Muzammil Ahmad: The lack of nutrition education in med school
Transcript of the No-Bullshit Vegan podcast, episode 81
Muzammil Ahmad on the lack of nutrition education in med school & what he's doing about it
Karina Inkster: You're listening to the No-Bullshit Vegan podcast, episode 81. Soon-to-be Dr. Muzammil Ahmad joins me to discuss nutrition education in medical schools (actually the lack of nutrition education in medical schools), and his work to reform it, including bringing plant based nutrition to the forefront.
Welcome to the show. I'm Karina, your go to, no BS vegan fitness and nutrition coach. Thank you so much for joining me today. I hope that you have been doing well during these continued bizarre and uncertain times. I hope that you are able to prioritize your health and fitness, even if it looks a little different right now, compared to the pre pandemic times. You know, the “before” times. A few of my clients are actually back to training in their gyms now, but most of them are still training at home, myself included. My husband and I, in the “before” times, used to go to our town’s rec center three days a week. He would work out in the gym while I would swim laps in the pool. The pool closed back in March, and it is still closed. We have no idea when it's going to reopen.
Luckily, when we moved from Vancouver to Powell River a couple of years ago, my first priority was building a full garage gym. That has been getting a ton of use. In the swimming department, I have been attempting to get over my extreme dislike of cold water. I did several months ago, invest in a wetsuit. I started open water swimming a few days a week in Powell Lake, which happens to be two minutes down the street from our house. People kept telling us, my swim buddy, and me "why are you swimming there? It's colder than the ocean. It's such a cold lake. There are no other options that are that cold." Last week my swim buddy and I decided to test out the ocean and I can tell you, it is exactly as cold as the lake. There's no difference at all. I mean, it's October on the West coast of BC, what do we expect? It's so cool that our faces hurt. I don't know how long this is going to last. Am I really going to be out there in December swimming in the ocean? I don't think so. I might need to adjust my cardio plan for the winter…
Anyways, I have several copies of my book, Resistance Band Workouts, lying around my office, and I would love for them to go to good homes. These days, a lot of us are working out at home. Most of my clients are using resistance bands in some fashion. Here is your chance to not only score a free-signed copy of my book, but also to help support this show. Go to nobullshitvegan.com/applepodcasts, leave a star rating and a quick review, and send me a screenshot of your review. You can find me on Instagram or Facebook. On Monday, October 12th, I will draw three names from folks who submitted reviews. These three people are going to get a free copy of Resistance Band Workouts. Again: head to nobullshitvegan.com/applepodcasts, send me a screenshot of your review, and then you'll be entered into the draw of awesomeness. If you need more info, or if you need direct links for where to send your screenshots, head to our show notes at nobullshitvegan.com/081.
Now I'd like to introduce our guest for today, Muzammil Ahmad. Muzammil is a Canadian vegan working toward finishing his medical education. He's a third year medical student at the University of Alberta. He has a certification in nutrition and a master's degree in Psychology. He's known for his Instagram account, @drplantbased, and he hosts a medical and health based podcast, The Plant Prescription Podcast, with a fellow medical student. His favorite vegan meal is smoothie bowls. Here's our conversation.
Hi, Muzammil. Thank you so much for coming on the show today.
Muzammil Ahmad: Thank you so much for having me.
Karina Inkster: I am excited you're here. We're going to talk about something that has not been discussed on the show yet, which is super awesome, important, and very long-term health related. First, can you tell me and our listeners a little bit about where you're at in medical school, a little bit of history of your own vegan journey, a little bit of an origin story would be awesome.
Muzammil Ahmad: Right now, I'm in my third year of medical school at University of Alberta, in Edmonton, Canada. Before I get into my vegan journey, maybe I'll just share how I even ended up in med school, because I don't have a very typical story. The last time I had done sciences like biology or chemistry was actually in grade 10. I never took it in high school after that. My undergrad was in business, so I didn't have a science background whatsoever. I did a business degree. Initially, I worked at a nonprofit focused on mental health, because mental health has always been one of my passions on the side. I worked there on a contract for a year, and when that one ended, I actually got a job in oil and gas. I worked at Shell in their finance and marketing departments for some years. I never thought medicine would be something that would ever happen in my future, which is kind of funny.
As a kid, I always used to say, "I want to be a doctor. I want to help people”. Somewhere along the way, I think that just got lost. For some reason, back in high school, I did not enjoy the science courses in grade 10. I did not want to do them. Do I regret that? I don’t know. If I had done sciences in high school, maybe I would have considered medicine sooner, but I didn’t, and that's the path I took. I worked in oil and gas for a bit, and initially I enjoyed it. I still questioned myself if I enjoyed the work, or the fact that you make a lot of money, and Shell gives you a lot of vacation. I was getting seven weeks of vacation. That's a lot, especially for someone who just graduated. I was getting a lot of vacation. I was always traveling and had enough money to travel, but then I never truly liked what I was doing. I was always looking forward to my vacation, and my weekends and was just going about my day, trying to just do my work and stuff.
I always questioned myself deep down. Do I even want to do this? For the first year or so, I worked in the finance department and then I was not happy. I was thinking: I'm quitting my job. HR got involved and they didn't want me to give up on the company so fast, so they moved me into the marketing department because I'd mentioned how I love psychology. They thought marketing's kind of psychology related. You might enjoy that. A funny thing: there’s a lot of psychology in marketing, but not the type of psychology I enjoy. You're not really helping people there. I learned all the tricks then; all the strategic tricks that they utilize to get people to buy more things. I learned all that, but it was just not something that I gravitated towards.
Eventually, I decided it wasn't my thing. It actually happened on one of my trips. I was backpacking through South America; I had taken a couple of weeks off from work as I had vacation. I met this chef who was also backpacking, and him and I were just having conversation. He was telling me how he's really passionate about his work. He loves what he does. He asked me what I think about it, and all the things I liked about my job had nothing to do with my job. It had to do with the fact that I had a lot of vacation, I had good money, and then he was said, "Okay, cool. But it doesn't seem like you actually like the job.” And I thought- you know what, you’re actually right. I don't. That kind of just like further triggered me to reconsider what I was doing.
Eventually I came back from a vacation and I kept working for a few months while pondering over this idea, about never actually pursuing any of my passions, and never actually fully getting a chance to explore my passions. I eventually did decide to quit my job. Just to please my parents (at that point in my life, my parents were very involved in my life), they wanted me to have a backup plan before quitting. I actually had applied to law school because I had all the stuff I needed for law school and I applied. I got accepted. So, I decided I would just do law school. It has to be better than this. I quit in February of 2015, and law school would have started August/September, so I had a lot of months. I actually decided to go just on a really long trip by myself to travel from New Zealand up to Japan.
That was a self-discovery trip. During that time, I was meeting all these people, and just having amazing conversations and exploring. One thing I realized was that I'm happiest when I'm discussing things with people and I would meet random people. I've always been a type of person that enjoys listening, and listening to people's situations, stories, and problems, and helping them regardless of what it is. A lot of people I randomly met said that to me too. I thought, "You know what, whatever I decide to do, it has to be with people and something I'm doing that's helping them. That's what I truly enjoy at the end of the day.
Medicine hadn't clicked in my mind at the time, because I didn't have a science background. That was not something I considered. I actually decided that law wasn't something I was going to pursue because I was literally going to not do one thing I wasn't happy about. The second thing that I wasn't passionate about it; I just applied as a backup thing. I actually finally decided to do something in mental health, because that's something I was actually passionate about. I applied for a Master's in Psychology in the UK. It was just a program I really liked and I've always been fascinated by Scotland, so I wanted to live there for a bit. After coming back from my trip, I moved to Scotland. I had actually applied from a trip while traveling, so I got accepted by the time I came back. I moved to Scotland and did my master's in Psychology.
That was the first time I truly, truly enjoyed going to school and learning. It was a fascinating experience. I loved everything I learned. After that, I thought maybe I would do a PhD in psychology and become a clinical psychologist. I just started shadowing psychologists. I enjoyed everything except for the fact that I felt like in a lot of the situations; the psychologist did not have the final say. A lot of the time, the doctor makes a lot of the decisions. I knew I would not be happy doing that. I also realized that a lot of things are interconnected. Mental health is not just mental health in a bubble. It's interconnected with your lifestyle, with your diet, with your relationships, with so many factors. And I wanted to learn all that.
It's all connected together holistically. I'd also decided at the same time to start shadowing psychiatrists, as well as other types of medical doctors. I realized that I really actually enjoyed medicine. I felt natural at it; meeting those patients, listening in, talking and everything. I thought that was literally the first time it was a hundred percent: I want to pursue this. I did not look back. I went back to undergrad to take science courses (like I said, I had no science courses). I took science courses, got ready for that, took the MCAT, and then applied for medical schools. I was very, very fortunate that I got in at my top choice: the University of Alberta. That's how I ended up in medical school.
Karina Inkster: My goodness. That is probably the most interesting medical school origin story I've heard.
Muzammil Ahmad: It was an interesting experience, but honestly I'm so glad that it worked out. I'm actually really glad for all my experiences because now when I meet patients, I feel like I've had this variety of experiences, that I'm able to relate to a lot of patients. If someone works in the corporate world, I've done that for a few years, so I can kind of relate to it. I've traveled. I've traveled quite a bit. I have seen a lot of different cultures and stuff. I just feel like it has given me an edge when I'm speaking with patients and connecting with them. I'm kind of glad that it worked out the way it did.
Karina Inkster: One hundred percent. That's amazing. Where now, in this whole interesting saga, is veganism?
Muzammil Ahmad: I have kind of, for a very long time, been interested in fitness and nutrition. I'm trying to remember when it started. I would say a long time ago, there was a time where I was quite overweight, which eventually led me to say enough is enough. I need to lose weight and get fit. At that particular time I was only interested in losing weight. I did not even think about chronic lifestyle diseases that come in later in life, or disease prevention. None of that was something on my mind. I just needed to lose weight. Back in the day I lost weight, I got into fitness, working out, and I fell in love with it. I had been doing that for the longest time, but I was eating a very typical diet, a typical bodybuilder diet.
I was eating chicken breast with broccoli, and maybe sweet potato, that type of a diet. I thought I was being very healthy, but then I never felt as good as I wanted to feel. That's something that always bothered me. I realized I needed to eat really well. I work out and I sleep well. I try to do all the things that you're supposed to do, but I don't feel well. I had always had migraines all my life since I was a kid. I don't remember not having migraines. I've always had them, and have seen urologists for migraines. They always told me, “ Oh, your mom has them. This is genetic. You're going to have them." They prescribed me really strong medications. I've also had other health problems like cystic acne, and then a bit of eczema. Then, the fatigue thing that I was telling you about. I never felt good. I always had a bit of fatigue.
I remember drinking a lot of coffee to battle my constant fatigue, for a very long time. I had seen dermatologists for my skin, and they would always tell me diet plays no role. I had seen other types of doctors for my fatigue, and they ran all the blood tests, telling me that they could not find anything. I saw a specialist once and he literally told me that he wanted to put me on antidepressants, because my blood tests were fine. This is the only thing he could think of. Talking about diet was never an option; it seems like, so it must be depression. He just went straight into "you should experiment with antidepressants", which was really interesting for me, because I do have a psychology background.
One: you’re jumping to antidepressants, so you're automatically assuming it's depression. You're not even a psychiatrist. You didn't do any of the tests to even see if I'm depressed. Secondly, if I'm depressed, shouldn’t you start off with therapy? Shouldn't that be the first step instead of just putting me on these strong antidepressants? I remember just leaving the office, telling him, "I'm not going to take antidepressants and I'm going to do my own research.” By then, I was in medical school in the beginning of first year when that was all happening. I needed to figure things out on my own. Two things kind of happened at the same time. This whole antidepressant story, and then around the same time, we had a lecture on cardiology held by cardiologists, who were telling us how children, by the age of 10, get plaques in their arteries.
There was no conversation on why is that the case, or how can we help these children not get plaques in their arteries. It was just a very definitive statement. This is what I find fascinating: a lot of medical students are okay with that type of learning. They accept it. They think, "This is how it is”. I've never been that type. (I think) you've told me the facts, but now tell me why, and how to change it. That piece is missing.
In the same lecture, I'm already quite bothered and frustrated. The cardiologist goes: you're sitting with your friends, look at the friend to your right, and look at the friend to your left. You've looked at two people. One of them is going to get heart disease because 50% of people get heart disease. Again: another definitive fact he gave us and I just thought, “okay, but what do I do with this? Why do 50% of people get heart disease?" Is that normal or is this a Canadian problem/ North American problem or is it a global problem? Can we do something about this? None of those questions were answered. He just jumped into talking about drugs and surgeries. The two things kind of happened back to back, and I was just really bothered.
I had come into med school thinking that I'm going to learn all the ways to help patients. I'm not saying they're not teaching ways to help patients, but it's just one way of hoping. My goal is to help patients prevent disease in the first place. I just started to do my own research and I started looking at nutritional literature. The more I looked into it, the more I was fascinated with how little I knew, and how little in medical school they teach you. That's how I discovered plant based nutrition. I discovered that a lot of the studies that have compared different types of diets, like plant based diets, tend to do better. Then I discovered the blue zones, and I found out that what I thought was the Mediterranean diet is not Mediterranean diet. They make it seem like it's a lot of cheese, a lot of chicken, a lot of fish and vegetables and fruits, but the Mediterranean diet is pretty much a plant based diet as well, just with a bit of fish (and such).
The more I learned about this, the more I thought, and “nutrition is a lot more than what I thought it was." I thought it was just a way to lose weight and that's all I ever thought about. That's when I personally decided to go plant-based. I started seeing a lot of health benefits. My acne went away (the cystic acne). I used to get these really big, painful pimples under my skin that went away. My eczema got better. I haven't had migraines since, and my energy shot up. All these things didn't happen on the first day, I had to keep doing it for a bit, for all these things to slowly take place, but they all did take place.
That was the nutrition aspect of veganism that I discovered. I was really fascinated. I think that kind of opened my mind to learn further. I remember watching so many videos on plant based stuff by a lot of these doctors, like Neil Bernard and Kim Williams, and all these doctors that I aspire to be like. I think YouTube suggested a video about the impact of diet on environment, and I watched it. I don't remember exactly, but I think at the end of the video, they were recommending to go watch Cowspiracy. I watched Cowspiracy and I thought, “ wow. I’ve never thought about this.”
It was like a rabbit hole. I knew I had to keep learning more. How does diet impact everything else? Eventually I came across Earthlings and Dominion, and after watching that, there was no going back. What I have seen; you can't ignore it. I'm not going to be part of this. I'm not going to be part of so much animal cruelty. It's so unnecessary. I know eating plant based is healthy and you can thrive on it and help prevent disease. Even if those factors weren't the case, just knowing that you can live a healthy life would have been enough for me, if I found out about Earthlings and all that right after. Since then, going fully vegan has been about a year and a half; and plant-based, a bit longer than that.
Karina Inkster: That's so awesome. This story of coming to veganism for one very specific reason and then branching out is very common. Of course that one reason is different for everybody. I think increasingly, it's becoming the environment/personal health, and then ethics come later. That seems to be the trend these days. Back in the day, 20 years ago, it was definitely the other way around. I'm actually really glad that there are now these other avenues that are bringing people to plant based eating, even if it's not directly ethics at first, it usually is at some point.
Muzammil Ahmad: It’s bringing more people, absolutely.
Karina Inkster: It is; that’s really awesome. You know what, you were talking about migraines. Just recently on the podcast. I mentioned I had a migraine. I don't get them very often at all (I think I've had three in 10 years.) I used to have them way more often before I went vegan, and I did the same thing: went to a neurologist, did the whole thing. Nobody mentioned that dairy could be a potential trigger. Now there are other triggers. There could be things like weather, and sometimes you don't even know. Sometimes it's a food you eat that you normally eat with no issues, but it really was correlated with stopping dairy. I was vegetarian first. Then I went vegan, and it really wasn't until I went vegan, when I noticed, "Hey, I haven't had one of these migraine things for awhile."
Muzammil Ahmad: Dairy is an interesting one, because I feel like cutting out dairy seems to help with a lot of things. Yet, dairy seems to be perceived as the most innocent one out of all the animal products. I find that very fascinating, because dairy was the first thing to go from my diet. When I went plant-based I took things out one by one: dairy and eggs, then meat was the last thing to go, which is interesting. Usually it’s the other way around. I’ve talked to a lot of people who haven't even gone fully vegan yet, and they've taken the first step of cutting out dairy. They have seen tremendous benefits, and I'm just always fascinated by how dairy has this innocent image.
Karina Inkster: Yes, but that’s because it’s complete bullshit marketing. I think you're right. It's brainwashing: "Oh, it's good for your kids. Make sure they're getting enough calcium, et cetera." I want to talk about the nutrition specific to medical school, but first: what's your longer term plan? You came to medical school in a very, I don't want to say roundabout, but l a really intriguing way. What's your plan with having this education? Where do you want to go post medical school?
Muzammil Ahmad: Initially when I came in, I had just done a master's in psychology, and I was fascinated by mental health (which I still absolutely am). Over the course of learning everything and shadowing, I realized that I want to be in a place where I can help prevent a lot of these diseases, including mental health problems. I see that best fit at the forefront, as the first person that patients see. I am now very strongly considering family medicine, with the goal of practicing lifestyle medicine. It's very interesting, because I never thought family medicine would be something I would consider coming into medicine. (I thought) I want to do one of those fancy things. Now, I would rather be the person to help patients. Those fancy things, the specialists, are not necessarily (most of the time) needed.
My goal is now to finish my med school, then do a residency in family medicine, and then get my accreditation in lifestyle medicine. I really want to focus on having a multidimensional, integrative practice with other practitioners from various backgrounds, to help patients from more of a lifestyle perspective. I want to make sure that in the clinic there's a dietician, a psychologist, a therapist, and exercise physiologists, all those things. They’re all related and working together to help patients prevent disease. If they are starting to get sick, if they're becoming pre- diabetic or just recently diagnosed with Type 2 diabetes, I want to be able to help them reverse those things, or at least treat them as much as possible with lifestyle choices. Most likely, they won't need a specialist, and they are able to go on about their lives in a healthy manner, enjoy it with their kids or grandkids. That's kind of my goal right now.
Karina Inkster: It's fricking awesome. You mentioned a lifestyle medicine. Accreditation, certificate, something like that. What is that? I don't really know much about that.
Muzammil Ahmad: Lifestyle medicine is a branch that's more commonly known right now in the US. It's a fully accredited branch in the US. After any sort of residency in medicine, you can get your accreditation in last semester, and you have to do a certain amount of hours in lifestyle medicine. Then you have to pass all the board exams, to be able to get that accreditation. Then you can call yourself a lifestyle medicine practitioner, and then you can integrate that within medicine.
Lifestyle medicine has six pillars, the first one and the biggest pillar, being diet and nutrition, focused on plant based nutrition. The second one is exercise. The third one is sleep management, fourth is stress management, then the mental health piece, and then substance use and alcohol and all that. I think one of them is relationships. I know I said more than six, but a few of them are combined together. Those are all the pillars of lifestyle medicine. The point is that integrating them within modern medicine is not a replacement; it's more of an integration. A normal doctor just has that modern medicine, or pharmaceutical and surgery as options. This kind of adds six more tools to treat patients.
Karina Inkster: Interesting. We don’t have it here in Canada. It's only available in the US, is that right?
Muzammil Ahmad: That’s where you can get your accreditation, but you can practice it in Canada. I actually know a lot of doctors who are doing that now. What you would do is complete your hours under a doctor who has that accreditation. A good thing, like I mentioned, Canada does have doctors like that. You have to go to the US to write the exam, and then you can come back and practice it here. It doesn't in any way go against modern medicine. That can be a concern for people, especially if you have your medical license. It doesn’t in any way go against it. If someone has Type 2 diabetes, and you are able to get them on a lifestyle that helps them reverse it, and now the lab values say they don’t have diabetes anymore, you don't need to give them medication.
It's not that they're sick, and then you just take away the medications and say, "let me treat you." It's a step by step process. You are obviously being cognizant and doing it properly. You're not risking their health, but rather you're trying to improve their health, with the goal of kicking them off medications (if possible). If someone has a very severe condition, then most likely, you won't be able to do that. It really depends on when you catch it, but regardless of whatever, state of condition they're in, you're able to make a huge difference in their life, if you're able to get them to make lifestyle choices.
Karina Inkster: We definitely need more of these professionals.
Muzammil Ahmad: I agree with you. Absolutely. I've been spreading the message in my medical school, hoping that more medical students will later get that accreditation.
Karina Inkster: That's awesome. So: that’s your plan, and then you could technically run a clinic. You could liaise with other professionals. The sky's the limit, isn't it?
Muzammil Ahmad: Absolutely. I want to do both of those things, and then I have other a few ideas as well in my mind that eventually I would like to implement. It’s not fully fleshed out yet, but I would want to have some sort of a retreat for chronic diseases, where people come in for a week or two, and then you teach them all the lifestyle things they need to learn. It's very intensive; it’s a week or two they're there. Of course, that would depend on the particular plan they had, if they can afford it. I don't think any of the government health services would cover something like that, but the people who can afford it would be able to come in, and you teach them all the lifestyle changes they need, and teach them the important things. I think skills that a lot of people lack, and one of the major causes of many of the diseases, is lack of knowing how to cook healthy foods. I think if you can get people to come in, and if you're not able to help them with anything, but you’re able to help them cook healthy meals, you will see a drastic change in their health.
Karina Inkster: Absolutely. That's something I think we should all learn in elementary school and nobody ever does. You know, we're doing Home Ec class and learning how to make like biscuits….
Muzammil Ahmad: …and cookies, and pastries. We never learned anything healthy. And then those are the things we want when you go home.
Karina Inkster: Exactly! So… let's talk about med school then. It's kind of common knowledge, unfortunately, that the average medical curriculum here in Canada, also in the States (maybe also in Europe), but let's call it North America, is sorely lacking in nutrition education. Let's talk about the problem first. What is the deal? How much nutrition education is really included in someone's medical schooling, if they're in Canada or the States?
Muzammil Ahmad: The unfortunate thing is a lot of the nutrition that's taught in medical curriculum is not always regulated. A professor can come in and add a piece of nutrition that they feel is right. The next professor may come in and say something completely contradictory. That itself is a huge problem. You don't really see any of the professors/doctors coming in and doing that with medication and surgeries. With all those things, there's consensus. They come in, they say the same thing, and there is no contradiction or confusion. I think that itself is a huge problem. Then, the lack of quantity of hours spent teaching nutrition is also another problem. It's very, very limited and very basic things that are taught, like macros, which I think is such a useless skill, compared to other more important skills within nutrition.
They focus a lot on learning what a macro is, how to get protein, and how you get your fats and all that stuff. A lot of the myths about nutrition are still within the medical curriculum. The whole dairy and calcium thing is still heavily part of the curriculum. The whole "meat being one of the best sources of protein”. People may say stuff like, "Oh, you might want to make sure someone's trying to cut down on meat." They're still getting some sort of animal products for the iron, and things like that, which is very surprising. There's a lot of evidence out there, but they're just not looking at it. Now we have an amazing Canadian Food Guide, that's telling people to go more plant based.
Karina Inkster: Finally. It’s about time, right?
Muzammil Ahmad: Unfortunately, it’s not fully integrated. What I mean by that is we do have nutrition classes, but literally anyone can come in and teach whatever. We had a dietician come in, talk about the new Canadian Food Guide, and talk about all the flaws in it. The flaws, for her, were-
Karina Inkster: Ahh…no dairy?
Muzammil Ahmad: Yes. The dietician, straight up, said, "What am I going to tell children to drink anymore? Just water? Are they going to get the calcium?” I was just so appalled. You’re a dietician. I’m sorry, but I know this is a very easy thing to answer. How do you not know this? That dietician also talked about other problems in relation: they’re saying get more protein from plants, but she was worried about the incomplete protein thing.
Karina Inkster: That’s an old school myth!
Muzammil Ahmad: I'm just so surprised about these things. We have the new Canadian Food Guide. Dieticians shouldn't be able to just come in, say things like that, and just confuse medical students. Now, a lot of medical students are questioning the new Canadian Food Guide, because the dietician confused them. That's a huge thing. There are a lot of other things that have been taught that are completely outdated. Within a psychiatry block, we were taught that vegans don't get certain nutrients, so they can have more mental health problems. The study that he used was very flawed. I looked into it, and I even sent an email to the Dean about it. My point is that the nutrition we are taught is very limited, and what we are taught is very contradictory. It just seems to do more harm than good at the current state.
Karina Inkster: Interesting. You mentioned what is wrong with the situation, because we're going to talk about what your proposed solutions are too, but you mentioned things like focusing on things like macros, which in certain cases can be useful, but for the average doctor/general practitioner working with patients, it's going to be completely useless. What kind of stuff should they be talking about instead?
Muzammil Ahmad: Before I answer that, I do want to mention it's very fascinating, because whenever they go over guidelines of anything, they're always diet and lifestyle. That's the first thing we should recommend to our patients, but it's never talked about. What diet are we recommending? All the information we got was contradictory within the curriculum. If I hadn't done my own nutrition training (I actually got my own nutrition certification), I would be confused with the rest of the medical students. They’re thinking, “okay: you're telling me that diet helps with diabetes and with heart disease. But everything we've learned is so contradictory from one professor to the next." I would not even know what to tell the patient.
It's interesting, because they know diet helps, they just don’t know what within the diet helps. For example, the macro thing. Sure, if someone has a very specific fitness goal, it makes sense, but that is not the general population. That is not what patients go to doctors about. Maybe they go to a personal trainer about that, but they don't go to a doctor about that. Most of the times, they want to know (for example) about diabetes, which runs in their family. What can they do to prevent it? Or, their cholesterol is going up, what can they do to lower that? Things like that are what we need to be teaching. There is a lot of good nutritional science that we could be teaching about that. What I did, actually, was near the end of first year after learning everything about plant based nutrition, having gone vegan and everything, I talked to one of the deans about this problem.
I explained the entire situation, and said, "This is creating a lot of confusion and chaos with the current nutrition curriculum. I don't think it's going to help future doctors help patients in any way." I told her all the facts and she said, "you're absolutely right”. This was last summer. She said, “why don't you, next summer, work on a project where you go over the entire curriculum, figure out all the flaws in nutrition that are taught, give us sources and evidence to show your recommendations, and we can try to implement them? That was 12 months away, though. I could that, but I wanted to make changes sooner. I proposed starting a plant based nutrition club, and I was able to get funding. That's something now we have in med school. It's not a part of med school, but it's a club that people can join and attend events.
I initiated that club, and then a couple of other people later joined me in running it. We had a dietician come in and talk about the plant based diet in relation to how to help patients use a plant based diet, and how to do a plant based diet properly. We showed Gamechangers. Now we have a monthly newsletter in regards to plant based nutrition. I'm going to get into my podcast, which came up later. The cohost of my podcast is the one who creates this monthly newsletter. She picks a topic: breast cancer, high cholesterol, hypertension, whatever it is, that is medical related. Then, with evidence of course, she explains the entire situation, makes recommendations, puts in all the references, and attaches a few nutrition facts or videos, if people are interested in watching videos over looking at the evidence. We've been sending those out to whoever joined the mailing list.
We have raised awareness because we know more and more people now within the class are starting to eat plant based, and asking us a lot more questions about all this now. Of course there are other people, who are not at all interested in nutrition, or don't believe in the power of it, which is fine because you can't convince everyone. We started that club and then also I proposed, around the same time, about the podcast. There are a lot of great podcasts, but I think having a podcast from medical students will get more medical students and health care professionals within Canada to listen to a lifestyle focused podcast. We got funding for that eventually. Now the podcast has been helping a lot as well, because more medical students are listening to it. That was our goal: if medical students listen to it, then we'll hopefully have more lifestyle medicine focused doctors in the future.
Karina Inkster: Fantastic. I had no idea the podcast was supported by your school.
Muzammil Ahmad: Yes, we got funding from them. All these things happened step by step. I’m making it seem really easy, but it required a lot of work and convincing. Throughout the semester, every time something was wrong that was in the curriculum that was said, such as the whole vegan thing and mental health thing, or the dairy thing, I would type up a long email to the Dean and the professor who said it. I’d say, "this is what was taught, this is what the evidence is showing”, and I’d put in all the references. I did that for the entire semester. The Dean clearly knew that I knew what I was talking about. That truly helped me get the funding and approval and everything.
Karina Inkster: That's so interesting. Even though it was clearly a lot of work and a lot of hurdles to jump through, I'm sure, it's really interesting that the Dean (and presumably other high level staff at the school) were so supportive in the end, even if it took a little bit of kicking them in the shins. How can other schools do something similar, where they're taking a critical look at what they're actually teaching, where they have a plant based nutrition group focused on medical students who are going to be helping (who knows how many) thousands of other people during their careers…. how do you expand this to other schools?
Muzammil Ahmad: I think one more thing that I didn't mention can help other students as well. I mentioned how the Dean mentioned a year from now, you can look at the curriculum and find flaws. The co-host of my podcast took over that project from me because she just had more time. I had something else going on. She actually did that. She went through the entire curriculum, and then found all the gaps in relation to nutrition and all the (I would like to say) flaws. Then she came up with a really long document, summarizing everything with the evidence and then sent it to the Dean. We're just in the midst of that previous Dean; her term is done and we're getting a new Dean. The implementation process has been paused.
What I was trying to say is that would be step one. For medical students to keep a diary of some kind: write down all the things you noticed in relation to nutrition that's taught, which is false. Having that is very important. You need to write everything down, but having that is very important. Know what lecture that was taught in, what slide number it was, what was taught and what is the evidence has to say about it. Keep that log, and then present it to the Dean and the professors, whoever is interested. Also proposing the recommendations for each thing (helps). I think those things really, really help because a huge piece that's missing as to why nutrition's not implemented is because no one has time.
I'll be completely honest. That's the biggest reason why nutrition is lacking: none of the doctors have time for it. No one's putting the effort to do it. I feel like once someone does it, it's going to stay, but it's that lack of time and lack of motivation. That's where medical students who have a personal interest in it can push for it, because then a lot of the times, these Deans are happy to give the project to a student to do it, as long as they don't have to do the work. That's what happened in our school. The Deans said, "if you want to do the work, do the work, and then present it to us and we'll see how we can implement it." They don't want to do the work. They don't have the time, and that's a major piece.
If you have that passion, put in the work, put in the recommendations, and see if you can do the same thing: try to start a club and then try to bring in people who are willing to do talks for free. We brought in a dietician who did a talk for free. Showing a documentary like The Game Changers is free. Just put on Netflix in one of the lecture rooms with a projector, send a big invite a few weeks before, and see how many people show up. I feel like small things like this can really increase awareness. The newsletter thing is another idea. Start the newsletter and see if you can send out a mass email to the entire class; see whoever wants to be part of the mailing list. It doesn't take more than a second for those people to just sign up, and then they can start getting that monthly newsletter. Maybe if they keep reading it, then they might say, "you know what? This is fascinating. I did not learn that in med school, but I can use that later to help my patients."
Karina Inkster: Absolutely. That's amazing. What are the next steps for you specifically? You've passed this crazy document onto your podcast co-host, putting together recommendations and things that were not accurate. That sounds like it's in progress with the new Dean, but what else is? What else is going on in your world right now, in this area?
Muzammil Ahmad: I am now starting clerkship. For those who don't know, clerkship is third and the fourth year of med school. That’s where you spend the entire time in the hospital or clinics in clinical setting. That's where you don't have much free time. You’re on call; you may have one day off, but that might be the day you’re on call, so it’s not really a day off. It's going to be quite busy for me for the next two years, but I'm still doing things on the side. My cohost and I are still running the podcast to keep inspiring other medical students and healthcare professionals to keep making changes. I am doing all my own mini projects on the side. I have an Instagram account, where I help a lot of people with transitioning to the plant based diet.
I've been working on a few eBooks that I want to circulate around for free, so they're easy to read for people who want to switch to more of the plant based way of eating with the evidence there (if people want to see the evidence.) I'm always doing these mini projects, but I put on hold any of the big projects I had because clerkship is starting in a week. That's going to be brutal. I was trying to close off the big projects. I'm going to keep the podcast going, but that's one big project that I might keep going while focusing on the clerkship so I can be a good doctor.
Karina Inkster: That makes complete sense. Hey, that's really amazing. We are actually going to have links in our show notes to you, your Instagram account, and ways to connect with you. I do want our listeners to go and check that out. First of all, on behalf of the future patients of the doctors, not just your future patients, but also the doctors in your cohort, you are doing amazing work. You are going to have a huge impact on countless thousands of people, in very positive ways. I think we need more of this from the inside, which is basically what you're doing. You’re changing things from the inside, and you are making lasting changes that are going to affect thousands of people. That's amazing. I have personally enjoyed speaking with you. I really loved getting to know you, and having a discussion about these topics that we have not touched on, on the podcast before. Is there anything that you want to leave our listeners with before I let you go?
Muzammil Ahmad: Well, first of all, thank you so much for all those compliments and kind words. That was really sweet of you. I've been enjoying talking to you as well. In regards to any tips, I'm not sure if your listeners are mostly vegans or non vegans, do you know that?
Karina Inkster: I would say mostly vegan or vegan curious.
Muzammil Ahmad: OK. I was going to say, one of the biggest tips from me would be in regards to people around you. I feel like going vegan was not difficult. It's dealing with people around you who are not vegan that can be difficult, especially those who question you all the time, and make you question yourself all the time. I think it's really important to find friends who believe in the same stuff as you; have the same values and the same vision. Even if they are online friends, that's okay too. Having those friends that you can even DM, finding those friends online, whatever it is: having that is really important. Sometimes when all the people around you don't see it your way, and all you're trying to do is just good work, you're trying to help the planet, you're trying to help the animals, you're just trying to help a healthy life, and you get constant criticism. I think it's really important.
Remember why you're doing it, and have people who value the same stuff. Sometimes you need to rant, and it's important to have those people around you so you can do that. Instagram and other social media pages can be really good for that. You can easily just find people who are into that stuff through going through various hashtags, and making friends. A lot of people, especially in the vegan community, are very receptive to new people and very helpful. That would be my thing. I think that was my struggle in the beginning: realizing that first you feel like you're alone, and then you find all these amazing people and then you know there is support.
Karina Inkster: Yes! Even if it's coming from halfway around the world, (especially nowadays we're all at home anyway), connecting on Zoom or apps or social media, that's a really important point. I think that's a great, great concept to leave our listeners with. Thank you so much. Muzammil, it was great speaking with you and I really appreciate you coming on the show. We're going to direct our listeners to our show notes, so they can connect with you and check out your Instagram account (which is kick ass by the way, I checked it out right before our discussion.) Thank you for coming on. It was fantastic.
Muzammil Ahmad: Well, thank you so much for having me. I had an amazing time chatting with you.
Karina Inkster: Thanks again Muzammil, for joining me on the show today, and thank you for sharing with our listeners the impressive work you're doing to reform nutrition education in med school, and beyond. To connect with Muzammil and check out his podcast, head to our show notes at nobullshitvegan.com/081. Don't forget, you can enter for your chance to score one of three copies of my book, Resistance Band Workouts: 50 Exercises for Strength Training at Home or On The Go, by submitting a review of this show on Apple podcasts, and then sending me a screenshot of that review on Facebook or Instagram, so I can enter you in the draw. Head to nobullshitvegan.com/applepodcast to submit your review. Thank you so much, and thanks for tuning in!