Integrating nutrition as a transversal competence: a curriculum mapping and implementation study in undergraduate medical education

BACKGROUND: Nutrition is widely recognised as essential to clinical practice, yet its integration into undergraduate medical curricula remains inconsistent and fragmented. While previous work has primarily focused on identifying gaps or evaluating isolated interventions, less attention has been paid to how nutrition can be systematically integrated within existing competency-based curricula. METHODS: We conducted a curriculum mapping study to identify nutrition-related learning objectives across an undergraduate medical programme, complemented by stakeholder engagement across disciplines, and a student needs assessment. Based on these findings, an integrated curriculum framework was developed to align nutrition as a transversal competence across disciplines and study phases. RESULTS: Of 3,423 preclinical and clinical learning objectives, 574 (16.8%) were identified as nutrition-related. These were widely distributed across the curriculum but were not previously conceptualised as a coherent domain of competence. The mapping process enabled the identification of implicit content and informed the development of a structured framework comprising three domains: fundamentals of nutrition, applied nutrition and public health, and clinical nutrition. Integration was achieved through alignment of existing curricular elements rather than the addition of new content. Student survey data indicated moderate general nutrition knowledge but low confidence in applying nutrition in clinical contexts, with around 79.1% of respondents rating their clinical nutrition knowledge as inadequate. CONCLUSION: This study demonstrates how curriculum mapping, combined with stakeholder engagement, can support the integration of nutrition as a transversal competence within undergraduate medical education. The findings indicate that nutrition is already present as an implicit transversal theme within the curriculum but lacks visibility and structural coherence. Beyond curriculum description, this study provides theory-informed insights into structural, organizational, and learner-level educational outcomes, including curriculum integration, institutional embedding, and identified competence gaps among medical students. It further offers a transferable, system-level approach for integrating cross-cutting competencies within existing medical curricula.