Yesterday I spent a day at WIC following clients through the appointment process.
Here's a microcosm: a girl who looks several years younger than me comes in with her 3+ year old son and newborn baby. She had the baby on Christmas eve (about 2 weeks ago) but you could never tell it looking at her. She's amazingly calm and really confident and capable at caring for her kids. All three are weighed and measured and the mom and toddler have their hemoglobin tested with a finger-stick test. The toddler cheerfully puts his heels against the wall and holds his head still while the nutritionist lowers the measuring board to the top of his head, but his baby sister isn't very impressed at having to lay down on a measuring board. In the counseling room, the nutritionist explains the results of the hemoglobin tests - their iron statuses are all fine, and plots the childrens' growth on their charts. The little boy's weight has jumped ahead of the normal curve, so mom and RD talk about ways he can stay active. The dietitian shows them pages of pictures - one page for each food group, and they talk about the foods the family eats from each group. This mom breastfed her baby for five days, which the dietitian commended her for, and now the baby will get most of her formula from WIC. The mom and dietitian discuss a few other topics - encouraging the toddler to drink water instead of juice, and giving him an open cup instead of sippy cup or bottle since it's better for his teeth. Finally the mom picks which food options she wants - milk alone or with cheese, and dried beans or peanut butter, plus the standard cereal and juice - and the dietitian prints her food vouchers then they're on their way.
The whole day went like this, but each client had their own experiences to bring to the discussion. One little boy had so many allergies that he's on a pediatric supplement drink, which WIC covers for him. Another little girl's hemoglobin has been continually low, so the dietitian offered to send a letter to her doctor alerting him of the problem. One dad came in with his son as his wife had fallen and broken her ankle that day, and another father-to-be came in with his pregnant wife who had arrived in the US only two years prior from Thailand.
The thing I really respected about the dietitians was their gracious manner of just talking to people about where they're at, encouraging and praising all the good things they are doing to care for their kids and themselves, and sharing ideas for changes to help them and their kids remain healthy. And I went away thinking 'hmmm, maybe if I'm ever pregnant I'll go on WIC.'
Tuesday, January 8, 2008
Wednesday, December 26, 2007
Staff Relief - the real thing
This week, being that many of the VA dietitians wanted to take some vacation, myself and two other interns are doing 'staff relief' where we cover for one of the dietitians who we've been with already. This week I am Karen, the extended care dietitian. Since Karen's been gone for four days now, there was a long list of people to see, lots of menus to correct, plus a few complaints from patients which made for a really busy day. It's the first time I've cut short my lunch and the first time I've had to stay after to finish everything ... maybe I'd rather just be an intern.
On the up-side, and it really wasn't a bad day despite the busy-ness, it's very encouraging to be able to do the work of a dietitian relatively unsupervised (an RD still has to co-sign my notes) and feel like I know what I'm doing. I guess this internship is serving it's purpose!
On the up-side, and it really wasn't a bad day despite the busy-ness, it's very encouraging to be able to do the work of a dietitian relatively unsupervised (an RD still has to co-sign my notes) and feel like I know what I'm doing. I guess this internship is serving it's purpose!
Thursday, December 20, 2007
Open House Questions: Interviews and Application Letters
Last Friday was our open house for prospective applicants to the MVAMC program. Dan, one of the other interns, said he felt pretty important being part of the Q&A panel. For me it was just so strange to be answering questions that were my questions less than a year ago, and giving a tour of the VA (and trying to disguise my occasional glances at the map and round-about routes from still not totally knowing my way around) since I was on the other side of the process so recently.
The students asked some really good questions, particularly about application letters and interviews. The MVAMC actually doesn't interview applicants but Beth and Joanna (two other interns) shared about their phone interviews at other sites. Before interviewing they talked to students from the previous year or friends whose interviews were before theirs about the questions so they could prepare ahead of time. I didn't prepare for the interviews that I did - I just ad libbed - but maybe that's why I didn't get any of those internships??? I do remember that the VAs in Chicago and LA asked basically the same questions and that all three interviews (including Hines) asked a lot of questions about past experiences and how I dealt with them. I struggled the most with recalling times where I had experienced whatever the question was addressing so I think it's a good idea to at least think back over your past experiences before-hand so you don't draw a blank when you're on-the-spot.
Dan shared some really good advice regarding letter-writing as he's been reading the application letters of some his friends from school who are applying this year. He says take advantage of your space in the letter to talk about things that you don't get to talk about anywhere else. Or in other words, don't list your achievements and activities in your letter, impressive as they may be, because you already got to list them in the application. Sound counsel I'd say. I'm not sure that my application letter is a textbook example, but in case you're interested, I'm including it below.
Dear Ms. Hoover:
Greetings! I am writing to express my interest in the Minneapolis VA Medical Center Dietetic Internship Program and to explain how my experiences and skills would make me an asset to your facility as an intern.
For me, dietetics is the perfect field where three of my passions come together: my love of food and cooking that was first sparked by the 4-H foods and nutrition project, interest in biochemistry (it was my favorite subject even in high school!) and heart for teaching people how to live healthier lives. Right now my short-term goal is to gain additional clinical experience by completing a clinical dietetics internship and then working as a clinical dietitian, preferably with patients with Diabetes or renal failure as those diseases are prevalent in the Hispanic population. During that time I intent to continue improving my Spanish language skills, particularly my medical vocabulary. After a few years I want to transition to working as a community dietitian in the Hispanic community in the United States and ultimately work as a community dietitian in low-income communities in Latin America.
Several of my experiences as an undergraduate student have begun to prepare me for this career, particularly the semester I spent studying in Guadalajara, Mexico. This experience allowed me to become conversationally fluent in Spanish and taught me how to learn a new language – a skill that will be invaluable if I work in a community where a language other than English or Spanish is spoken. I wanted to get experience speaking Spanish in a medical setting so I inquired at a hospital near my school in Guadalajara and was offered a volunteer position helping in the kitchen and preparing an in –house diabetic diet meal plan. This experience was very valuable in expanding my vocabulary and understanding of the health-care system in Mexico.
When I visited the Minneapolis VA Medical Center in January I was impressed by the level of specialization and dedication to their area of practice among the dietitians. I know that I will receive a high-quality, thorough, clinically-focused experience which is my objective for the internship. Although my long-term career goal is community –focused, I want a solid clinical background because I believe that the knowledge and experience of clinical dietetics will make me a better community dietitian. I believe that the Minneapolis VA internship is one of the best places for obtaining that experience.
Although I enjoy interacting with and helping people, I am an independent person who doesn’t like confronting conflict especially when it means negotiating with others. Although I have the managerial skills of organization and efficiency, I need to improve my skills in human resource management and conflict resolution and am confident that I will have the opportunity to do so as an intern at your program. Some other unique and valuable skills that I would bring to your program include flexibility and patience, which I gained in Mexico where life moves at a slower and less organized pace than in the United States, an appreciation for diverse people and perspectives, a strong work ethic and the ability to solve problems creatively.
My career goals are evidence of my personal interests in languages, particularly Spanish, international travel and cooking. I also enjoy outdoor recreation such as hiking, running and cross-country skiing and consider myself a musician as I play the piano, oboe and guitar and enjoy singing.
As an intern I will do my best to use my skills to benefit your program and the people who you serve. Thank you for considering my application and I look forward to hearing from you.
Sincerely,
Meg Dill
The students asked some really good questions, particularly about application letters and interviews. The MVAMC actually doesn't interview applicants but Beth and Joanna (two other interns) shared about their phone interviews at other sites. Before interviewing they talked to students from the previous year or friends whose interviews were before theirs about the questions so they could prepare ahead of time. I didn't prepare for the interviews that I did - I just ad libbed - but maybe that's why I didn't get any of those internships??? I do remember that the VAs in Chicago and LA asked basically the same questions and that all three interviews (including Hines) asked a lot of questions about past experiences and how I dealt with them. I struggled the most with recalling times where I had experienced whatever the question was addressing so I think it's a good idea to at least think back over your past experiences before-hand so you don't draw a blank when you're on-the-spot.
Dan shared some really good advice regarding letter-writing as he's been reading the application letters of some his friends from school who are applying this year. He says take advantage of your space in the letter to talk about things that you don't get to talk about anywhere else. Or in other words, don't list your achievements and activities in your letter, impressive as they may be, because you already got to list them in the application. Sound counsel I'd say. I'm not sure that my application letter is a textbook example, but in case you're interested, I'm including it below.
Dear Ms. Hoover:
Greetings! I am writing to express my interest in the Minneapolis VA Medical Center Dietetic Internship Program and to explain how my experiences and skills would make me an asset to your facility as an intern.
For me, dietetics is the perfect field where three of my passions come together: my love of food and cooking that was first sparked by the 4-H foods and nutrition project, interest in biochemistry (it was my favorite subject even in high school!) and heart for teaching people how to live healthier lives. Right now my short-term goal is to gain additional clinical experience by completing a clinical dietetics internship and then working as a clinical dietitian, preferably with patients with Diabetes or renal failure as those diseases are prevalent in the Hispanic population. During that time I intent to continue improving my Spanish language skills, particularly my medical vocabulary. After a few years I want to transition to working as a community dietitian in the Hispanic community in the United States and ultimately work as a community dietitian in low-income communities in Latin America.
Several of my experiences as an undergraduate student have begun to prepare me for this career, particularly the semester I spent studying in Guadalajara, Mexico. This experience allowed me to become conversationally fluent in Spanish and taught me how to learn a new language – a skill that will be invaluable if I work in a community where a language other than English or Spanish is spoken. I wanted to get experience speaking Spanish in a medical setting so I inquired at a hospital near my school in Guadalajara and was offered a volunteer position helping in the kitchen and preparing an in –house diabetic diet meal plan. This experience was very valuable in expanding my vocabulary and understanding of the health-care system in Mexico.
When I visited the Minneapolis VA Medical Center in January I was impressed by the level of specialization and dedication to their area of practice among the dietitians. I know that I will receive a high-quality, thorough, clinically-focused experience which is my objective for the internship. Although my long-term career goal is community –focused, I want a solid clinical background because I believe that the knowledge and experience of clinical dietetics will make me a better community dietitian. I believe that the Minneapolis VA internship is one of the best places for obtaining that experience.
Although I enjoy interacting with and helping people, I am an independent person who doesn’t like confronting conflict especially when it means negotiating with others. Although I have the managerial skills of organization and efficiency, I need to improve my skills in human resource management and conflict resolution and am confident that I will have the opportunity to do so as an intern at your program. Some other unique and valuable skills that I would bring to your program include flexibility and patience, which I gained in Mexico where life moves at a slower and less organized pace than in the United States, an appreciation for diverse people and perspectives, a strong work ethic and the ability to solve problems creatively.
My career goals are evidence of my personal interests in languages, particularly Spanish, international travel and cooking. I also enjoy outdoor recreation such as hiking, running and cross-country skiing and consider myself a musician as I play the piano, oboe and guitar and enjoy singing.
As an intern I will do my best to use my skills to benefit your program and the people who you serve. Thank you for considering my application and I look forward to hearing from you.
Sincerely,
Meg Dill
Sunday, November 18, 2007
Question and Answer
I got an email last week with some great questions about internships - questions I didn't even think to ask when I was applying, so in case others have similar questions, I've posted part of the email conversation here.
Hi Meg,
I actually just posted on your blog and got so excited that I wanted to contact you personally so to not bore all your blog readers with a super long comment! (Comment: if you're bored, you can skip this post!) I'm very interested in this program and would love to hear what you think of it so far. Most specifically, I was wondering what the structure is, how active/involved the director is, and if you feel like a VA hospital will expose you to a wide range of experiences. Basically, do you like it there and why??
If you get the chance, I'd love to hear back from you. If not (I'm sure the life of an intern is very busy), I'll just keeping reading up on your blog for more information :)
Take care!!
Mona
Hi Mona!
It's good to hear from you!
And I'm glad to know that someone is reading the blog. :)
About your questions...
I have honestly been really impressed with this program and the MVAMC
so far - much more than I thought I would be. I suppose that comment
is biased as hopefully all interns have a good experience and would
promote their program, although I have heard some stories of interns
who feel like they are at the bottom of the totem pole or are
intentionally made to feel like they don't know anything, and that
hasn't been my experience here at all. Quite to the opposite, we have
been warmly welcomed to the nutrition and food service department and
the dietitians even planned a lunch in our honor and have monthly
'lunch with the interns' to get to know us which is a big surprise to
me.
The MVAMC program as far as I can tell is structured around the
expertise of each preceptor. My schedule for the year has 1-3 weeks
with each dietitian plus around 6 weeks of planned community
experiences, which includes WIC, nursing home, vet's home, Extension,
school lunch, lifetime fitness, and 'miscellaneous' which I'm not sure
exactly what is included in that. In addition I have 3 or 4 weeks of
staff relief where I cover for one of the dietitians and 2 weeks of
vacation.
I think our internship director does a good job of making sure we have
enough support but giving us the independence we need to become
competent dietitians. In addition to directing the internship she
also works in research on weight management so we don't see her that
often - maybe once a day. However, when the internship first started,
she spent 2 weeks orienting us to the hospital. Now that we're in
rotations, she emails us once a week with a 'question of the week'
from the ADA exam and schedules our intern classes which are
1-2/month. We attend staff meetings but since I've only been to one
so far, I can't say much about that.
While I can't say that the VA exposes me to a diverse patient
population, we do see a wide range of diseases and all ages except for
children so I would definitely say that we get a wide range of
experiences here. Each dietitian's job is different from the other
dietitians' and our director tries hard to plan external experiences
to make up for anything we don't experience in-house. For example,
she sent us to a cultural competence in dietetics workshop hosted by
the Twin Cities District Dietetic Association, we're having a day-long
pediatrics workshop with the Fairview interns, and she sent us to the
International Diabetes Center for more in-depth training on treating
diabetes.
Whether the details I have given you are unique to the MVAMC
internship I don't really know as I haven't talked much with interns
from other programs except for the Fairview interns who have been at
all the external events we have gone to.
You asked if I like this program - I seriously love the VA and it's
not because of the program itself, but because of the people who work
here. The rate of turn-over among the employees at our hospital is
incredibly low because it's really a great place to work. Most of the
people in our department have been with the VA 15+ years - even many
of the food service workers, which I think says a lot. At least 4,
maybe more, of our dietitians did their internships at the MVAMC and
stayed on or came back. In addition to the employees, our patients
are great too. Because the VA is a teaching hospital, they're used to
students coming in and out of their rooms and in my experience always
try to be accommodating and pleasant, even when they don't feel the
greatest. One patient even apologized to me after being a bit crabby
with my preceptor the day before.
So for what it's worth, there's my opinion about the MVAMC.
Keep me posted on where you end up going.
:)
Meg
Hi Meg,
I actually just posted on your blog and got so excited that I wanted to contact you personally so to not bore all your blog readers with a super long comment! (Comment: if you're bored, you can skip this post!) I'm very interested in this program and would love to hear what you think of it so far. Most specifically, I was wondering what the structure is, how active/involved the director is, and if you feel like a VA hospital will expose you to a wide range of experiences. Basically, do you like it there and why??
If you get the chance, I'd love to hear back from you. If not (I'm sure the life of an intern is very busy), I'll just keeping reading up on your blog for more information :)
Take care!!
Mona
Hi Mona!
It's good to hear from you!
And I'm glad to know that someone is reading the blog. :)
About your questions...
I have honestly been really impressed with this program and the MVAMC
so far - much more than I thought I would be. I suppose that comment
is biased as hopefully all interns have a good experience and would
promote their program, although I have heard some stories of interns
who feel like they are at the bottom of the totem pole or are
intentionally made to feel like they don't know anything, and that
hasn't been my experience here at all. Quite to the opposite, we have
been warmly welcomed to the nutrition and food service department and
the dietitians even planned a lunch in our honor and have monthly
'lunch with the interns' to get to know us which is a big surprise to
me.
The MVAMC program as far as I can tell is structured around the
expertise of each preceptor. My schedule for the year has 1-3 weeks
with each dietitian plus around 6 weeks of planned community
experiences, which includes WIC, nursing home, vet's home, Extension,
school lunch, lifetime fitness, and 'miscellaneous' which I'm not sure
exactly what is included in that. In addition I have 3 or 4 weeks of
staff relief where I cover for one of the dietitians and 2 weeks of
vacation.
I think our internship director does a good job of making sure we have
enough support but giving us the independence we need to become
competent dietitians. In addition to directing the internship she
also works in research on weight management so we don't see her that
often - maybe once a day. However, when the internship first started,
she spent 2 weeks orienting us to the hospital. Now that we're in
rotations, she emails us once a week with a 'question of the week'
from the ADA exam and schedules our intern classes which are
1-2/month. We attend staff meetings but since I've only been to one
so far, I can't say much about that.
While I can't say that the VA exposes me to a diverse patient
population, we do see a wide range of diseases and all ages except for
children so I would definitely say that we get a wide range of
experiences here. Each dietitian's job is different from the other
dietitians' and our director tries hard to plan external experiences
to make up for anything we don't experience in-house. For example,
she sent us to a cultural competence in dietetics workshop hosted by
the Twin Cities District Dietetic Association, we're having a day-long
pediatrics workshop with the Fairview interns, and she sent us to the
International Diabetes Center for more in-depth training on treating
diabetes.
Whether the details I have given you are unique to the MVAMC
internship I don't really know as I haven't talked much with interns
from other programs except for the Fairview interns who have been at
all the external events we have gone to.
You asked if I like this program - I seriously love the VA and it's
not because of the program itself, but because of the people who work
here. The rate of turn-over among the employees at our hospital is
incredibly low because it's really a great place to work. Most of the
people in our department have been with the VA 15+ years - even many
of the food service workers, which I think says a lot. At least 4,
maybe more, of our dietitians did their internships at the MVAMC and
stayed on or came back. In addition to the employees, our patients
are great too. Because the VA is a teaching hospital, they're used to
students coming in and out of their rooms and in my experience always
try to be accommodating and pleasant, even when they don't feel the
greatest. One patient even apologized to me after being a bit crabby
with my preceptor the day before.
So for what it's worth, there's my opinion about the MVAMC.
Keep me posted on where you end up going.
:)
Meg
Monday, November 12, 2007
Undergrad Years - Do More than Study
From my observation most people who choose dietetics as a career have a passion for food, wellness, exercise or maybe even hospitals that pre-disposed them to becoming an RD. That's great because it leads them to naturally seek out jobs, volunteer opportunities or organizations related to those passions. If you are an undergrad student and haven't done that yet, do so post haste. There's a section on the internship application that asks for nutrition-related experiences and you want to have something interesting to put there. A really dedicated advisor will make sure you're doing this and may even fill your inbox with information about possible summer internships and other opportunities.
Rather than wait for your advisor to do the work for you, here's a short list of some of activities to pursue taken from the diverse undergrad experiences of myself and all the dietetics students I know:
- internships at a bakery and food coop
- working for WIC
- EMT/Paramedic
- student dining service on campus
- hospital or nursing home food service
- hospital volunteer
- working in a research laboratory on campus or at a hospital
- working for Extension and 4-H
- volunteering at a soup kitchen or food bank
- summer program teaching nutrition to mothers in Peru
- involvement in the American Dietetic Association and Student Dietetic Association
- became a certified personal trainer
- TA for a nutrition or food science class
So the moral of the story is that for the 3 (or more!) years before applying for internships, dietetics students do a lot more things related to nutrition than just study chemistry, food composition and nutrient tables.
Rather than wait for your advisor to do the work for you, here's a short list of some of activities to pursue taken from the diverse undergrad experiences of myself and all the dietetics students I know:
- internships at a bakery and food coop
- working for WIC
- EMT/Paramedic
- student dining service on campus
- hospital or nursing home food service
- hospital volunteer
- working in a research laboratory on campus or at a hospital
- working for Extension and 4-H
- volunteering at a soup kitchen or food bank
- summer program teaching nutrition to mothers in Peru
- involvement in the American Dietetic Association and Student Dietetic Association
- became a certified personal trainer
- TA for a nutrition or food science class
So the moral of the story is that for the 3 (or more!) years before applying for internships, dietetics students do a lot more things related to nutrition than just study chemistry, food composition and nutrient tables.
What's this all about?
Any dietetics student can attest that the fall of their senior year of college was complicated by a the time-consuming, stressful process of applying for dietetic internships. When I was applying for internships, one of my advisors recommended that I blog the process so that future students could avoid some of the frustration. This isn't by any means a comprehensive guide to getting an internship. It's just my experience, and I hope that other RDs or interns will add their comments or links to their own blogs to expand the pool of wisdom so to speak.
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