8 Tips for Studying for the RD Exam

It wasn’t that long ago this summer that I was stressing and studying for the Registered Dietitian exam, but luckily I can say I’ve passed and I am now an RDN (Registered Dietitian Nutritionist). While I don’t have all the answers, here are some of my top tips on studying for the exam:

1. Find some good study material:

Many internships provide at least some study material for their interns post-internship. I was provided with the Inman study binder and USB audio, which seems fairly common for other internships as well. I also purchased the AND study binder outline, and that’s exactly what it was, just an outline. That was fine, but for me it was not as useful as the Inman study materials. I did, however, utilize the practice paper and online tests that were given through the AND binder, but all of the five practice tests were exactly the same questions so unfortunately it was solely a practice for timing and how the online platform would generally work.

2. Pick a test date & make a study plan!

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It’s easy to pick a date and get lost in the weeks that lead up to the test and then before you know you have run out of time. When you are done or almost done with your internship, look up the dates and locations in your area and mark it in ink on your calendar when you sign up. Then, count the number of days you will willingly study before your test date. For a more specific division of study, look up the percent of content from each section that will likely be on the test and divide the number of study days you have by that percent for each section. Then divide the number of pages for each section by the number of days you’ve designated for that section. Or you can focus more time on a section that you know maybe isn’t your strong suit.

3. Be aware of your preferred learning method.

Click here to learn about your learning style!

For me, I learn best visually and with hands-on learning. So that meant I used videos and diagrams in addition to the audio and written materials. Some people liked to listen to the audio on walks, in the car or around the house but I knew I needed to see the words while hearing them.

4. Make it a routine.

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Make time in your planner for study time each day and make a routine of how you will study too. This routine helped me (almost) look forward to it instead of dread it. For instance, I first would listen and read the study guide two times for the pages I allotted that day and highlight parts I needed more work on or parts that were emphasized in the audio. Then I would look up some parts I highlighted, mostly on YouTube so I could have a visual representation of it. I then wrote flash cards of the points that were highlighted. The next day before I started the routine over again, I would review the previous notecards for extra repetition. After every section I would take a practice test and highlight what I may have missed to re-emphasized later.

5. Think outside the box.

When things get monotonous, sometimes you need another way to look at the material to really grasp it. Sometimes this came in the form of YouTube videos, sometimes reviewing with friendly (virtually), other times I made a matching game out of it. For instance, for the vitamins and minerals I wrote out the sources, deficiency signs, functions, and RDAs on separate slips of paper and then shuffled them up to make it a matching game. I also drew out some of the macronutrient pathways and cut them out to make another matching-like game to help remember the pathway better (although I wouldn’t stress learning the entire pathways in great detail as you might have for advanced nutrition since the test is about a variety of dietetic information).

6. Take some “me” time.

When you only have a few notecards left to really cement in your head and a couple days before your test, take some time for yourself. Get a message, your nails done, have a night out with friends, treat yourself to a favorite dinner or dessert, or relax with a trip to the beach or a hike.

7. Take a test drive.

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The day or two before your test take a test drive to the testing center to make sure your testing day goes as planned. Also read over all of the expectations for the testing center, such as having a picture id, not bringing your own calculator, wearing a mask, being aware that you’ll have to turn your phone off, and arriving at least 30 minutes early. *requirements may vary based on the testing center*

8. Get your beauty sleep!

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Go to bed early and take a deep breathe. You’ve studied a long time and know more than you think.

Spring Lobby Weekend 2020

I have never liked politics and I never thought I’d be one to put myself out there to advocate for policies. I’ve always thought that was way too above my head and uncomfortable. I was wrong.

A couple of weeks ago my fellow dietetic interns and I had the very unique experience to lobby our state (Michigan, not Wisconsin) legislators on the topic of climate change through the Spring Lobby Weekend put on by the Friends Committee on National Legislation. This event is usually held in person in D.C. but if there is one positive thing to come out of this pandemic it’s that many more young people were able to participate since the event was held virtually and we lobbied via phone. How lucky am I to say that I lobbied my legislators about climate change, a topic I’m very interested in, with many of my inspiring interns, from my couch!

The piece of legislation we were lobbying for was the Climate Action Rebate Act of 2019. The goal of this act is to reduce global green house gas emissions (GHG) by 55% by the year 2030 and by 100% by 2050 by adding a carbon price of $15 per metric ton of GHG emissions and increasing that price by $15 yearly. The income from this carbon price will not be for nothing. The money will go back into the people who need it most, middle and low-income households, fossil fuel workers transitioning to cleaner energy production, and funding for clean energy infrastructure.

While I was nervous about how I was going to discuss this topic effectively, the advice and simple trainings held the previous days virtually through the Spring Lobby Weekend were very helpful and they even gave us a layout to follow on the call. I also learned about how to talk to those who don’t have the same viewpoints as you might. I learned about climate change and its relation to agriculture and public health, the economy, mass incarceration and immigration. It really does affect us all. However, being a dietetic intern, the agriculture and public health aspects appealed to me most. One of the hot topics in sustainable agriculture is no till farming to reduce the amount of carbon released into the atmosphere as well as reducing soil erosion, nutrient loss and evaporation. In addition, our overall health is being affected by climate change due to the direct effect it has on our water and food supply.

As you can tell I am passionate about climate change, that is why I chose to apply to the internship program I am in. But the one thing that was drilled into our heads over the course of the three-day lobbying weekend was that the most important piece to lobbying is your personal story. If you can tie the legislation to you and something that you have experienced personally, your legislator will find tremendous impact in that. They are there to listen to you! I really enjoyed this experience so much more than I thought and found it to be so inspiring and eye-opening.

 

More Information:

• https://www.fcnl.org/updates/spring-lobby-weekend-2020-watch-the-recordings-1914
• https://www.fcnl.org/documents/1068

I Simulated Living with Diabetes for Three Days

This past week I worked with registered dietitians that are specifically versed in educating and counseling those with diabetes at the Spectrum outpatient endocrinology and diabetes care clinic. I had already known that I was interested in diabetes outpatient care and that that could possibly be a future career path for me. Little did I know that I would love it as much as I did. The dietitians I worked with were so passionate about caring for those with diabetes, they not only educated patients at the level they were at of understanding diabetes management, they also were experts in managing the electronic devices used to regulate blood sugars and took a step back at times when patients simply needed a shoulder to lean on regardless of the reason why.

Diabetes is an autoimmune disease that can be genetic, as in type one diabetes. Diabetes can also be incurred in various ways with increased risk with obesity, old age, race, history of gestational diabetes (increased blood sugar especially in the second or third trimester of pregnancy) related to a decrease in the amount or efficacy of insulin secretion from the pancreas, as in type two diabetes. It is part of dietitian’s responsibility to educate newly diagnosed patients about the type of diabetes they are diagnosed with, what markers diagnose them, how to better control their blood sugars throughout the day, how to deal with high or low blood sugar, and how to use equipment such as a meter, glucose pump or continuous glucose monitor.

For three days I was “diagnosed” and lived as though I had diabetes. I did not, however, have to inject myself with insulin or take an actual pill as I do not indeed have diabetes. I did learn a lot about how I might teach or assist someone who actually is a new diabetes patient. I had to re-arrange my schedule a little bit to accompany testing my blood sugars when I woke up, before lunch, dinner, and bed. I was on the phone with my dad one night and he was shocked how many times I had to prick my finger throughout the day and noted that it must be painful and not enjoyable. I told him that it really was not that bad, specifically in the beginning, but that was probably due to the fact that I did not have to take insulin, deal with actual high and low blood sugar symptoms throughout the day, and knew that I would not have to live with this for the rest of my life. I became a lot more aware of what I was eating, just like tracking your food in general, but knew that I had to attempt to dose my insulin prior to eating so it would work on the food I consumed when it was being digested. This was sometimes a challenge as I would not always eat all of my food, be in a rush, or simply would dose incorrectly. Had I actually had diabetes, I might have run low in my blood sugars due to too much insulin, resulting in feeling shaky, sweaty, dizzy, or if left too long without taking in some sugar I could become unconscious. This is all very scary for a newly diagnosed diabetic. A dietitian’s role is so crucial in preventing diabetes diagnosis, monitoring symptoms and maintaining good blood sugar control over the course of someone’s daily routine.

Culinary Medicine

The second week of my clinical nutrition rotation at Spectrum Blodgett hospital I got to sit in on an evening culinary medicine class at the Grand Rapids Downtown Market. What is culinary medicine you ask? It is a program that has been spread across the country, originally started at Duke University School of Medicine, and focused on educating medical students on the role nutrition plays in fostering health and how to alter dishes to be more nutritious. Now this new take on teaching nutrition is used in community settings as an intervention for improving health. Participants sign up for a weekly or biweekly course and learn about various traditional recipes that they can alter to be more nutritious such as incorporating more veggies or adding healthy fats. They even get to take home premade leftovers!

The class I assisted with and attended was the first class in the series and was called “Less Meat, Forget Fried”. This class started out by introducing families to kitchen utensils and their uses and ingredients that would be used, then addressed topics like the Mediterranean diet, how to buy seafood that can be used as a part of a Mediterranean diet and mindful eating practices. Finally, families were broken up into pairs and the dietitians and volunteers assisted them in making various dishes for the feast later on. The dishes served (in the following order below) were spaghetti with lentils instead of meat sauce, black bean brownies (my personal favorite), apricot lentil soup, sesame ginger broccoli for a crisp vegetable, oven-baked fish sticks instead of fried, and salad with a homemade vinaigrette. I assisted with the groups that made the oven-baked fish sticks and the salad. It was such a fun and rewarding experience to see families working together and excited about what they were making.

 

Click here for more information about how the project started through Duke!

Interning in Food Service

While food service management may not seem like the glamorous rotation in dietetics, I definitely learned a lot and met some great people along the way. My rotation was at Clark Retirement Home in Grand Rapids, Michigan.

I really had a great staff to help me pick topics for various projects and support me even when I may not have felt the most comfortable. I would recommend really becoming good acquaintances with the chef and other managers since you will be working with them and shadowing them a lot.

          One project that was great to have the support of staff on was my theme meal. I was a little nervous, to say the least, for this project since it involves delegating more. However, the meal turned out just fine and residents claimed to have enjoyed it. The theme was apples since it was National Apple Pie Day on December 3^rd. I served apple stuffed chicken breasts or apple glazed pork for the entrees, cheddar mashed potatoes or apple and bacon brussels sprouts for the sides,  a butternut squash soup, and of course, apple pie for dessert.

I also worked closely with the dietitian on one project, my medical nutrition therapy menu adaptation. However, I will be working more with her in the spring when I go back to Clark for my long-term care rotation. For my menu alteration I adjusted the Clark menu to fit the needs of a liberal Muslim diet, someone who simply avoids pork products and alcohol in food served. In addition, I also adjusted the menu for a diabetic, making sure to reduce carbohydrate portions like starches, desserts and coffee sweeteners. This project is a little more difficult than it may seem since the dining database doesn’t provide all of the origins of the ingredients, especially related to being halal (safe for Muslims). This is why I kept it simple with excluding specifically pork or alcohol.

Being that I was at Clark right in the midst of the busy holiday season, I got to participate in one of the catering events as well. This event was at a new assisted living location that is using the same dining services as Clark, Unidine. The event was much fancier than I expected and all chefs from a few different locations were on deck to make the night special for the potential residents and business people coming through the door. There was also an ice sculpture and jazz band performing at the event! I helped decorate the place and make some of the appetizers beforehand and then served the cake and appetizers during the event. This was my first time experiencing serving, let alone at a fancier event such as this. It was fun to see it all come together and work with my directors, chefs, and the fellow servers. Keep in mind, (for future interns) this is a great opportunity to get to know you workers or peers and build respect and relationships with them.

My next rotation is clinical, so wish me luck! Fifteen weeks of working with all different kinds of dietitians and patients. You’ll find me passed out in bed at the end of the day but I’m excited to learn a lot quickly.

The Mental Game

In tennis you have to have a strong mental game to beat your opponent. Well, I was never great at that. I still love the sport, but I will say my mental game in life pans out better for me than in tennis. Even still, I’ve been called sensitive more times than I can count, on and off the court. I have to remind myself every day that I’m smart enough, fit enough, and eat the right thing to be a great nutrition professional and women. Do I have diagnosed anxiety, depression or disordered eating? No. But I’ve experienced all of these at some point in my life to some degree, and more in the past couple years than ever.

Being an intern, starting a new job or going off to college all have something in common…added stress. With a new environment to adapt to and new people to impress, the stress and possibly anxiety are high. I’ve always been happy with who I am and had a positive outlook, but at the same time I’ve always been a type A people pleaser. So, when someone says something, even constructive criticism, I take it personally. Most of the time I know what to do with the information and use it to improve myself but sometimes there is so much input that it gets overwhelming.

Take a tip from me, future interns and anyone starting a new chapter in life: take a deep breath, take the information people give you but don’t let it weigh you down. Every new rotation or job is a new opportunity and fresh start. Give it your best and that’s all you can do. And what I’ve learned most recently in life: It’s okay to speak your mind and be honest, you don’t always have to worry about other person’s feelings. Find the balance, it’s not easy.

So hit the tennis ball like you mean it, eat that delicious cookie, and have some veggies too!

 

Wellness Rotation

A lot happened in a one week rotation!

Corporate wellness and nutrition can take on many forms, some can involve employee wellness programs and some can involve the wellness of the company involving the consumers. I spent the last week working with the nutrition professional for Spartan Nash here in Michigan. Spartan Nash has a few different brand names that you may recognize: Family Fare, D&W, Family Fresh Market to name a few. There are 170 corporate stores in total and at least 70 stores in Michigan. For my Wisconsin friends there are a few stores too, one in Madison, in Chippewa Falls, Hudson, and I believe River Falls. Spartan Nash is also the leading distributor of groceries for U.S. military commissionaires.

This week I did so much it’s hard to remember. I visited the on-site warehouses at the corporate location. We spent some time touring the frozen and dry goods sections of the warehouses and saw just the mass quantity of food that is distributed every day! I also got a tour of Swiss Lane Farm, a local dairy farm that Spartan Nash sponsors. Spartan Nash helps fund tours of the farm and the kids cow to cup maze that shows the process of milk production. This is because the main milk sold in the Country Fresh brand or the stores brand jugs is from Swiss Lane Farm! This farm is run as sustainable as possible since they collect the manure to create fertilizer before it becomes run off in our water systems. Another interesting thing about Swiss Lane farm is that they have about half of their cows milked via a robotic system. I got to see this system in the works and how it massages the cow, cleans the cow and checks over 100 attributes of the cow’s health. In addition, this farm sold Wisconsin cheese because they thought it was so good!

I visited many of the nearby grocery stores and saw the variation in set ups and signage. I also got to write a blog about food safety during the holiday season that will be published online and in their Living Well publication. Did you know that the holidays are when most people encounter food poisoning? Remember to refrigerate your leftover turkey within two hours after cooking!

Another project I did was find a holiday pear salad recipe to serve at the corporate associate wellness fair. The salad was a pretty good hit and a great alternative to some more calorie-dense salads during the holiday season. We handed out the recipe for the salad, and you can find it too on my blog by clicking here.

Nathan, my preceptor for the week, has a large array of duties. He works to organize the stores more efficiently with the Living Well products they’ve discovered. Living Well is the healthier products that are categorized in stores by purple signage. He has also been working on another project to help people pick out healthy foods that fit their health condition such as low sodium or gluten free products. In addition, Nathan works with his team on a program called Kids Crew that is used to teach kids about groceries and where they come from with store tours and has awesome merchandise with characters that represent the food groups on the MyPlate.

I got to sit in on various business meetings regarding the above programs and new product pitches that could be offered in stores as well. I loved seeing a different aspect of nutrition and the various ways it can be implemented for the public.

Next up: Food Service Management at Clark Retirement Home!

Community Nutrition

Over the past three weeks I have been working with Cherry Street Health in Grand Rapids with the outpatient dietitian. What is community nutrition or what does a community dietitian do? Well, the answer can be very broad but I will explain what I learned during my rotation. Click the picture below to visit Cherry Health’s website!

Community nutrition can focus on nutrition policy and advocating for change, it can be education both in a clinical setting or through community programs, and it can be working with other health professionals for the best possible care of the patients. Community dietitians also work with a variety of community associations and projects to provide more resources to their clients. I learned and did a variety of these things.

I gave a sports nutrition talk to a high school cross country team regarding pre and post-workout nutrition. Surprisingly, the young athletes were fairly engaged and interested in the material. I also visited the Fulton Street Farmers Market to see how they utilize SNAP (formerly known as Food Stamps) and other food assistance programs to benefit the community and the farmers. It’s a lot more work than you might think to manage a large, year-round farmers market. Click the pictures below to visit the farmer’s market website!

                      

I also shadowed a Meals on Wheels pantry, deliverer, and assessor over the course of three mornings. These people really make a difference in the lives of those in need. We were even invited into a couple’s home who were so thankful for the meals they were receiving since they both recently were in the hospital.

Another program I visited was UCOM (United Church of Christ Outreach Mission). They do SO much for the community. Not only are they are food pantry, they also have a farmers stand inside that provides cheaper locally grown produce that also gives back to farmers. They also provide financial services and have a professional and everyday clothes pantry and they also work with Spectrum hospital in Grand Rapids with the NOW program that supports diets like low-sodium or no sugar for those with heart issues, diabetes or renal disease. Below are pictures from their community gardens. Click the here to visit UCOM’s website!

However, I spent most of my time observing or giving outpatient client nutrition education one-on-one. Most of the patients were mothers or going to be mothers soon, so we discussed prenatal nutrition and overall healthy lifestyle choices. There was also the occasional referral for weight loss or pre-diabetes education. This was the first time I was able to put my nutrition counseling and general counseling classes to work and it taught me about working with a variety of clients and learning to interact in ways that each client prefers. Everyone can improve some aspect of their nutrition and lifestyle but if there is one piece of education we talked about the most, it’s eating five servings of fruits and vegetables daily!

Next rotation: Wellness (corporate grocery nutrition)!

Starting My Dietetic Internship

Hello!

I’m finally beginning to use my blog that I started my senior year of high school for my Girl Scout Gold Award project, maybe I’ve been a little busy being a dietetic intern! I was accepted into the Western Michigan University dietetic internship in early April and began the internship in late August. The process of getting matched to an internship was a daunting one, however, I was so grateful to be matched with an internship that has allowed me to explore a new state while also integrating my passion for sustainability and the environment.

Dietetic interns go through rotations, much like nurses or doctors might do, that highlight the main concentrations a dietitian might work in. My first rotation was with the Grand Rapids Public School district working with the dietitian and the other nutrition center employees. I got hands-on experience working in the kitchen with the cooks at various schools assessing the flow of the kitchen, staff productivity, communication and product satisfaction. I also learned to develop menus for the school district while altering them according to certain allergens. But my one of my favorite projects was conducting a food demonstration and tasting at one of the high schools. The dietitian and I handed out baked sweet potatoes and veggie nuggets with a recipe card, facts about eating produce in season and an evaluation of the tasting. Much to our surprise, students were very eager to try AND evaluate the tasting. The students were very pleased and wanted to see the items again in the menu!

Now I am with the Holland WIC (Women, Infant, and Children) clinic, and I get to see babies everyday! It’s a dream come true. I have been working on a nutrition education resource for parents about fiber and constipation for both children and pregnant mothers. And I know this won’t be the first time I’ll be talking about poop in the field of dietetics. The dietitians often talk about another personal topic, breastfeeding. I never knew just how much can go into educating about breastfeeding and all the health benefits that can come out of breastfeeding your baby such as immune support, vitamins and minerals, and promoting healthy growth for baby. Breastfeeding can also promote weight maintenance for mom and is free believe it or not.

I can’t wait to see what else is in store throughout my internship but I know I will continue to learn a lot from a variety of seasoned professionals, and they really are so supportive in the educational journey that is the internship.

Next up, community nutrition!

 

My Path

The page describes my personal RD path. I hope the information is helpful, insightful, and relatable.