Recommendations from a Dietitian to a Dietetic Intern

Compared to other health professions, there is a low presence of dietitians out there to provide an account of what to expect during didactic programs, internships, and the profession itself. When I started my programs, both as an undergrad and as an intern, I felt like I was going into the great unknown because I didn't know anyone else that had been through it and the internet space for dietitians was silent. It was a big part of why I started Notable Nutrition, to share my experience as a student and professional as well as to help others have some expectations about what lies ahead.

All internship and graduate programs will vary in their rotation and class offerings, but they must meet a set of standard requirements to be accredited. No matter the type of program you are attending, here are 5 recommendations I would give to dietitian students starting their internship programs this fall.

Be Curious: the opportunities to focus solely on learning and exploration of a wide variety of populations happens only during an internship and clinical practice hours, so take advantage of it. Once you land a job, you may be working in only one area consistently or you may land a float position that allows you to practice in a wide variety of areas, but you will then be required to complete all patient care tasks including care coordination and patient advocacy which takes a lot of time. As an intern, your sole job is learning and practicing. This is a great time to soak in as much as possible, explore areas of interest, and seek out opportunities that you may not easily have access to once you finish your program. Being curious is also a great way to help you get the most of your time as an intern. Ask questions; if you don't understand something, are wondering why a process is the way it is, or just want to know more, ASK. This can be beneficial to you and your preceptor. Your new perspective is valuable.

Be Aware of Strengths and Weaknesses: as an intern myself, and as a preceptor, I find it important for interns to be aware of their own strengths and weakness. While it may be uncomfortable, an internship program is the perfect time to round out your skills, learn to step out of your comfort zone, and work on your weaknesses. I ask my interns what they feel like their strengths and weakness are in order to learn how to best serve them. If you worked in a healthcare support role previously, speaking to patients likely isn't as scary for you as it is someone that has never been in a patient facing role before. Maybe you have never stepped foot in an ICU and it is terrifying, that's okay. It's better to be aware of that in order to be able to approach it in a way that sets you up for success. If you spent a lot of time working on counseling skills in undergrad but only spent 1 day learning about TPN, that's okay but knowing that will help your preceptor be able to find better experiences to support your learning.

Communicate Well: communication is an important puzzle piece for all relationships but it is especially important in education and in healthcare. Communicating clearly and efficiently with your preceptor will help you get the most out of your learning experience. For example, be open about the challenges you face, the opportunities you are looking for, and your own needs. Communicate if you have special interests and areas that you feel you may want to work in post-graduation. The dietitian community is small and it seems like everyone is connected one way or another. Communication = Networking. Communication is also very important for patient/client care. Ask your preceptor about the different communication styles they use with the populations AND multidisciplinary teams they work with. It can be a game changer for optimizing outcomes.

Explore Concepts After Hours: the longer you work in the profession, the more you will recognize that the more you know, the more you don't know. It is impossible for preceptors and professors to teach you everything there is to know in a short amount of time. Preceptors are also responsible for managing their full workloads on top of precepting which can limit teaching time on busy days. I LOVE teaching students, but it is helpful when students come to me with a background knowledge of the populations I work with. Typically I provide a "worksheet" with medical terminology, medications, and concepts to review prior to a student's rotation with me to help them familiarize themselves with the population. If that is not an option for you, I recommend reviewing previous MNT notes at a minimum.

One strategy I used as a student and continue to use as a practicing dietitian is taking note of new diagnosis, treatments, medications, devices, etc. that I might hear about during the day and reviewing them when I have free time. You don't have to become an expert, but becoming familiar with these will make you a better clinician. Nutrition is impacted by every body system, all types of physiology, and other care variables (like treatment burdens and timing for example), so being familiar with medical, pharmacological, and other treatment concepts is important. I know that being an intern is HARD. Between coursework, practice hours, and extra activities, it can seem like there is no time left in the day to complete an additional task that is not required. It is daunting while you are in it, but I promise you, the effort you put in will make your future easier, more fruitful, and more rewarding.

Recognize Your Privilege: it may not feel like privilege when you are working for free, so here me out. Being able to receive post-graduate education is a privilege that many locally, domestically, and globally don't have the opportunity to participate in. When I was working in a food pantry providing nutrition education as an undergraduate student, I had a participant tell me, "you can lose you home, you can lose family, but you can never lose your knowledge" and that was impactful. Soak up the opportunities you are being given. We take having this knowledge for granted, but it will not only help others that you care for, it may help you too. Aside from the privilege of education, there is also a huge privilege in working to care for people. Healthcare can feel thankless, overwhelming, and scary sometimes, but being able to care for people when they are in their most vulnerable, challenging moments is a big deal. Some people have jobs where the only thing that is impacted at the end of the day is the bottom line. Our jobs directly impact humans, their quality of life, their wellbeing, and the ones close to them. Keep that in mind daily when you are struggling to put in the work. It is both humbling and beautiful.

Being an unpaid intern after working so hard to be matched is hard, and it can feel like you are overworked and under appreciated, but it is important to recognize that you will get out of a program what you put into it. Remember that where you are now is where you wished you would be all throughout undergrad. The challenges put in front of you serve a purpose and are in place to make you a better practitioner. Mindset is everything. My principle in middle school would start off the school day with the quote, "make it a great day or not, the choice is yours" and while it's cheesy and cliche, it holds a lot of truth. You've got this!

I am an open book, if you are looking for further perspective, assistance, or insight on the profession or on being a student, feel free to reach out to me.