by Chelsea Brown
Neurology: the science of the nerves and the nervous system; especially the diseases that affect them. That definition could not have prepared me for what was coming in my first two weeks of rotations as a dietetic intern. No definition can prepare me for my experiences as a dietetic intern during the next 40-plus weeks.
Just to fill everyone in, to get into a dietetic internship we had to first complete a didactic program in dietetics. These are found throughout the United States at various universities of all sizes. At my particular university, the University of Arkansas, I was required to complete 27 hours of hard science classes and labs and 52 hours of nutrition classes, which is no easy feat. On top of that, most dietetic internship programs suggest a 3.4 grade point average or higher to be competitive for a spot. So, we had to take tough classes and do well in them for a shot at an internship.
The internship is a match process. Each person submits a generalized application and a resume. He or she also submits a personal statement, letters of recommendations and anything else required. Our professors encouraged us to apply to at least three to seven internships, all of which varied in application fees, admission forms and acceptance criteria. Once I submitted my applications, like all other applicants, I waited and waited, for six weeks, hoping for an interview.
After the rigorous interview process, I waited to find out the match. Match day is the same for all dietetic internships in the country, thus some 5,500 students and dietetic internship directors are trying to obtain the results at the same time. The anticipation of getting into the website (which locks out every year on match day, April 1 this year) and the prayers made that I matched to my first choices (or any choice) are consuming.
There are only 240 dietetic internship programs nationally, taking anywhere from two to 30 interns, equating to about a 50 percent match rate for all those who apply. The 50 percent who don't match must wait to re-apply for the next match (6 to 12 months later depending on programs) or find an alternative profession to pursue — good-bye nutrition degree earned in college. Candidates must successfully complete a college didactic program in dietetics and a post-graduate internship before qualifying to sit for the registered dietitian (RD) exam. Without the credential of an RD, you cannot legally provide medical nutrition therapy in most states and cannot be hired as the nutrition professional at most Joint Commission on the Accreditation of Healthcare Organizations accredited agencies or agencies who accept Medicare/Medicaid.
Even after the waiting and all the stress, when I logged on and saw that I got my first match at MUSC, I was nowhere near prepared for what was coming in rotations. Ten of us were accepted into this dietetic internship; we were the top 10 of more than 150 candidates that applied. We are from S.C., Arkansas, Georgia, New York, Ohio and Illinois. We are here with the hope to be RDs, experts in our field, studying to better the understanding of nutrition in healing and striving to help better the lives of the patients we serve. We do 25 to 30 different rotations during a 10-month period to learn everything we can find that defines nutrition and gain more than 1,200 hours in clinical observations. I will be the first to admit that there is nothing easy about the next 10 months.
My first two weeks of rotation were in the neurology/neuroscience floors and the neuroscience ICU. Having never stepped foot on a hospital floor for anything more than dropping off a patient tray, I was in for a rude awakening. The neuroscience ICU (NSICU) is easily one of the most intense locations to start learning about nutrition in healing and actually seeing it in practice. There is a continuous flow of patients, most of whom cannot talk and may never be able to carry on a conversation as they used to.
Beds are never empty in the NSICU, so much so that a second NSICU is being built. Patient nutrition is crucial for quick healing as well as for hope of continued brain function. My first preceptor was quick to remind me to keep a level head in the midst of the chaos in order to be effective as a dietitian, which is a lesson I will take from her to the rotations of the future..