Becoming a Registered Dietitian
By: Wendy Wu MS, RD
This post is for those of you who are considering a career as a Registered Dietitian or is interested in the process of becoming a RD.
Like most other college students, I had no idea what I wanted to major in during my freshman year at Queens College. I was just happy and grateful to have gotten into the college of my choice. Going into college, I knew that I wanted a career which would allow me to help people. I didn’t know how, but I loved the social sciences so I took some introductory courses to test my appetite. Anthropology 101, Sociology 101, Psychology 101, Nutrition 101, etc. Psychology and Sociology quickly dropped out but I think it was because I had really boring professors-which in turn, made the subject really dull. I was intrigued with Anthropology and took as many classes as I could the following years. However, I realized that finding work in this area will be quite difficult so I decided to minor in Anthropology instead. Nutrition 101 was taught by a highly respected and no bullshit professor. She would give pop quizzes based on the reading assignments (so you better do the readings) and her exams were in essay form which meant you better know everything or you’ll fail! In retrospect, her classes were the most difficult of all my years in QC. After passing her class, I had an inkling that I would do pretty well in this field so I signed up for more nutrition classes.
Give me some Guidance please…
I’m sitting in the guidance counselors office and she asks me. So what do you want to major in? I tell her, nutrition. Her response: Majoring in nutrition will narrow your options. Why not consider a career in dietetics? Your grades show that you are doing well in this field. Me: Urrrrr….but that means I have to take chemistry-yikes! I hated chemistry and physics in high-school but after much thought, I decided that yes, I would major in dietetics.
Everything that dietetics had to offer, I loved. Science of Food, Family and Consumer Sciences, Family Relations, Food service, Meal Planning and Management, Experimental Foods, Cultural Foods, Clinical Nutrition, Biology and even Chemistry (which was a shocker for me). I distinctly remember my chemistry professor telling me that I should consider a career in this field. Yeah, I laughed out loud but was secretly swelling with pride. Me, a chemist? Ha!
I did well in those classes because I felt a connection to the subject matter. I was learning about the world around me in a way that I understood it-being kind to others, caring, helping, and healing with food. It also helped that I love to eat. If I had conformed to the stereotypical careers of my other Asian friends, I would probably be an accountant, or in some other finance job. *shivers* (No offense-it’s just not for me) Unless!…I’m an accountant working for Chanel and get 70% off their merchandise. Nah, I’ll still be miserable even with all the perks.
You mean I have to pay for the internship?!…
This was a big shocker for me but it’s my own fault for not doing more research. Towards my last year in QC, I learned that I would have to apply for a internship and that it would cost anywhere between $10,000-$30,000. Yes, my jaw dropped. I thought most people get paid to intern? Nope, not in this field and it’s highly competitive too. You can choose to do just the internship, do both the internship and MS/MA in one/two years or do the internship and work on the MS/MA at your convenience. I chose the later. I didn’t even bother applying to Sodexho, Aramark, or Stony Brook. I didn’t have a year or two to just study and work for free, I needed to get a paying job ASAP. I did a little research, consulted with my fellow classmates and decided to stay with Queens College for my internship. My GPA, relationship with the professors, professionalism, involvement with student clubs (Jr. ADA-President and PhiU-Secretary), and work experience (food service in restaurants and children’s hospital) was what made me stand out amongst the other applicants. It also helped that I had a really good relationship with the internship director (hey, you gotta do what you gotta do). The Queens College internship was great because it killed two birds with one stone. I gained experience in the real world and was earning credits toward my MS. Advised by a fellow classmate, I took my internship experience into my own hands. I knew where I wanted to intern and asked my internship director to push for those locations.
Community Nutrition Round 1: City Harvest
I loved loved loved interning for city harvest-mostly because I adore and respect my preceptor who was the director of nutrition education. I was involved in almost all of the programs and absorbed it all like a sponge. My most memorable experience was a day in the City Harvest Truck. I followed this lovely man around Manhattan collecting food donations from banks, supermarkets, small food shops, etc. It was such a fun day. Other projects I was involved in were participating in mobile markets (handing out produce to people living in neighborhoods of NY that didn’t have access to fresh food), teaching a nutrition education/cooking demo class at a after school program (Operation Frontline), a one day exploration as a health inspector, creating a game for the mobile market, data entry for the fruit bowl program, helping out at various nutrition education programs, and earning a food handler (soup kitchen) certification and servsafe certification. The nutrition education department at city harvest is truly amazing and I highly recommend students intern with them.
Food Service Round 2: FLIK International
I was kindly assigned to intern at a small private school in kew gardens. I honestly have to say I didn’t learn much from this internship only because I have so much experience already in the food service world. Daily work included preparing, cooking and serving meals. I was quite bored but looked forward to monthly menu planning and ordering food.
Clinical Nutrition Round 3: Terence Cardinal Cooke Health Care Center
I remember being so nervous about clinical rounds. There’s just so much dietitians have to learn and it’s hard keeping up with all the changes in this fairly new field. It seems like every other day, there are new recommendations as a result of new scientific studies. The first few weeks were difficult. Really difficult. The first dietitian I was assigned to follow around for the week made sure I suffered in the most hardest and cruel way. Her cruelty didn’t stop me though, I think the best teachers are the ones that make you suffer. She pushed me to my limits and for that I thank her. Only by being challenged will we know our true potential. The second dietitian I followed around was in charge of the dialysis and children’s units. I learned so much from her because she basically handed me most of her work. Good thing I was eager to learn so I handled all the work quite well. The third dietitian was in charge of the aids unit. My absolute favorite as it was so interesting and challenging. The last dietitian I was suppose to follow fell sick so I was on my own. Good thing though because I was scared to death from all the stories that was told to me about her from the other dietitians. She was basically super anal, but that’s okay. To me, it just shows that she cares about her work and thinks it’s important. She was in charge of the Tubefeeding and Huntington units. I followed her written instructions of work for me and breezed through the week. I later found out she was happy with my work. *phew* The entire experience was life changing. I left TCC with confidence that I would be worthy of this work. That I would make a difference. With the help of my clinical preceptor, I was offered two jobs and accepted the one that was closest to me.
Nursing Home Years…
I graciously accepted a Clinical Dietitian position at a nursing home in Jamaica Estates in 2007. I would be responsible for roughly 120 patients (or residents as we call them since the nursing home is where they reside). One short term unit and two long term units. Patients in the short term unit are usually admitted just for physical and/or occupational rehabilitation (s/p knee replacement, a fall, s/p fractures, etc). My job in short for the patients is basically to assess their needs, educate and make sure they are nutritionally sound. That’s the stuff that matters. The other nitty gritty jobs are documentation (till my hand falls off), filling out MDS forms, meal rounds, and care plan meetings.
When I first started, I was all about giving advice. I found out the hard way that most people (especially the elderly) don’t really care about nutrition. They’re already sick, feeling like crap, and the last thing they want to hear is someone telling them what they should be doing to improve their health. I quickly changed my tactics to be one who is inquisitive. I’d ask a lot of questions to get to know the patients, build rapport (by not giving advice), monitor their meal habits, monitor their weekly/monthly weight, and when the occasion arrived where I had to address a problem (weight loss >3 lbs/week, > 5lbs/month, and/or 5% in a month, weight gain >5lbs per week + month and/or >5% in a month, loss of appetite, etc) I handle it in the most gentle, non judgmental and caring manner. Much of my job involved detective work. Why did he lose weight? Why did he gain weight? Why isn’t he eating? Then explain the reasons. Documentation is key because it’s the only proof of nutritional interventions for specific problems. It’s strict, but it’s needed. I have to admit that sometimes, I feel more like a waitress trying to please the customers than a professional.
I’m a true believer in life is what you make of it. I focused on building relationships-with the patients, staff and family. I treat my patients as if they were my family members (well, most of them). Getting along with the nursing staff is so important. If there was a problem, who better to ask than the ones that are with them on a daily basis. I enjoyed my job very much and it was truly rewarding. As with any job, there are struggles that people face. I would have liked a more peaceful environment to interview the patients. Larger budget to provide more variety in the foods offered. More appealing therapeutic foods. More nursing staff. More dietitians. More doctors. More of everything good and true. But that’s wishful thinking because at the end of the day….it is a business.
After work headache…
While working a full time job, I was also studying for my RD exam and pursuing my graduate degree. To prep for the exam I bought flash cards, studied my textbooks, took online tests and signed up for the Jean Inman study course. I guess it helped because I passed. Oh yes, dietitians are required to earn continuing education credits and pay CDR $50 every year to keep the RD title. You can also apply for a CDN if you’re in NY (Unfortunately, there’s no licensing in NY yet). Other credentials? CSG, CSSD, CSP, CSR, CSO, FADA and CDE.
My advice for students considering a field in dietetics (with my food service, nursing home and internship experience) is if you enjoy helping people, like to read, are patient and empathetic, don’t mind being treated like a waitress, are detail oriented, have a passion for nutrition, don’t mind the mediocre pay, are good at problem solving, have a great love for food-all kinds, work well with others, communicate well, are super organized, can deal with patient death, don’t mind the dirty stuff like poop, drool and urine, are willing to do volunteer work, can think outside of the box and sincerely care about people then this might just be the perfect job for you.
I hope this helps. I may have left out a few details so feel free to ask questions! I’m happy to help.