March 2015 Issue

Education: The Dearth of Dietetics Internships
By Amelia R. Sherry
Today's Dietitian
Vol. 17 No. 3 P. 18

Shortages continue, but there are other pathways and programs to help increase the chances of being admitted.

The biggest hurdle most dietetics students face en route to becoming an RD is being admitted to a dietetics internship program. The odds of getting into a program are only 50%, according to the Accreditation Council for Education in Nutrition and Dietetics (ACEND). The competition is fierce, as there are many more applicants than available spots. In 2013, a record high of 5,444 dietetics students applied for internships, a 112.5% increase over the 2,561 who applied in 2001. The available spots have been hovering around 2,900 for the past two years, only a 15.6% increase from 2004 figures totaling 2,509, according to ACEND.

Admission to a dietetics internship isn't the only way a student can obtain the 1,200 hours of supervised practice required before taking the RD exam. Alternatively, students can enroll in an accredited coordinated program that combines academic coursework with supervised practice. However, there are roughly five times as many dietetics internship programs (251) than coordinated programs (56) offered across the country. To help increase the number of available positions within dietetics internship programs, ACEND Executive Director Mary B. Gregoire, PhD, RD, says, "The Academy [of Nutrition and Dietetics], ACEND, and the Nutrition and Dietetics Educators and Preceptors Group have been working diligently together to address the internship and preceptor shortage through preceptor recruitment programs, National Preceptor Month, outreach to didactic students, programs, universities and institutions, and through the development of the Individualized Supervised Practice Pathway program."

In the meantime, how can dietetics students increase their chances of being admitted to an internship program, and what can RDs do to help?

Bevy of Choices
First, students must strategically narrow their options during the application process so they can boost their odds of being matched to a program. Most dietetics internship programs use a computerized service that matches each student to just one program; therefore, applying to several won't increase the chances of being matched. Students are better off limiting their applications to programs that likely will accept them and rank them high on a list of accepted students. "We recommend limiting applications to four programs since their chances decrease the lower they rank a program," says Jenny Westerkamp, RD, owner of All Access Internships (, a company that offers both free and paid services to assist students in choosing and applying to dietetics internship programs. "However, we've seen students apply to as many as 15, which is both costly and stressful, and may distract them from adequately focusing on their top choices."

For students, identifying programs that will both give them a high ranking and meet their needs is a challenge. Different types of organizations, such as academic institutions, hospitals, foodservice companies, and private firms, run the internship programs; what they offer can vary considerably in terms of schedule flexibility (full vs part time), program duration (from eight to 24 months), costs (free to upward of $47,000), elective rotations (eg, communications, education, corporate wellness), graduate credits, and prior assessed learning acceptance policies. For example, an internship program may or may not award credit hours for previous professional experience in dietetics. Moreover, an increasing number of programs now offer distance learning options, so students aren't limited to a program close to home since they can participate in one anywhere in the country while doing their rotations locally.

For some students, whittling down the selections is the most difficult aspect of the application process. Less than one month before her upcoming deadline, Michelle Ashley, a senior at James Madison University, was still struggling with this task. "It's tough," she says. "I'm interested in a variety of things, which is both the best and worst part. And I'm also willing to relocate because I want to get matched with an internship that is best for me and is in a good location."

Pinpointing the Perfect 'Match'
To successfully narrow down internship choices, Westerkamp suggests students think of three specific reasons why each program may be a good fit. "These should be reasons that don't fit any other program," she says. For instance, the fact that a program has an emphasis in foodservice won't work, because that can be said of many programs.

Students who have the flexibility to relocate can boost their odds of becoming a perfect match for an internship program. That's the approach that may have helped Lindsay Colman, RD, LDN, land a spot in her first-choice internship program at Loyola University Chicago in the spring of 2012. "I looked around at the size of the programs in the New York area, and I looked around at my cohort and realized we would all be competing for the same few spots," she recalls. "On paper, we all seemed quite similar: second career, 4.0 GPAs, and tons of volunteer work experience." Knowing that her classmates likely were her biggest competition, she opted to look outside the New York area.

Broadening Possible Pathways
In recent years, some dietetics internship directors have taken steps to increase the possibility for qualified, nontraditional students to match with their programs. They've done this by diversifying the traditional program structure by using the ACEND program guidelines in innovative ways.

For example, when Ann Gaba, EdD, RD, CDN, CDE, became internship director at CUNY School of Public Health at Hunter College in 2008, she recognized the need to give graduate students, career changers, and non-RD nutrition professionals an opportunity to re-enter the credentialing process. "Internship sites are a scarce resource, and I knew that I didn't want to take away rotation sites from traditional students already applying to our program," Gaba says. After researching what other programs offered, Gaba developed two coordinating policies that could be used either separately or together to accommodate people who couldn't adhere to a full-time schedule. One was the prior assessed learning policy, which allows a maximum of 600 hours of internship credit to be awarded for previous post-didactic program in dietetics professional experience equivalent to other internship experience in the same areas. The second was a regional, distance learning option, enabling students to arrange rotations at sites where they already may have connections or be working. The idea was to maximize the amount of experience students bring to the program while still meeting the ACEND competencies, Gaba says.

Dietitians in academia and other organizations can increase students' awareness of the various policies that can fulfill the ACEND requirements and those of the internship programs that use them to help maximize their chances of matching to an appropriate program.

The good news is that once students are accepted to an internship program, "the competitiveness subsides," Colman says. Most interns agree that the atmosphere within the program is a much more collaborative environment that will help them achieve their goals of becoming RDs in the near future.

— Amelia R. Sherry is a freelance writer, graduate student, and dietetics intern at CUNY Hunter School of Public Health. She blogs about pediatric nutrition at

Combatting the Shortages
The number of dietetics internships available hasn't kept pace with the significant increases in applicants over the past 10-plus years, but the number of openings has increased by 28.5%, from 2,305 in 2001 to 2,963 in 2013. However, these increases still fell short of meeting the needs of the 6,184 students who graduated from accredited didactic programs in dietetics (DPD) last year, and they continue to fall short.

What happens to dietetics students who fail to match to an internship is a loaded question. Some may choose to pursue the DTR credential, which requires DPD-only coursework. Others may never apply to internships at all and enter the workforce as noncredentialed nutrition professionals.

Jenny Westerkamp, RD, owner of All Access Internships (, a company that offers both free and paid services to assist students in choosing and applying to dietetics internship programs, says, "By the time students come to me, some have failed to match three or four times. On the bright side, many persevere. They gain the experience they need and eventually place. On the other hand, when they do come back after working in the field, we see that they often have been employed in gyms and wellness clinics as nutritionists."

To combat the internship shortages, ACEND launched the Individualized Supervised Practice Pathway (ISPP) program in 2011 to help two groups of students desiring to pursue the RD credential: Those who had failed to match to an internship, and those who already held doctoral degrees. The ISPP is slowly increasing the number of internship positions available, but the impact hasn't been significant. To date, 44 ISPP programs have been introduced, and 140 students have completed them. "Unfortunately, awareness of the ISPP is pretty low," Westerkamp says. "And that's because once a student fails to match, usually in the spring of senior year, they lose access to their DPD advisor. Without that extra source of guidance and support, it can be tough to know what the options are."

Students who go through the ISPP programs may find the internship application process more straightforward since they apply individually as opposed to going through a computerized matching service. However, as with the distance learning internships, students are responsible for finding their own preceptors and setting up their rotations.

In April 2013, ACEND also started celebrating National Preceptor Month to "help raise awareness of the need for preceptors and to thank preceptors who are willing to serve," says ACEND Executive Director Mary B. Gregoire, PhD, RD. In conjunction with this program, the Find-a-Preceptor Database debuted, which helps both students and internship directors connect with RDs willing to act as preceptors. Since its inception, almost 800 preceptors have registered with the database, which can be accessed at Connecting preceptors with students doesn't necessarily increase the number of internship positions, but it can make it easier for students to pursue alternative pathways, such as distance learning dietetics internships or the ISPP.