Medical Students Get Taste of Budget Dining

Jamie Robinson has always been a healthy eater, but she never had to work as hard to make a healthy trip to the grocery store as she did in January. “I wanted to get a big bag of grapes for snacking, but they were $4, so no grape snacks,” Robinson says.

The unbought grapes were lesson one for the second-year medical student. Robinson and her 100-plus Vanderbilt School of Medicine classmates were asked to participate in the SNAP challenge as part of a class. SNAP stands for Supplemental Nutrition Assistance Program—the federal program formerly known as food stamps.

The challenge was to eat for five days on the amount of money the average person on SNAP receives—about $3 a day, or $1 per meal. To make things tougher, students were instructed to track their calories and nutrition on a government website ( to make sure they were still eating healthy.

That meant no midnight trips to stock up on all-you-can-eat tacos, and for healthy eaters like Robinson, it even meant eating foods she considered less healthy. At the end of her shopping trip, Robinson had white bread and bananas for lunchtime banana sandwiches, canned beans, frozen vegetables, eggs and no meat.

“The purpose of this experience is to help medical students better understand the patient’s perspective on the challenges he/she faces to maintain a healthy lifestyle given certain financial restraints,” says Lynn Webb, assistant vice chancellor for health affairs. “We want to put the students in the shoes of the patients so they can be better clinicians.”

David Marcovitz spoons out a plate of pasta mixed with egg and tomato sauce, a meal he ate four nights in a row during the SNAP challenge.

David Marcovitz spoons out a plate of pasta mixed with egg and tomato sauce, a meal he ate four nights in a row during the SNAP challenge.

Webb coordinated the SNAP challenge for the School of Medicine’s Patient, Profession and Society course. As part of a major curriculum revision in 2006, the course was added to integrate topics like ethics, economics, communication skills and prevention.

Many students commented about the lack of variety in their diet during the challenge. Second-year student David Marcovitz longed for a granola bar and blueberries on his cereal, but couldn’t afford them. Instead he located “day old” bread at Target so he could afford the whole-wheat variety for sandwiches at lunch, and ate a concoction of pasta mixed with egg and tomato sauce for dinner four nights straight.

“The lesson from this is that it’s not really about hunger in the U.S., because anyone can take this amount of money and go to the dollar menu and get enough calories for the day,” Marcovitz says. “But if you want to have good nutrition, it takes a lot of work, a lot of education, a lot of thought, and a lot of preparation.”

For the estimated 600 SNAP recipients who come to Vanderbilt clinics every day, following the advice of practitioners about the importance of diet may not be easy.

Webb says that is the point. “Overall, the goal is to help our students maintain an appreciation for the human dimension of care: that the disease being treated is just one aspect of what’s going on in a patient’s life.

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  • Charlotte Perry

    Many of the challenges the students faced in this lesson are the same challenges we face in the school nutrition industry. School Nutrition is often a focal point in childhood obesity. As a school nutrition director I know the challenges of creating a diverse menu that includes whole grains, fruit, vegetables, dairy and protein while maintaining a low budget. I serve a population of children that mainly consists of students who receive free or reduced meals. While creating the menu I try to focus on the needs of the students and exposing them to items that they do not ordinarily have at home. For many of these students their parents receive SNAP benefits. Every day these families must try to feed everyone in the household on an allotted amount. They often choose the highly processed, prepackaged foods not because they prefer them over whole, organic foods but because their benefits would not stretch as far. The school nutrition budget of a small school that serves mainly poverty children must also make choices in how far they must stretch their budget. In the past few years school nutrition has come a long way in finding creative ways to incorporate items that are more nutritious and pleasant to taste. What good is a whole grain pizza with low fat cheese if the child will not eat it? Thankfully the food industry is coming up with foods that are nutritious and taste good. These items are more expensive than many others. Often the school must help cover these costs. Education is also a key. If you are not exposed different foods how do you know if you like them? Often this does not happen in homes due to the lack of money and trying to make your benefits go as far as possible.
    I hope all of the students who took this challenge will remember when speaking to their future patients about making healthy choices for their health have a back up answer to “How can I eat healthy when the cost is so much more than I can afford? “

  • Jocelyn Mallard

    I took the challenge this fall. The SNAP amount for Illinois is 4.50/person/day. I was able to have some variety in my diet and get 20 gr. of fiber. It required planning, cooking, creativity, and shopping at the “stock-up” stores in the area. I bought frozen vegetables, and canned fruit. This week I can bought fresh vegetables and fruit because I had leftovers from last week. Portion control was critical as well. I applaud Vandy med students for this project. It is important to know what you are expecting your clients (patients) to do.