WHAT IS LIFESTYLE MEDICINE?
What is Lifestyle Medicine?
Lifestyle Medicine is the use of a whole food, plant-predominant dietary lifestyle, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection as a primary therapeutic modality for treatment and reversal of chronic disease. It is the fastest growing field of medicine globally and holds the promise for true health reform as it addresses the root-cause of chronic illness. Certification is now available through ACLM’s partner, The American Board of Lifestyle Medicine (ABLM).
Learn more about lifestyle medicine via our FREE webinars titled: “The Power of Lifestyle Medicine to Treat Chronic Disease” by ACLM President (2020-2022) Cate Collings, FACC, MD, MS, DipABLM and “What is Lifestyle Medicine?” by ACLM Past President (2018-2020), Dexter Shurney, MD, MBA, MPH, DipABLM, FACLM.
Where does Lifestyle Medicine reside within the field of medicine?
The AAMC featured Lifestyle Medicine as one of the top emerging fields in an article published in July of 2018 titled: Five emerging medical specialties you’ve never heard of — until now.
WHAT IS THE LIFESTYLE MEDICINE RESIDENCY CURRICULUM (LMRC)?
Can you tell us more about the Lifestyle Medicine Residency Curriculum and the time commitment required for its implementation?
The LMRC consists of both Educational and Practicum
components. The educational component is 100 hours
with 40 hours of didactic units and 60 hours of application
activities that can be delivered over a 1 - 3 year time frame.
The practicum component includes 400 lifestyle medicine
related patient encounters, 20 hours of intensive therapeutic
lifestyle change (ITLC) program experience and 20 hours
of group facilitation experience. Find out more details
via the LMRC Flyer and Webinar recording available at lifestylemedicine.org/residency-curriculum.
How many months will we need for the LMRC implementation?
We encourage a 2-year (24-month) or a 3-year (36-month) implementation time frame based on your residency program needs. If your site can ensure all program requirements are met within a 12 or 18-month time frame, we can work with you to make this time frame feasible as well.
What is the cost for the LMRC?
The cost for each residency site is $5,000 for the initial year of implementation ($3,500 for implementation and start-up costs; and $1,500 for curriculum access, hosting and support).
Each renewal year is billed at $1,500.
*Please note that all pricing and offerings are subject to change as new LMRC Versions are made available and the LMRC program site adoption expands.
Can you outline a typical 24 or 36-month LMRC implementation plan for the 40 didactic units?
Can you explain how the 10 modules are covered in the 40 hours of required didactic time? How are the independent application hours allocated?
10 Modules are split over 100 hours (40 hours of didactic units + 60 hours of application activity hours) based on the percent a topic is covered in the ABLM competencies - see ablm.org/how.
Is the LMRC specifically designed for certain types of medical specialties?
The curriculum is designed to be implemented in ALL specialties. At present, it is largely focused on adult health considerations, however, unique content is in development to meet other specialty and sub-specialty educational needs. We are open to considering all specialty site applications.
Does the curriculum include other aspects of medicine, say from Integrative Medicine, Functional Medicine, and others?
The LMRC has been designed to address the competencies of the ABLM certification exam found at ablm.org/how.
Are all residents required to complete the entire LMRC?
When a site adopts the LMRC, we hope that all residents complete the 40 didactic units for the Educational requirements and the 400 lifestyle medicine patient encounters for the Practicum requirements. Then, residents who desire to qualify for the ABLM certification exam by completing ALL of the LMRC requirements can opt in to complete the following remaining requirements: 60 hours of application activities, 20 hours of intensive therapeutic lifestyle change program experience and 20 hours of group facilitation experience. A site may choose to implement a unique Lifestyle Medicine track that residency can opt into as a special point of interest in order to complete the full LMRC. The goal is for each LMRC site to require all incoming residents to complete the full LMRC within 3-5 years of site adoption.
We have several interested residency specialties and/or geographical sites all within the same institution. Does each specialty or site need to apply separately?
If the interested residency specialties or sites have the same Designated Institutional Officer and are interested in working together in a coordinated effort, we will work with your site to create an infrastructure that allows for all residencies to appropriately implement the LMRC together under one contract. As such, we would appreciate inclusion of all possible residency specialties and sites on the application so we are aware of residency leadership, support and infrastructure in place for each specialty/site. On the other hand, if multiple residencies/sites under the same DIO will be implementing the LMRC separate from each other, without collaborative efforts, individual applications and contracts will need to be completed.
What residency sites and programs are currently implementing the LMRC?
Current LMRC sites and programs are listed on our website, lifestylemedicine.org/residency-curriculum.
Can International Medical Graduate (IMG) physicians participate in the LMRC?
The LMRC is not available internationally outside of North America. The Lifestyle Medicine Global Alliance (LMGA) will be working with each national society/organization to consider when infrastructure is in place to support adaptations and implementation globally. For further details and global developments, please reach out to [email protected].
LMRC IMPLEMENTATION QUESTIONS:
Can you tell us more about the 40 didactic units and how they are completed?
A virtual delivery of the didactic units will launch in the 2022 academic year. Each didactic unit is approximately 60 minutes in length and can be completed asynchronously by each resident. We encourage residency programs to provide dedicated didactic time for completion of these units.
400 Lifestyle Medicine patient encounters seems impossible given our clinical opportunities. How is this typically met and what exactly counts as a LM visit?
LM patient encounters can be accomplished in both the inpatient or outpatient settings, although it is more common to complete them in the outpatient setting. Our hope is that LM will be another lens that each resident will use to assess and treat every patient they interact with in a clinical environment, when appropriate. Within the 400 encounters, there are subdivisions for the various LM pillars that also need to be met in order to provide broad base competency in all LM pillars. These subdivisions include: 1) nutrition, 2)physical activity, 3) emotional and mental wellbeing, sleep, and connectedness, and 4) tobacco and toxic substances. The great news is that many of these requirements can be met simultaneously with the same patient encounter. For example, if a resident sees a patient with diabetes, we hope the resident will address all the usual diabetes visit expectations and also have their LM lens on to address physical activity, nutrition, sleep and/or connectedness. If the resident takes a motivational interviewing or coach approach to counseling based on the stage of change in any of the 4 subdivisions, the resident can count the encounter as one of the 400 LM encounters and obtain credit for the specific subdivision(s)covered as well. Thus, one encounter can meet multiple requirements for patient encounters. At this time, we do not have a hard and fast rule about what does and does not count as a qualifying LM visit, however, our general rule of thumb is the visit will count if the patient walks out of the room having been counseled and/or having set a SMART goal based on appropriate interventions for stages of change.
I see a requirement for 20 hours of an ITLC program
experience and 20 hours of group facilitation experience.
What if our residency does not have ITLC and/or group
opportunities for residents?
The LMRC team will work independently with your site to
problem solve how to meet the needed group and/or ITLC
requirements. Possible options for ITLC implementation at your
site may include: 1) creation of programs, 2) establishment of
relationships with existing programs within your institution/
community such as cardiopulmonary rehabilitation or the
Diabetes Prevention Program, 3) development of electives
within or outside the institution, 4) access to free virtual
options such as Diabetes Undone, or 5) purchase of virtual
options such as the Complete Health Improvement Program
(CHIP) for a discounted price.
When we start implementing the LMRC, how do we
manage the variety of PGY level residents the first 1-2 years?
Depending on whether your site has a 24 or 36-month
implementation plan, we can support highly engaged faculty
and residents to “make-up” (at most) a year of the LMRC. For
instance, a Family Medicine program that has decided on a
24-month implementation plan can, in theory, assist incoming
PGY3s that are highly motivated to complete the curriculum
in 12-months if they have oversight by highly engaged faculty
dedicated to creating alternative methods for information
delivery and completion.
We think that some residents and fellows outside our core
residency program will want to participate in the LMRC. What
allowances are there to involve other GME programs within
our system? What obstacles arise in scaling and expanding
LMRC implementation across programs?
We would love to include as many residents/fellows as
possible at your site. It is often easiest to start with one
program and then scale to other programs, but we are open
to multiple programs starting at the same site in the same
year. Scheduling logistics is typically the biggest hurdle for
integration across residencies at the same site, however
the virtual didactic delivery format will make integration
easier. In addition, a formal commitment of the programs,
specialties, and selection of residents is required before each
academic year begins. The LMRC team is unable to process
rolling enrollment throughout the year, rather will have select
enrollment periods for each site.
We are concerned that we do not have the Lifestyle
Medicine skills and education as faculty to teach Lifestyle
Medicine to our residents.
Although LM board certified faculty at LMRC sites are
highly encouraged, we still consider sites who have strong
faculty leadership in the field of LM who express interest in
LM certification. In addition, our site contracts are designed
to financially incentivize faculty to obtain certification within
the first few years of the LMRC site implementation. Core
residency faculty are eligible for the certification exam by
completing either the Educational Pathway through the LMRC
along with residents or through the Experiential Pathway. Find
out more about how to certify at ablm.org/how.
We are concerned our residency program does not have
enough time to integrate the LMRC into our already existent
program. How have other residency programs navigated
meeting the requirements?
We understand that there are many competing priorities
within residency programming. We have an administrative
LMRC team available to assist with identifying barriers and
finding solutions to implementation. Additionally, current
LMRC sites have valuable insight into the adjustments and
adaptations that made the LMRC adoption possible at each
site. We are happy to connect you with the LMRC site leads for
Our site currently implements several Lifestyle Medicine
initiatives that overlap with the LMRC. Can we skip those
modules within the LMRC?
In order to adequately meet the ABLM requirements, all
units and modules within the LMRC are required and may
not be excluded from the program. We encourage your site
to evaluate the current Lifestyle Medicine initiatives you are
offering and replace them with the LMRC materials if you
feel there is duplication. This allows for more availability
to complete the LMRC on time and also allows your site to
receive full credit for the LMRC.
I have questions about implementing the LMRC at our site
and would like to speak to someone before applying.
We understand you have questions and may not feel
completely ready to apply. However, completing the interest
form ensures that you are logged into our system and notifies
our LMRC team to contact you. Even if you still have questions,
we encourage you to fill out the interest form so we have your
residency contact and basic information needed in order to
answer questions and provide follow up support.
LMRC DOCUMENTATION REQUIREMENTS:
How are the 60 hours of application activities tracked and
how are the hours divided?
We have an excel spreadsheet that sites can utilize for
tracking purposes, if helpful. Usually, residents manage this
with faculty oversight and check points. In addition, some
academic sites have used learning management platforms
such as Blackboard or Canvas to create assignments, due
dates, and tracking of activity completion. Additional virtual
solutions may be available in the future. For the 60 hours
of application activities, at least 20 hours are encouraged
to be completed in a group environment whereas 40 hours
are designed to be completed independently, however, it is
possible for sites to complete all 60 hours independently if
How are the practicum requirements including patient
encounters, ITLC hours, and group program hours tracked?
Most residency sites have a learning management
system such as MedHub or New Innovations where patient
procedures, etc… are tracked. These sites simply add tracking
options for the LM patient encounters, ITLC hours, and group
hours to the system that is already in place. For those who
don’t have a system in place, the LMRC team will work with
your site to create a reasonable solution.
What support will we receive from the LMRC team to help us implement the curriculum at our site?
You will be connected with an LMRC online community
for ongoing support, resources and answers to common
implementation questions. In addition, you will take part in
frequent support group meetings to help navigate through the
LMRC implementation process.
Can you clarify what the LMRC support group meetings
entail – who attends, how long they are, and what is on a
The support group meetings are held virtually for about one
hour, generally, every 1-2 months at first and then quarterly
as the sites become confident with implementation plans.
We ask that at least one faculty leader from each site attend.
The meetings are set up to group together all sites starting
implementation the same academic year. Some sites have 2-3
people who rotate attending meetings based on availability
and then keep each other updated between meetings. During
the meetings, we discuss general updates, what is going well,
potential concerns/barriers, and other relevant feedback.
AMERICAN BOARD OF LIFESTYLE MEDICINE CERTIFICATION:
Once the residents complete the LMRC, what certification body issues course competency?
The LMRC support team will work with your residency team
and the ABLM to determine compliance of requirements and
eligibility for the certification exam. The residency program
director will submit an attestation letter of LMRC completion
to each resident for submission to ABLM when registering
for the exam. Residents will have 3 years of eligibility for the
Is the LM Board Review Manual part of the certification process for residents?
Upon completion of the LMRC, residents and core faculty
are eligible to sit for the ABLM exam. The LMRC is designed
to prepare the resident and core faculty to sit for the exam
without purchasing or participating in any other courses. Some
residents and faculty still opt to complete the Foundations of
Lifestyle Medicine Board Review. More information about the
course is available at lifestylemedicine.org/boardreview.