“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,

@julie_rochefort