Is the Training to Become an RDN Enough?

"Too Linear"

I am so incredibly proud to be a Registered Dietitian-Nutritionist.  I worked very hard for that credential and couldn't be happier with my choice.  But lately I've heard the conversation brewing that attempts to attack the credential.

It is a very expensive endeavor to educate a dietitian.  I went through 4 years of college in a Dietetics program, and an MS/DI (Master of Science/Dietetic Internship) program.  [Please note that the MS is being phased into requirement but wasn't at the time of my completing it.]  During the Dietetic Internship I was paying to work 40-50 hours weekly in the hospital setting and completing mounds (trust me, mounds) of research, case studies, presentations, disease oriented worksheets and self-evaluations to check off all of the didactic requirements of the program.  It was a chaotic, exciting, and exhausting endeavor and I left the program with excellent yet formal scientific training.

On a phone call the other day with a fellow wellness professional, he informed me that he felt RDN's to be "too linear".  I actually totally understood what he meant.  Not to the detriment of our industry, but in order to build good clinicians in all aspects of healthcare you must first instill the ability to critically read research and practice guidelines, and apply those to a patient population in congruence with the most up to date best-practices.  The process of teaching that in a clinician is a rather linear process, ask any PA, MD, RN, or RDN about their education.  It is an essential foundation.  With that foundation, you can go on to use critical thinking, patient outcomes, and clinical judgment to craft your practice over the coming years.

I think where the going gets tough for RDNs is that the world of nutrition is rather difficult to study, has a lot of moving pieces in terms of lifestyle, is constantly evolving (let's face it: the sum is always greater than the total of its parts), and because at the core we're dealing with food and behavior change.

The Good

I feel that RDNs are the best suited professional to help the public understand the most up to date nutrition research, translate that into layman's terms, and apply it with practical and individualized advice.  We are able to take into account medical history, medications, allergies/intolerances, labwork, etc. to plan your care and give you the tools you need to succeed.

The Bad

RDNs get a very broad education in the arenas of clinical nutrition, food service management, and community nutrition.  Many programs lack in properly educating the RDN on business, marketing, public policy, communication and healthcare management.  There is a newer initiative being created by the Commission on Dietetic Registration that will go into effect over the next decade to create "advanced practice pathways" for more specialized residency programs and advanced board certifications.  This is a positive step - we can't be all things to all people in nutrition, honing in and becoming the expert on a smaller scope of topics makes more sense, and so does creating structured programs to do so.

The Ugly

About 45% of those that apply to programs annually get accepted.  The growth of educational programs can't keep up with the demand and so people are taking other paths to becoming nutrition professionals.  I think that ultimately this will sort itself out but in the meantime there are certifications that cost way less and take about 1/20th of the time (scary isn't it?).  RDNs have to work even harder to compete against professionals with an entirely dissimilar education.  I feel that there are some fantastic credentials available (such as in the integrative nutrition realm!) that make the RDN a stronger, well-rounded health care professional, but right now it is up to us to make it happen.