Just in time for National Nutrition Month and Registered Dietitian Day.
It has come to my attention that all reputable dietitian-run blogs all have a post dedicated to BECOMING A REGISTERED DIETITIAN NUTRITIONIST (RDN). I actually get asked quite often by students interested in pursuing this career path or chefs/health professionals passionate about nutrition. Here's my hot take and autobiography. There will be a lot of unpopular opinions, so buckle up.
TL;DR: don't do it unless YOU KNOW YOU WANT TO BE A DIETITIAN*
*bolded text is relevant information
My backstory:
I've always been interested in health, service, science, and medicine. And I've always loved food. Sure, everyone LOVES food, but my curiosity, enjoyment, and ardor for all things food-related was really some next level shit. I can confidently state that I took #foodporn photos and started food blogging before all the other millennials did.
In college, I started off as a pre-med student and very quickly decided (halfway through first semester freshman year) that I was not cut out for the competitive cut throat nature of getting into med school. Unfortunately my alma mater Tufts did not have a nutrition undergraduate program (total BS to me because they have a WHOLE Tufts Friedman School of Nutrition Policy and Science... more to come on that), which meant that I took every nutrition-related course I could get myself into ranging from anthropology to bio-statistics to biomedical science engineering. I also volunteered at Peer Health Exchange and taught basic nutrition to high school freshman at inner city schools in Boston. I whole heartedly loved my liberal arts undergraduate experience, but the education did not pave a straight path for me to become a RDN.
There are a specific list of pre-requisite classes required to apply for a Dietetic Internship (DI) and only colleges or universities offering a Didactic Program in Dietetics (DPD) will have all of these available. Many of the science classes are similar to pre-med requirements (biology, chemistry, biochemistry, orgo, physiology, anatomy etc.), so I was able to take them at Tufts. Other classes such as food science, nutrition through the life cycle, medical nutrition therapy, food production and service systems, and practices in community nutrition and clinical dietetics are specific to DPD programs in preparation for the DI. I realized quickly during my medical nutrition therapy observation that the RD was the healthiest looking staff member working at the medical center. That's when I was convinced that I had chosen the right way.
In wanting to pursue the RDN path, I decided to apply to graduate school after college and complete my DPD requirements simultaneously. I got accepted to Tufts Friedman's food policy program and Simmons College's DPD program and took classes at both. In retrospect, I wish I worked before attending a graduate program, seeing most of my peers have had substantial work experience before choosing to further their knowledge in nutrition policy or communications, whereas I was still figuring out my nutrition niche. I also wish I participated in the joint MPH program because getting noticed in community nutrition programming without it has been challenging. Regardless, requirements are now changing and starting in January 2024, a graduate degree will be "the minimum degree requirement for eligibility to take the registration examination for dietitians." How 'bout that? Raising the bar, yet salary thresholds may or may not budge.
My graduate concentration was nutrition interventions. And I was all about it. I loved volunteering** at Cooking Matters, teaching a nutrition and healthy cooking series to seniors in Chinese at the community center in Boston Chinatown. I also loved teaching a nutrition and gardening class at a local elementary school. I also interned at the Department of Health Services at Tufts' undergraduate campus. It was a great excuse to visit my friends on campus and to implement healthy living programming for students. I was able to develop my nutrition communications and marketing skills, while working with health educators and prevention specialists. I also collaborated with a farm in rural Massachusetts to develop farm to school education programs for middle schoolers. I wasn't able t to see the execution of the program, but I loved visiting the farm and working with the down to earth staff!
(as I'm recounting all this, I'm wondering how in the world did I have time for all this?? I was also an avid runner, consistently lifted weights, attended Zumba, food blogged, and had a live-in relationship lmao)
I am grateful for my Tufts graduate education, for all my professors are active leaders in their field and deeply engrossed in their nutrition policy and science research. I will forever remember my graduate summer internship at City Harvest, where my supervisor was a very seasoned community dietitian. This experience really shaped my interests in community nutrition and how access to food and nutrition education can directly impact a community. I loved weighing out pounds of fresh produce at food drives, I loved creating a family curriculum for a site in Brooklyn and teaching the kids about the joy of fresh fruits and vegetables. And to be honest, I'm still chasing that high.
**I did a LOT of volunteering because I genuinely love sharing nutrition and food knowledge and because DI's look for that when you apply and having a heart for service is what life is about
Applying for dietetic internships must've been one of the more stressful processes I've gone through. It's a ranking + matching system, so you have to balance prioritizing the competitiveness of the program with your own qualifications. Plus the match rate right now is ~60% because there are not enough DI programs. Simmons had a large DPD program and is located in Boston, so it was unnecessarily competitive and my classmates were discouraged from applying to certain DI's and all this other drama I specifically did not go to med-school for. I figured I had a good chance, seeing as I had ample internship and volunteer experiences and a whole masters degree. But I didn't get my first 2 choices in NYC. Instead, I got matched to Tulane in NOLA, baby!
Honestly the biggest blessing in my life. Moving to the south opened a whole new world to me. I am so grateful to have experienced the most vibrant and authentic city in America with a thriving food culture. It's a constant celebration of life, death, and everything in between. I would trade nothing for my time in New Orleans. First off, Marsha is the most chill Dietetic Internship Director you will ever come across. She has seen it all and is not phased by anything. She was honestly more concerned about us letting the good times roll because she knows what NOLA has to offer, and she did not want us to miss out.
This is how I got to rotate at 27 different clinical, community, school, sports, food service, and culinary medicine practices in 10 months.
You will meet a number of dietitians and health conscious people on your path. Some more woke than others. But you will come to realize that most people that choose the dietetics field genuinely love food, can talk about food all day, have food available on them at all times, and generally has some degree of food obsession. If that's not that case, I would not trust that dietitian.
I truly enjoyed my Dietetic Internship at Tulane's School of Public Health and Tropical Medicine. I learned a lot from shadowing my preceptors, seeing countless patients, starting community based projects, visiting countless schools and kitchens, and observing what other dietitians do. I was intrigued with outpatient pediatrics, was frustrated that the community rotations weren't longer, and was enamored by sports medicine (always have, still am). I loved working in teaching kitchens, visiting school gardens, and being involved in hospital and school food service. A lot of my fellow dietitians saw serving food as beneath them, but I found it a humbling experience. Being in the deep south, I saw extreme medical cases especially in underprivileged and underserved populations. It really opened my eyes to the greater picture of food and health policy and accessibility in America.
During my DI, I waitressed at Evangeline in the French Quarter, which provided yet another perspective to my understanding of food, nutrition, and food service. I also started my own specialized meal prepping service, where I provided 5 breakfasts, 5 snacks, and 5 meals a week for my friends at an affordable price or reasonable barter. I catered to specific dietary needs and offered a vegetarian option. I don't know how I did all of this in my tiny Tulane dorm kitchen with a mini stove and oven, but I did it.
I took my DI exam shortly after finishing the program. I had all the information and material and just needed to get the exam over with. I mostly studied by taking practice tests generously provided to us by Marsha. I find standardized tests to be more about learning how to take the test than actually developing a deep understanding of the material. First time was a go, so I took my new credentials to get me a clinical job! I didn't take all these science classes and spend countless hours in clinical practicals for nothing! A lot of these skills and medical vernacular simply slip aside once you stop using them.
I was assigned to the stroke stepdown unit at Ochsner Hospital outside of Orleans parish. Patients were generally stable by the time they got to me, and I spent most of my workdays on my computer charting and providing discharge nutrition education to uninterested folk. Everything I did and ordered for a patient had to be signed off by a MD. Because there was no professional ladder system for the dietitians (we were contracted to the hospital via the food service department - Morrison, ugh, so we were technically food service workers), it was predictably a high turnover job. Also, >85% of dietitians in the States report to be female. From experience, I saw a lot of my dietetic peers and elders getting into relationships with people of higher income status, getting pregnant, starting families, then transitioning to part-time. This was demoralizing for me. But hey, it was my first fulltime job, and I was grateful for the responsibility and the experience. I shortly got transferred to the cardiac / medical ICU and worked with heart transplant and LVAD patients. I also consistently pushed to be cross trained in pediatrics and the neonatal ICU, which came in handy because no one else was, and both those dietitians were on maternity leave near the end of my time with Morrison. Important lesson here: always advocate for yourself to get the experience you want! I only stay at jobs that offer opportunities for continued growth and education. During my last 6 months at the hospital, I had 3 different clinical managers. I ended up creating my own schedule covering both the CICU and NICU because my manager had an overwhelming amount of learning and catching up to do (she was entirely clueless and not fit for a clinical manager), and I do not stand for inefficiency.
The in-patient clinical experience is critical if you want to work in the medical system. My hospital experience and thorough DI rotations helped land me my next job as the clinical dietitian for the bariatric weight management program at UCLA. But it's not easy finding a full time job as a dietitian, so I actually had 2 other simultaneous jobs. I was also the dietitian at To Help Everyone's community clinic in South Central LA and at UCLA's pediatric Fit Clinic.
Let's start with the bariatric program. The surgeons, my bosses, never expected me to stay longer than a few years. That's a typical turnover time for a dietitian. Working with doctors, the answer to health questions are always medication. Working with surgeons, the answer to weight loss is always surgery. I'm a dietitian, so naturally my answer to health related questions are all DIET. I loved my team, the dynamics, the personalities. I was able to address issues beyond food choices and act as an exercise physiologist and CBD advocate. But the hospital did not understand the value of dietitians. It makes sense, because our billing reimbursement is menial compared to other medical staff. After my first year there, the general surgery department decided there was no reason to continue accepting dietetic interns. This was a slap in the face. This meant UCLA Medical Center had no interest in training and cultivating future dietitians. What would that mean for my future as their current dietitian?
I really enjoyed working with my patients at the community clinic. Except when they didn't show up, which was a lot of the time. The doctors were great at giving referrals, but my schedule was still sparse. Not speaking Spanish was a huge hindrance. There were translator lines and nurses that would interpret for me, but that definitely placed a barrier between me and the Spanish speaking patients. I learned a lot about social, educational, and environmental barriers to health. I was grateful that the patients were grateful. But it was a solitary position, mostly me sitting by myself in my own office and having minimal contact with other staff members.
My favorite job during my time in LA was at UCLA's pediatric FIT clinic. It was a pediatric outpatient weight management program for when nothing else worked. I loved being part of the physician, psychologist, dietitian tag team. All weight management programs take note: having a psychologist on board is so key because once they are able to address all the stressors and other factors affecting eating habits, nutrition would just naturally fall in line. We saw families back to back on a monthly basis, so it was easy to follow up on trends and changes. It was so gratifying watching kids "graduate" from our program. However, there was always the ever looming threat that our clinic time would decrease (...we met 1 afternoon a week) or having to share our clinic times with other teams because we weren't profitable enough. This was the dream job that I wanted as a dietetic intern, and I achieved it in less than 5 years. But I also had to let it go when deciding to relocate back home to NYC.
To this day, I'm still figuring out if I made the right education and career decisions. Being a Registered Dietitian Nutritionist does not pay the bills that I want to be spending (not even going to get into the tuition I spent getting here...). We are not valued in the medical field because medicine pushes medication, not fresh fruits and vegetables. There's so much I want to do with my Registered Dietitian Nutritionist title, but there are societal and bureaucratic structures in place that keep advancements in this field stagnant.
I started applying to mostly community jobs, meaning a pay cut while practicing what I love, but it was tough because we just entered the pandemic and it was clear all my recent experience had been clinical. I created my own job posting for a nutrition and wellness coordinator for independent schools, but schools were struggling just trying to stay open, so timing was off and conversations were cut short. I interviewed for an exclusive high end preventative care clinic whose patients were "high level execs and stay at home moms" with annual follow ups. I thought back on my coworker who left the bariatric clinic to work in nutrition support sales because that's where the money is at for dietitians. I did not want to sell my soul for some dough. I am not about that life.
After leaving LA, I took time to become a yoga teacher and to acknowledge my authentic self. The nutrition I want to teach and share is part of a holistic lifestyle. It's not about counting calories, processed foods in fancy packaging, or losing weight. It's about choosing nourishing foods that empower your body and your being. It's about integrating healthy habits and positive choices in every part of your daily living.
It feels like I'm starting over again. I once again am working multiple jobs, but with way more flexibility. I created
zi-on, where I provide private consultations addressing whole body wellness through nutrition, yoga, and meditation. I'm the Community Educator a community center in the Bronx, a volunteer position where I review the Headstart menus and act as their nutrition consultant. I also work in corporate wellness as a virtual wellness provider with MoodFood, a start up connecting dietitians with tech employees. And finally I have something cooking up with
Ki Body & Spirit, a new yoga and wellness studio. There are still so many moving parts, as there always has been. But I have found opportunities that fit with my personal nutrition philosophy (my favorite question to ask when interviewing or speaking with other dietitians).
Like Michelle Obama, I'm still becoming. I'm learning to be patient with my process and recognize that even though this is a competitive field, other dietitians are not my competition. We should be uplifting each other and encouraging each other to provide the best service that we can to our clients and our patients. I don't necessarily encourage students to pursue the dietetics path unless they have a clear vision of what they want their future practice to be and what they plan to do with their RDN credentials, but I can't help but be excited when BIPOC are interested in working in nutrition because there is a need for representation and culturally competent dietetic professionals #diversifydietetics.
This retelling of my education and professional journey may not be too helpful, but I'm always happy to answer questions to up and coming dietitians, nutrition students, or individuals interested in bettering the health of themselves or those around them. Reach out! lettucespoon.rdn@gmail.com
