“Failure by instructors to appreciate other life priorities is an additional, and possibly academically fatal, stressor” (Taylor,M)

Comments have been generating from Dr. Jacqui Gingras’ recent compassionate and concerning post STRANGE LITTLE HURTS. In her post she brings our attention to the distress and harm that the dietetic internship creates among nutrition students.  I remember the application process like it was yesterday and I assume many others do as well.  Instead of celebrating four years, students were in constant states of anxiety, fears and self-evaluation. Our peers and friend were not a competition.  A competition towards a dream we’ve all equally deserved and worked for. With a 50/50 chance of being a successful applicant- a lot was on the line. 

While the application process is convoluted, political and very much subjective (my humble opinion); what grinds my gears the most about the road to becoming a dietitian is the lack of financial support the successful applicants have through their one year training.  

Below are some of the basic costs students must endure using PERSONAL financial means (we are not eligible to apply for student loans primarily because we’re not associated with an academic institution. The internships are  managed by each individual  hospital. <— click on Post degree internship tab to see list of available internships).

Application fee$140 

Transcripts:  $60 

Internship tuition: ~$300 

Practice insurance:$175 *

Dietitians of Canada membership (mandatory for my internship- sigh*): $206*

Total internship program associated costs= $881.00

 * the annual membership and insurance schedule runs from April 1 to March 31st. Since my internship started in September 2009 I had to pay full membership fees to cover September until March and subsequently, purchase the full membership again to cover the remainder of my internship, April-August). 

Let’s not forget, I had to also to pay RENT, GROCERIES, BUS PASS and bills…about $10,000 for 12 months. While it would have been more economical for me to pick an intership in the city my parents reside; unfortunately, I didn’t have the privilege to such a choice. The internship picked me. 

In addition to my 40- hour per week intensive “accredited” training,  I had to find a job to support myself; even though its often “frowned upon” to work during your internship (why that is, I have no idea!!!).  This added responsibility and financial constraint made it difficult for me to process what I was learning from my rotations and limited my ability to provide self-care.  Accordingly,  in a questionnaire distributed to dietetic interns 79% of students identified “Limited funds/debt” as a STRESSOR (Lordly, D and MacLELLAND Can J Diet Prac Res 2008;69:126-130).  

As such, when we consider the stressors student’s experience while in internship (e.g  financial+ no sleep+ job+ caregiving..etc), its not surprising that Dietetic Educators identify the performance issues listed below (Lordly,D. Can J Diet Prac Res 2007;68:36-40).  

Personal issues: actions attributed to the student as an individual
– Sick a lot  
– Argumentative
– Psychological problems
– Not motivated
– Insecure/low self-esteem/no confidence
– Uncooperative

While this may seem like the  typical “poor-student” dilemma, its disheartening that the dietetic profession who works endlessly to promote health, seems to ignore the financial burden of our professional training. Just because the process has always been this way doesn’t make it right.

We need a strategy to make dietetic training accessible to all applicants, regardless of their financial status.  Who will help us in this process? Who will be our advocates? 

“Failure by instructors to appreciate other life priorities is an additional, and possibly academically fatal,

stressor” (Taylor,M: p.10)**

 **Taylor M. Generation NeXt comes to college: today’s postmodern student ODCE Conference; 2006 [cited 2006 18 Jun]. Available from: http://www.oln.org/conferences/ODCE2006/ODCE2006papers.php

With concern,



7 thoughts on ““Failure by instructors to appreciate other life priorities is an additional, and possibly academically fatal, stressor” (Taylor,M)

  1. nutritionartist says:

    I find it so ironic, Julie. Dietitians are seen as enablers for people needing support in the area of food and nutrition wellness. But how can dietitians help others… if no one is helping us? I have many friends who are being trained/work within other regulatory bodies governing certain professions: law, pharmacy, medicine, occupational therapy, accounting… and I cannot help but compare. Why are the endowed with so much more support (financial and other) than we are? In a field that prizes itself on compassionate care when working with clients… why isn’t there more compassion for us?

  2. Jacqui Gingras says:

    In work soon to be published, our research team has shown that those who do NOT get internships on the first attempt experienced the following:
    a) personal stress or anxiety due to financial insecurity,
    b) conflict in relationships due to financial stress, and
    c) food insecurity.

    Unsuccessful applicants also took short-term loans to cover living expenses. How is this process preparing future dietitians? Our hopes for the future of the profession is being forged by stress, anxiety, conflict, financial insecurity, and hunger. This must stop.

  3. Internship Applicant '12 says:

    I feel rather uncomfortable posting my name about this topic before the results come out next week. I REALLY wanted to comment though.

    During all my interviews I felt all the internship co-ordinators would ask at least one question that pertained to financials indirectly. One of them came out and said it, and since I knew a handful of interns that worked during their internship…I didn’t think it would be a big deal to say I was planning on doing that to. But I felt a look pass over the co-ordinator’s eyes before she scribbled something down and I IMMEDIATELY regretted saying what I did. Now, reading this blog I feel I jeopardized my chances by saying this.

    Personally, I come from a lower class family and I’ve had a job since I was 14. If this is frowned upon during internship, what kind of class of people are they looking for? If they are looking for the people that are privileged enough to be able to just work for a year unpaid, does this system then perpetuate class injustice? other forms of social injustice? I feel that coming from a lower class neighbourhood, certain practitioners would be able to have a fresh, critical perspective on food insecurity issues and other relevant topics pertaining to less privileged individuals. If they can’t squeak by this system … how can these issues ever be appropriately addressed by the dietetic field?

    This is going to be a long night….

  4. the fat nutritionist says:

    If they are looking for the people that are privileged enough to be able to just work for a year unpaid, does this system then perpetuate class injustice? other forms of social injustice?

    In my opinion? Yes. And yes.

  5. NutritionGIrl says:

    This entire system is flawed. As someone who has recently left an internship I still want to support students and help out as much as I can but I am glad to be out of this system entirely. I was asked by a fellow RD mentor of mine how I felt after I left and I said “like a weight has been lifted off of my shoulders” and I haven’t looked back ever since. Many ask why I chose the path to begin with but that is another story. I have left a life of confusion, insecurity and perceived “dead ends” that was partially perpetuated by this process and organization.

    I wish everyone the best with their applications and I want to let everyone know that you are good enough the way that you are and what’s meant to be will always find its way.

  6. Dave says:

    Dear Julie,

    Thank you for your post and for your blog. I wanted to touch on one additional challenge of the current post-degree internship structure.

    Because the post-degree internship is run by hospitals and not by universities when we became interns we were not members of a students’ union. We lost the benefits and voice that this body had provided us with in undergrad. These benefits included a health insurance plan, dental plan, prescription drug plan, optional coverage for our spouses and children, and access to a clinic that could immediately follow us as a patient if need be. There are also all the academic and community supports that a students’ union provides its members.

    During internship I always wondered if in some way students of post-degree internship programs could apply to join a students’ union such as the Canadian Federation of Students or the Canadian Alliance of Student Associations. During our internship we received forms from the government that confirmed our internship tuition fees were tax deductible because the government formally recognized our program as being an officially registered educational program. So, can post-degree interns join a students’ union? I’m not sure. The list of member unions for the CFS published here: http://www.cfs-fcee.ca/html/english/about/member_locals.php and CASA published here: http://www.casa-acae.com/membership/current-members/ only include programs affiliated to universities or colleges.

    If post-degree interns cannot join a students’ union perhaps DC or the internship coordinators via DELFO could help post-degree interns to optionally join some pooled health and dental insurance program so that interns have something beyond basic provincial coverage.

    The lack of a health and dental plan for ourselves and for our loved ones is another challenge that post-degree interns face compared to colleagues in integrated university programs. Out-of-province post-degree interns also face additional expenses as many medical clinics in Ontario commonly charge a fee to patients who have out-of-province health cards. I just wanted to touch on this.

  7. shiftthefocus says:

    Thank you all for sharing! I’ve also been getting comments of facebook which goes to show how much this affects students in dietetics.

    Internship Applicant ’12: i can definitely hear your struggles and anxiety. I now remember being asked a “how are you expecting to pay for internship?” question. I remember feeling awkward and caught off guard with this question. This is definitely not something we’re advise to prepare for by undergraduate internship coordinators. Should we? Coincidence or ignorance? As for the job, its really sad that you would be made to feel ‘bad’ for taking responsibility to support yourself. The only other option is to quit internship- who benefits from this system?

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s