Seconds, Anyone?

The Second Round is here. Are you applying? How are you changing your cover letter? Your resume? Have you sought feedback? If not, why? If yes, was the feedback constructive? How are you feeling? Share with us.

Open Letter to the Ontario Task Force on Dietetic Education and Practical Training

Dear Members of the Task Force,


According to your communication in November 2010, you indicated that a final report would be completed and shared by March 31, 2011. It is now April 20 - almost three weeks has passed without hearing anything from you regarding a proposed new model of education and training. 


You also indicated that you would be seeking input, but to our knowledge no students have been consulted. We would be hard pressed to understand why students have not been consulted since we are central to the education process. If students have been consulted, please let us know. Have interns been consulted? They are also key figures in this process with immediate experience as to how the education and internship model might be enhanced.


It seems to be common knowledge among those that are privy to insider information, that students will be consulted by the Task Force. In iSAD email conversation, one of the program Dean's stated that "The task force has the interests of the students at heart and it will provide opportunities for student input." We don't know how that Dean arrived at that conclusion, but we hope it is true. Until we hear otherwise, we can only wait.


What we would propose however, instead of waiting, is for the Task Force to arrange a town hall type meeting organized at each of the four Ontario universities where students (and interns) could come together to hear about the work of the Task Force to date. We would suggest that such a town hall would be open only to students/interns in order for them to feel free to speak openly about their experiences and responses to information being shared by the Task Force.


So, we are looking for an indication from you, Task Force members, that our voice counts as you reconsider the education and training processes that impact our path to becoming dietitians. 


On behalf of all Ontario food and nutrition/dietetics students as well as interns, we ask you for any information whatsoever of what your work has produced and we would be happy to provide feedback from our perspectives.


Sincerely,
iSAD

Another Influence to the Dietetic Landscape

E-mail received from anonymouslytoisad@gmail.com   

Many students decide to do a Masters degree when they do not obtain an internship position within a Hospital program. Several Masters programs actually combine an MSc degree with a dietetic internship. This is the new alternative way to go about becoming a dietitian.

Now, more than ever, there are more interns and dietitians with Masters degrees. How are these dietitians to be treated – like advanced practice dietitians? Should they be compensated differently? Be promoted to leadership roles, despite having little real-world experience? Perhaps maybe internship should be a two year MSc degree/or a 5 year undergraduate/Masters degree with a practicum component. This would be similar to other professions (i.e. speech language pathologists), which is a totally different model for dietetic training not yet suggested. Not that I personally think it is better, but it is another option.

Based on the current availability of combined MSc training programs, I think eventually there may be two tiers of dietitians: those with graduate degrees and those without. I’m interested to know what students and dietitians think about how these programs are going to influence the dietetic landscape.

We've Come a Long Way

In one month, the iSAD blog and twitter feed have registered:

5200 page views – 183 comments – 80 twitter followers – 47 tweets – 20 posts – 1 poll

The conversation has moved from a sharing of impact statements to a sharing of ideas for improving the current system. Along the way, many misperceptions have been aired out – iSAD blog visitors have enthusiastically informed each other of the realities of being a student, intern, preceptor, coordinator, and educator. Students are not spoiled, entitled brats. Interns work really hard and learn lots. Preceptors lack adequate time to spend with interns. Internship coordinators are feeling pressured by an overwhelming large number of applicants for an underwhelming small number of positions. Educators are facing increasing enrollments and accreditation demands.

The blog has not registered a post or comment explicitly from Dietitians of Canada or the Task Force, although all have been informed of its existence. This is unfortunate. Their voices and representation are missed, but always welcome.

There are clearly issues with the internship system, which we have demarcated as beginning with being a student to completing an internship placement. We have noticed that while blaming individuals was the initial, hurtful response, we can certainly see that people have mostly shifted into identifying structural changes that can enhance the education and training of future members of the dietetics profession.

We have even had calls for renaming the blog. We have considered and discussed this request very carefully. While we acknowledge and applaud a move away from only being “sad,” and towards constructive, collective brainstorming, it is more important to remember that the sadness and hurt is what motivated the blog to be created and what enabled students a safe place to share their feelings – FOR THE FIRST TIME EVER! This blog will continue to provide that space for the emotional stories AND will promote constructive and collaborative moves forward. Both can happen without neglecting or diminishing the other. We hope that internshipSeasonalAffectiveDisorder motivates and reminds us to strive for making improvements to the system.

For people who want to RANT, you are welcome to it. Just let it out, spill your feelings. Anonymously. Tell *your* truth. Don't be silent about how the current system has affected YOU and the people that care about you.

For people who want to put forward ideas in support of change – all ideas are worthy of consideration – please feel free to post or comment everywhere else. We will still accept posts from the anonymouslytoisad@gmail.com and from theprojectisad@gmail.com email portals.

We wish this to be a place that registers and promotes an historic change in the way internships are done in Ontario. We are pleased so many of you are bearing witness to these changes. We hope that more of you will feel free to share your stories, your ideas, and your hopes for a better future. We believe this better future is possible and within our grasp. We want to see that future arrive very soon.

The truth about integrated internship programs

The following entry came to us via our iSAD Anonymous e-mail. 

Thank you very much for submitting your story.

I keep reading this blog hoping that someone will say something about the students like me who have been left out of this conversation so far.  I guess it’s up to me. I have wanted to be a dietitian since I was 12 years old. My dad got sick and I got to see how a dietitian helped him get better. From that moment on I wanted to be a dietitian. 

I did my homework and decided that my best chance was to go to an “integrated” program – I won’t say which one. So I applied and got in. What I didn’t know then was that being accepted in the program didn’t mean that I was on my way to make my dream come true.  Once I was in the program, I had to apply AGAIN to become one of the chosen few who would actually have the chance to do an integrated internship and become a dietitian.  I studied incredibly hard, volunteered for four different dietitians, and worked as a diet tech.  Nobody wanted this more than me.  It turned out that there were only a small number of internships available in the “integrated” program and that there were at least three times as many applicants as there were internships.  But I had done everything I possibly could to show how much I wanted to be a dietitian and I knew it was the right path for me....... I didn’t get in.  I couldn’t believe it.  It was so wrong. I asked the university why I didn’t get in – they said that they didn't have enough internship positions for all of their “qualified” students.  UNBELIEVABLE.  I had to finish my degree taking classes with those lucky few students who got those precious internship spots. That was hell.  After four years together, they went on to do their internships in their 5th year and the rest of us – and there were lots of us – graduated and were left to fend for ourselves.   I still work as a diet tech. I still want to be a dietitian, but there is no way for me to do this.  I think it's time someone told the truth about integrated internship programs on this blog.

I see job postings for dietitians all the time.   I don’t think it matters which kind of program you graduate from, I think the question we should be asking is

“Why aren’t there enough internship positions?”

If anyone else would like to send e-mails anonymously:

Log into: anonymouslytoisad@gmail.com           

Password: isadisad

Send your questions or statements or comments directly to: theprojectisad@gmail.com
We will post it the way it is written. We will use your title, or if there is no title we will use a sentence from your entry. The more stories we have the more complete a picture we can see. We invite all students from 1st to 4th year, master students, interns, RDs, and anyone else who would like to contribute, from Ontario and outside of Ontario to participate in our conversation. Your voice is needed. 

Survey/Poll

Please take a moment to answer the survey located at the bottom of this page. We will periodically post questions regarding topics from the discussions in this blog.

If you have any suggestions for questions, or additional comments on the questions asked, please post them here.

The first question is in regards to the preferred model of dietetic/nutrition education. We appreciate your participation!

Thank you,

The iSAD Team

Brainstorming Session for Different Models

We are eager to work collaboratively on brainstorming ideas for different models. Any idea counts in this post. We will collate the ideas and share them with the Task Force and any other groups our readers suggest. Thank you!
--iSAD
~~~~~~


Okay, so now we are going someplace.

What characteristics would students like to see in a different model? Realistic or not... 

Write in positive words/phrases so that we do not offend anyone entity/being.
If you have a hard time with this which is understandable... emotions can play alot. write it out on a piece of paper then bring them together and post.

Looking forward to having this discussion.

From iSAD Anynomous

This e-mail came to us from our anonymous e-mail address, anonymouslytoisad@gmail.com. Thank you for sharing your thoughts with us. Each voice counts.
 
Hello,

Even though you promise to keep my identity a secret, I am still nervous to share my ideas. This separate email helps. Thanks. I wouldn't have commented otherwise.

OK. I am currently a RD, just new. I was one of those who was told that I should tone down my looks before my interviews. Keep my hair tied back in a low pony tail, no lipstick or mascara, simple suit. From what I have read on the blog, students can be under-qualified, over-qualified, too pretty, too entitled, and too spoiled. This seems quite unfair. Really unfair. 

Now that I am a dietitian working in clinical practice as my first job, I have started to question if this job was everything I thought it would be. My colleagues are really great and the patients are appreciative for the most part, but the actual work is pretty mundane. Maybe I need a change or I am just tired after going through the whole undergrad and internship process (not integrated, btw). It feels anti-climatic sorta.

Anyway, I wanted to share, so others didn't feel so alone. This blog has helped me to feel more connected to my peers, strangely, when I read their stories. I feel for you. I feel for all of us.


To send e-mails anonymously:

Log into: anonymouslytoisad@gmail.com           

Password: isadisad

Send your questions or statements or comments directly to: theprojectisad@gmail.com

 

Are we qualified yet?

What we are required to do?

• B to B+ GPA
• “Relevant” work and volunteering experience in clinical, foodservice, community nutrition
• Leadership, self-direction, teamwork, motivation, ability to work independently, communication skills, effective critical thinking, word processing and computer skills, flexibility, good judgment, time management

What do we do?

• Sacrificed pay to volunteer 260-780 hours a year
• Searched and pursued volunteer positions independently
• Worked part to full-time while in school
• Worked as a dietary aid (washed dishes in hair net and scrubs)
• Was unable to work for years
• Spent hundreds of dollars on sending internship packages
• Lived for 4 years without pay
• Attained a higher than a 3.0 GPA
• Networked with dietitians
• Sucked up to dietitians and professors 
• Endured disrespectful treatment while volunteering
• Spent an extra course worth of time preparing internship packages (~72 hours)
• Lost my friends 
• Isolated myself from those who do not understand what we’re going through
• Led research projects
• Started a club
• Wrote weekly articles on nutrition and health issues for a student newspaper
• Took extra courses outside of school (leadership, professional development, public speaking)
• Lost hours and hours of sleep
• Sought career counseling
• Inserted 5 spaces between my name and signature on cover letter
• Spent $500 on an interview outfit
• Sought psychological counseling
• Applied for OSAP, various scholarships, and loans during undergrad
• Compromised my mental, physical and emotional health
• Published an article in a peer-reviewed journal
• Paid $60 to park for interviews
• Asked for numerous references
• Became members of numerous professional associations, including DC (which cost $100 each year!!)
• Cared for a family member while being in school 
• Attended Internship Forums since 1st year
• Attended stress management classes 
• Missed family events to volunteer or study to get an A+
• Applied and won academic awards
• Pursued an additional degree, minors, certificates, additional majors
• Balanced school, volunteer and work, social, self(?)
• Worked abroad
• Compromised my physical and emotional 
• Compromised my diet to be able to afford to volunteer with a dietitian and not being able work
• Waited…

What have you done to get the internship?

Anonymous Emails and Communication

Dear readers,

It has come to our attention that some of you may be concerned about the anonymity of submitting and/or posting on our blog.  We want to encourage your participation, because we believe that change can only happen when people come together.  To ensure that this is a safe place, we have set up an anonymous email address that you may log into and send questions and impact statements directly to our iSAD account anonymously.  This way you can avoid revealing your identity even to the iSAD group, if this is a concern to you.

Here are the instructions:

Log into: anonymouslytoisad@gmail.com           

Password: isadisad

Send your questions or statements directly to: theprojectisad@gmail.com

Remember, this blog is for you.  And your voice matters in facilitating change. We look forward to your contribution.

iSAD

iSAD is....

The following question was posted as a comment, we felt the answer deserved a separate post. 


Q: What does the non-integrated internship process entail? Consider the big picture: applying to a DC-accredited undergraduate program, volunteering, working, studying, completing the degree, applying for internship, being qualified and getting lucky enough to get that internship, and then completing the internship.

Did I miss anything?

Owners of this blog, are you suggesting all of these stages when you say iSAD is about the "internship?" Or do you just mean the actual 40-50 week internship?

Please clarify for the confused among us.


A: Thank you for your inquiry. iSAD is concerned with the lasting impact of the current dietetic education and training model in Ontario, which is not limited to the internship, but spans the whole model from enrollment into an undergraduate program to graduating from an internship program and everything that happens in between.

Tuition-Hungry Universities

Dear Readers,

It was brought to our attention that some comments do not appear on our blog. We would like to ensure you that we are  not screening the comments. All comments are automatically posted, however some comments are automatically treated as spam and are not posted. If you are trying to post a comment but are not successful, please e-mail it to us at theprojectisad@gmail.com and we will post it for you.  The following post came to us from Carolyn T. Thank you, Carolyn, for your perspective.

Dear isad,
 
I know the process seems unfair from your vantage point, but I do not feel that it is the fault of the internship process but rather the universities. Do a little research into this side of things and you may discover that some universities have actually been reprimanded for cutting back on their curriculum. If you want to advocate for something, advocate for the poor quality of your education and against the misleading information that you feel you may have been provided by these institutions.

As someone who has recently experienced both sides of this process I fully understand your collective disappointment, and feel that your desire to commiserate with one another is a reasonable thing to do. I was unsuccessful at obtaining an internship the first time I applied, and felt, admittedly, heartbroken. I had to change my best-laid plans, and take time to do things to give myself an edge. I was eventually successful and at this point I am happier to have those other experiences under my belt.

Nevertheless, I do not feel that it is necessary, professional, or appropriate to target the internship programs in this spiteful way. From my perspective, there are several things that you are failing to properly consider:

1. The internship application process is not designed to cause harm or be discriminatory. These ideas are born out of hurt feelings and misplaced blame. I’m sure your families and friends are right there with you, telling you how unfair the process is and that it’s not your fault, desperately trying to satisfy you with justifications for why you were not offered a position. I know it is hard to believe, but after observing the process from the inside I can honestly say that it is constantly being revised with the applicants in mind. The bottom line is, there are just far too many well-qualified applicants. 

2. Perhaps you are focusing your energy on the wrong side of the picture. Why don’t you have any initiatives directed at the tuition-hungry universities and ensuring the quality of your education? Who is it that continues to open up their programs to more students each year, forcing the programs to cut back the curriculum and produce students who are progressively less well prepared? What good is opening up the university programs to let in far more students than the internships, (and the profession), can accommodate?

3. Your manifesto states that the internship programs should be redesigned to guarantee positions to all qualified applicants. Is this realistic? Would you feel better if you had been allowed to complete not only your undergrad but also your internship before reaching the roadblock of not being able to find a job?

4. Lastly, we are a pack of high-achievers! Most of you have probably never been said “no” to before in your life; you’ve probably been offered every job you applied for, and are accustomed to receiving constant praise for you work. It is difficult to accept, but sometimes you just can’t have everything you want in life. This is not the first time you won’t get what you wanted, and frankly, no one ever promised it to you! The best thing you can do is be flexible and work with what the world hands you. These skills will get you further in the future!

If you still think this is what you want then pull yourself together and keep trying! If you give up at this point you can’t possibly have wanted it badly enough in the first place. Find out what you can improve on. Better yourself through job experience and/or further education. Make sure you are well-rounded individuals; being academically strong on its own is not adequate to prepare you for a professional work setting. Seek out unique new learning opportunities to add to your resume, gain job experience working with a variety of people, and really understand what type of program you are applying to. The programs are all designed differently and require interns whose work habits, communication skills, future goals, and personalities are properly suited to them. In a sea of well-qualified applicants, those who are accepted need to “fit” into their internship program to be truly successful. Take a deep breath and a long, hard look at yourself before you consider giving applications another shot. Maybe you aren’t ever going to be the right person for this job, but you definitely won’t find out until you can be done with this pity party and start doing something productive.

I wish you all luck in your future endeavors and encourage you to take responsibility for your own success!

Sincerely,

Carolyn T., MSc
Dietetic Intern

Define Lobbying

In response to those who think this blog is not going to be effective at lobbying for change, I have several questions: 
1. Why, after decades of lobbying by dedicated and savvy individuals using “cold hard facts,” has the system remain unchanged? 
2. Why does effective lobbying have to be limited to the use of "cold hard facts" i.e. is there not a place for personal stories alongside the "cold hard facts"? 
3. Why are programs so averse to new funding models, multiple academic streams (one stream for dietetic students and one or more for other food/nutrition students), or other alternate approaches? 
4. Why is Ontario one of the only provinces in Canada not to have an integrated model? 
5. Why are the stories and experiences on this blog so threatening to some? Why have we waited so long to invite students to talk freely, albeit anonymously about their experiences?
6. Why is it so important to silence the stories that appear here or respond condescendingly to the storytellers by telling them to "do research on the problem" or "get a job" or "be grateful" or "think of the poor pre-med students" instead of actually doing something to change the system?
7. Who has the status quo been serving all these years?

Lucky Me

 Okay. I’m sorry. I don’t understand. I was one of the “lucky” ones. I got that precious internship. I’m suddenly the privileged one who cannot possibly imagine what it feels like to suffer. Well, let me tell you something. Obtaining an internship doesn’t make the bleeding stop. It is not even a band-aid to my pain. I do not feel proud, I do not feel excited.  The only positive sensation that came when I opened up that email was relief. And even that was fleeting. Because soon after that moment, I thought about you, and you, and you, and you.

You, who like me, got up early every Saturday just to get in a few extra hours of studying.

You, who like me, turned down countless opportunities to see your friends because you had to volunteer doing some mindless task.

You, who like me, couldn’t enjoy your Thanksgiving dinner with your family because you had to finish the lit review for the professor you were assisting.

So you ask me why I still have iSAD? Why aren’t I jumping for joy at my good fortune? I survived, I “succeeded”, didn’t I?

No. I didn’t. It would be completely naïve of me to assume that an internship makes the iSAD go away. iSAD is contagious, its incredibly susceptible to relapse, and there are many different origins. Today my iSAD came because of your distress, because I know that you are just as deserving as I am, and maybe even want it more.  I’m hurt because this system has left you to feel inadequate, unsure of yourself, and betrayed by the profession. 

And in that moment of strength, when you manage to wipe away your tears, I hear you tell yourself that maybe, just maybe, next year you will be “good enough”…. But what if they say you aren’t?

Please, don’t let this sick, unfair system let you believe that you have done anything wrong, or not done quite  “enough”  right.  Your insecurity is consuming, and now, I too feel betrayed. Is this the culture I want to subscribe to? One that pushes away capable, passionate people and never cares to look back? 

Well, it’s certainly easier just to forget this pain, to move on as a privileged intern and forget about you, and you, and you, and you.  But I’m going to be brave.  I hope I won’t be alone.

Frequently Asked Questions

Who is iSAD? Why is your identity secret? 

As some of you may already realize, it is very risky to speak out about the internship process. In speaking out we risk our future professional opportunities, future chances at internship, or future professional relationships. If the risk did not exist, it would not have taken so long to initiate a group like iSAD where everyone affected by the internship process can share their experiences. Now that we have, we welcome you to join us and enjoy the benefits that sharing our stories can bring.

What is iSAD planning on doing with these stories and comments?

We will invite all those who have an ability to change the current internship system to view the impact statements and the associated comments. We believe that by sharing our stories, we can influence change. When people understand the harm the current system inflicts, the urgency to change the system will hopefully intensify. We have waited long enough. We need as many stories as possible to make the greatest impact. We are counting on you.

What more could I have given?

I’m at the foot of the stairs to MINS. It has taken me longer than usual to get here today. At the doors, I can’t take one more step. My feet won’t move me forward. Tears stream down my face. I found out I didn’t get an internship yesterday. I am still devastated.

I’m usually so positive and upbeat. This sadness and emptiness has taken me by surprise. What did I do wrong? What could I have done differently? What more could have I given?

I think back to my very first day on this campus and feeling so joyful, almost skipping up these same steps into this distinguished red-bricked building where I would be learning all that I needed to learn to become a dietitian. I remember going to class and admiring my professors for all that they had accomplished and wishing I could soak up every single bit of wisdom they shared with me. Now I only feel disillusioned with this place and that knowledge. Where have the countless nights studying gotten me? Where have the hours spent in conversation with those same professors gotten me? What difference does any of it make?

I listened to you when you told me what I needed to do to become a dietitian, to get this internship. I did exactly what you said I should. I knew that it was competitive, but I thought that if I just did a little bit more than everyone else, I would have a better chance. Why did I believe you? Why did you betray me? Where are you now when I feel so completely alone?

Why haven’t you changed this ridiculous system? How many students need to go through this process? Can’t you see how it hurts us? Can’t you see we are in pain? Can’t you see how we come to class now, empty shells of our former selves? Can’t you see how it even affects those who did get an internship - not wanting to show their success? How can you ignore all of our pain? How do you hide it so well?

I could go to grad school, but quite frankly I don’t want anything to do with this place. Right now it is all I can do to get out of bed in the morning. What is the point?

Through the sadness, I begin to feel tiny sparks of anger. I think maybe there might be an enormous pool of anger buried deep inside me just waiting to explode. What is DC doing to fix this system? How long will it take? I recall seeing something from DC in the fall about some group working on a different approach. It is about time. It occurs to me that it has taken a really long time for DC to decide to do something. How many students have suffered because our leaders don’t have the guts to confront those who want to maintain the status quo? How can you live with that? You know who you are. How can you sleep at night? I can’t.

And, what makes us different from BC or Sask or AB or Quebec? How come they are doing it different? Who led those changes? Why can’t we do the same here? Who does this really benefit? Not the students, obviously. Are your egos so fragile you can’t even think beyond your own safety and comfort? How could you support us so much as students in your classes and then betray us so hugely just as we are coming into our professional selves? What recourse do we have? We can’t say anything because we risk not getting a positive evaluation from you in the future. We just have to swallow it in silence. Brutal.

I want to thank this iSAD group for giving me the space to write this. It helps, a little.

My Internship Application Experience

When I applied for this program, I knew that after graduation I would have to do an internship to get registered as a Dietitian. Becoming a Dietitian is important to me because I feel as thought this is what will be the basis of my reputation, and I believe it is important to be apart of this elite group of healthcare workers which provide me with the support I would need to keep myself up to date with all the latest information. When I joined this program, I had no idea what the application process would be like, let alone how difficult it would end up being.
Since the end of high school, I have had a job. I have worked to pay for all of my schooling, and recently when I started this program, I took a job to support myself so that I could live closer to school. I have prided myself on the ability to remain in school and achieve good grades while working. Few of my friends in this program have real jobs that require more than 10 hours a week, so I considered myself one of a kind. I was not aware that while I was working to support myself, others who have the luxury of not having to work were able to seek out significant volunteer opportunities that, although not required to complete this program, seem to be very important in retrospect. I don’t believe it is right that, just because I have to work to pay the rent and therefore may not be able to volunteer as much as the next person (even though volunteering is not required), I won’t be considered for an internship position.
In October when the application process started, I considered not applying because I thought, maybe I’m not qualified enough, maybe I’m not ready. And after 8 years of university, I decided I was ready for this internship and even though maybe I didn’t have a lot of volunteer experience and even though I don’t have a 4.0 GPA, the coordinators would see my experience and my well-roundedness and maybe grant me an interview. All I needed was an interview to show them I was worthy. And so for 4 months I worried and stressed and collected all of the required documents for the applications and made sure everything was in check. It took a lot of money that I don’t really have, and a lot of time that I couldn’t really take, and concentration that took away from my school work and my job and that drove me crazy. I thought, okay if I’m making this much of an effort and I have all of these experiences and I want this SO badly, they will see that and interview me. I was not thinking that everyone thinks like I do, and everyone thinks they deserve an interview. And the reality of it is there are just too many applicants and not enough space. How is it possible that there were that many people that were so much better than me? What did I do wrong? What am I missing and how can I improve? What am I going to do now? These are questions that I have asked myself a million times since realizing that I was not getting interviews. I have made myself sick over waiting to hear and hearing other people get calls and myself not getting called. My family and friends tried to comfort me and calm me down and tell me that it’s impossible that they wouldn't even consider me for an interview. The stress I endured and the frustration I have with this process has affected every aspect of my life for the past month. The realization that I wasn’t even considered has made me rethink and regret applying in the first place. I feel so happy for my friends who got interviews and I sympathize with their anxiety over waiting for the acceptances. At the same time I feel bad that they feel bad that I didn’t get anything. How is this process supposed to encourage people to become Dietitians?
Although there is much more I can say about going through this process, I will leave you with this thought: it was hard to organize my thoughts like this, however I have realized that I do not feel inadequate because of this experience. Rather I feel this process is inadequate. Hopefully by this time next year, I will feel better about the process. Something needs to change.

To whom it may concern

Since the beginning of the school year, I have been experiencing severe ISAD (Internship Seasonal Affective Disorder) in vicious bouts.  The first bout arose as soon as we began to have our internship information sessions, when I witnessed the relationships between 4th year Nutrition students shift from colleagues to competition. The toxic environment continued to build through cautionary emails and messages that warned us about the “danger” of committing simple mistakes in our applications.  We were told that a single grammatical error, or forgetting to sign our cover letter would move us from "the yes pile, to the no pile".  While I appreciate that grammar or the signing of ones cover letter are important considerations in an application, they should not override or discount the breadth of a student’s incredible experiences and academic success.  It was not long before I stopped socializing at school because I couldn't handle the constant chatter about where people were applying, or what they wrote in their application.

Then came the day I mailed off my packages. I cannot explain to you the enormous anxiety I had, and the obsessive practices that I felt were “necessary” parts of the process. Checking, checking, checking. And once it was sent off... I did not sleep. I told myself that I should have checked one more time. I was acting irrationally, but I felt that it were these irrational thoughts and behaviours that the "internship application culture" prescribed. I was taught that it was normal, expected and encouraged to make yourself sick with anxiety.

Winter break came and went without a single full-nights rest.  Then the next bout of ISAD ensued. We began to get called for our interviews, and suddenly the whole world stopped. Of course this all occurs during midterm season, when you need to be studying and concentrating on schoolwork, but that was a near impossible task. I am normally an incredibly disciplined worker, but I found myself starring at my phone for countless hours unable to read a single page of my textbook. Aside from interfering with my schoolwork and sleep, I started to really feel its effects on my relationship and friendships. Suddenly, the culture at school became very eerie... one did not know whom to confide in or who they could ask.  Did ______ get her call from UHN yet? Can I ask? Should I ask? Will it upset her? Will it relieve her? I feel so alone.

Sometimes friends would ask me to tell them if I got a call and they didn’t, so that they could judge whether or not they would even get an interview and just be able to stop thinking about it.  This was an awful experience.... No one likes to see their best friends cry, while at the same time being forced to feel almost as if they are boasting. It is sickening.

Because I felt I could no longer speak with my friends, I turned to my boyfriend.  While supportive at first, I think that this process took its toll on our relationship.  It made me aloof, it made us fight, and it interrupted my ability to sleep, eat and think.

And now I am awaiting the biggest bout of all. I wait to hear if I got an internship.  I anticipate that the week of March 14 will be a bad, sad week, and I do not yet know how I am going to handle it.

As you can see, the anxiety of the internship process has reached hysteric heights, where it reaches beyond the students and impacts their families and friends.  I believe that if our “culture” is going to place such urgency and importance on obtaining the coveted internship, then they MUST make them more accessible.  This ideally would mean more positions, or fewer undergraduate opportunities, and thus, less competition.  More realistically, however, I ask that you make the selection process more explicit, more transparent, more fair.  Describe to us in detail exactly what the expectations are for GPA (yes, the minimum is a B+, but we all know that students with A+ averages are often turned away); how many hours and what type of volunteer/work experiences do the programs require; and what would define a good “fit” in each institution.  It is unfair for us to enter this field, fight our way towards graduations, and be left to feel inadequate because we didn’t quite do “enough”. It is time for this system to change, and we cannot reduce another cohort of talented, passionate, intelligent graduates to mere failures. Please acknowledge this urgent need.

Nutrition Student

Victim Impact Statement

The impact that my dietetic education and training experience has had on myself and my family has been profound and long-lasting.  The experience took a serious mental, physical, financial, and emotional toll on me personally and professionally. 

The competition to secure an internship potion among undergraduate students is well known.  Fortunately, I felt very little competition among my peers during.  What is rarely talked about however, is the extreme inner rivalry that students, driven to work longer, study harder, and volunteer more, experience in an effort to prepare a competitive internship application package.  I was one of those students.  Knowing early on how few students are rewarded with an internship spot, I worked tirelessly to make sure my internship application stood out.  I had straight ‘A’s, I had volunteer and/or paid work experience in clinical, community, and administrative practice, I had published an original research paper, I had excellent references.  The tremendous stress and isolation from my family and friends that I endured to do all that was required to get an internship position finally culminated in my final year in a destructive relationship with food.  I binged and purged to numb the stress, just to cope.  Let me be clear that this had not been an issue previously.

I was devastated and embarrassed when I didn’t get an internship. Tears still well in my eyes as I write this.  I was embarrassed to tell all those who had supported me, especially my husband, that I wasn’t good enough.  The time with family, friends, and myself that I had sacrificed was not enough.  I spent days being consoled by people who cared about me, but really, I felt as if had only let them and myself down and so their support was of little consolation. 

The feedback I received from internship coordinators was also of little help.  Being told “you’re not as good as you think you are” only taught me that I needed to be less enthusiastic, less convinced of my ability and commitment to be a successful intern and a good dietitian. 

The following year I applied again and was given a spot in one of the programs to which I applied.  Finally, having proven myself, I looked forward to the camaraderie and support of my future colleagues and fellow interns.  Nevertheless, once in internship, little changed.  The interns were treated as if we enjoyed more than 24 hours in a day.  Few preceptors understood that I needed to work part-time just to afford the basics, to pay rent and buy groceries.  The complete lack of financial support available to me meant that I did not have the luxury of choice.  It is not however, a choice that interns should have to make.  For the majority of students, including myself, who graduated undergrad with significant student debt, and whose parents are unable to offer support, there are few viable alternatives to financially surviving internship.  What angers me now is that I hear nothing from the supposed leaders in the dietetic profession advocating on behalf interns who desperately need access to financial support.  It is shameful.

Although I am now a registered dietitian, I have chosen for now not to practice.  The harm that all those involved, whether as student, intern, or educator, have been left with is apparent.  Past traumas culminate in a professional culture of isolation, burnout, and silence.  This is not what I signed up for; this is definitely not the professional I want to be.

Looking back, I would not have entered the field if I knew what I know now.  If I knew how much I would have to sacrifice to gain membership to a profession that all but eats its young, I would have saved myself and made a very different choice. Knowing this today however, I find myself left with little to recommend entering the dietetic profession to others. I am not proud to say I am a dietitian because to me earning the right to do so has cost far too much.  What is it that being a registered dietitian mean?  My undergraduate and internship experiences have shown me that it does not stand for what I thought.

These are sorry statement to make about what could actually be a vibrant and creative profession. The real tragedy here however, is that I am just one person, easily dismissed, but I am not alone in my experience.

Do I really want to be an RD?

Although I decided not to apply for the internship this year, the time leading up to the application and the application process was extremely stressful.

The competition within the program was noticeable in my first year and has gotten considerably worse over the years. Fellow classmates often do not work well together because of the underlying competition, and have said that other classmates are seen as a ‘threat’ to their success. The system and internship application process demands so much from the students, which is fair, yet the competition is unhealthy and creates a great divide within the program. Professors also contribute to this negative environment by supporting this type of behaviour. Professor’s biases towards the internship and certain fields of Dietetics are sometimes pushed upon students and this has made me feel as though I have no other career options in nutrition.

The type of environment this process has created, in my opinion, is not conducive to a supportive work environment, during internship or practice. One reason I chose not to apply for the internship is that my experience thus far with dietetics and nutrition does not convince me this is the best, or the only way, to help people. The politics within the field and the internship process do not always represent the health care profession in a positive way. In researching the route the take to become an RD, there is no transparency and very little communication about the stressful process and the slim-to-none chances there are of actually getting an internship. It is also very difficult to understand why certain candidates are chosen over others. There are so many amazing candidates in this program, yet they are often denied an internship – even when we have been told that we all meet the criteria we are supposed to.

The structure of the RD accreditation process is not reflective of what I thought a RD was. The tension within the program and the poor communication create an unsupportive environment; how does this teach us to be supportive and good team players in our practice? My experience thus far has really made me question if I want to be a RD. This in itself forces me to question my choice to attend Ryerson and to caution others of the program. I feel that looking to other health care professions for direction on their accreditation process would really benefit this profession, and would make this a more positive experience for students.

I’m blinking back tears...

  ...I’m biting my lip.   I have to focus on my breathing.  Deep, slow breaths – in, out, in, out - anything so that I won’t cry in the middle of my class.  I try to focus on what my professor is teaching, the topic usually provides so much inspiration for my always-active critical imagination seems colourless and distant.  “You’re okay,” I tell myself.  “You’re smart and motivated and sociable-“; this self-talk isn’t helping.  I’m dreading the night I have before me.   I know I’m not going to be able to focus on anything.  The mound of schoolwork now seems almost futile, and I feel utterly betrayed by my education.  I feel useless and absolutely paralyzed.  I realize that the last time that I felt this way was when my best friend died in a car accident after my first year of university. 

All of this was sparked by a colleague’s disclosure that she had been invited for an interview at a dietetic internship program to which I had also applied; of course, I had not received this same invitation.  It was at this moment that I realised that I would not be getting any interviews.  My friends, parents, and boyfriend all persisted to tell me for days that I may still hear from a program, but that feeling in my gut knew better.

I got home that night, put on my pyjamas, and laid on my bed with the lights off.  This was how my confused boyfriend found me, several hours later, with a mascara-tear-streaked face and a Kleenex box’s worth of used tissues in a pile beside me.  I resented his encouraging words.  Why couldn’t he realise that there was no other option for me?  How could he not see that the pain incurred by this rejection was unbearable in a way that all of the encouraging words in the world would never be able to relieve?  I told him he wasn’t helping and with a hurt look, he retreated.  It’s not his fault that he can’t fully grasp the colossal importance that obtaining an internship has in my life’s path and I can’t expect that he would comprehend how humiliated and judged I feel by my rejection .  I begrudge the system that initiated this rift between me and my very best friend in the world.

                Two days later, I’m working a Friday night shift.  I was so excited to come into work tonight; this is a place so far removed from school, from internship applications, from my ‘real life’.  Instead, I find myself barely going through the motions.  I forget to punch in someone’s order.  I get into a pointless squabble with a line cook about where the key for dry storage is located.  I am completely oblivious to the fact that a family of four has been seated in my section for the past fifteen minutes and have almost given up hope that they might eat dinner tonight.  This is fairly representative of how I’ve gone about my days: unfocused, uninterested, and, unfortunately, ill-tempered.

And then there are my colleagues – more than colleagues, they are my friends.  They are all passionate, incredibly intelligent, beautiful women with the same dream as me: help people, change the world, become a dietitian.  I am thrilled every time they tell me that they have received interviews and I encourage them to tell me about how they’re preparing and how the interview went.  It makes me sad that some of them can’t feel total happiness about their success because they know how hurt I am about my failure.  I’m just embarrassed to be the person who wasn’t successful; I’m embarrassed to be a barrier to their excitement.  I’m ashamed about this gulf and am desperately trying to ignore its presence.

So here I am, still blinking back tears, still biting my lip, still focusing on breathing slow, deep breaths in and out.  My positive days are starting to outnumber my negative days and I’m getting back to my life.  But – I know that I will have to go through this all over again: second round, next year, for as long as it takes.  I will get an internship – I will succeed - I will not go through this pain for nothing.

On February 7th

It is a mixture of feelings. Hope. Frustration. Sadness. Weakness. Depression.
It is the week in which I am supposed to receive a phone call from internship coordinators.
Talking to myself does not really work anymore. I don't feel confident enough to go into the interview. I am not better than anyone else in my class. We are all wonderful individuals capable of anything. All deserving the internship. But we don’t really talk about it anymore, there is nothing to say. We don’t want to think we compete with each other. But we compete for the same spots. How different is that? Silent competition, covered by being nice. Like a double identity. We live in isolation and pretend we are doing just fine. And at night we cry. Desperately waiting for that call. Maybe tomorrow the phone will ring. 

I feel terrible today. I don't want to do it. I don't want to deal with this. I have worked for the last 5 years from dawn to dusk. I have neglected my family and my friends. They don't call me anymore, because I am always busy.  And they know it so they don't even bother.

 Will this be worth it? My partner tells me that people who really care will understand. Will they? They don’t believe that I care. They say my priorities are out of whack. These relationships hurt.

I'm exhausted. I don't have the energy. I used to have the drive for it, but I feel like I'm losing it. I don't know if this is worth it. But I am so close the finishing line that it would be stupid to quit. After all, this is my dream.  This is what I really want. I’m here because I want to help sick people make sense of what to eat and how to enjoy it. But today I don't have the energy to carry on.

Where can I find the energy to keep going? How can I create supportive relationships? How can I reconnect with people in my life, with my peers?

If I am not the only one experiencing it this way, then we are creating a profession of individuals who are hurting unable to reach out to others. Through the culture of competition we are creating a competitive profession of individuals unable to support each other. Professionalism does not allow us for sharing feelings pertaining to weakness, depression, or sadness. We need to be able to perfectly manage our time, be organized, have emotional intelligence and be on top of every new report, research study, and attend every single conference, and conduct research and publish papers and be productive in our practice, having perfect weight and diet composed of home cooked and healthy meals so we can be role models for our society. These are unrealistic expectations. They are brought upon us and then internalized by us. If we will practice dietetics thinking that this is who we need to be, but knowing inside that we are not, we are creating hypocritical profession.
This is hurting the profession. This is hurting individual dietitians. This is hurting the clients. This is causing burnout and makes dietitians leave the profession.

I.N.T.E.R.N.S.H.I.P

The internship selection process brings about an emotional acronym…

I.N.T.E.R.N.S.H.I.P.: Interest. Neglect. Tension. Empathy. Relieved. Nervousness. Shame. Hope. Insecurity. Powerlessness.

The month of February brings about so many mixed emotions for students applying for an internship, myself included. I have felt hopeful, excited, stressed, anxious, fearful, happy, sad, optimistic, pessimistic, and disappointed – this list of mixed emotions could go on. Fortunately, I was incredibly lucky to have been chosen for interviews during the internship process this year. Being invited for an interview was exactly what I had been waiting for, especially since this was my second time around applying for an internship. Becoming an intern is the next step to my absolute dream and aspiration to becoming a registered dietitian. However, I know what it feels like to not be invited for an interview, at all. At that dark and saddened time in my life I felt inadequate, upset, distraught, angry with the dietetic profession, hopeless and surprisingly ready to give up. I figured this year when I was invited for internship interviews I assumed my emotions and feelings would be the complete opposite from the previous time I applied. I was wrong. Yes, I did feel incredibly honoured, happy, and excited, but the separation of applicants being interviewed from those applicants who unfortunately would not be interviewed this year, was a bittersweet feeling for me. I care deeply about my friends and I believe they will make wonderful, trusting and competent dietitians; however, I found it unbelievably saddening and difficult that I felt I could not be happy for myself for my accomplishments in the next steps of reaching my goal because my friends’ dreams had been shattered and completely crushed. It is an ironic situation because in one breath I should want to feel happy for myself, but in the other breath I feel guilty for celebrating reaching that following step of my ultimate goal when my friends are terribly hurt and feeling helpless. Something needs to be changed. How can we morally allow this to keep happening, year after year? We cannot allow this form of training to isolate, dehumanize and demoralize peers, classmates, and friends.

Impact Statements

Please feel free to comment on your internship application experience here. You can post anonymously. Be mindful in including any personal information or information to ensure anonymity. To communicate privately with iSAD, please email us at theprojectisad@gmail.com.