This past summer as part of my dietetic schooling I completed the first 480 hours of my supervised practice. To sit for the registered dietitian exam, one must complete a total of 1200 supervised hours and meet all the competencies set by ACEND. The program I am in at Chapel Hill is a Future Education Model (FEM) so some of our hours are built into the curriculum, but the bulk of them are completed during the summers. This program is a full 24 months, as opposed to some of the other MPH programs at UNC as the remainder of the supervised hours are completed during the second summer.
Traditionally the first summer students complete their clinical and foodservice hours. Due to COVID messing up the trajectory of many in the cohort above mine, many of us, including me, had to be a bit more flexible. So I completed my public health and advanced rotations this summer. And looking back, I’m so glad everything went the way it did. I had so much fun this summer and I truly believe things work out the way they are supposed to. I also see the opportunity to do clinical so close to when I will take my exam as a positive because much of the exam covers clinical nutrition. Obviously I will still study, but all that clinical information will be fresh. Without further ado, let’s get into the details.
Northeastern North Carolina
May 2021 – June 2021
I think the UNC program is a bit different in that they place students throughout the whole state within agencies that otherwise may not have student interns. I was randomly placed at a health department in Northeastern North Carolina. I had never been to the city I was placed. Going into this program I knew I’d have to do things that would help me grow as an individual and a professional. I took this opportunity and definitely made the most of it.
This was my first experience in an office setting. I’ve worked many different jobs since my first job as a lifeguard at age 16, but never in an office. I learned pretty quickly the whole 8-5 in an office really is not my jam. I think this was especially difficult after spending a year in my bedroom doing virtual grad school. I do appreciate the experience, and sometimes learning what you don’t want is just as important as learning what you do want. I did like the social aspect of working in an office setting.
For a majority of my rotation I was working in WIC. For those who don’t know, WIC is the special supplemental nutrition program for woman and children. I often worked with the WIC nutritionist in the office to learn about the program and observe the appointments. Due to COVID, all WIC appointments were still being conducted over the phone. This was not the only change to the program due to COVID. I learned about the many waivers that were in place and how things seemed to continue changing as the pandemic continued. Although I believe WIC is a great program that needs to continue, I do not see it being a part of my career as a dietitian. Everything related to WIC is pretty scripted and depending on the stage of life certain nutrition education has to be given. Thinking of the perspective of a participant, it may be frustrating hearing the same information over and over at each appointment, but continuing to schedule and attend appointments to adequately feed your children. Another critique of the program is the food benefits packages. This is the only supplemental food program that has set packages and you can only receive what is on your package. Especially with increases to other supplemental programs, many participants chose to use those programs because they can choose any approved food and it isn’t controlled.
One thing I though was cool about this health department though was a program for WIC nutritionists to go and pursue dietetics. I don’t know all the details, but the health department has struggled to get dietitians. So they decided they would help train some of their staff to be dietitians. This program does require a commitment to working at the health department after obtaining your RD credential. They’ve had I believe two people go through this program and were looking into the next person to put into that program. I hope that in the future more organizations start programs such as this.
When I was not in WIC I was most likely in diabetes clinic. Multiple days a week the health department hosted diabetes clinic. Many of the RDs on staff and a nurse also held the certification for diabetes education. In these appointments I again mostly observed. We saw a variety of patients. Some who were newly diagnosed and needing to learn how to use a blood glucose testing machine and others who had been diagnosed years ago. Personally I thought diabetes education might be a bit emotional for me as my grandfather has had diabetes and resulting complications of diabetes. When I was in diabetes clinic I had to constantly remind myself that not everyone wants to pursue health. Like it is really easy at this point for me to understand that a lot of people just don’t have access and can’t pursue health, but when people have access to services or education and don’t use that knowledge, that is difficult for me. I think that is something I will struggle with for a while as I start my career. Obviously the RDs I observed have done these appointments for much longer than I have, but coming from a public health standpoint I think we did not talk about accessing food and what is available to the patients as much as we should have. People that receive care at the health department meet certain income criteria that makes them eligible to receive care there and only on the initial demographics interview did food insecurity ever get discussed. I hope if I am ever in a position working with a similar population I will get more into that conversation and make potentially more reasonable recommendations.
Those were the two main clinics I worked with during this rotation. I did get to observe some education during the clinics high-risk maternity clinic. It is really unique that this health department has a high-risk maternity clinic, but due to the structure and the doctors volunteering their time, nutrition and other education were often missed. Because of this I only was able to observe a few of these appointments. In the ones I did observe we often used the time to ask if the mother was on WIC and if not getting her set up with the program. That was cool to see how all the clinics can work together and refer patients to the services they may need. I also sat in on a board meeting with all the managers. This was interesting and it occurred right before children were starting to be able to get COVID vaccines. Much of the conversation was related to the children getting vaccinated and how that would work.
Overall I had a good public health experience. For me, it was mostly observational and I would have like to have practiced my skills more. I will have other opportunities to practice these skills as I continue on this journey. Going in, I was nervous, I had never worked in a health department and I did not know what it would be like. The staff welcomed me, they ate lunch with me and checked in on me throughout the journey. I’m glad I have this experience, but don’t believe that public health and community nutrition will be a long term part of my career. I don’t want to say never, because life happens and things change, but the energy necessary to educate folks who don’t want to change seems like a lot to me.
With Morgan Sinclair
June 2021 – August 2021
The last six weeks of the summer I went remote. The advanced nutrition experience is really self directed and many of the competencies for this experience are related to leadership and collaborative work. Many people will do extra clinical hours if they are interested in clinical practice, or work with organizations they are interested in potentially working for in the future. I got so lucky because I got to work with Morgan Sinclair. I had been following Morgan on Instagram for a while. And then one day I was on her stories and she mentioned that she was finally ready to take on interns. It was like the stars aligned and I DM’d her so quick. And after some emailing and a conversation between Morgan, my program coordinator and myself it was decided I would intern with Morgan. In so many ways this was exactly the rotation I needed. So if you have a sort of self directed rotation and want to work with someone specifically here’s your little nudge to reach out to them and connect.
So I won’t go too much into detail about all the specific projects I worked on during this internship, but do want to give a broad overview. This rotation was essentially an entrepreneurship rotation. Through school and other rotations I feel pretty comfortable with nutrition information and knowledge, but I see myself one day owning a business. So I found a rotation with a dietitian whom I could gain some more business and entrepreneurship knowledge from. A lot of what I did was self study utilizing resources Morgan had either produced herself, or from businesswomen she looked up to. After completing some self study I would bring questions to our regular meetings and learn more from Morgan on the topics I had been studying. Some of the topics I learned about included email marketing, copywriting, crowdsourcing, women in the food scene and so much more. Then after learning about the topics I practiced what I learned and received feedback from Morgan. This worked well for me and I liked this way of approaching my advanced nutrition experience.
I also learned that although I was not a fan of remote schooling, I am a fan of remote work. Working remotely gave me the ability to visit some of my family and friends whom I hadn’t seen much since school started. I saw my nieces for the second time since they were born, coworked with my dad and step-mom in their condo, visited my grandparents all because I was able to work from my computer. I don’t think this will be my reality right after school, but I do hope this is my reality within a few years of graduating. It really does work for me!
Personally I am so grateful for this opportunity because none of this is in any dietetics curriculum. I feel like more and more dietitians want to open practices and become business owners and the system does not teach them how to do that. If you have an advanced rotation, or a rotation with some flexibility and you aspire to own a business consider working with a dietitian that has a business. This way you can learn more about business and marketing and all the other things you won’t learn in your classwork or other rotations.