Dietetics
Kyla Scheese
RD Journey Part Three: Getting the Letters
RD Journey Part Three: Getting the Letters
Dietetics
Kyla Scheese
Dietitian vs. nutritionist: Not the Same
Dietitian vs. nutritionist: Not the Same

RD Journey Part Three: Getting the Letters

I packed up my car and moved down to Oklahoma the first week of January 2018, ready as I’d ever be for what was ahead. My internship was through the University of Oklahoma Health Sciences Center (OUHSC). It had equal emphasis on the three main rotations: foodservice management, clinical, and community nutrition. Each of these rotations were nine weeks long, and then there was a final five-week elective rotation.

Cuddles didn’t get to come :(

Cuddles didn’t get to come :(

We had one week of orientation before starting any of the rotations. All of our projects, plans, and expectations for the next eight months were laid out.

o-v-e-r-w-h-e-l-m-e-d.

That’s how I felt. Overwhelmed and stressed. I was just going to have to take it one day, one week, and one rotation at a time.

Word of advice before I get started:

Treat your internship like a job interview… every. single. day.

You never know what connections, references, or job opportunities you might be crossing paths with.

There were 16 of us in my internship “class”, but we were all at different locations and in different rotations throughout the eight months. My internship director intentionally kept us from having our clinical rotation first, since this is where you’re given the most responsibility as an intern. I did my foodservice rotation first, then clinical, and then community. We all had the 5-week elective rotation last. I also got to do my foodservice and clinical rotations in the same hospital which was nice.

The Rotations

Foodservice Management: January 22-march 22

I won’t lie to you… this was my least favorite rotation by FAR. It had the most projects, the largest number of positions and trivial tasks to learn, the earliest shifts (see ya at 6AM), it required a lot of physical labor, and unfortunately there were some major struggles going on in the kitchen/hospital I was placed at. They were extremely understaffed, the employee turnover rate was HIGH, and when you’re the responsible intern… you get to pick up the slack.


I wouldn’t even be able to tell you all of the different things I did in this rotation, but tasks included:

  • Building patient trays and delivering them to floors

  • Working at the sandwich station, the grill, or on the hot food line in the cafe

  • Working cash register in the cafe and keeping items stocked

  • Cleaning any and all areas of the kitchen and cafe

  • Unloading shipments into the freezer, fridge, or dry storage

  • Checking inventory and dating/labeling anything without proper identification

  • Preparing and delivering stock to each floor of the items kept available

  • Preparing/cooking different foods

  • Safety and sanitation inspections

  • Working in the dish room

  • Setting up for catered events around the hospital

  • Answering calls for late trays or special orders

  • Setting up interviews for the Foodservice Director

With all of this, we were responsible for a LOT of projects during this rotation. Projects always required many hours of work at home, after working 8+ hours everyday. Some of those projects included:

  • A productivity study

  • A sanitation inspection

  • A management review

  • A test tray evaluation

  • An employee inservice presentation

  • A recipe development

    • I had to modify one of the recipes from the kitchen’s database, make it, and do an evaluation out in the cafe.

 
 

  • A performance improvement project

    • I organized, because I love to. 🙂

  • A business plan complete with marketing strategies, a menu with recipes and nutrition analyses, an operating budget, income statement, and operations.

    • These were done on a holiday or celebration of some kind to present a theme out in the cafe. I was assigned Mardi Gras.

clinical: March 26-May 25

The clinical rotation is just that: seeing patients in the hospital everyday and charting following the Nutrition Care Process. You can be exposed to all different types of patients and floors which could include general med/surg floors, ICU, CCU, labor and delivery, mental health, and more.

Occasionally I would get to do little food demos or educational tables with the other dietitians which was a nice change of pace.

At the end of this rotation is something called “staff relief” where you will essentially takeover the role of one of the dietitians in the hospital. It’s a big deal, a LOT of responsibility, and a good gauge of how well you’ve grasped everything from the rotation. There were also a number of performance evaluations that had to be done throughout the rotation by my preceptor.

The projects in this rotation were all case studies. We had twelve different diseases or medical conditions to find amongst the patients we cared for throughout the rotation, and we would do a short case study work sheet on each one. The biggest project of the entire internship was another case study done during this rotation.

My final case study was 39 pages long (🙃), and this thing is a BIG deal. It’s done on a patient I actually cared for during the rotation, and the report includes ALL information about this patient: background information, medical history, all past and current diagnoses and treatments, a detailed walkthrough of their entire hospital stay, nutrition history and nutrient analyses, intake during their stay, all medications and potential interactions, all different types of anthropometric measurements (weight, height, ideal body weight, weight changes, etc.), all biochemical data (labs) and medical tests done, nutrition diagnoses and detailed reports of each time you saw the patient, estimated energy and nutrient needs, economic outcomes of your medical nutrition therapy… and I’ll stop there because I think you get the point.

These case studies were presented to our preceptor (and typically all of the other dietitians in the hospital) at the end of the rotation.

community: may 29-july 26

Our community rotations were setup to be done at a different location each week. This way, we would be exposed to as many areas of dietetics as we could in a short period of time. It was tough having to learn a new role each week and then leave once you finally had everything down. However, I really enjoyed it, and I actually had FUN during this rotation!

Some of the locations I was placed at and projects I did were:

(** = probably included in some way in all internships)

  • Women, Infants, and Children (WIC) **

  • The Health Department

    • I got to help give out free groceries from the food bank to over 100 people one day (and little did I know I’d be doing this with the food bank in a few weeks… see below!)

  • DaVita Dialysis **

    • I got to do a “Thirst Busting Tips” table in the lobby for patients during this rotation, and it was a hit!

  • Oklahoma Heart Hospital

    • I was at this rotation on my birthday, and my preceptor brought me a GT’s Kombucha… it’s the little things 🙂❤️

  • Senior Nutrition rotation **

    • There are a lot of safety and sanitation inspections in this rotation. We also got to do a food demo, which the seniors really enjoyed!

  • Regional Food Bank

    • I helped with a number of their kids feeding programs, and one day I got to travel around with two of the employees to setup and teardown their mobile food pantry for seniors at a couple different locations. I loved this rotation!

  • Kid’s Cooking Camp

    • This rotation was two weeks due to an immense amount of planning that was necessary for the first week and running the actual camp the second week. It was hosted through OUHSC, and twelve of us interns were in charge of running it with my director.

    • Days were LONG (12 hours) and kids have way too much energy, but getting to teach them about food and nutrition, helping them learn to cook, and encouraging them to try new things was so worth it.

  • Private practice fitness dietitian

    • This rotation was really unique, and I enjoyed it. I made a lot of different handouts and helped plan for and run a kids endurance camp.

elective: July 30-august 31

The elective rotation was such an awesome opportunity and truly what stood out to me the most about the internship when I applied. This rotation could essentially be done anywhere in the country; all 16 of us in my internship class were from out-of-state, and about half of us returned home to complete this rotation.

We were responsible for finding a preceptor that was willing to take us on for these five weeks, as well as creating a learning plan with objectives, activities, evaluations, and learning needs codes.

I connected with a dietitian in South Carolina who had her own private practice and worked with many eating disorder clients. I was able to work remotely and got to live at home, which was awesome after not seeing my family for seven months. Most of the work that I did was:

  • Writing blog posts for her website

  • Creating handouts and ebooks for her to use in her practice

  • Doing research on different faith-based eating disorder treatment centers

  • Revamping her social media accounts and posting 1-2 times daily

I also had weekly video sessions with her where she would teach me about starting and running a private practice, different things about working with eating disorder clients, and I could ask whatever questions I had.

tip: always write a thank you card to your preceptor after each rotation, plus anybody else that provided their guidance and time to you.

We were working at our internship rotations Monday through Friday every week from January through August, with one day off for Memorial Day and one day off for the fourth July. However, there were a couple of days that we had some unique planned experiences.

  • “Class Days”

    • There were two days that my class met to learn about a specific area of dietetics or a unique connection to the field.

      • The Oklahoma City Beef Council told us all about what they do and took us to tour the factory where all of the burger patties get made for McDonald’s (I have to admit, it was quite impressive). We also visited one of the farms that produces a lot of this beef, and they showed us how cows are artificially inseminated. 😷

      • We got an awesome presentation from the dietitian that works at the Laureate Eating Disorders program. We got to ask lots of questions, tour the whole facility, and meet the extremely passionate chef.

  • OKAND Spring Conference

    • We were required to attend at least one day of the Oklahoma Academy of Nutrition and Dietetics Spring Conference. This was the first real conference I got a chance to go to, and I enjoyed it SO much. I definitely recommend attending as many things like this as you can!

  • Video-taped counseling session

    • “Actors” were given a patient role to play, and without much background information, we had to conduct a live counseling session. Then with partners, we had to critique each other’s performance.

  • COMPetency exam

    • The last day before our elective rotations (and before many of us in my ‘class’ moved home to complete that rotation), we had to take what I would call a pre-RD exam. It was basically a final exam for the internship, and you had to pass. There were a number of people in my class that didn’t pass, so they sorted out some way to retake it during the elective rotation. Thankfully, I didn’t have to worry about that.

I finished my internship on August 31st.

Then it was time to study for the RD exam. I did take a couple of days off after the internship to relax, but I knew I didn’t want to wait very long to take my exam.

Studying basically became my “job” for the next 5-6 weeks, because it’s what I did for hours a day. I made sure to take breaks and days off so that I didn’t burn myself out, but I swear I could hear Jean Inman’s voice ringing through my ears all day long.

I took the exam on October 11th, and when I was ready to click the last button to see if I had passed, my heart was racing so fast. I said (another) little prayer, clicked, and smiled so big.

I finally accomplished what I had been working towards the last 4.5 years, and boy did it feel GOOD. It’s also pretty cool to have letters after your name 😉

 
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If you don’t pass the exam, you’re eligible to retake it after a 45-day wait period (paying again too, of course). You can also choose to take the NDTR exam that I mentioned in part two.

The RD journey is not an easy road, but if you’re truly passionate about dietetics, you will make it. That passion is honestly what I feel carries all dietitians through this intense process. Without it, I’m not sure the effort is worth it.

I hope you’ve enjoyed this series and learned a thing or two along the way. Please never hesitate to reach out if you have questions about ANYTHING.

If you’d like a post about life after the exam, more detail about a specific part of the journey, or even a Q&A style post, let me know on the Instagram post below. RD out! ✌🏼

 
@keepyourlifealive.rd

@keepyourlifealive.rd

 

RD Journey Part Two: Getting the Internship

The dietetic internship…

brace yourself.

Like I said in part one, my internship was probably the most strenuous and draining eight months of my life.

First, let’s talk about landing your internship.

There are two application sessions each year: one for spring match (internships that begin in the fall) and one for fall match (internships that begin in the winter). Once you know when you’re graduating and when you’d like to start your internship (ideally, at least, because there is no guarantee that you will be matched), then you can begin to look through internships. The Academy of Nutrition and Dietetics has a search engine for this.

Just about every internship will cover the three main rotations in some capacity: foodservice management, clinical nutrition, and community nutrition. Some may put emphasis on a certain area, include an elective rotation, or have a connection with a certain specialty. There will be at least 1200 hours of supervised practice, and internships range from 8-24 months depending on a number of factors. There are internships that are coordinated with earning a Master’s degree, often lasting longer than those that aren’t, but my internship was not coordinated.

All internships cost tuition, and note that you will not get paid during them while you work full-time. The programs with a Master’s are typically more expensive.

The applications are done through an online portal called DICAS. It’s nice having everything in one place, especially if you’re applying to multiple internships. I’d recommend applying to more than one too, because you aren’t guaranteed a match. Whichever internship(s) you do apply to get ranked in the order that you want to get them. That way, if your first option does want you, that’s the one you get matched to. 

In DICAS, you’ll enter typical resume information such as personal, background, and contact information, work history, extracurricular activities, awards and honors, and volunteer experience.

Keep track of ALL your volunteer hours, and keep them organized!! This will make the application process so much smoother and less time consuming.

You’ll upload transcripts and complete any special requirements from each individual internship. You’ll also need at least three letters of recommendation, and your references will upload their letters right into DICAS confidentially. Be sure to ask for these early, giving your references plenty of time to write their recommendations. Your program director will have to verify certain elements of your application as well. You’ll have a cover letter and a personal statement for each individual internship that you apply for, and these are important.

Your personal statement is basically the heart of your application. You need to make an impression—a GOOD one that lasts.

You’ll discuss these things in your statement:

  1. Why do you want to enter the dietetics profession?

  2. Discuss experiences that have helped prepare you for your career.

  3. What are your short-term and long-term goals?

  4. What are your strengths and weaknesses or areas needing improvement?

  5. What other information do you consider important for the selection decision?

Be sure to have family members, peers, professors, advisors, and anybody else that you can go over your statement and provide feedback. You want this thing to be perfect. Also, don’t forget to tailor your personal statement for each program, whether that’s simply changing the name of the program, adding an experience relevant to that internship’s specialty, or answering another question they’ve specified for you. You’ll upload a separate one for each internship into DICAS.

There are far more fall-start internships than winter-starts due to the fact that a majority of students do graduate in the spring. Since I was a winter graduate applying for a winter-start, my options were more limited. I only applied to one internship near my home in Michigan, and it was an extremely competitive one. The other was in Oklahoma. 

Some internships will do interviews between the application deadline and deciding on their interns. I did get an interview for the internship in Michigan, which was done over Skype, but I didn’t end up getting that internship. “Match Day” is about 6-8 weeks after the DICAS applications are due, and this is a big deal in the world of dietetics. You probably know by now that I landed in Oklahoma; it was far away and somewhere I’d never been before, but you’ll be thankful to get whatever internship you can.

The computer matching is actually done through D&D Digital, which is where you’ll rank your internship selections and where the internships will rank the students they want. Once you are matched, there’s a lot of communication, paperwork, and prep you have to do before the start of your internship. And don’t forget about finishing your degree if you’re still in your last semester. 

If you don’t get matched, don’t lose all hope. There is “round two” matching to fill any internship spots that weren’t filled, so you have a couple days to reach out to these programs and see if things work out. You can also apply again during the next round of DICAS. If you want to forgo the internship, at least for the time being, you can sign up to take the Dietetic Technician, Registered (NDTR) Exam. 

Okay, are you ready to hear about the internship finally?

here’s part three!

RD Journey Part One: Getting the Degree

I’m not going to get into WHY I chose dietetics in this blog series; I can cover that in a future post. My hope is that this series can shed some light for anybody on or considering the RD path!

I graduated high school at the top of my class in May 2014. At the end of 2013, I had committed to Olivet College to play golf. Although I already knew I wanted to be a Registered Dietitian at this point, Olivet did not offer a dietetics degree. I was going to be an exercise science major, and I was told that I could take a ‘nutrition path’ with it. I didn’t know any better at the time (which is where a post like this probably would have been very helpful), but that wasn’t going to get me where I wanted. I took the one general nutrition class offered, the same class that just about every health-related major student takes. I excelled and truly loved the class. However, this was the end of that so-called ‘nutrition path’, and I realized this during that first semester at Olivet.

Your degree needs to be from an ACEND-accredited program.

This is something that you should clarify with an advisor to be sure that the degree you’re going for is going to make you eligible for a dietetic internship.

Ultimately, I decided to transfer that winter.

I transferred to Madonna University in Livonia, Michigan. Ironically, I had toured this campus and talked to the golf coach about playing for the team here when I was weighing my options in high school. It’s a shame that I didn’t choose to go here, because by going to Olivet first, I lost a TON of scholarship money. Like, all of it. I had a 4.0+ GPA in high school and was offered an extremely high merit scholarship from Madonna (not including whatever I could have received from golfing), but all of that was lost by transferring. I chose to give up golfing after Olivet too, so 2014 was the end of my competitive athletic career.

Madonna was just about an hour from my house, so I lived at home to save money on room and board. I could also take some of my classes online since Madonna is a very commuter-friendly school, so I didn’t have to drive to campus every single day. 

Before I started classes in January 2015, I sat down with my advisor to plan out ALL of my classes up until graduation. DO THIS, no matter what. I wanted to finish in three years (3.5 years total with the semester at Olivet), and there’s no way I would have been able to do that if I didn’t have an intentional plan. Graduating a semester early would mean a December graduation, hoping for a January-start internship (I’ll get more into that in part two). It also meant summer classes, but I was determined.

Below is the core list of classes required for my dietetics degree, which doesn’t include any electives or general education requirements. It’s extremely science-based, so get your safety goggles ready. Organic chemistry is HARD, but I actually took it over the summer which meant a lighter class load during that time. I’d highly recommend doing that if it’s possible for you.

 
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The “major elective” classes were extremely important and provided so much applicable knowledge. Some of the elective courses I took were Dietary Supplements, Becoming Vegetarian, Nutrition for the Aging, Nutrition Education and Counseling, Nutrition through the Life Cycle, Nutrition Assessment, and Community Nutrition. I’m going to insert my complete list of classes by semester below.

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A few of the (MANY) big projects I did that stand out include:

  • In Nutrition Education and Counseling, we had to video tape ourselves doing a counseling session with a classmate. Each of us were given a patient role to play, and we carried out what would be like a real-life appointment with a dietitian. These sessions were analyzed and critiqued very thoughtfully.

  • We also had to do an interactive educational presentation in this class geared toward a specific target audience. I shared about eating healthy on a budget, and the class got to make trail mix!

 
 

  • In Medical Nutrition Therapy (MNT) I, we had to do a huge case study on a patient with a given disease. I was given chronic pancreatitis… definitely not a simple condition!

  • In Becoming Vegetarian, we had to collect a 24-hour food recall and food preferences from another individual. Then, we had to do a “diet makeover” creating a vegetarian meal plan that would be practical and meet the needs of this individual.

 
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  • In Foodservice Management II, we had to create our own business complete with a mission statement, marketing plan, budget, business plan, kitchen design, menu, and more. I created a meal delivery service!

 
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  • In Experimental Foods and Research (essentially Food Science II), we had to conduct our own food research and experiment with a legitimate sensory taste panel in class. I tested the replacement of oil in brownies with cauliflower puree, and although each of the tested replacement levels (0%, 25%, 50%, 75%) were ‘acceptable’, the brownie with no cauliflower puree was the most preferred.

 
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  • We also did a food demo in Experimental Foods and Research, and I made some delicious dessert crepes!

 
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  • Community Nutrition was actually a required summer class, because Madonna had a connection with a local center where we helped young kids grow and harvest a garden. It was really cool!

  • In Senior Seminar (which wasn’t actually taken as a senior), we learned about public policy and wrote a letter to the Legislator, presented on one of the Academy of Nutrition and Dietetics position papers, and practiced writing a personal statement-- a HUGE part of the internship application process!

  • In Food Service Sanitation, we took the exam to become ServSafe certified. This will be necessary if you choose to go the foodservice route with your career, but it’s great to have in dietetics no matter what!

As I moved further along into intense nutrition material, online classes weren’t as much of an option. I was having to be on campus just about every day, so I ended up getting an apartment from April 2016-June 2017. During my last semester, I only had to be on campus about two days per week, so I moved back home for this period of time.

Another important part of college is getting relevant work and volunteer experience for dietetics. I worked two part-time jobs during my three years at Madonna, both of which had relevance to the field. The first was at The Vitamin Shoppe. This job was retail- and customer service-based, but I did learn a lot about different supplements and making individualized recommendations to customers. The second was in the best hospital around, Beaumont Health. I worked as a nutrition services attendant, mainly delivering meal trays to patients. I highly recommend getting a job like this if you can, because patient interaction is KEY on your internship resume. If not, try shadowing a dietitian in the area or volunteering somewhere that could offer this. However, don’t take on more than you can handle.

The extent of my volunteering and community service was pretty much limited to what I did during my Community Nutrition class and the couple of times I had worked at the local food pantry during high school. There were some different programs and opportunities through Madonna while I was in school, but I felt like anything more was going to stretch me so thin that I would break. I had to keep my schoolwork a top priority and give it the time that it needed, which meant forgoing some of these other opportunities that would have certainly looked good on a resume. I did have some “leadership” roles that I was able to include on my internship application, such as being a team captain in high school and assistant coaching a girls’ golf team during college. Ultimately, I still got an amazing internship, and that’s what matters.

Focus on keeping a good GPA and finding work experience with relevant knowledge and patient interaction… quality over quantity. If you have one or two extra little things on top of that, you’re doing really good.

I want to note that I only wanted (and needed) to get my Bachelor’s Degree before my internship. However, starting in 2024, a Master’s degree will be required to take the RD exam. 

Beginning to look at internships adds a whole other realm of responsibility and time commitment to your plate. This process is done through an online portal called DICAS. If you’re looking to get your internship right after graduation, your DICAS application will be submitted during your last semester of college. Since I was graduating in December of 2017, I was working on my application from about May 2017 to the day it was due in September. I’ll talk much more about this in part two, but the internship process is tough and SUPER competitive, so prepare yourself ahead of time.

Fortunately, I matched to an internship my first round through DICAS. This meant that I graduated in December and started my internship in January… requiring a move across the country from Michigan to Oklahoma too! I was in for just about the most stressful and exhausting eight months of my life. But, completing your internship means you’re eligible to take the RD exam.

FINALLY!

click here to read part two!

Dietitian vs. nutritionist: Not the Same

A Registered Dietitian, or Registered Dietitian Nutritionist, is NOT the same thing as a “nutritionist”. The RD and RDN credentials do mean the same thing and have the same requirements. However, just a “nutritionist” does not have the same, or often any, credentials at all.

To become a Registered Dietitian, one must have at minimum a Bachelor’s degree from an ACEND-accredited program. The individual then must complete an accredited dietetic internship which provides over 1200 hours of supervised practice, lasting 8-24 months long. He or she is then eligible to take the national registration exam, and must also gain licensure in any states they plan to practice in. All registered dietitians must maintain continuing education for as long as they practice as well. Beginning in 2024, a Master’s degree will actually be the minimum degree required. Legally, a dietitian is a nutrition EXPERT. He or she is qualified to promote good health through proper nutritional habits.

At least here in the United States, “nutritionist” is a self-proclaimed title. Someone that claims they are a nutritionist may have received education or educated themselves about nutrition, but there is no legal regulation. There are no initial requirements or continuing education requirements. Essentially, anybody could give themselves this title. That’s why it’s so critically important to know who you’re working with.

I can promise you that the process any dietitian is required to go through is RIGOROUS. If somebody isn’t truly passionate about the field, they wouldn’t have been able to earn the credentials… honestly. It’s a hard, long, and draining process, but I know that personally, I never looked back.

I guess my main takeaway for you is this: know who you’re talking to and what you’re signing up for. Dietitians are not perfect; we’re human like everybody else. However, we have been trained and educated as professionals and experts in the field of nutrition, and we abide by a code of ethics and standards of practice. I can’t speak for all dietitians, but I can assure you that I have nothing but your absolute best interest in mind. I want to see you succeed, & I am here to help you to meet your goals.