Just a note – this is a post directed at systemic issues, and specifically the way my field is structured, and is not at all a complaint about the work I do currently, which I love – or about my readers and clients, whom I also love. It’s also an explanation of sorts for the media, who often mistake me for a dietitian. Many of my fellow dietetics students have expressed similar frustrations.
So, here’s the thing: I’m not a registered dietitian.
I know it’s confusing, since I have an accredited degree in dietetics, I’m a member of Dietitians of Canada (and formerly of the American Dietetic Association too, but they sent me too much shit in the mail from food and diet companies), I’ve received extra training through DC- and ADA-approved workshops, I’ve attended honest-to-goodness dietetic conferences, and I’ve worked in legit hospitals doing legit clinical nutrition stuff.
But, still, I’m not a dietitian – and I use the generic, mostly meaningless term “nutritionist” to describe myself.
What I am is someone who teaches people about normal, healthy eating.
I teach people to give themselves permission to enjoy food and eat enough to feel satisfied, to have regular, reliable meals, to find out which foods help them to feel good, to pay attention when they eat so that they can enjoy it and learn from it, and to learn to value healthy eating in its own right, because it feels good and makes one’s life better, without it being contingent on weight loss.
Here’s what I don’t do: clinical nutrition. I don’t assess, diagnose, or treat disease with nutritional therapies.
Sometimes my clients, people who want to learn the basics of normal eating, also have diseases with a nutritional component – diabetes, celiac disease, high cholesterol, etc. And I don’t refuse to work with people who have diseases, provided they receive diagnosis, support, and treatment for that disease from a qualified professional – who isn’t me.
Because I don’t practice clinical nutrition. So I guess it’s a good thing I never actually wanted to.
In October I graduated with a science degree that, without the attached RD behind my name, is essentially worthless in my field. I have spent the last nine years not only learning about nutrition at an accredited school, but working in nutrition at various hospitals, and, according to the way the profession is set up in Ontario, I have achieved nothing. I am qualified to do…nothing. Because I have not endured the professional hazing of dietetic internship.
I’m sure you can detect my bitterness.
I am, and always have been, a fan of the scientific method. I believe science is limited in what it can prove, but remains the best way we have to investigate the natural world. Is it perfectly objective? No, but only because it is practiced by hopelessly flawed human beings. But, battered as its practice has been by our nasty little biases, I still love it, and still believe it is the closest we can come to being objective, to learning whatever does exist of universal truth.
I’m a science girl, and a nutritionist in the lay sense of the word. I have a good education, good training, and good experience. The one thing I’m not is a registered dietitian.
When I refer to a dietetic internship as a “hazing,” it’s not because I believe dietitians are mean or evil. In my five years working in various nutrition departments at various hospitals, my bosses have always been dietitians, and I have loved, really loved, them – as people, as practitioners, and as scientists. Because that’s exactly what they are, despite hardly ever being credited as such.
But I’ve also experienced the necessary underbelly of that world. The conveniently gender-, race-, and class-stratified social and professional hierarchies of the clinic. The interpersonal tensions, the brutal systemic limitations, and even on occasion, the subtle violence of professional jealousy.
I had enough – I got my experience, learned what I could learn from the truly remarkable women whose decades of experience made me feel like a tiny speck in a huge, wondrous world; I took my lumps; I jumped through hoops; I got out so I could finish what I started.
Eleven years ago, I decided to study nutrition because I read a passage about normal eating from Ellyn Satter in the book Losing It by Laura Fraser. It was a revelatory answer to the question I’d asked myself – “How then shall I eat?” – and spent my time and energy searching out, only to find a cesspool of lies, disorder, unscientific thinking, and shameless contortions of logic. I decided then that this – teaching ordinary people to eat normally, based on sound science – was what I wanted to do.
Ellyn Satter was (and is still) a registered dietitian, and I wanted to do what she did – so I set out to become a dietitian and to learn about the science in the answer I’d stumbled upon.
Along the way, I figured out that I didn’t actually want to be a dietitian, nor did I need to be to do what I’ve wanted to do all along.
So in October, I walked across a stage and took possession of a hard-won piece of paper that made me…nothing. After spending a third of my life and tens of thousands of dollars on this project, I’m no one of consequence to anyone who matters professionally, and may eventually be called a quack and a charlatan because I do a job that hardly anyone in the world does – defending normal eating against the encroachment of a disordered, deeply classist culture, helping ordinary people pick their steps through the muck of anti-intellectual horseshit that is pop nutrition – and I do it audaciously without those two letters, R and D, behind my name.
Because I don’t have the resources, emotionally or financially, to spend a year doing hard, unpaid labour as an intern at the same hospitals that used to pay me by the hour for doing similar work. And maybe because I am troubled by the financial connections between the letter-granting organization and various food- and diet-industry concerns.
I have an education that makes me more qualified than most of the authors who write mass-market diet books – but because I’m not a dietitian, it doesn’t matter. I exist in the gray margins, professionally and scientifically – and our society does not do margins (or shades of gray) very well.
Do I think it’s unfair? Yes. Does it make me angry? Yes. But I accept it for now, because, thankfully, what I do and what I’ve learned still matters a whole lot to me. If you’re reading this, I suspect it matters to you, too.
So, until I figure out all of this big professional mess, I remain
Yours truly,
Not a dietitian.
59 Comments
well if i had the money to pay you to help me learn to eat normally again i would ma’am. i have been bulimic for over 15 years and am actually finally making a go at stopping. the thought occurred to me: i don’t think i have eaten breakfast since like 5th grade…and I’ve been skipping lunch as well since middle school. Registered dietitian or not, it was you and your articles that really led me into a place where i thought i could try actually eating. don’t think that just because you don’t have the letters behind your name, it doesn’t mean you aren’t making a difference.
Thank you, that means a lot to me. Although I think you’d be better off with someone who specializes in eating disorders, because I am truly not trained to treat those disorders – and because those people do exist! Either therapists or RDs, and they tend to be HAES-friendly.
Erylin:
I am currently a nutrition student and am working under a dietitian in a private practice specializing in eating disorders and intuitive/normal eating. She is awesome. Her name is Jennifer Pereira. You can visit her website at http://www.healthylifestylebalance.com. She is located in Arlington, Texas, but does Skype sessions with some clients who are out of state. Definitely schedule a session if you would like to chat with her about your ed. There should be a contact form on the website if you would like her to contact you about scheduling!
Michelle:
The information you provide on this site is outstanding and enjoyable for all that know, understand, and love the art of eating normally! Thank you for providing all that you do! There are not enough people out there that preach normal eating!
Erilyn:
I am a dietitian who specializes in eating disorders and would be happy to point you in the right direction for help, depending on where you live. I currently work for the Inner Door Center® located in Royal Oak, MI. Please feel free to check out our website: http://www.innerdoorcenter.com
If you are unable to find help through us, please still contact us and we can help refer you to a place that will help you!
Michelle, I understand this, I truly do, and I believe you are doing worthwhile work. The sad thing is, many people such as me cannot afford to access your services, and because you’re not a RD, can’t use our insurance coverage to offset the cost of those services. I would dearly love to pay you what I know you are worth, but I can’t. And that makes me sad. But I’m always glad to read your writings here.
Thank you, I really appreciate it – and I’m sorry it’s so expensive! I’m working on that.
could you register as dietitian just for insurance purposes and just help people in the way you know how to help them?
No, that wouldn’t be allowable. But it’s really not a barrier to continuing to do what I do (except for the cost factor, which is really something I’m working on) – it’s really only a barrier (to me) in the sense that I’ll be considered “illegitimate” by lots of people in the field.
While insurance is pretty picky, reimbursement through a flexible spending plan might be possible, especially if a doctor or RD will write someone a “Go work with Michelle” prescription. The downside of FSAs is that you’re just spending your own money, but at least it’s pre-tax money. (Do they exist in Canada, or are they just a US thing?)
I’m not sure if I’ve heard of people having FSAs in Canada, but maybe? I think I’m spoiled by living there because, even when working in the hospital, I never had to deal with complicated insurance stuff in the single-payer system. It just wasn’t on my radar at all, so it is a big, frightening, scary world to me in general.
I have to say from what I see on this blog, you are very affordable and you charge rates that are consistent with that we charge here in the states for nutrition therapy.
Most insurances do NOT reimburse for nutrition therapy with dietitians unless…
a) you have diabetes or renal disease
b) dietitians have licenses in your state (the state that I work in does NOT have licenses for dietitians for many, many aggravating reasons)
So you all know – at my clinic we charge $125 for initial assessments and $95 for follow ups (US). We have sliding scale pay rates and package deals to help people out, and we will work with people if they have financial difficulties.
Anyway! Just wanted to let you know, Michelle, that your rates seem very fair to me!
I would be interested in what prompted you to write this… I have seen some really nasty and unfair criticism of your work on other blogs and I guess you probably comments and/or emails along the same lines.
For what it’s worth: I come from another scientific discipline with a similar difference between people who got a degree and people who are “registered practitioners, as you know, namely psychology. When I was getting my undergraduate degree, I saw the college counselor regularly in order to help me deal with my personal brand of craziness. She was not a registered therapist (she had the equivalent of an MSc in psychology and was doing her PhD at the time), and yet working with her has been more helpful than any work I have done with a “proper” therapist. Similarly, working with you has been more helpful for me than any nutrition advice I have ever gotten from a registered dietician (although to be fair, I have had only little contact with registered dieticians) and certainly more helpful than anything I have heard from a doctor. And as someone who holds degrees in both, biochemistry and psychology, I think I am qualified enough to judge that your work is indeed in line with or at least never contradicting the part of the scientific evidence that I have looked at which cannot be said of a lot of things that I have heard from therapists, doctors, and to some degree registered dieticians.
Registration is – in principle – a good idea, I think. However, there are problems in the current system here, and it sounds as if the same is true in Canada.
I wrote this originally just before I graduated – because I was thinking about what the graduation really meant for me and my work. I’ve had discussions along these lines with lots of my fellow students, all of whom are up against the same weird system. In Ontario especially, there is a huge bottleneck that occurs between school and internship, because there are not enough placements available for the hundreds of students who want them each year, and so the competition is incredibly fierce, the pressure is very intense, and I worry a lot about how interns in that situation could be vulnerable to exploitation, as well. It’s not a topic that is really considered a friendly thing to talk openly about, but since I am not technically part of that world anyway, I wanted to talk about it.
But what made me publish it was the fact that a media outlet wrongly described me as “a Registered Dietitian” and after correcting them (a thing I’ve had to do several times with several different websites), I thought I should put this up on my site as a full explanation of that.
(As far as nasty criticism goes, I figure if people have an actual criticism they would like me to address, they will come here to address me directly. And they never do, so I don’t worry about it. People are allowed to think mean things about me, and to say mean things about me if they want.)
All I can say is: You are far wiser than I am in that respect. Maybe one day I manage to get to a similar place, I really hope so.
Not having this two letter credential may have absolutely no consequence–except for the lack of mail and the increased money in your bank account from not paying dues. I, too, have my anti ADA sentiments; primarily, their lack of value to me as an entrepreneur, as they get us into situations (ie Medicare arrangements) that are horrific from a business standpoint. And I have heard more rigid thinking from RDs than from the general public–ughh!
The RD still remains the most qualifying and respected credential in our field–and one we can build on (like becoming a Certified Diabetes Educator); not just because of the educational and hands on experience and the national qualifying exam, but the continuing education mandate.
That said, there are ways to more constructively become an RD–to get the credential (if you should choose to) and not put in the lengthy internship. One can get a Master’s degree with a built in (and much shorter) internship, as I did. And least you choose your course of study while simultaneously gaining hands on experience–much, much needed in this field.
Somehow, though, I suspect you’ll be remarkably successful with or without the RD!
I appreciate your encouragement – and I may or may not go back to school at some point, but right now I’m definitely taking a break from it. The idea of a Master’s degree fills me with dread at this point, haha! There is something called a “self-directed internship,” I hear, however. I have a lot of research and deciding to do over the next three years.
There are definitely problems with the way internships work in a lot of fields. (I’m thinking back on my own student teaching experience.) On the one hand, it’s reasonable that you have to get practical experience and demonstrate competence before you’re actually certified or registered or licensed. On the other, there’s something very messed up about not only working for free, but paying for the privilege.
This is a really big thing that sticks in my craw – here, you don’t get student loans or any sort of insurance or financial help for the internship. Nor can you get your student loan repayment deferred (or at least, this is what I’ve heard from fellow students who’ve gone on to do their internships in Ontario.) Which means that internships are truly only available to people who are privileged in a specific financial way – either they have a partner or parents who can support them financially and keep up on the payments for their student loans.
A lot of the students in my program were adult learners who already had degrees in other fields, and didn’t have family to support them through a year of unpaid labour. So this obviously is the source of a lot of bias in who ends up being a dietitian. I don’t think it’s a coincidence that dietitians mostly fit a very similar demographic mold (white, female, upper-middle class) because, for whatever reason, these are the people who are more likely to get the resources to spend a year doing an unpaid internship.
Wow, that’s incredibly messed up. At least my scholarships and student loans covered my student teaching semester.
As a dietitian I appreciated reading this post. I find that even with the RD title dietitians have to work hard to get respect in their work settings from some of the doctors nurses etc who often feel that they themselves are well qualified to provide the same type of services. Some nurses still see RDs as “the food preference” people, and you get referrals that say things like so and so wants snacks or double portions. :) Being a nearly all women profession does not help, the few men in the profession are often the ones writing blogs and being confident about their knowledge and credentials. I really appreciate reading this blog from you as a younger female who is confident in what you have to offer. The RD title would restrict you a bit in what you could say because of the College wanting everyone to parrot the same evidence-based messaging (which again hurts our credibility, Health Canada takes so long to update their recommendations etc). Many RDs are going under the radar to give different messages to people than the standard ones based on our own experience and analysis of the evidence but it’s not usually on a blog, congrats to you.
I find that even with the RD title dietitians have to work hard to get respect in their work settings from some of the doctors nurses etc who often feel that they themselves are well qualified to provide the same type of services. Some nurses still see RDs as “the food preference” people, and you get referrals that say things like so and so wants snacks or double portions. :) Being a nearly all women profession does not help, the few men in the profession are often the ones writing blogs and being confident about their knowledge and credentials.
I completely, totally, utterly agree. The dietitians I’ve worked with, and been taught by at school, are some of the most scientifically intelligent people I’ve ever known. And thank you so much.
The restriction in speaking one’s mind is definitely something I’ve run up against, and totally didn’t include in this post. This came up a lot in a course I took on nutrition communications – we were basically taught that all we were allowed to do publicly (as RDs) was say exactly whatever Health Canada says. And don’t get me wrong, I quite respect Health Canada and the huge amount of research that goes into those recommendations – but I would also like to be allowed to speak for myself, my own experiences, the experiences of my clients, and to critically analyze the role that culture and media plays in those health messages in the first place. And to acknowledge that every message about health, even coming from a government source, is inherently biased.
I’m curious about that–do you actually lose your official RD-ness or face some kind of sanction if you deviate from the mandated script?
I really don’t know what happens – just that we were cautioned strongly not to do it!
I’m from the USA and during my internship I was strongly advised to take on the views of the American Dietetic Association… until I finished my internship and passed the RD exam. Once that was done, I could hold my own opinions about things like the new gluten free craze (for people without a gluten sensitivity/allergy) or high fructose corn syrup, irradiation of food, etc. etc. You could very easily NOT get your RD if you deviated from their point of view, but I don’t think you could get your RD taken away from you for stepping outside the box. You’d have to really mess up (kill a patient or something with your recs) or not complete your continuing education credits.
Basically… becoming a RD means a never-ending money suck… I am glad that the ADA requires us to get continuing education because we need it just as much as any other profession that requires it, but there is a lot of money involved in getting those and in keeping our registration!
“parroting evidenced based messages?” It’s evidenced based for a reason… On peer reviewed research… Peer reviewed by people who are properly educated and have done their own research….geez….I hope you arent getting your info from that Trudeau guy or Dr Oz…
Btw, I did my internship, and I was not unpaid labor, it wasn’t hard, and I got paid.
You are being rude. I appreciate your viewpoint and I love to hear from dietitians, so there’s no need to be antagonistic here. We are listening.
I don’t know where you’re at, but not everyone on this site is an American or lives in the US (myself included) – so internship experiences can vary. For me personally, this is a complicated situation and I have a lot of mixed feelings about internship. When I wrote this, I was feeling frustrated and angry – and I know a lot of my fellow dietetics students have felt the same way.
Did you ever know that you’re my hero?
No, seriously, I already had a tremendous amount of respect for what you do and who you are, and that was before I knew that you were doing it not only despite society but also despite the pressures of your discipline, and if I ever move back to Toronto area I am going to buy you a dozen totally platonic and possibly chocolate roses. Cheers from another poor lass trying to figure out how to do the work she wants within a system that only wants to give her a paycheque for doing something else!
omg chocolate roses! Awwwwwww :)
Best of luck to you in your career as well. I know it can be hard.
Michelle, I’ve been following your blog for about two years. The content and results of your work speak for themselves, and anyone who reads comments around here knows it. I think your position on eating is incredibly intelligent, thoughtful, well articulated and sincere. An “RD” behind your name wouldn’t make you any more insightful, relatable and helpful than I’ve found you to consistently be. I hope your future brings you a wide scope for your work and a good paycheck to boot – you deserve both.
Thank you so, so much. People who read and comment really make writing this blog even more meaningful for me.
This is becoming more and more of an issue in various fields. People that are not willing or able to jump through increasingly complex hoops and therefor are barred to be professionals… and the world misses out on great, caring and well-educated individuals – mostly in the field of teachers, trainers and therapists. And the more your walk in life is not direct (‘high school->right college-> right profession’), the more difficult it is to get the correct qualification.
It sucks, and the loss is everyone’s.
In the mean time: I have learned tremendous amounts from all those Not A Real Instructors I’ve met, including your blog, and partly because they arrive on those positions through different routes, and do it from a real passion (and not just because they landed in the field and performed the tricks.)
And a diploma does mean something. It first means something for you: you did complete it, so hah, they can’t take that away. It also means something for everyone that actually is interested in making their own assesment of your skill and knowledge. Not in the simplistic ‘diploma=good, else=bad’ but it is part of your whole package of knowledge and experience and as such it matters.
Very true. I’ve also not noticed a difference in the quality of care I get from, say, PT students as opposed to physical therapists who’ve completed their internships. Likewise, I’ve had lousy doctors and awesome PAs (not quite the same because PAs have completed their own form of training and internship, they’re not PA students, but still an indication that the letters after your name don’t magically make you intelligent, skilled, or empathetic if you weren’t before).
Professionals jump thru hoops such as “hands on training,” clinicals, and professional exams for a reason…. For the safety of our patients. Once we get our RD, we still have to do continuing education to keep it…. For the safety of our patients. In the US, you still need to be licensed in many states to claim the title nutritionist whether you are an RD or not.
That’s a valid point. But the hoops that you jump through to prove that you can do a job shouldn’t include doing it without pay for an entire year, particularly if your student loans can’t be deferred during that time. There has to be a way to prove people are qualified without requiring them to have independent means of supporting themselves through a full year of unpaid labor.
If I had to give you a dollar for every time I told someone that “Eat or die” is the only rule for nutrition, I think I could finance your year of an unpaid internship. It’s frustrating that you don’t have letters after your name to make you an “authoritative” voice, but I find your work and your voice to be some of the most useful, meaningful, and power I’ve ever encountered. Thank you.
I absolutely love your site, and just reading these articles has really, really helped me with actually being healthy and accepting that I’ve got a belly, and it likely isn’t going much of anywhere.
Bureaucracy is ridiculous. I’m amazed that you can’t say “Well, I’ve already done that exact job for that length of time”. Or, I guess more accurately, I wish I were surprised.
Haha, I’d at least love to get Time Served for assessing all those three-day food records. And for wearing a hairnet. And for having people treat me like a peon when I worked in food service (though I didn’t have it as bad as the dietary aides, god love ‘em.)
This issue of unpaid internships in many fields is becoming an international issue – the same complaint is being heard across the English speaking world. It’s always been the case that ‘volunteering’ was the way to get into highly sought-after creative fields like film and fashion, but if you worked in other professional fields, you started at a low wage and worked your way up. But the insistence that people work for free is creating a new kind of aristocracy, where the connections your parents have and the ability to fund a year of no income means what your social background is is more important than the skills you bring to the table.
It’s no surprise that Germany, which still has a solid apprenticeship system, where graduates in all fields are apprenticed to a firm for a year as part of their qualifications, has one of the strongest economies in the Western world – it turns out that taking training seriously pays off economically.
Having said that, your voice is so unique and your insights are so cogent and thoughtful, that I predict a stellar future for you.
the insistence that people work for free is creating a new kind of aristocracy
I totally love that way of putting it, and of course, I agree. Thank you.
I found your blog by chance this year and it has been such a comfort to me! I hope to save up and be able to do one of your online sessions next year and quite frankly don’t care that you don’t have two letters after you name. From what I have read I trust what you have to say.
I understand what you are saying though, I didn’t do my degree in the field that I’ve ended up working in. I learnt on the job which I think is just as good if not better.
You well may eventually be called a quack and a charlatan, but so might we all! In the mean time, you are a ray of shining awesome, in a sky of bleak crappiness. How about adding the letters DNE after your name? Defender of Normal Eating.
Authority confered by letters after your name, or by institutions is redundant to educated readers who appreciate you for your actual work as it is.
This post made me cry. I endured a very similar mess, coming from an anthropology undergrad and fighting to take all the classes the ADA required in addition to that… but because I will not move to some other part of the country alone, for at a year, to undergo the official internship process, I am not an RD. I am a DTR, which mostly feels like a backhanded way of keeping me on mailing lists for pricy continuing education workshops. But I digress.
I want to thank you for sharing your knowledge and experience with others. Thank you for making me feel less alone in my angry gray margin. I believe we will rise and accomplish great things even without the endorsement of a certain corporate-owned professional health organization.
And congratulations on the amazing things you’ve already done! You deserve a party!
Hi Rene – solidarity! I totally feel for what you’re going through. One of the profs at my school, and someone I admire greatly, wrote this article about the process of dietetic education, and what may be missing in it. She doesn’t address the internship problem here, directly, but it is something she is concerned with:
http://kwantlen.ca/TD/TD.1.3/TD.1.3_Gingras_Vulnerable_Learner.htm
I am getting ready to graduate in May in Dietetics and Public Health Nutrition. I really appreciated this post because I’m facing many of the same frustrations and challenges. I have worked hard the last four years to learn and equip myself with the skills and knowledge I will need to help people in the areas of food and nutrition. However, because of the difficulty of the internship requirements, I am not going to get my R.D. anytime soon. Thank you for your voice and inspiration, truly appreciated.
I hear your pain.
Here in Australia I couldn’t graduate from my B.Social Work without having done 2 three month unpaid internships. I had to take time off from my full time paid position to do those placements. When I started my Masters in Counselling, I ended up transferring to another university so that I didn’t have to do another 3 month unpaid internship. I would have had to move away from my family to secure that internship because there was no one with my geographical region that had the qualifications the uni required for my placement supervisor. Then I had to find someone who was WILLING to take on a counselling student to work with clients who also had the needed quals. Needless to say that wasn’t going to happen in my area, I would have had to travel at least 3 hours in each direction, every day for 3 months.
So I transferred to a university that didn’t require me to do an internship to graduate with my Masters. But people tend not to take a Masters in Counselling seriously. They want a registered psychologist. Social workers here tend not to do counselling (not privately anyway, they might as part of the social work program they are funded to work in) and counsellors (and social workers) do not have to be registered to practice as such. (There is actually no peak body for counsellors. There are two that are vying for the position and the govt has said until they sort their shit out, they (the govt) doesn’t want to talk about regulating the industry. Social workers often have to be AASW eligible in order to get various positions etc but membership is not compulsory and there is no registration process for social workers or counsellors.
This article made my day! A couple of years ago I decided I wanted to become an RD, and maybe a degree is social work, and help people to eat “intutively.” I made the decision to go back to school and now I don’t know what the heck I’m doing. I’m learning about tube feedings and fluid requirements and how to run a food service operation and…I feel lost. This isn’t what I wanted to do at all. I’m starting to question whether I will actually be able to do what I set out to do or if I will be forced to spend my life figuring out how much protein someone with a stage II bedsore needs or planning menus for a nursing home. I’m not knocking anyone that does those things. It’s just not what I want to do. I guess I just don’t know how to get where I want to go.
Haha, this comment is so familiar to me! Although I did find it helpful to just throw myself into learning that stuff – I found out that I was surprisingly good at calculating TPN and EN requirements! And then I did spend some time helping to teach people to feed themselves through a G-J tube while they were going through cancer treatments. And I worked in food service – it wasn’t exactly fun, but I learned a lot and also got to directly help a lot of people in ways I never expected. There’s no greater joy than managing to somehow finagle a hamburger for some poor soul who’s been existing on random hospital food for weeks. And alllllllll those three-day food records. And learning about diabetes, helping to teach classes on carb-counting for insulin-pump users. Some fun, some not-so-fun. But much of it surprised me with how interesting it ended up being.
But yeah. This isn’t what I knew I wanted to do from the beginning – and I had a really strong idea of what I wanted to do. It wasn’t just a passing fancy – so feeling like one is being shoehorned into some role they really aren’t interested in can be frustrating.
While I was in school, I took every opportunity to do projects and write papers on health at every size, fat acceptance, etc. Because it helped me learn more about the thing I really had a passion for, and it kept me more engaged with school in general, but it also helped me to connect with those professors and faculty who were also into these topics. Turns out the chair of the nutrition dept. was really, really supportive of me and HAES, and so were at least three other professors. It was scary, but so worth it. I had some good conversations with fellow students about this stuff, too.
Overall, though, school was incredibly hard for me. Working, being married, living on one’s own (when some of my fellow students had parental support and few “adult” responsibilities, which made me sooooo jealous) made it really hard, in addition to having depression, and then developing super intense performance anxiety around school. I became such a perfectionist that the idea of studying, or writing a paper, or taking an exam filled me existential terror – my body responded as though every test of my ability were a life-or-death situation. I shook, I couldn’t sleep, I hated myself, I had to get sick notes and turn stuff in late, and I’m sure I completely exhausted the patience of all the faculty. It was ridiculous. Now that it’s over, I’m hoping my brain will heal after a while from the trauma. The weird thing was, at work I never had these problems – I was always an ace employee. I don’t know why all my anxiety was transferred to school.
Michelle, you have touched so many peoples’ lives, including my own in ways you might not even know. I’m a nutrition student in Maryland and on Sunday night I shared this site with a classmate. She emailed me the next day; the only thing she said to me was “I LOVE THIS WOMAN!”
I talk about your site to anyone who I think could benefit from your words and wisdom.
Please know that you truly have a gift for helping people navigate their relationships with food. That’s breathtaking.
When I see that you’ve written a new post, I stop whatever I am doing and immediately read it. I then scroll right back up to the top and read it again. And I’ll likely read it another time a week or two down the line. I drop everything to read your posts because what you are writing is so incredibly important to me. And because when I’m in the presence of greatness, I can’t help but stop and take notice.
Thank you for sharing your gift with me and all your other readers/clients. RD title be damned. :-)
Wow, thank you so incredibly much. That kind of blows me away!
It always makes me so happy to hear that other nutrition students read my site.
Honestly, as someone who works in academia, a year’s unpaid internship isn’t as bad as what medical residents go through, or post docs, or fellows. It’s a part of the deal.
It’s certainly not as bad. But that doesn’t mean it isn’t still privileging certain people over others purely due to their financial resources. It’s just further amplified in medicine and higher academia. Doesn’t make it ok.
Also, in most post-grad studies, there are chances of grants and financial aid and stipends. Not so in this situation. kthnxbye
Agreed 100% Michelle. Getting an internship was so stressful and I am very lucky to have been able to afford it. There are very few dietetic internships that pay you a stipend, and they are hard to get. And there are even fewer that offer financial aid unless you’re going to go on to get a Masters degree in nutrition or something else, which usually doesn’t increase your pay what-so-ever, so why would you spend another tens of thousands of dollars?
Michelle – I just found your blog, and I must say I love it. I understand your feelings toward the field of dietetics and becoming a dietitian… obviously from my name you can see that I am a registered dietitian.
BUT… I agree with so much of what you said in this post. It is a really tough field. And really all that I gained from my dietetic internship was experience in clinical nutrition. Sure I gained a lot more than that… but it’s something that I probably could have gained from the same experience YOU have.
I was very frustrated with the field when I started but I kept on pushing because that was “the right thing to do”. And realize that RDs sometimes feel the same way you do – because where I am at, many nutritionists with MUCH less experience and education than what you have are taking jobs that should be for more experienced, more trained individuals (what a RD should be!).
So, I want to just say that you’re awesome. I love the name of your blog and the content of your blog. I found it looking for “Marilyn Monroe’s body size” because I also have struggled with accepting my body size. I am also a “fat nutritionist” and you know what? I kinda love it now. I’m glad that you have been so sucessful without caving to the expectations of society the way I have – that you HAVE to be a registered dietitian to be successful.
So you know – I love Ellyn Satter as well, and I specialize in eating disorders as a dietitian. I teach the same thing you do – how to eat “normally”, mindfully, etc.
Sorry for my babble – I just read this and it really hit home for me. I’m glad there’s someone out here like you!
- Megan
Awesome – so glad to hear from you, and have another piece of proof that there are RDs who get it. I’m constantly referring people to RDs trained in eating disorders because the work you do is so critically important, and because body acceptance is such a crucial part of it.
Also glad to have some encouragement from someone who’s gone through internship and made it through – so thank you for that :)
I’m not all that familiar with the world of dietetics so you should take what I say with a huge grain of salt (I’m a sociologist who knows a fair bit about the professionalization of the medical field ) — I would still urge you to consider doing the internship at some point, not only for the weight that the title carries but also because you can’t change the profession if you’re not part of it. It sounds like the certification process is really something that needs to change, and from what I know of you through your writing on the blog, I can see you being a real kick-*ss advocate for change!
Thanks Nicole, I really appreciate the encouragement – and I am still seriously considering it (if anyone would even accept me at this point, given all the shocking nutritional opinions I put on the internet!) I’ve got three years to decide, so I’ll be doing some research to figure out the best way of going about it. And I agree – it’s hard sometimes to change things from the outside.
Hi Michelle,
Thank you so much for writing this. I am in Australia – supposedly a qualified Nutritionist but it’s not a qualification that is deemed good enough by those who are handing out jobs. To become a APD (accredited practising dietitian) I need to undertake more study which is only possible by quitting work and receiving no income for four years. Not possible with a mortgage! And because I can’t break into the industry, I can’t justify the costs of taking on any further professional development (a lot of which is not even available to me because I don’t have the right qualifications), so I am stuck in a bit of a vicious cycle here!
Like you I am not particularly interested in being a clinical dietitian – I did a brief stint in a hospital as a dietetic assistant and realised it was not my cup of tea at all. I am more interested in health promotion and helping people develop a healthy relationship with food, but this is an area that is hard to break into unless you have that APD after your name.
So I am glad to see that you have bucked the system and have made a career for yourself doing what you love – it is inspiring for me who is struggling to find a niche for myself.
Wow, your background (and area of focus) sounds so much like mine!
I have to admit that I find it kind of funny how I’m considered qualified enough to work in a hospital, helping to educate patients about their therapeutic diets, carry out nutrition orders, and screen patients for assessment, but somehow not officially qualified to teach healthy, ambulatory people about Canada’s Food Guide. Something ain’t right.