A diabetic what? An overview of the Dietetic Internship Process

This is a conversation that I have almost every day:

Other Person: “What do you do?”

Me: “I’m a dietetic intern.”

Other Person: “A what?”

Me: “A dietetic intern.”

Other Person: “A diabetic what?”

Me: “Nutrition. I’m a nutrition student.”

Other Person: “Oh. I eat McDonald’s every day, but I put butter in my coffee, so that’s healthy, right?”

Most people in my life know that I’ve been a teensy bit preoccupied for the past 8ish months, in addition to the 4 years prior that I was in school. The people who really know me understand all of the things that went into the process. My best friend in Boston teared up when I told her that I matched to an internship last year, and my sister calls me and sings me songs about how many days I have left until I’m done. Most other people probably just know that I’ve been pretty unavailable, and it has something to do with nutrition, so here’s a comprehensive explanation.

To become a Registered Dietitian, a person must complete a Didactic Program in Dietetics, complete 1200 hours of supervised practice (dietetic internship), pass the national registration exam, and maintain registration with continuing education. The only people who can apply for a dietetic internship are those who have a bachelor’s degree and have completed ACEND-accredited coursework through a Didactic Program in Dietetics (DPD). Some people do an undergrad nutrition program that includes the DPD requirements, while others earn a bachelor’s degree in another field, and then return to school to complete a DPD program, which is what I did. Someone who earns a master’s degree in nutrition without completing a DPD program cannot apply to an internship. Anyone who has not completed a dietetic internship cannot become a Registered Dietitian (excluding ISPPs). DPD coursework varies slightly across programs, but follows the same general ACEND guidelines. If anyone is interested, you can see the Simmons curriculum here. Basically, I took a bunch of lab sciences and a bunch of nutrition courses in different areas of nutrition (food service, community, and clinical).

Simmons requires a C- or better in the science courses, and a B- or better in all DPD nutrition courses, but of course, getting by with the bare minimum does not make a student competitive for dietetic internships. This is what we are told throughout the program. The match rate is approximately 50% for dietetic internships. There are WAY more students applying for internships than there are places for them. The internship thing is tricky. You have to be willing to put other things in your life on hold, spend a bunch of money on tuition, and work full-time for free for 9-12 months. Once you make the decision to do an internship, you have to decide which programs to apply to. Dietetic internships are primarily accredited through hospitals and colleges, with a handful of exceptions. All internships must include rotations for clinical, community, and food service, but they can emphasize different aspects of nutrition by having interns spend more time in certain rotations. Once an applicant decides what they’re interested in, they fill out 58 million forms, acquire all of their transcripts, and beg professors and employers for recommendations to submit to a computerized database for the big event of them all. MATCH DAY. After submitting the required materials, applicants rate their internship choices. The internship programs then rate the applicants. Applicants bite their nails, cry to their loved ones, and generally freak out while waiting for match day. If it’s a match, well, then a dietetic intern is born.

I knew that I would want to do individual counseling, so I chose to apply to the Simmons internship program and the UMass Amherst program because (a) I wanted to do a community nutrition-based program vs. a clinical program, and (b) I didn’t want to uproot my life by leaving Boston. Most students apply to 5 or more programs. I took a risk by only applying to 2 programs because I wasn’t willing to compromise on what I wanted. Had I not matched, I would have either waited another year and reapplied to internships, or pursued something else and not become an RD.

The internship has been interesting/stressful/frustrating/exhilerating. I have (almost) completed 6 rotations:

  1. Government/non-profit: Executive Office of Elder Affairs (Elderly Nutrition Program for state of Massachusetts)
  2. Counseling/Education: Harvard University, sports nutrition/eating disorder counseling w/student athletes.
  3. Food service: New England Conservatory
  4. MA Dept. of Public Health- WIC Program
  5. Community Health Center- Cambridge Health Centers, outpatient counseling
  6. Acute Care Hospital- Melrose-Wakefield Hospital
  7. Will complete: Intern’s choice week, shadowing 3 different private practice/outpatient RDs who do ED counseling.

I certainly did not expect that I would be writing this, 2 weeks away from the completion of this 5-year journey. I didn’t expect any of this to happen when I started out with Intro to Nutrition, thinking that I would just explore some career options and take advantage of free tuition. I was convinced that I would fail every single exam and every class along the way. Even if I passed, I wasn’t sure that the internship would be worth the sacrifices, but I have learned something new every single day for the last 8 months,  and the perspective that I’ve gained cannot be acquired through any other experience. I am grateful for the opportunity.