The Road to RD

Chapter 1

Overview to Becoming a Dietitian

Not all programs are created equal.

If you do a Google search for become a nutritionist all kinds of degree mills may pop up, there may even be some college programs in nutrition that are NOT accredited. Do your research and prior to choosing a program and make sure the one you choose is accredited. If you are not sure, you can look at the description on the school’s website, call the department or go to the Academy of Nutrition and Dietetics Website to search for an accredited program: http://www.eatrightacend.org/ACEND/content.aspx?id=6442485414

Additionally, the description of the dietetic program on the college or university’s website will likely mention the current accreditation status – pending, accredited until 2020, etc.

Registration as a Dietitian requires a Bachelor’s or Master’s degree from one of these accredited programs. Accredited means the Accreditation Council for Education in Nutrition and Dietetics (ACEND), has given the A-Okay to the program. Accreditation ensures the curriculum adequately prepares you for the field of dietetics. ACEND prepares competencies to be met by the curriculum, however each program has the flexibility to decide just how to meet these. Therefore, every ACEND accredited program is a little different.

The undergraduate portion of your education will be heavily science based. You will be exposed to some variety of the following (will vary depending on the program):

Anatomy and Physiology

Theories of Behavior & Behavior Change

Counseling Technique

Motivational Interviewing

Chemistry

Organic Chemistry

Biology

Microbiology

Biochemistry

Micronutrient and Macronutrient Metabolism

Medical Terminology

Medical Nutrition Therapy

Genetics

Food Science and Cooking

Food Service Management

Statistics

Calculus

Public Speaking

There are two program option currently available among ACEND accredited programs. One is a didactic program- meaning your internship is independent of your degree program- your internship will come after graduation. The other option is a coordinated program, meaning the internship experience is part of the degree program. No matter which you choose, your internship must consist of 1200 supervised practice hours in a variety of rotations. Once you have passed the internship you will then be eligible to sit for the exam. Passing the exam will earn you the title of Registered Dietitian!

Once you’ve become registered, you will be able to practice Medical Nutrition Therapy- this is what sets dietitians apart. We practice evidence-based nutrition therapy with individuals and the public. The difference between an RD and a non- credentialed nutrition professional is that RDs are credentialed to work with people who need dietary changes to effect a disease state or disease risk, as opposed to general healthy eating for a generally healthy person. This is very important because our science and medical background is what makes the distinction between us and some of the other individuals working in the nutrition field. I hesitate to use the term nutrition professional, because there are people out there who hold zero credentials, some with credentials that don’t hold much weight in the professional field, and then there are other types of credentials that have varying degrees of appropriateness depending on the job.

At the time of this writing there is a movement to expose wellness bloggers with zero credentials who push unnecessary, unsubstantiated, and potentially harmful products and nutrition advice. Our credential is going to become even more relevant as consumers recognize the need for trustworthy nutrition advice. Protecting the integrity of that credential is a responsibility that falls on every single one of us, even while in the process of gaining the credential. Evidence-based practice protects the professional from liability, the client/patient from harm, and scientifically is proven to be the most effective treatment for the chosen disease state.

Because of an RD’s ability to apply evidence-based practice to a variety of environments regarding food and nutrition, dietitians work in many fields, and their role is expanding every year. Once you earn your registration you could work in any of the following areas, depending on your expertise and interest:

Clinical

Clinical dietitians work in hospitals, outpatient settings, rehabilitation facilities, long term care, short term care, specialized clinics such as dialysis or cardiac rehab, and sometimes in doctor’s offices. The job will differ greatly depending on the specific facility.

As a clinical dietitian for an inpatient facility, I taught classes in an outpatient setting, reviewed patient charts, coordinated with other medical professionals, and educated patients on survival skills before discharge.

One of the most important things to learn about the clinical arena is how your patient population dictates your practice. A lower income, lower literacy area will have its own unique challenges compared to a higher income and higher education area. For example, hospitalized diabetic patients in a low income, low literacy area requires survival skills education for blood sugar control. Patients from that area will require diabetes education that is appropriate to their education level and their income. Depending on the situation and the individual, that education may focus on what is a carbohydrate? or how to help a homeless individual count carbohydrates. In a wealthier area with a more highly educated population, patients may be more e interested in cinnamon supplements and chia seeds to help manage their diabetes.... So your area of knowledge and the patient educations will be HIGHLY dependent on your population. Ultimately, the individual is what drives the nutrition education.

Your priorities may differ depending on your facility as well. For a hospice dietitian your work may include more eating for comfort and less eating for health. You may become well versed in the dysphagia diets and possibly tube feedings. You will likely have more ethical considerations in feeding than an outpatient dietitian.

These are the things you will learn in your internship!

Food Service

The food service area of dietetics utilizes management skills and business oriented knowledge. In this role you must still be aware of therapeutic diets, food allergies, and food safety. The background of a dietetic education makes the dietitian well suited for this role, especially for a hospital food service.

RD’s also work in school food service to help interpret the National School Lunch Program guideline requirements for school lunches, as well as adjust menus according to guidelines, food allergies, availability, budget, and staff.

Dietitians may also work with restaurants, corporate cafeterias, or university cafeterias. Where there is food there is potential for a dietitian!

Community Dietitians

Community dietitian’s may work for a government agency or a non-profit working to alleviate food issues within the community. This may include hunger relief and food insecurity issues and programs, advocacy and public health, home health, and even food banks. The type of work in this area varies greatly. Some community dietitians will work one-on-one with clients of a food bank to help them make food choices that will met their dietary needs. Other community dietitians design community programs such as an outreach program to WIC recipients or those eligible for WIC.

Professors and Research Dietitians

Some dietitians choose to go into the academic world and teach. This will likely require at least a Master’s degree and usually a doctorate. If you enjoy science and lab work, finding answers to questions that have yet to be answered, you may consider going into research. Some dietitians participate in research on some level in their careers, however there are some questions that can only be answered in a lab and by a full time researcher.

Entrepreneurs/Private Practice/Consulting

Dietitians also have the ability to pave their own way. Some ways in which dietitians have demonstrated entrepreneurial ventures include nutrition related apps, books, blogs, and websites. Online private practice RDs are beginning to become popular. Freelance dietitians consult with a variety of facilities and individuals. For example, you may offer work-site wellness programs, work with sports teams, supermarkets, community groups, schools..... any organization or area you can think of that could benefit from your skills. In this line of work, you would market your skills, what you can offer and create your own job. You also have the opportunity to write freelance for magazines, newspapers, blogs, and websites.

Food Industry Dietitians

Some food companies hire dietitians to help with product development, recipe development, marketing, and public relations. There may also be some lobbying efforts on behalf of the food industry in this area. For example, a dietitian who works for a cereal company may research the health benefits of cereals for a marketing campaign, as well as interpret the labeling laws and health claim laws to prevent liability.

Military Dietitians

Dietitians in the military work to prepare our military men and women for their mission. This may mean research, community outreach to improve the food environment on post, aiding in the healing of wounded warriors, and weight management.

Corporate Dietitians

Some dietitians work above dietitians of an entire company to create policy which trickles down to how dietitians complete their job. This kind of work may look at how dietitians are charting on the company software, what tools are available, what policies are written, and how dietitians are effecting change. This job can vary widely depending on the company and type of work.

Chapter 2

Choosing a Program

Types of Programs

As a prospective dietetic student, you should be aware of the various program types to choose from. Understanding your options ahead of time can help in making decisions about your education that are best for you and your learning style.

Coordinated Bachelor’s Program

A coordinated program means class room learning is integrated with internship experiences. Upon graduation you will be eligible to sit for the Registered Dietitian Exam. You do NOT need to apply to an internship with this program.  The biggest benefit of this option is the ability to complete an internship while still in school. Some students enjoy the hands on experience concurrent with book learning. However, you may need to apply to the college and the dietetic program separately, or complete some number of classes before applying to the coordinated dietetic program. Each program has their own policies and way of going about it. Do your research before making any assumptions! Acceptance into the college may not necessarily mean acceptance into the dietetic program or the internship program. Each has different policies, make sure you’re in contact with the program’s that interest you so there aren’t any surprises!

Didactic Program

The Didactic Program in Dietetics (DPD) is the more traditional route, it consists of classroom learning for four years then a supervised practice experience in the form of an internship after graduation. There are some entirely online programs available through some schools. Some programs have a pre-select matching agreement within their own internship program. There may be limited spots, so you must still position yourself to be competitive. Otherwise, you will have to apply for other internship programs and compete with students from schools across the nation. I don’t mean to scare you off but first round matching usually ends with 50% of prospective interns WITHOUT a position in an internship program. 

For more information, visit: http://www.eatrightpro.org/resources/career/become-an-rdn-or-dtr

Note: There ARE Dietetic program offered ENTIRELY online! Use the link above to search for these programs. Please be aware this is only the bachelor degree that is offered online, not necessarily the internship. Please visit the internship section to learn more about those!