March, 2007

Finding Your Niche — Certification Options for the RD
By Chef Kyle Shadix, MS, RD, and Jenna A. Bell-Wilson, PhD, RD, LD, CSSD
Today’s Dietitian
Vol. 9 No. 3 P. 40

The perks of dietetics may lie in its vast opportunities for specialization and employment. RDs are everywhere: clinical settings, foodservice, sports teams, universities, marketing, management, and media. When dietitians find an area of practice where they wish to focus their attention, additional training and a deeper breadth of knowledge may be warranted. For this reason and to protect consumers, certifications have become available through the Commission on Dietetic Registration (CDR) and other venerated health organizations.

The CDR Board-Certified Specialist
According to Lois Hill, MS, RD, CSR, of Nutrition Solutions in Lexington, Ky., CDR specialty certifications are an excellent way to demonstrate and document knowledge, experience, and expertise in given specialty areas. In addition, CDR certifications can be a cost-effective way to get all 75 continuing professional education units (CPEUs) required for recertification through the CDR.

Recent pediatric and renal specialty program evaluation surveys indicated the following:
• 93% of specialists experienced pride/personal satisfaction;
• 61% of specialist employers reported paying for the CDR specialty certification, either in full or partially;
• 60% of specialists experienced peer recognition;
• 45% of specialists experienced increased credibility by other professionals;
• 29% of specialist employers reported providing a salary increase upon attainment; and
• 24% of specialist employers reported providing a promotion or career advancement upon attainment.

To become a Board Certified Specialist, which falls under the CDR’s umbrella, you must first complete the eligibility application and successfully meet the following minimum criteria:
• have maintained RD status for three years;
• have 4,000 hours (within the past five years) of professional practice as an RD in the specialty (1,500 hours for sports dietetics); and
• successfully completed the Board Certification as a Specialist in Dietetics examination (visit for descriptions of examinations for different specialties).

Currently, RDs may apply for four CDR credentials for certification:
• Board Certified Specialist in Gerontological Nutrition (CSG);
• Board Certified Specialist in Sports Dietetics (CSSD);
• Board Certified Specialist in Pediatric Nutrition (CSP); and
• Board Certified Specialist in Renal Nutrition (CSR).

In addition, the CDR has recently approved the development of a fifth specialty credential, the Board Certified Specialist in Oncological Nutrition (CSO), expected to be available by early 2008.

Once certified, you may request to be added to the CDR Specialty Online Directory so the public can easily find you, and you may also consider becoming active on the CDR’s specialty-members-only listserv so you can network and communicate with other specialists in your area of expertise.

Gerontological Nutrition (CSG)
Gerontological nutrition dietitians design, implement, and manage safe and effective nutrition strategies to promote quality of life and health for older adults. They work directly with older adults to provide optimal nutrition, food sources, and information in various settings (eg, hospitals, long-term care, assisted living, home healthcare, foodservice industry, correctional facilities, community-based nutrition programs, governmental programs) or indirectly as documented by management, education, or research practice linked specifically to gerontological nutrition.

It may be difficult to find an RD with the CSG credential because it is a new credential. According to the CDR’s senior director, Christine Reidy, RD, the first examination testing window began in mid-January and continued until early February. Expect to see RDs with the new credential this spring.

Sharon K. Leppert, RD, LD, an independent consultant to assisted living/Alzheimer’s facilities and community-based organizations in Dallas and chair of the Gerontological Nutritionist Dietetic Practice Group, says, “The new Gerontological Nutrition certification will give well-deserved recognition for the unique practice skills of this area and will soon become the ‘must-have’ expertise of the aging network. It comes at a time when nutrition is becoming even more recognized as an essential component of healthy aging and disease management.”

Leppert is in the process of gathering her paperwork and logging her 4,000 hours. “Administrators in facilities will seek this expertise to provide cost-effective quality nutrition care for their residents as well as community-based programs who wish to impact the health of participants,” she says.

Sports Dietetics (CSSD)
Working as RDs for a minimum of three years applying evidence-based nutrition knowledge in exercise and sports, those certified in sports dietetics assess, educate, and counsel athletes and active individuals. They also design, implement, and manage safe and effective nutrition strategies that enhance lifelong health, fitness, and optimal performance.

Leslie J. Bonci, RD, LDN, MPH, CSSD, sports dietitian for the Pittsburgh Steelers, director of sports nutrition medicine at the University of Pittsburgh Medical Center, and the incoming chair of the Sports, Cardiovascular and Wellness Nutritionists (SCAN) dietetic practice group, was one in the first wave of Board Certified Specialists in Sports Dietetics (CSSD). “As part of the Steelers organization for 14 years, I work closely with the medical staff, strength coach, and foodservice—a true team approach,” says Bonci. “Sports dietetics expertise enables me to address specific nutritional needs of each athlete and assist with goals for body composition, athletic performance, and career extension.”

Bonci believes there are advantages to having the sports dietetics certification and says, “Specialty certification [in sports dietetics] will ensure that I am on top of my game and provide up-to-date, evidence-based information and guidance.” Bonci appreciates that, from the client’s perspective, “working with a certified sports dietitian ensures that nutrition support will be practical and grounded in food and fluids first rather than an emphasis on dietary supplements.” She explains that this is particularly important for athletes who have preexisting medical conditions and need unique dietary recommendations. “Sports dietetics certification advances sports nutrition knowledge and practical application, protects consumers against fraud, and is an asset in marketing sports dietitians.”

Pediatric Nutrition (CSP)
Those with this certification work directly with healthy and/or ill children (newborn to age 18) as well as children with special healthcare needs in various settings (eg, hospitals, community-based and/or family-centered programs, education programs, home) or indirectly as documented by management, education, or research practice linked specifically to pediatric nutrition.

In addition to adding to their skill set, dietitians report career opportunities after achieving certification. According to Aida Miles, MMSc, RD, CSP, LD, CNSD, the senior nutritionist at The Marcus Institute’s Feeding Disorders Program in Atlanta, “Having the CSP certification allowed me to move to the next level on our [The Marcus Institute’s] career ladder, which in turn gave me more fulfilling responsibilities and ultimately increased my salary.”

Miles adds, “Whenever I speak to a group, whether they are health professionals or people in the community, I am introduced as a board-certified specialist in pediatric nutrition, and I feel that this really increases my credibility in the eyes of the audience.” She also notes that passing the certification exam every five years is an extra incentive to stay on top of changes and advances in pediatric nutrition.

Renal Nutrition (CSR)
Those with this certification work directly with adults and/or children with acute or chronic renal dysfunction or failure, under treatment by kidney transplantation, dialysis, or other modalities in various settings (eg, home, hospitals, other treatment centers) or indirectly as documented by management, education, or research practice linked specifically to renal nutrition.

Patricia Weber, MS, RD, CSR, CDE, LD, a clinical science specialist at Genzyme Corporation in Massachusetts, notes the benefit certifications have had on her continuing education. “Studying for a board certification is equivalent to a college class, in my opinion, and I see the benefits of the refresher education.” Weber considers the certification a beneficial choice as it helped her “work smarter” and “negotiate for a better salary.” She emphasizes the impact it has on helping her stay “current, competent, and competitive.”

Certificate in Weight Management
The CDR also offers two certificate programs: the Certificate of Training in Adult Weight Management and the Certificate of Training in Childhood and Adolescent Weight Management.

There are three components to each training program:
• self-study module (eight to nine hours of readings, activities, and a pretest);
• 21/2-day live workshop; and
• posttest.

After passing the pretest, you may then take the 21/2-day course. After you have successfully completed the course, you will then complete the take-home posttest. An added perk is that you will receive CPEUs for completing the program. The current (tax-deductible) fee is $345.

Author of Our Overweight Children: What Parents, Schools, and Communities Can Do to Control the Fatness Epidemic and a New York University associate professor, Sharron Dalton, PhD, RD, believes the Weight Management Certificate is helpful to dietitians and clients. “It ensures that RDs who earn the certificate are up-to-date on current methods of assessment and related counseling skills.” Dalton adds that the field of weight management is a challenge for interventions that RDs may employ. “Besides food and behavior management, [areas of weight management] require expertise that the three-day certification process offers. [Areas include] an understanding of medication and postsurgical needs, both of which are essential to manage the majority of clients today.”

Professional Certifications for RDs to Consider
There are several other worthwhile certifications managed by other organizations such as the National Restaurant Association Educational Foundation’s Foodservice Management Professional credential or the National Board of Nutrition Support Certification established in 1984 by the American Society for Parenteral and Enteral Nutrition (see Table 1).

Many dietitians report career benefits from these additional certifications. Katherine L. Mulligan, MS, RD, LD, CDE, clinical instructor in medical dietetics at The Ohio State University (OSU) in Columbus, became curious about diabetes education when her father was diagnosed with type 2 diabetes. “I obtained a position with a diabetes team at the University of Rochester Medical Center, Strong Memorial Hospital [New York] as a result of the credential.” Mulligan notes that she has been asked to speak at the local professional diabetes meeting about nutrition and diabetes and has developed an academic course focusing on diabetes management in the School of Allied Medical Professions at OSU. In addition to the knowledge base, Mulligan reports, “the credential adds an additional level of ‘respect’ to my registered dietitian credential. I am required to recertify every five years [to maintain status], either by continuing education or examination.”

As Mulligan reflects on the changing environment of diabetes care, she notes, “When I think back to when I started in diabetes education, there was one class of oral medication, and glucose monitoring was done by urine testing or venipuncture. Wow, diabetes management has changed, and the need to keep up is essential.” Mulligan has been through five updates of the Exchanges Lists for Meal Planning, and now that carbohydrate counting is part of the CDE tool box of educational materials, there is always room for continuing education. “We are learning more about the physiology of the disease every day, and it is crucial to review the literature on a continuous basis to keep up with all of the changes.”

Erin Fennelly, RD, CNSD, LD, the transplant nutrition coordinator at the Center for Intestinal Care and Transplant at Georgetown University Hospital in Washington, D.C., admits that choosing to obtain the CNSD credential has given her more focus on her career path. “The advanced credentialing has been recognized by the physicians with whom I work. They have allowed me more autonomy in patient care, which continues to motivate me to further my professional development. I’m glad to have the credentialing and encourage colleagues working in nutrition support to obtain it as well. When I’m reading medical literature about nutrition support, I look to see if the authors have this credentialing, as I believe it lends a higher level of credibility.”

Considering a Certification?
Depending on your area of specialty, there may be a certification that makes sense for you and your practice. It is unlikely to catapult you into success if you choose a certification that is not part of your day-to-day position, but based on the experiences of certified individuals in their unique areas of expertise, it may be a career choice for you.

— Chef Kyle Shadix, MS, RD, is the director at Nutrition and Culinary Consultants in New York City.

— Jenna A. Bell-Wilson, PhD, RD, LD, CSSD, is a freelance nutrition writer and consultant and nutrition advisor for TrainingPeaks, LLC.

Reported Benefits from Certifications
• Gives the ability to leverage for higher salary
• Improves knowledge and practice capabilities in a specific area
• Provides continuing education credit for RD credential
• Builds confidence in your skills
• Assures patients and colleagues of your abilities
• Expands opportunities in practice

For the Commission on Dietetic Registration’s time lines, eligibility, application instructions, application forms, examination locations and/or computer test sites, exam study resources, exam content outlines, reference lists, fees, new online self-assessment simulations, problem types, online credential verification, and frequently asked questions, visit