malau-Aduli, B. S. (2020). Physical activity promotion: a systematic review of the perceptions of healthcare professionals. International journal of environmental research and public health, 17(12), 4358.

About the Author

Beth Brown

As the Operations Manager of the National Centre for Sport & Exercise Medicine in Sheffield, Beth brings over 10 years of experience developing physical activity interventions for chronic health conditions. In her current role, she is responsible for overseeing a co-location model that aims to transform the way physical activity is integrated into the National Health Service. In recognition of her expertise and dedication to this field, Beth was awarded with a Churchill Fellowship in 2020. This fellowship funded her travels across North America, where she was able to explore and learn about the latest innovations and best practices for incorporating physical activity into cancer care and clinical pathways