Emory University Hospital Nutrition
Support Pharmacy Fellowship

The fellowship program developed from our nutrition support residency program, which was established in 1984 and is one of the oldest ASHP-accredited programs in the country. It has been 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 focusing on adult nutrition support services and nutrition-related research. The fellow actively participates in the multidisciplinary nutrition and metabolic support team, which has over 200 years of combined experience providing inpatient and outpatient nutrition support. The second year of fellowship training is tailored to the fellow’s research performance and interests.

EUH’s Nutritional Support Team (NST) is one of the largest programs in the country, with an average of 50 inpatients daily and about 150 home parenteral nutrition (HPN) patients weekly. NST comprises two medical directors (Dr. John Galloway and Dr. Thomas Ziegler), two advanced practice providers, three clinical pharmacy specialists, two clinical dietitians, and two nurse specialists. NST provides a hospital-wide consult service with order-writing privileges to prescribe specialized enteral and parenteral nutrition support, as well as other nutrition and metabolic support services. In addition to delivering a high level of clinical care, the NST is actively involved in clinical research, including NIH-funded, multi-center studies. Dr. Ziegler, as director of the Emory Center for Clinical and Molecular Nutrition—a multidisciplinary research unit in the Department of Medicine—has promoted and enhanced the presence of nutrition-focused research on campus.

Goals

The EUH Nutrition Support Pharmacy Fellowship Program is designed to train highly motivated fellows to develop expert knowledge and skills in specialized nutrition support practice and research, and to become leaders in clinical nutrition support pharmacy. The program builds upon the broad-based competencies established during the fellow’s pharmacy school education, PGY1 and PGY2 programs, and past practice training, allowing the fellow to develop further and refine multiple skill sets (i.e., practice foundation, direct patient care, drug information, policy development, and practice management).

A nutrition support pharmacy fellow who successfully completes the NSPF Program will be prepared to assume a Nutrition Support position in an acute care or home care facility, a combination of academia and practice affiliated with a College of Pharmacy, and/or an advanced fellowship in the area of nutrition support or research. The fellow will also acquire the competencies to become a Certified Nutrition Support Clinician (CNSC) upon completion of the fellowship program, and/or a Board-Certified Nutrition Support Pharmacist (BCNSP) with additional one to two years of practice experience.

Required Learning Experiences

Elective Experiences

Clinical practice: The fellow will learn to incorporate their clinical knowledge in daily practice and develop the skills needed to function independently as part of the healthcare team. Each experience and activity will contribute to the fellow's growth into a self-sufficient contributor to the care of patients requiring specialized nutrition. The fellow will become familiar with providing specialized nutrition support across various patient populations and disease states through:

• Rounding with the multidisciplinary NST
• Providing formal and informal education to members of the healthcare 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.

Research: The fellow will conduct research projects in collaboration with pharmacy preceptors and/or nutrition and metabolic support physicians. The fellow designs, develops, and completes an original research project in nutrition support. This includes an abstract and a manuscript of research results intended for publication during and/or after the fellowship year. To enhance 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 for 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 relevant nutrition conferences, as 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 for each fellowship year.

Journal club: The fellow will present at least two journal articles during scheduled sessions with EUH NST throughout their fellowship training. The fellow will also present a patient case at one of these meetings.

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 present the findings.

Staffing: The fellow will staff in the central IV room for one shift each month to gain experience with 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 these weekends will be associated with a major and a minor holiday.

Teaching: Besides providing in-services to various healthcare providers during 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 have the opportunity to complete a pharmacy teaching certificate program offered by Mercer University College of Pharmacy (if not already completed). The fellow will receive the title of "Adjunct Clinical Instructor" and will be able to deliver didactic lectures at Mercer University College of Pharmacy. 

Gut Failure Clinic: The fellow has the option to see home parenteral nutrition patients on a longitudinal basis 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, held every other month. The fellow’s responsibilities include taking minutes, discussing formulary changes, providing updates on current shortages, and performing other related tasks. 

Guideline/protocol update: The fellow will assist in implementing or updating an existing practice guideline or protocol used at EUH and/or Emory Healthcare related to nutrition support practices.

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, promptly.

Licensure: The fellow  must obtain Georgia Pharmacist Licensure by September 30.

Compensation: First year salary is $59,000 plus medical, dental, vision and 401K benefits; second year salary is $69,006 plus medical, dental, vision and 401K benefits.

The fellow will receive some financial support for attending conferences and paying for professional membership dues, such as:

• American Society of Parenteral and Enteral Nutrition’s (ASPEN) Nutrition Science & Practice Conference (Required)
• Southeastern Residency Conference (SERC) (Optional)
• Georgia Society of Parenteral and Enteral Nutrition (GASPEN) (Required)
• Annual Conference ASHP midyear clinical meeting (Optional)

Recent Awards

• Dr. Thomas Ziegler: ASPEN Jonathan E Rhoads Lecturer Award in 2021
• Team: ASPEN Clinical Nutrition Team of Distinction Award in 2017 and 2023 (pictured below)

2017	2023

• Highlights of Past Residents and Fellows (featured below)

 Contact Information

For more information, please contact the program director or coordinator.

Vivian Zhao, PharmD, BCNSP, FASPEN
Program Director, Nutrition Support Pharmacy Fellowship
1364 Clifton Road NE
Atlanta, GA 30322
vivian.zhao@emoryhealthcare.org

Rachel Leong, PharmD, BCNSP
Program Coordinator, Nutrition Support Pharmacy Fellowship
1364 Clifton Road NE
Atlanta, GA 30322
rachel.leong@emoryhealthcare.org

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