Physician Nutrition Education

Abstract

Nutrition education for physicians in the United States is limited in scope, quality, and duration due to a variety of factors. As new data and quality improvement initiatives highlight the importance of nutrition and a generation of nutrition experts retire, there is a need for new physician educators and leaders in clinical nutrition. Traditional nutrition fellowships and increased didactic lecture time in school and postgraduate training are not feasible strategies to develop the next generation of physician nutrition specialists in the current environment. One strategy is the development of short immersion courses for advanced trainees and junior attendings. The most promising courses include a combination of close mentorship and adult learning techniques such as lectures, clinical experiences, literature review, curricular development, research and writing, multidisciplinary interactions, and extensive group discussion. These courses also allow the opportunity for advanced discourse, development of long-term collaborative relationships, and continued longitudinal career development for alumni after the course ends. Despite these curricular developments, ultimately the field of nutrition will not mature until the American Board of Medical Specialties recognizes nutrition medicine with specialty board certification.

ASPEN Consensus Recommendations for Refeeding Syndrome

“…Screening strategies to identify patients at risk for RS are imprecise and poorly validated, made worse by lack of a consensus definition for RS. Typically, RS risk is identified subjectively by a clinician at the time of enteral or PN evaluatión and initiation 42,43 …”

Current Status of Nutrition Training in Graduate Medical Education From a Survey of Residency Program Directors

“…Over the past 25 years, educators in both the undergraduate and graduate realms of medical education have sought to improve teaching, learning, and the application of sound nutrition practices to daily patient care in order to improve outcomes. Despite the nutrition community's own efforts at board recognition, 2 a more forceful cry from national experts prompted the American Board of Medical Specialties to formally recognize Nutrition Medicine 3 …”

“…Despite federal funding, only half of the medical schools in the United States subscribe to this program. DeLegge et al, 3 writing from the discussion at the 2010 summit on the shortage of physicians in clinical nutrition, ventured that an Advanced Cardiac Life Support (ACLS)‐type course in nutrition would suffice to meet such needs. A conference sponsored by the National Heart, Lung, and Blood Institute and National Institutes of Health Office of Disease Prevention led to a supplement focused on nutrition education for healthcare professionals.…”

Parenteral and Enteral Nutrition—From Hospital to Home: Will It Be Covered?

“…The field of nutrition is truly a multidisciplinary field with healthcare providers from many different backgrounds—nurses, pharmacists, dietitians, physicians, nurse practitioners, physician assistants, and others. It is generally recognized that nutrition education is lacking among the health professionals in our country, and this education varies by health profession 46 – 51 . In addition, as opposed to Europe where nutrition support is centralized and managed by specialized centers, HPEN in the United States is typically prescribed by providers who may cover only 1 or 2 HPEN patients annually 17 .…”