My 6 Tidbits of Advice for Dietetic Interns

Last year, before I started my Dietetic Internship, a girl in the class above me reached out to provide some advice and answer any questions I had about the dietetic internship that I would be starting.

She told me, “You will learn more about what you don’t like, rather than what you do like during the internship”.

This didn’t faze me as earth shattering advice at the time, but let me tell you, when 5 months of clinical rotations had passed and I couldn’t name a single area I really enjoyed, nor could I ever envision myself being a clinical dietitian, that advice was life saving. I still had a few moments of panic (I knew I still wanted to be a dietitian, but suddenly I had no idea what I wanted to do as a dietitian), but knowing that it is okay to not enjoy parts (or whole chunks) of the internship was very reassuring. There are so many areas of dietetics that you may not be exposed to in your internship, so there is still so many other opportunities to find where you fit in. And don’t worry- I’m still trying to figure out what that niche is for me.

Anyways, since I received that invaluable piece of advice prior to starting my internship, and now having completed an internship myself, I thought I would share a few pieces of advice for any RD2Be’s out there.

  1. Going along with the advice I was given, I would tell people to find an internship with tons of different rotations/areas of experience – especially if you don’t really know what area you want to go into. I worked in more than 25 different clinical areas during my internship, and although a didn’t love any of them, there were definitely some I liked more than others and I discovered interests that I didn’t know I had. Even if you do have a specific area of interest, gaining experience in a number of different fields will make you a better dietitian all around.
  2. Practice what you preach as a dietitian. Dietetic internships can be extremely busy and stressful, especially if you are also completing as masters degree at the same time (like me). It can be easy to slack off, skip workouts, and order pizza for dinner, but as future RDN’s, we all know that those choices aren’t the best for our physical or mental health. Make sure you have plenty of fruits and veggies to snack on and especially get a solid 7-8 hours of sleep every night.
  3. Ask lots of questions! I was terrified starting my first rotation because I felt like I didn’t know enough. Guess what…you aren’t supposed to know everything – that is why you are there. I never had a preceptor who wasn’t willing to answer my oodles of questions – especially regarding areas of nutrition that I didn’t learn a lot about in undergrad.
  4. Similarly, take advantage of all the knowledge your preceptors have to offer. This goes for nutrition knowledge (again, ask questions!), but I also liked to pick their brains about life and career advice. They all landed a job as a clinical dietitian and most had other jobs and experiences prior to their current job, so they have lots of valuable information to offer about careers in dietetics.
  5. I know I probably don’t have to say this to a bunch of type A, aspiring dietitians, but say on top of your work and manage your time well. I guess this mainly goes for interns who are also getting their masters at the same time (like I did), but you definitely don’t want to fall behind and let the workload pile up. Start your assignments early, chip away at them every day, and you will definitely still have time to enjoy life!
  6. Finally, your internship is the greatest study tools and experience to prepare you to be a dietitian. I remember worrying during the first few weeks of my internship that I needed to start taking notes or studying for the RD exam (this was when I still had 11 months of internship ahead of me!). Now, having passed the RD exam, I can confidently say that there is nothing to worry about. Those 1,200+ hours spent working during your internship aren’t for nothing and prepare you very well to be a dietitian and pass your exam.
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I’m a Registered Dietitian!

Wow, the past few weeks have felt like quite the whirlwind! I finished up the last of my four weeks working as the pediatric ICU dietitian, graduated from my dietetic internship, studied hundreds of pages of dietetics information, made and learned oodles of flash cards, and took (and passed!) the Registered Dietitian Exam yesterday!!

I am officially Dana Goldberg, RDN!

(Not to mention, this is also my 100th blog post!)

With all of these milestones comes lots of self-reflection and things I want to share about my experiences, so first I thought I would use this post to share my thoughts 1-week post- dietetic internship.

I’ll start off by saying that these past 11 months have been some of the toughest months of my career as a student- both academically and mentally. Taking almost a full graduate degree course load and working 32 hours a week as an intern sometimes made me want to pull my hair out, but I am proud to say that I successfully made it out alive. There aren’t many things that I am ever really proud of myself for; it just isn’t my personality and I tend to be pretty hard on myself. Graduating high school didn’t faze me (I was livid and embarrassed when my mom tried to put a congratulatory sign on our lawn), graduating undergrad kind of seemed impressive (but everyone around me was also graduating college so I didn’t feel like it was that special), but I will confidently say that I am proud to have completed a dietetic internship and passed the RD exam. It feels like the hardest part – the uphill climb – is over and I can finally catch my breath.

I know I have shared this in a few previous posts, but I honestly didn’t love my time working at a hospital as a clinical dietitian. I didn’t feel like I really made any lasting impact on patients’ lives nor helped improve their long-term health. However, spending over 1,500 hours 27 different areas of the hospital, plus working with over 35 different dietitians, I learned so much about clinical nutrition that will set me up for success in any nutrition field that I end up going into. Although I dreaded walking into that hospital some days, I don’t think I would have wanted to do it any other way.

Finally, I can’t talk about my experience as a dietetic intern without mentioning my staff relief rotation. During the last four weeks of the internship, each intern got to choose an area of the hospital where she would act as the dietitian. We still had a dietitian to co-sign our charting documents, but we were basically on our own as if we were the sole dietitian covering that area. I chose to spend those four weeks in the pediatric intensive care unit (PICU), and it was my favorite four weeks on the entire internship. I chose the PICU because I found I enjoyed all of the enteral and parenteral nutrition (nutrition via tube feeds and IVs) calculations in the ICU setting. I also went into my internship wanting to work with kids – and especially enjoyed my pediatric rotations during the internship. The first week of staff relief was absolutely terrifying but by the end, I felt like I had the confidence to go out into the field and be a dietitian (which was very reassuring!). Also, I have to give a huge THANK YOU to the PICU dietitian and my staff relief preceptor Melanie for teaching me more than I thought I would ever know (and also making me laugh every day – even when I was working with kids who were critically ill).

Now, one week since the end of the internship, these are my main thoughts, but I’m sure as time goes by I will have more thoughts and reflections to share.

If you are a current RD2Be, dietetics student, or dietetic intern, be sure to stay tuned for my posts over the next few weeks because I’ll be sharing my dietetic internship and RD exam advice. Feel free to send me all your burning questions and I can answer them in my posts 🙂

Artificial Sweeteners: Not so sweet after all

The next time you are about to tear open that yellow, blue, or pink packet or reach for a diet beverage, you may want to think twice. Throughout the 1900’s, artificial sweeteners seemed to be the miracle food – all the delicious sweetness people enjoy, without any of the sugar or calories. But now this “miracle food” might not be such a miracle after all. Recent research has been showing that these artificial sweeteners may be doing more harm than good!

One study of over 400,000 people found that, even though artificial sweeteners don’t have any calories, they did not help people lose weight. In fact, they found consuming more artificial sweeteners lead to weight gain and obesity, diabetes, and heart disease.

How could this be possible? Less calories should mean more weight loss, right? Well, just because the sweeteners aren’t providing any calories, doesn’t mean we aren’t getting more calories elsewhere. One Harvard doctor explained that artificial sweetener consumption could cause overstimulation and desensitization of our sugar receptors, which causes people to crave sweeter and sweeter foods. It can also end up making un-sweet foods (such as vegetables) unpalatable. These sugar cravings and vegetable aversions lead to people eating more sugary and high calorie foods, which cancel out any reduction in calories from using artificial sweeteners.

Also, remember the gut microbiome I talked about in my post about Probiotics? Well, researchers found artificial sweeteners can change your gut bacteria…and not in a good way! The sweeteners increase the number of Bacteroides, an “energy hoarding” bacteria species that make it nearly impossible to lose weight. Other changes in the microbiome, caused by artificial sweeteners, make it more difficult for your body to breakdown sugar – leading glucose intolerance and diabetes.

If you are looking for any bright sides, using artificial sweeteners in place of sugar can decrease likelihood of cavities and tooth decay, and while there is a lot of hoopla around artificial sweeteners causing cancer, there haven’t been any concrete studies to prove this. But! We only have short-term studies…we don’t really know what the effects of long-term use are.

In the end, regardless of weight gain, cravings, and diabetes, artificial sweeteners are, well, artificial. I don’t know about you but I would rather avoid putting artificial chemicals in my body and stick with the real stuff (in moderation, of course) if I had the choice.

Career Confusion

Unfortunately, if your looking for helpful nutrition information, this isn’t the post for you. Instead, it is only an update on my unknown future career plans. But don’t worry, I’ll be dishing up some more advise in my future posts.

I am officially passed the halfway point of my Dietetic Internship! I am currently in my renal (kidney) rotation in a dialysis unit, which is fine…nothing special. I still have critical care, pediatrics, and oncology rotations this semester.

Recently, though, I have been struggling a bit. As I have said before in other posts, I haven’t really loved working in the hospital. I haven’t felt like I make any meaningful connections with patients and most of them don’t seem to care at all about what I am talking to them about, which I totally get – I don’t think that if I were sick in a hospital I would really care about how much salt was in my food or if I was getting enough protein.

I did enjoy my outpatient rotations much more than working in the hospital, but something still wasn’t clicking. I think I almost convinced myself I liked it because that it what I had always pictured myself doing. Do I still see myself doing some nutrition counseling? … Yes, it is definitely something that is still interesting to me, but I am not sure that I can picture myself doing it as a full-time job.

I am very happy I am learning my likes and dislikes now and not later, but you can see why I am confused now. I feel like the college sophomore that realized they didn’t like their major and is trying to figure out what to do. From the time I declared my nutrition major freshman year in undergrad I always saw myself being a Clinical Dietitian, and now I am realizing that is not really the path I want to go down.

Thankfully I have tons of supportive advisors and professors at school that are willing to help me figure out what I want to do. Maybe it is working in industry (for a cool, healthy food company), teaching at local colleges, traveling with an international health organization, working in media or social media, or doing a job that I don’t even know exists — I am exploring my options.

So for now, we will see where the next year takes me. In the mean time, if anyone has any nutrition career suggestions… my ears are open!

Summer Plans and Future Blogging

As promised, I am back with a summer plans update. (If you want to know what I have been up to the past 5 months, check out my last post.) Being that my Dietetic Internship (DI) starts August 7, my summer is cut a bit shorter than usual…and it is probably my last summer ever since my DI/grad school will run from August 2017-December 2018 without much of a break. That means I am planning to have a very exciting and busy summer, hopefully with some relaxation involved too!

If you know me, you know traveling is obviously #1 on my to do list. Here are the plans so far:

  • Two days after commencement, my family is going to Peru for 10 days of adventure
  • We have a long weekend in New Jersey for my cousin’s graduation
  • A girls, long weekend trip planned in Chicago with my mom and cousins
  • My grandma and I are spending a week in San Francisco and Napa in July
  • I have a trip to Boston in the works with a friend
  • And hopefully I will also be able to squeeze in a weekend visit to see my friends in Cleveland and Columbus

I’ll also be working and coaching gymnastics here and there, cooking up some new recipes in the kitchen (my goal is to make 1-2 new recipes each week, which I will share…if they turn out well, of course), trying new Detroit restaurants while I am home, and getting ready to move into my first solo apartment. I will be living in Downtown Cleveland for the duration of my 18-month program. I am excited to not only live downtown close to all the good restaurants (obviously food is #1) but also experience Cleveland from a new angle. Since I want to move to Downtown Detroit when I graduate, I think this will be a great way to make sure I enjoy living in a growing urban area.

This brings me to my plans for future blogging. Part of the reason I took a little break from blogging is that I started to run out of ideas. Between gathering images, information, and trying to figure out what the lesson from each post should be, it was just a little too time consuming and began to feel like a chore.

With that being said, I still love writing these posts and sharing my experiences with you. That means, I am still going to be posting (hopefully even more now!) but the posts won’t be so much about sharing information and research or trying to teach a lesson. I will probably be writing more about healthy (and yummy) new things I find at the grocery store, healthy and cool new restaurants I try, and my travel adventures (which obviously will include a lot of food). I’m sure there will still be tips for making healthy choices and probably some interesting food facts here and there, but those won’t be the focus of the posts.

Honestly, I’m not sure how it is going to work out so I guess we will find out together 😉

Dana

Back & Better Than Ever

I guess senior year got the best of me and The Lemon Wedge took the back seat. But no worries, I am back to blogging. I thought I would use this post to update you on what I have been up to this last semester and what I have planned for the future.

As I have talked about before, in order to make my dreams of being a Registered Dietitian (RD) come true, I have to complete a Dietetic Internship (read more here). Soooo last summer and fall took the GRE, narrowed down the list of programs I would apply to and began working on my applications. The process to apply is similar to a residency after medical school where you apply to many programs but are only “matched”/accepted to one program (or you don’t match at all and have to reapply the next year). Deadline for applications was February 15th so I kept busy over winter break and the first few weeks of my semester writing, revising, and re-revising my personal IMG_7271statements over and over and over again until I could practically recite them to you by heart. Finally, on February 14th, with trembling hands, I clicked the infamous “submit” button. From there, it was a big waiting game until “Match Day” when you find out the results.

I ended up applying to 6 different Dietetic Internships, all which were combined with a Master’s degree program: University Hospitals (Cleveland), Veteran’s Affairs Hospital (Cleveland), Cleveland Clinic (Cleveland), Ohio State (Columbus), Rush Medical Center (Chicago), and Tufts Medical Center (Boston).

Finally, Match Day (April 2) rolled around and at 7pm on the nose I logged into my online application to find out that I had matched with my first choice- University Hospitals (Cleveland) and I would stay at Case Western Reserve University to get my Master’s in Nutrition! It was quite an exciting day and I felt a huge weight lifted off my shoulders…I was officially and “RD2Be”!

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Celebrating with Tacos and Sangria

In other exciting news from this semester:
-I had my first research paper published in the Current Nutrition Reports journal. It was a paper that I co-authored as part of my independent study class last semester about dietary supplement use in older adults.

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President Snyder and I 🙂

-I also was selected to be one of the students who decided which professor at the university receives the Excellence in Mentoring award. Being on this committee got me an invitation to Barbara Snyder’s house for a fancy reception…exciting!! (She is the president of the university and basically a celebrity around here!)

That brings us to today. I am currently writing this blog post, as it seemed like a great way to procrastinate studying for my last final exam as an undergraduate (#senoritis). I have one last exam in Pathophysiology next Wednesday before I am done. Then there is a week and a half of lots of food and fun activities with my fellow graduating seniors before commencement.

Now that you are up to speed on the past 5 months, and this post is getting long, I am going to call it quits here. I should get back to studying, but in the next few days I will be writing another post about my summer plans and my future plans for The Lemon Wedge.

Glad to be back!

Dana

What I Learned From Losing My Fitbit

Last week, I had a very traumatic event happen…I lost my Fitbit (okay, maybe traumatic is an exaggeration but I digress). Thankfully, my mom had one that she didn’t use at home and could send to me at school. Still, this left me Fitbit-less for about a week. One day that week, I had the strangest thought while walking to class. I felt like walking wasn’t worth anything because I had nothing to show for it (ie. No big green star at the end of the day when I hit my step goal). I quickly had to shake myself out of that crazy thought. It blew my mind that losing this little piece of technology and not being able to see how many steps I had taken made my walking feel useless.

I did, though, get a good lesson out of this crazy thought of mine: My life is constantly a numbers game: how many steps I take, how many ounces of water I drink, how many calories I eat, how many minutes I exercise for, and the list continues. I can have a few OCD tendencies at times; I like to keep track and make sure everything is neat and organized and I guess counting all these things can bring a little bit of organization to my life. Even if you aren’t someone like me who is obsessed with counting steps, calories, minutes, and ounces, it seems like that is what we are recommended to do. The US Food and Drug Administration recommends we consume about 2.5 cups of vegetables, 2000 calories, 5.5 ounces of protein, and 64 ounces of water each day.

My point is that we are a numbers and counting driven society even though that is not the recommended way to lose weight or create a “healthy” diet. Counting and recording everything has been proven to be an ineffective way to have long-term weight loss – it is just not a sustainable behavior. Instead, listening to your body and making logical decisions about what and when to eat and exercise is the best way to go. This crazy thought during my Fitbit-less walk showed me that I need to do a better job of just listening to my body and not worrying about the numbers- especially when it comes to physical activity.

Is your stomach growling? Go get something healthy to eat. Are you full? Stop eating- you don’t have to finish everything on your plate. Craving chocolate? Break a few squares off of the big bar, enjoy them, and leave the rest for later. The same goes for exercise. Sitting at a desk all day? Get up and go for a walk. Sore muscles and exhausted? Take a rest day. Feeling unmotivated? Remember that exercise will make you feel better so go get it done!

Your body knows exactly what it needs, you just have to learn how to listen and understand the cues it gives you. I know it isn’t as easy as it sounds. It takes time and work to be “on the same page” as your body. Setting number driven goals (like 10,000 steps per day) might be beneficial to working towards a target weight or activity level, but in the end, it is all about how you feel. Whether you meet those goals or not, if you aren’t feeling good all the calories and steps you counted don’t mean anything. You should always try to feel healthy, not hungry, tired, or deprived.

Dietetic Internship Search Update
The beginning of senior year means the hunt and application process for a Dietetic Internship (DI) has begun. A DI is a 1200-hour supervised practice program a student must go through to in order to sit for a board exam to become a Registered Dietitian (read more about the process here). I am looking at DI’s that have a master’s degree program combined, so that narrows down my options but there are still lots to choose from.

Step one in applying to any of these programs is taking the GRE (Graduate Records Exam), which I just took in August. I got my scores this week and thankfully I did well enough that I don’t need to take it again!

The next steps are figuring out exactly where I am going to apply and starting my personal statement. Stay tuned for more DI updates 🙂