By Hassan S. Dashti, PhD
I spent a lot of time contemplating whether I should pursue an RD after completing my PhD. I was told by one of my professors that back in his days, he had to choose between dietetics and research. He told me that it was assumed that students with ‘social’ and ‘people’ skills went into dietetics, whereas the rest went into research. The mutual exclusivity of nutrition clinical practice (dietitian nutritionists, RDNs; but more commonly referred to as RDs) and research is no longer the case. A recent 2016 survey from the Academy of Nutrition and Dietetics (The Academy) revealed that 4% of RDs hold a doctoral degree (PhD, RD) in the US. For the vast majority of those 4%, their curriculum vitae(CVs) will likely indicate that they have completed a dietetic training program (RD) followed by a doctoral degree in nutrition (PhD), and rarely a PhD first then RD. So having completed vigorous doctoral programs, what makes some researchers go back to school to get their RDs?
Perhaps the most common reason is to obtain training for effective translation of nutrition research. Being able to communicate nutrition knowledge to patients and other people was also particularly the reason why Stephanie Harshman, a doctoral student at Tufts University studying vitamin K, applied to RD programs while in her last year of her graduate training. She shared, “The RD training provides a different perspective when examining clinical research, community based interventions, and allows someone to better translate basic science research into terms and ideas that will positively impact human health.” Similarly, the PhD, RD combined training program at Cornell University’s Division of Nutritional Science recognizes the growing need for translational research expertise in order to enhance the “effectiveness and impact of clinical and public health nutrition,” which is made possible through this combined training.
As nutrition is a young and evolving science, a PhD, RD is particularly crucial when leading the translation of novel and cutting-edge science, like nutrigenomics or nutritional chronotherapy, where the translation is not as simple as a dietary prescription like a low-fat diet. Previous president of the American Society for Nutrition (2014-2015) and current director of the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Simin Nikbin Meydani, DVM, PhD, shared with me the story of one of her former doctoral students who wanted to bridge the gap between what is studied and what makes the news headlines and thus went on to getting her RD. Dr. Meydani said, “[The PhD and RD training together] could be applied to meaningful approaches that promote the health of an individual through proper nutrition.”
But it’s not only about how to apply and translate the science, a combined PhD, RD training may facilitate generating pertinent research questions with important implications. Having that human and patient interaction experience, which is often very limited in doctoral training, may help in study design development, particularly in human intervention studies. President-elect of the American Society for Parenteral and Enteral Nutrition (ASPEN) and Professor of Nutrition Science at the University of Pennsylvania School of Nursing, Charlene W Compher, PhD, RD, CNSC, LDN, FADA, said, “The best translational research comes from clinicians who understand what a nutritional problem really means for patients.”
While more than half of RDs (~58%) do work in clinical nutrition (acute care, ambulatory care, or long-term care), contrary to common belief —particularly among non-RDs— not all RDs end up working as full-time clinical dietitians. Practice areas for RDs keep expanding and now include community, food management, communications, consultation and business, and as indicated earlier in this article, in education and research. Thus it’s not uncommon that the realization of the need of a dietetics training may occur later in a PhD’s career.
Stella Uzogara, PhD, MS, RDN, LDN CFS works in public health and decided to pursue an RD in order to get both clinical and non-clinical training to effectively discuss the challenges in public health nutrition and to positively impact health of consumers and patients. Dr. Uzogara who got her PhD in food science is also a certified food scientist (CFS). She now works as a nutritional epidemiologist in the Bureau of Family Health and Nutrition at the Massachusetts Department of Public Health and a state liaison for pediatric nutrition and pregnancy nutrition surveillance systems between Massachusetts and the CDC. She also works in several community health programs. Dr Uzogara said: “Personally, nutrition has served me well in my job and it gives me more flexibility, enabling me to practice both food science and health science, two disciplines which interest me a lot.” On the other hand, incoming Brigham and Women’s Hospital dietetic intern and current doctoral student at the University of Connecticut in biomedical engineering, Anna Roto, MS, MPH, is learning about clinical instruments, mobile health devices, as well as how to design new equipment for medical use in her doctorate program. When asked about her intentions for pursuing an RD, she said, “I am not getting the clinical experience that I believe is necessary for a career in the rehabilitation science field, as I plan to work with individuals experiencing trauma or debilitating illnesses to improve their physical abilities and overall quality of life.”
An RD may also be used as an opportunity to steer towards a new career. Dominica Nichols, PhD, RD, LDN, competed her doctoral training at Northeastern University in microbiology where her work in microbial ecology informed the technology used by several biotech startups. However, after years of culturing microorganisms, Dr. Nichols was looking for other opportunities that would enable her to mentor students and have more interactions with people. Having completed her dietetic internship at Simmons College, she now serves as a pediatric outpatient dietitian at a community center affiliated with Boston Children Hospital. Her research training allows her to work closely with other physicians on various research projects. She said, “Dietetics is an interdisciplinary field. Having training in another field, microbiology in my case, benefits my dietetics practice.”
While less demanding than a doctoral program, completing an RD does come with its own challenges. Interns should be ready to work very closely with a preceptor and shadow current practicing dietitians for an extended period of the internship. As most dietetic internships are fulltime programs, it is often challenging to work on other ongoing projects and jobs, but possible. When asked about the difficulties she experienced as a doctoral student who decided to pursue an RD, Stephanie Harshman shared, “I think the most challenging part of this experience has been trying to find support and guidance from faculty as I pursue the credential.” Dr. Dominica also claimed, “I constantly had to explain to other people why I was doing what I was doing.”
Despite these challenges, most of which are only temporary, whether your interests lie in public health policy, community, or teaching (yes, numerous teaching opportunities are now seeking PhD, RDs), an RD is nonetheless an opportunity for growth and expansion. Dr. Compher said, “I continue to treasure my clinical practice because it keeps me in touch with issues of importance to patients.”