Addressing the Urgent Need for Clinical Nutrition Education in PostGraduate Medical Training: New Programs and Credentialing.

The importance of nutrition in the development of disease, and in the recovery from illness, is among the most fundamental tenets in human biology and optimal health. Nutrition was fundamental in many traditional forms of medicine until its role in medical care experienced a rapid decline over the last century. We believe a key cause of the decline in nutrition's essential role in healthcare and preventative medicine is the escalating crisis of inadequate nutrition education in medical training. Recent data show 75% of United States medical schools have no required clinical nutrition classes and only 14% of residency programs have a required nutrition curriculum. More troubling, only 14% of current healthcare providers feel comfortable discussing nutrition with their patients. The purpose of this paper is to present the evidence illustrating the distinct lack of nutrition education in medical training. Further, we present key examples of existing formal nutrition curricula to incorporate nutritional science into all healthcare providers' education and practices. We discuss existing nutrition fellowships and training programs, including the new Duke Online Clinical Nutrition Fellowship. We also cover a physician nutrition certification allowing physicians to pursue clinical nutrition as a career path. Finally, recent financial incentives and quality measures incentivizing healthcare provider nutrition education is discussed. Thus, in conclusion, we advocate the inclusion of nutrition education curricula as a priority in medical schools, graduate medical education, and continuing medical education. Formal clinical nutrition training should be a requirement for hospital leadership and administrators for all Parenteral Nutrition and Nutrition Team Physician Directors in hospitals worldwide, and this key clinical role must become an essential position in all hospitals. In addition, we immediately need to address the critical shortage of physician nutrition specialists who will serve as the next generation of leaders in clinical nutrition care and research.