Is a career in dietetics worth its salt?

July 6, 2024

Becoming a nutrition or dietetics professional today is as easy as baking a cake without a recipe. It’s not (easy). The educational pathway to earn the Registered Dietitian Nutritionist (RDN) credential has recently changed: now there are more than 5 accredited program types to choose from. The acronyms alone are like a random spoonful of alphabet soup – DPD, CP, FEM, DI, ISPP. [Sorry not sorry for the food puns.] Future RDNs, brace yourselves: you'll need a bachelor's degree, a master’s degree, over 1000 hours of supervised practice, and to pass a tough credentialing exam. That’s about 6-7 years of full-time dedication. Here’s the salt on the wound: in many cases, the cost of education is often equivalent to, if not more than the starting salary of an RDN. During education and training, students are individually tracked to ensure they master each mandated competency. Only those students who master each are allowed to advance to sit for the credentialing exam.

 

The RDN exam sounds simple but is anything but. Educators, preceptors, and program directors (like myself) have thought it tested competency knowledge. Surprise! It actually tests knowledge needed for the first three years of practice. No wonder the pass rate has plummeted to 63% in 2023. For comparison, the pass rates on other health professions exams, like nursing’s NCLEX pass rate for US-candidates, was 83% in 2023. Pass the RDN exam and you’re looking at a starting salary in the $50k range – with a master’s degree. Ouch. The average dietitian in the US makes around the high $60s. Not exactly a jackpot. In fact, the ROI is so poor that many don’t even break even on their educational investment. Salaries for dietitians have been fairly stagnant and, with the increased educational requirement from a BS to an MS (which went into effect January 1, 2024), if wages don’t increase, ROI will be a moot point.

 

Dietetics is at a crossroads, with more dietitians leaving than entering (a net loss of over 5% in recent years). The biggest culprit? A glaring lack of diversity and inclusion. There may be many reasons for this, but the most problematic (to me) is our lack of diversity and inclusion (because it affects our profession, our practice, and limits the effectiveness of patient care). Activist-Dietitian Anjali Prasertong poignantly asks “is being a dietitian a job for wives?” – highlighting the profession’s historic and current skew towards white, affluent women who can afford not to work. (Full transparency: the structural barriers to inclusion with the dietetics profession and practice are also the focus of my research.)

 

So, if you’re considering a career in dietetics, you’re probably wondering: is this profession worth it? Worth the sacrifice of your time and energy for low pay, worth dedicating yourself to an exclusive ol’ girls club? Though a very personal question, I help undergraduate and graduate students figure out their answer to this question every day.

 

As a service profession, many interested in the field like to interact with people. And, one of the most wonderful things about working in dietetics is talking about food because everyone eats. We all have food we love, food we hate, food that makes us smile, or food that makes us think of a holiday, event or memory. We all have emotions about the food that we eat. Food - talking about it, eating it, preparing it – facilitates personal exchanges and connections in ways that other professions don’t. And, because everyone eats so frequently, there are so many different types of work in nutrition and dietetics, which enables professionals to really find a meaningful niche. Of course, the most common areas of practice are clinical and community nutrition. Clinical sites include hospitals, long term care facilities, and places where dietitians provide medical nutrition therapy. Community dietitians may work on government funded food programs, for non-profit organizations, or in emergency food sites (like food pantries). But the highest paid dietitians? They work in management and they’re often earning north of six figures. There are also a number of dietitians who are entrepreneurs, work in legislation and policy, research, food justice, or environmental sustainability. Many more jobs have recently become available in these “non-traditional” categories – and more are emerging. For many of these roles, being an RDN isn’t required. Upskilling and reskilling are the name of the game.

 

The RDNs I know have created – or are creating – the careers they want, including myself. I started in sports nutrition, then fell for clinical, landed a community job, and now I juggle teaching and running the undergraduate nutrition program, serving the Bronx community, and researching ingrained bias in a 35 hour work week. And I love it. I hire many folks who are practicing dietitians but really love working with students and want an opportunity to teach in an academic institution. And what about you? If you think you like ‘a little of this’ or ‘a little of that’, well dietetics might be the place for you. Don’t love the first sub-specialty you picked? Well, we have 10 others to choose from.

 

I used to pejoratively tell people that dietitians are “jacks of all trades, masters of none.” I intended to convey that we are each so different in where and how we work, that we are trained to do a smattering of everything. But, that narrative is a false one. Our education, training, and credentialing is a jack-of-all-trades but dietitians are not. We are a transdisciplinary profession, composed of experts in important, niche areas. Sure, dietetics education and training may feel like the wild west, especially when its time to study for the exam, but day-to-day, there’s a lot of work to do in food and nutrition professionals are needed. We are in demand and at this pivotal point in our profession, if you get engaged, I can promise it won’t be boring. Though I’m quick to criticize, I also think of the words of Evelyn Crayton, the Academy of Nutrition and Dietetics’ first Black president, who said “you can both love your profession and want it to change at the same time”. I won’t persuade you to dive into dietetics – at this point, it might be financially reckless advice. The livable wage in your area could be a far-off dream. But, I urge you to consider it because it’s exciting. It’s contentious. There’s a LOT to debate and there is new science to explore every day. Dietetics is a profession that can enable you to connect with anyone from anywhere over a passion for food or health. It’s a field where you can work in nearly any kind of environment and shape a career that spans your lifetime interests. It’s a career that can be molded to change as you do and enable you to choose yourself.

It's time for change
Building a better system for ALL patients and Healthcare Workers
PO Box 75972, Los Angeles, CA 90075-9997
501(c)(3) Organization, EIN: 87-2641586
Copyright 2023 IMPACT in Healthcare.