My patients and colleagues ask me that question almost daily!
I am a registered dietitian (RD), which also makes me a nutritionist. It’s fitting that I start my blog on this confusing topic on RD day! Here’s what a typical journey to becoming a registered dietitian is like.
Education:
A minimum of a bachelor’s degree at a US regionally accredited university or college and course work accredited or approved by the Accreditation Council for Education in Nutrition and Dietetics (ACEND) of the Academy of Nutrition and Dietetics (AND) must be completed. My journey began in Rutgers University, where I completed most of the accredited course work with my fellow pre-med, pre-nursing, pre-pharmacy, and almost all other pre-healthcare professionals students. At Rutgers, I learned that dietetics is an art that combines the science of food, nutrition, and health.
Dietetic Internship:
An ACEND-accredited supervised practice program, also known as the dietetic internship (DI), must be completed. Students apply to a traditional DI program, distance program, or dual DI and master’s degree program. The practice program aka internship (which by the way is almost always UNPAID), runs between 6-12 months, depending on the type of program. The master’s degree with the DI (or dual program) may last 2-3 years.
The DI will cost time and money! There is tuition and fees to attend (almost all) of these programs. The total costs vary between programs. The DI program is VERY competitive and is done by a computerized match process (similar to MDs or pharmDs when they apply to their residency programs). In the past few years, the match rate has been discouraging due to the shortage of available internship spots and programs around the country. But, congratulations to those who matched and good luck! For approximately 1 year (depending on the practice program), their lives will be on hold and the grueling practice program will be their first (if not, only) priority.
My dietetic internship was completed from the School of Health Related Professions at Rutgers. During the internship, students complete at least 1,200 total hours of supervised practice and gain experience in the three areas of dietetics: clinical dietetics [medical centers setting such as ICU, medicine, surgery, etc], community dietetics [ambulatory setting such as outpatient dialysis, diabetes, or cancer centers; corporate wellness; health fairs; food pantry; WIC, etc] and food-systems management [working beside chefs, kitchen staff, and foodservice managers and purchasers to plan, prepare, cook, budget or purchase food supplies]. Depending on the internship program, they may also offer additional experiences in research, sports nutrition, or other areas.
RD Exam/RD professional:
Once students complete an accredited DI and the Verification Statement has been obtained from the internship director, they may sit in for the national board registration examination (as with any other healthcare professional). The RD exam is administered by the Commission on Dietetic Registration (CDR), which is a computer-based exam that covers the three major areas of dietetics: clinical, community, and food service. Once students pass the RD exam, they obtain the credentials “Registered Dietitian” or “Registered Dietitian Nutritionist” after their names. At least 75 hours of approved continuing professional education within a specific 5-year reporting period must be completed in order to maintain the credentials.
Specialization/Certifications:
Many RDs or RDNs have certifications in specialized fields such as sports (CSSD), pediatrics (CSP), renal (CSR), oncology (CSO), or gerontology (CSG). The certifications are awarded through CDR, the credentialing agency for the Academy, and/or other medical and nutrition organizations and are recognized within the profession. The eligibility criteria includes maintenance of the RD status with CDR for a minimum of 2 years and documentation of a minimum number practice hours as an RD in the specialty area within the past five years.
There are other certifications or specializations that are interdisciplinary. Two common ones are: Certified Diabetes Educator (CDE) and the CNSC (Certified Nutrition Support Clinician). The CNSC is credentialed by the National Board of Nutrition Support Certification (NBNSC), an independent credentialing board established in 1984 by the American Society for Parenteral and Enteral Nutrition (ASPEN). National Certification Board for Diabetes Educators (NCBDE) is the independent credentialing board for the CDE.
Optional RD title:
Note, the new credential name, Registered Dietitian Nutritionist (RDN), was approved for optional use in 2013 by the Academy of Nutrition and Dietetics’ Board of Directors and the Commission on Dietetic Registration. So, when you see the credentials RD or RDN at the end of our names, it means the same. The optional re-branding was to help more accurately reflect to consumers who registered dietitians are and what they do and emphasize that: all registered dietitians are nutritionists but not all nutritionists are registered dietitians.
RD vs Nutritionist:
The word “nutritionist” is not regulated as “registered dietitian or registered dietitian nutritionist”. RDs or RDNs have specific education and professional requirements and scope of practice. A nutritionist is a broad title and is not generally protected. A nutritionist may be someone who completed an undergraduate degree or graduate degree in nutrition. They may be someone working as a research scientist, a health and wellness educator, or a professor at a university. The scary part is that a “nutritionist” may also be someone with little or absolutely no training in food, nutrition, or health.
State regulatory laws:
Many states have regulatory laws (of varying degrees) for dietitians and nutrition practitioners. There are 46 states in the US that have legislation regulating the practice of dietetics. New Jersey has no state legislation for dietitians or nutrition practitioners. State licensure and state certification are entirely separate and distinct from registration or certification by the Commission on Dietetic Registration. State requirements are frequently met through the same education and training required to become an RD or RDN. This means that if you are an RD or RDN, you will only need to fill out some paperwork and pay the fee to abide by your state’s regulatory law for dietetics.
So, long story short: am I a nutritionist? Yes! But be cautious with that word (nutritionist) because even you or your pet may be a nutritionist (depending on where you live).
Sources:
Information about the practice program: http://www.nutritioned.org/registered-dietitian-schools.html
Information on the match process: http://www.eatrightpro.org/resource/acend/students-and-advancing-education/dietetic-internship-match-students/top-10-questions-about-computer-matching-for-dietetic-internships
Information regarding the examination: www.cdrnet.org.
Information on state laws: http://www.nutritioned.org/registered-dietitian-certification.html.
Information on CNSC: http://www.nutritioncare.org/NBNSC/Certification/Certification_Main_Page/
Information on CDE: http://www.ncbde.org/
To find a dietitian near you: http://www.eatright.org
