Most of us would be hard-pressed to go a day without thinking or talking about food and nutrition. After all, everyone needs to eat. But what about those who want to make nutrition their career? In honor of National Nutrition Month, we’re exploring the world of registered dietitians (RDs): what it takes to become an RD, what sets them apart from other similar-sounding specialties, and how the field of nutrition is changing and adapting to new healthcare challenges.
For this two-part series, we interviewed Dr. Khursheed Navder, a professor and director of the nutrition program at Hunter College in New York City, where she oversees the undergraduate, graduate and dietetic internship programs. She created the master’s of science in nutrition curriculum at Hunter and has worked to provide unique pathways for inner-city students to pursue a full-time nutrition education. She has been a recipient of the Outstanding Dietetic Educator Award from the Academy of Nutrition and Dietetics and she has held several elected positions within the Academy and the Commission on Dietetic Registration. Read the first half of our interview here.
Can you tell us about the requirements and the process for becoming a registered dietitian? If someone wants to go into the field, what can they expect?
There are two main options for students who are pursuing the RD credential. One track is where the didactic (meaning “educational” or “instructional”) coursework is completed first, and then they go through a dietetic internship where they complete another 1,200 hours or so of supervised practice. Then, they are eligible to sit for the RD exam. The second track is where both the didactic and the internship components are coordinated, and these are relatively shorter programs. One thing to note is that to date, the entry into the profession is at the undergraduate level. One only needs an undergraduate degree, and the coursework is to be completed at the undergraduate level to sit for the RD exam.
What are some of the challenges or misconceptions that there might be about dietitians or nutrition science?
One major challenge in our field is that RDs perceive that they do not command enough respect, recognition, and are not really rewarded for all the education that they go through. This has been a persistent issue in our profession. One way we at Hunter have tried to go around this is by elevating the educational preparation for these RDs to a graduate level. When we look at all the other healthcare professions, whether it is physical therapy or OT (occupational therapy), all have increased their entry-level education to a master’s or even to a professional doctorate, and we have seen that further level of education has resulted in greater respect and [helped] their credentialed members to feel much more valued as members of the healthcare team. At Hunter we’ve moved our didactic program to a master’s level. We find that when these students are educated at a graduate level, they have higher self-esteem and they are able to have better critical thinking skills, are much more mature, much more competitive and are better respected in their areas where they are working. Hunter has been at the forefront: we are one of seven programs out of the total 215 programs that have moved to educating the prospective RDs at the graduate level.
Another issue that we find challenging is that most of the research in our profession is done by MDs. We all know that research is the backbone of any profession, and when we do not have registered dietitians contributing to new research, that is a big issue. This ties back to the preparation that most RDs receive, which is at the undergraduate level. Research is not emphasized at the undergraduate level and so they lack sufficient knowledge of statistics [and] they lack hands-on involvement in research during their training. At Hunter, by moving our preparation to the graduate level, our students are getting the research preparation that will serve them well when they go out in the field. They are able to not just discuss research, but also contribute to new research in their job settings.
What are some other challenges? There is a lot of quackery in our field and that is because most people feel just because they eat every day, that makes them experts in nutrition. We’ve got to make sure that the registered dietitians are the ones who should be disseminating the nutrition information out there. Another issue is you will hear that medical doctors should be receiving more nutrition education, because many consumers are going to seek nutrition advice from their physicians. And while I agree that it is important for the physicians to understand some baseline information on nutrition, they need to know when to refer their patients to someone who has much more expertise in nutrition science. And that is the RD.
What do you see as some of the emerging topics that are coming up for RDs, or developments or changes in the future?
As our profession starts elevating the education and starts preparing the students at the graduate level, we will find that RDs will be better prepared to meet some of [the] challenges, whether it be the microbiome or genetic and genomic nutrition counseling, or whether you talk about personalized medicine. All these emerging topics will require the RD to be better trained at the graduate level with elevated science preparation so that they can meet the challenges of understanding and translating the medical science into research and practice in the 21st century.
I would like to see the future RD serve as a family dietitian. Just like we have family practitioners, I would love to see the future where people would go, say, twice a year for a regular check-up to their family dietitian. The RD would have access to their genetic profile, they would have detailed accounts of their diet and medical history and would perform routine checkups, including reviewing blood work and the microbiome analysis. All this could be combined into a customized and tailored diet prescription. Does this sound far-fetched? I sure hope not.
Before we go, is there one bit of advice that you could give people who are interested in becoming an RD or RDN?
I would tell the prospective students that they should not get too concerned by all the science prerequisites, because a lot of them who enter from non-science majors, whether it is music or finance or social sciences, should not be put off by the sciences. Take the basic prerequisite sciences and jump into the field because if they want to work in a health-related profession, if they want to help improve the health and the welfare of individuals and communities, then really this is the profession for them. The Bureau of Labor Statistics says that the employment for registered dietitians is looking good. It is going to grow over the next ten years at a much faster rate than average for all occupations. It is a very satisfying career and there are many new avenues for people with the RDN credential to work in the healthcare area.