Emory University Hospital Nutrition
Support Pharmacy Fellowship

Emory University Hospital (EUH) offers a Nutrition Support Pharmacy Fellowship (NSPF) that builds on your PharmD training and helps you develop expert knowledge and skills in specialized nutrition support practice and research.

The fellowship program evolved from our nutrition support residency program, which was established in 1984 and is one of the country’s oldest ASHP-accredited programs. It is the only NSPF program endorsed by the American Society for Parenteral and Enteral Nutrition (ASPEN) since 2021. The NSPF is a one- to two-year clinical fellowship specializing in adult nutrition support services and nutrition-focused research. The fellow is an active member of the multidisciplinary nutrition and metabolic support service, with over 250 years of practice experience providing inpatient and outpatient nutrition support services. The second year of fellowship training is based on the fellow’s research-based performance and interests.

EUH’s Nutritional Support Team (NST) is one of the highest-volume programs in the country, with an average of 50 inpatients per day and approximately 150 home parenteral nutrition (HPN) patients per week. NST comprises two medical directors (Dr. John Galloway and Dr. Thomas Ziegler), one advanced practice provider, three clinical pharmacy specialists, two clinical dietitians, and two nurse specialists. NST offers a hospital-wide consult service with order writing privileges to prescribe specialized enteral and parenteral nutrition support and other nutrition and metabolic support services. In addition to providing a high level of clinical service, the NST is also active in clinical research, including NIH-funded, multi-centered studies. Dr. Ziegler, as director of the Emory Center for Clinical and Molecular Nutrition - a multidisciplinary research unit in the Department of Medicine, has facilitated and strengthened the presence of nutrition-oriented research on campus.

Goals

The fellowship allows you to develop expert knowledge and skills in specialized nutrition support practice and research and become a clinical nutrition support pharmacy leader. You will develop and refine multiple skill sets (i.e., practice foundation, direct patient care, drug information, policy development and practice management).

After completion, you will be prepared to assume a nutrition support clinical position in an acute care or home care facility, a combination of academia and clinical practice affiliated with a college of pharmacy and/or advanced fellowship in nutrition support or research. You will have the competencies to become a Certified Nutrition Support Clinician (CNSC) and/or a Board-Certified Nutrition Support Pharmacist (BCNSP).

Required Learning Experiences

Elective Experiences

Clinical practice: The fellow will learn to incorporate their clinical knowledge in day-to-day practice and how to function independently as a member of the healthcare team. The fellow will become familiar with providing specialized nutrition support in various patient populations and disease states through:

• Rounding with the multidisciplinary NST
• Providing formal and informal education to members of the health care team
• Demonstrating competence in nutritional assessments
• Developing patient-specific nutritional regimens and monitoring plans for patients receiving enteral and parenteral nutrition support
• Monitoring drug therapy used in specialized nutrition-support patients.
  Each experience and activity will contribute to the fellow's development into a self-sufficient contributor to the care of specialized nutrition patients.

Research: The fellow will conduct research projects with pharmacy preceptors and/or nutrition and metabolic support physicians. The fellow designs, develops and completes an original nutrition support research project. This includes an abstract and a manuscript of research results to be published during and/or post-fellowship year. To expand the understanding of and compliance with research requirements, the fellow will complete all Emory IRB-certified modules for investigators.

Poster presentation: The fellow will present their research project at least once during the fellowship year. The fellow may present the research project at the American Society of Parenteral and Enteral Nutrition (ASPEN) Nutrition Science & Practice Conference, the Vizient University Health System Consortium Pharmacy Network Resident Poster session, the Southeastern Residency Conference (SERC) and/or other nutrition conference when applicable. The fellow may also present a Medication Use Evaluation (MUE) project at the Emory Quality Conference.

Grand Rounds presentation: The fellow will prepare a 50-minute presentation for ACPE credit on an approved nutrition support topic.

Journal club: The fellow will conduct at least two journal articles at scheduled times with EUH NST during the fellowship year. The fellow will also present a patient case at one of these sessions.

Quality Improvement (QI) Project/Medication Use Evaluation (MUE): The fellow will participate in the development and completion of a QI/MUE during the fellowship year and presents the findings.

Staffing: The fellow will staff in the central IV room one shift per month to gain experience in the pharmacy’s medication distribution system. 

On call: The fellow will be on call for the nutrition support team one weekend per month and one of the weekends associated with a major and a minor holiday.

Teaching: Besides providing in-services to various healthcare providers while on rotations, the fellow may assist in precepting fourth-year advanced pharmacy practice experience (APPE) students. The fellow will also participate as a facilitator for the introductory pharmacy practice experience (IPPE) for third-year pharmacy students. Additionally, the fellow will be able to complete a pharmacy teaching certificate program offered by Mercer University College of Pharmacy (if not previously completed). The fellow will receive the title of "Adjunct Clinical Instructor" and can give didactic lecture(s) at Mercer University College of Pharmacy.

Gut Failure Clinic: The fellow has the options to see home parenteral nutrition patients longitudinally in the Gut Failure Clinic at least once a month depending on schedule and interest.

Emory Healthcare (EHC) NST Committee: The fellow will participate in system-wide nutrition support committee meetings every other month. The fellow’s responsibilities include taking minutes, speaking about formulary changes, providing updates on current shortages, etc.

Guideline/protocol update: The fellow will help to implement and/or update a current practice guideline or protocol used at EUH and/or Emory Healthcare related to nutrition support practice.

Newsletter: The fellow will be responsible for creating and sharing a newsletter with any pertinent practice updates to the EHC nutrition support committee following the ASPEN Nutrition Science & Practice Conference.

Evaluations: The fellow is expected to complete all evaluations, including rotational evaluations and global evaluations, in a timely manner.

Licensure: The fellow must obtain Georgia pharmacy licensure no later than Sept. 15 of each fellowship year or within 90 days from the issuance of the temporary license, whichever is earlier.

Compensation: First year salary is $59,010 plus medical, dental, vision and 401K benefits; second year salary is $61,006 plus medical, dental, vision and 401K benefits.

The fellow will receive some financial support to attend conferences and pay professional membership dues including:

• Children’s Healthcare of Atlanta two-day pediatric nutrition conference
• American Society of Parenteral and Enteral Nutrition’s (ASPEN) Nutrition Science & Practice Conference
• Southeastern Residency Conference (SERC)
• Georgia Society of Parenteral and Enteral Nutrition (GASPEN)
• Annual Conference ASHP midyear clinical meeting

Recent Awards

• Dr. Ziegler: ASPEN's Jonathan E. Rhoads Lecturer Award in 2021
• Team: ASPEN's Clinical Nutrition Team of Distinction Award in 2017 and 2023

2017	2023

Highlights of Past Residents and Fellows:

Contact Information

For more information, please contact the program director.

Vivian Zhao, PharmD, BCNSP, FASPEN
1364 Clifton Road, NE
Atlanta, GA 30322
404-712-7800
vivian.zhao@emoryhealthcare.org

This program is endorsed by the American Society for Parenteral and Enteral Nutrition (ASPEN).