How to Become a Registered Dietitian

As a dietetics student, you’ll study a variety of subjects, ranging from science-based courses to advanced nutrition and statistics. The goal is to obtain the ability to translate complicated nutritional science into simple, everyday life recommendations for clients and patients.

Listed below are descriptions of a few courses you’ll take in your journey to becoming a RD:

• Medical Nutrition Therapy: Learn evidence-based approaches to prevent and treat chronic conditions, such as heart disease, kidney disease, cancer and chronic obstructive pulmonary disease. Understand how pathology and biochemistry impact nutrition related diseases.
• Biochemistry: Focuses on biochemical principles of human nutrition, including gene expression, bioenergetics, and metabolism. Learn the structure and functions of biological nutrients including water, proteins, enzymes, macronutrients and micronutrients.
• Quantity Food Production: Provides an overview of food service organizations from food safety and sanitation to culinary math and laboratory exposure. You’ll develop the ability to plan menus and become familiar with quantity food preparation and holding equipment.
• Nutrition Counseling: Learn and practice using theories of behavior change through counseling patients and promoting changes on an individual and group basis.

There’s no typical day for a dietetics student. One day you’ll be practicing complicated chemistry equations and memorizing the names of every bone in the body, and the next you’ll be making muffins in a food lab or writing a lesson plan for a nutrition education session.

In RD school, you have to balance your scientific, analytical skills with creativity and ability to empathize and relate to people. Your success in a dietetics program requires flexibility and dedication, skills that will translate into becoming a competent RD.

Some dietetics programs require field experience in addition to coursework to prepare you for a DI. This may include working or volunteering under the supervision of a RD for a certain number of hours. You’ll have opportunities to apply your academic knowledge to real world situations and shadow RDs in their day-to-day work.

There are a variety of locations where you can obtain dietetics field experience both paid and unpaid. Working as a dietary aide at a nursing home or hospital, for example, is an excellent field experience opportunity. You can also explore volunteering for hospital nutrition departments or school foodservice.

It’s important to think outside the box and step outside your comfort zone when searching for field experience as opportunities can be competitive and difficult to find.

Here are some examples of projects you may be assigned during field experience:

• Planning and reviewing menus
• Developing nutrition education handouts and brochures
• Conducting a nutrition class for older adults in a nursing home
• Educating clients and patients under the supervision of a RD
• Writing nutrition newsletters

Another requirement to become a RD is completion of a dietetic internship (DI), otherwise known as an ACEND-accredited supervised practice program.

The DI is often described as the most challenging milestone for aspiring RDs. It involves 1200 hours of supervised practice at a health care facility, community agency, or foodservice corporation running six to 12 months in length.

During your DI, you’ll spend 32 to 50 hours a week at various clinical, community, and foodservice rotation sites, switching locations every 1 to 3 weeks. Some DIs have unique emphasis areas, such as public health, eating disorders, or medical nutrition therapy which are excellent options if you want to specialize in a certain area.

Your rotation site placements will vary depending on your DI requirements, preferences, and location. Some examples of dietetic internship rotation sites and what you can expect from them are listed below:

• Clinical: Sites may include hospitals, outpatient clinics, and long-term care facilities. Most of your time will be spent implementing the Nutrition Care Process in a variety of areas from cardiology to critical care. You’ll learn how to analyze nutritional data from medical records and patient interviews. Additionally, you’ll receive practice with completing physical assessments, charting, monitoring patient progress, and interacting with other disciplines.
• Community: Sites may include hunger relief organizations, WIC clinics, and extension offices. Your time will be spent on projects that promote knowledge and behavior change within a community setting for individuals, families, or groups. You’ll master skills in counseling, nutrition education, program development and administration, and management. Depending on your rotation site, you may have the opportunity to lead community cooking classes or teach nutrition lessons at a school.
• Foodservice: Sites may include hospitals and schools. This rotation will teach you the ins and outs of running a foodservice operation. You’ll assist your preceptor with managing the budget, help with monitoring production schedules, and develop menus. Additionally, you’ll likely be asked to help with food prep and the serving line. These tasks help you understand the full picture of the foodservice operation and how they contribute to the organization’s success.

In addition to being present at your DI rotations, you’ll also be assigned projects, such as case studies, research papers, and continuous quality improvement projects to further your learning.

According to ACEND, the chances of obtaining a dietetic internship are only 50%. There are more applicants than available spots, making it incredibly important for you to work hard and gain competitive experiences to better your odds.

A few skills and strengths that are important to obtain before starting your internship are flexibility and willingness to adapt to change. You’ll be changing work settings frequently during your internship year, which is challenging but rewarding based on how much you get to learn and experience.

Applying to DIs also requires planning ahead financially as there are several expenses in the process, including the internship itself. The three types of dietetic internship programs are described in detail below:

This is the most common type of DI. To obtain one, you’ll go through a placement process or “matching” which takes place twice a year. Accredited DIs require submission of an application through a portal called Dietetic Internship Centralized Application Services (DICAS).

DICAS applications consist of a written personal statement, work and volunteer history, resume, and professional references. The system provides an orderly way of matching preferences of DI applicants with preferences of DI program directors. If selected for an accredited DI, you’ll start your program between three and six months after being matched.

There are two types of accredited DIs, explained below:

• Traditional: DI director sets up rotation schedules and preceptors; you’ll meet with your director face-to-face throughout the experience; often requires relocation.
• Distance: You’ll be responsible for setting up your own rotation schedules and preceptors; correspondence with DI director occurs mostly online; allows flexibility in where you reside.

Accredited coordinated programs are often described as the most efficient DI route, as they combine DI supervised practice hours with DPD coursework.

Coordinated programs don’t require matching but must be applied to after completing prerequisite courses. These programs aren’t widely available, so they’re more competitive than traditional or distance DI programs.

In a coordinated program, some of your semesters will be coursework heavy, while others will be entirely focused on your DI rotations.

The mission of ISPP programs is to provide a DI option to two groups of students: those who didn’t match to an accredited internship and those who hold doctoral degrees. ISPPS are a newer option, developed in recent years to help combat the shortage of DI programs in the US.

The application process for ISPPs is more straightforward than other programs. If selected for an ISPP, you’ll be responsible for setting up your own rotations and preceptors.

As mentioned above, DI programs are competitive. It’s inevitable that several applicants won’t be selected for a DI on their first try, no matter how much experience they have or how hard they’ve worked.

If you end up in this situation, don’t give up! You can apply again during the next semester or round of matching.

No matter how confident you are during the DI application process, having a plan B is important in case you don’t get matched. This can be anything from obtaining a job that gets you more experience in the field, to retaking classes to improve your GPA.

The reality is that several aspiring RDs end up applying to internships two or even three times before they’re selected. This sounds discouraging, but emphasizes the importance of being prepared for either outcome, which will better your chances for the next time you apply.

Within a few months of graduating from your DI, you’ll be eligible to earn the RD credential through the Commission on Dietetic Registration (CDR). This requires taking and passing the CDR registration exam.

The registration exam addresses what you’ve mastered during your schooling and DI. The topics on the exam are different for every person, as they’re pulled from a pool of thousands of questions. You’ll answer questions on anything from calculating tube feeding formulas to where raw meats should be stored in the refrigerator.

Once you’ve passed the exam, you must obtain state licensure and/or certification before practicing as a RD. Find out RD licensure requirements for your state here.

The next step is continuing education. RDs are required to obtain 75 continuing education credits every 5 years in order to maintain registration and licensure. Continuing education credits can be obtained in several different ways, from attending webinars and conferences to reading books and journals.

RDs aren’t required to have a specialty, although having one sets you apart from other professionals and highlights your talents. CDR and the Academy of Nutrition and Dietetics (AND) offer special certifications for RDs who wish to further their professional development. Here are some examples:

• Certified Specialist in Gerontological Nutrition (CSG)
• Certified Specialist in Pediatric Nutrition (CSP)
• Certified Specialist in Renal Nutrition (CSR)
• Certified Specialist in Oncology Nutrition (CSO)
• Certified Specialist in Obesity and Weight Management (CSOWM)
• Certified Specialist in Sports Dietetics (CSSD)
• Certified Diabetes Educator (CDE)
• Certified Nutrition Support Clinician (CNSC)
• Certified Lactation Counselor (CLC)

There are also certificates of training available for RDs to obtain through AND on topics such as food allergies, vegetarian nutrition, and leadership. Additionally, you can tailor your continuing education credits to an area of interest or join a Dietetic Practice Group (DPG) to further establish your specialty.

Finding your first position as a RD can be overwhelming. Your best bet is to find one that provides a broad experience, such as a clinical role at a hospital. This will allow you to practice working with a diverse group of patients and establish baseline knowledge before moving on to something different.

Jobs that build general strengths, such as communication skills and public speaking, are beneficial for entry level RDs. It’s important to avoid taking jobs you know aren’t a good fit, while also keeping an open mind.

You might tell yourself you’ll never work in a certain area, such as foodservice management, but end up working in that setting for several years. It’s a given that you never know what you could end up enjoying and succeeding at.

As an entry level RD, it’s important to be patient with yourself as it may take a while for you to master your routine in your chosen setting. If you start as a clinical RD, you may spend a significant amount of time at the beginning reviewing medical records and charting until you feel more comfortable with it.

In your first RD position (and every position), you should prioritize understanding the “big picture” functions of the organization you work for. Learn about the foodservice operations of the hospital where you’re doing clinical work, or how health outcomes impact the budget within a community organization. Doing this will help you succeed at working towards the common goals of your employer.

After you’ve obtained your first RD job, there are a few steps to take to help find your place in the field. First, networking with other RDs and professionals is incredibly important. Not only is networking helpful for learning about new jobs, it also has the potential to connect you with learning opportunities.

Joining your local AND chapter is a great way to get started with this. Finding a mentor, such as an experienced RD, is also recommended. A mentor can answer your questions about the profession, help assess your professional strengths, and coach your career growth.