The Dietetic Internship Program at Massachusetts General Hospital provides rich learning experiences in a variety of settings. The internship rotations give interns the opportunity to explore the role of nutrition in clinical, community, food service, business, and research environments.
Inpatient Clinical and Acute Care Nutrition (12 weeks)
Dietetic interns practice among an interdisciplinary team that includes Registered Dietitians (RD) physicians, nurses and other professionals who are leaders in their fields. Mass General offers the advantage of working within an electronic medical records system that allows multiple care providers to access patient information simultaneously. Interns develop the skills and confidence to write concise, effective electronic nutrition notes.
All medical nutrition therapy experiences focus on comprehensive assessment and evaluation of patient nutritional needs. Interns play an integral role in the development, implementation and evaluation of the nutrition care process.
Ambulatory Care and Community Nutrition (7 weeks)
Dietetic interns work with RDs in the Ambulatory Nutrition Services at Mass General and in the Mass General Neighborhood Health Centers. These rotations emphasize nutrition education and counseling to individuals and groups, with time devoted to developing and refining interviewing and counseling skills. Dietetic interns work with the healthcare team in group practice settings and in specialty service units such as oncology, diabetes, pediatrics, and cystic fibrosis.
Community outreach is central to these rotations. Interns practice among a large client base, from diverse cultural and economic backgrounds, at the Women, Infant & Children (WIC) Supplemental Foods program. Interns teach classes to community groups, participate in the Mass Geneneral wellness "BeFit" program, write newsletter articles and blog posts, and propose projects to enhance the efficacy of the WIC program. Interns also gain exposure to the RD's role in a long-term care facility.
Interns gain food service management and nutrition education experience working with the RD food service director at the Braintree Public School System. Interns provide nutrition education to students and staff in the cafeterias, develop recipes, analyze sales records and learn about policy that impacts school food service.
Food Service Systems Management (12 weeks)
The management rotations are second to none among dietetic internships. Dietetic interns work alongside the Mass General chefs in a kitchen that prepares 20,000 meals daily. Interns study food quality and cost control measures. The rotations challenge interns to apply their food service knowledge to food purchasing, receiving, storage, ingredient assembly and distribution. Interns learn food production and food service principles within both conventional production and cook-chill systems.
Professionally trained chefs teach culinary skills through tutorials and hands-on kitchen experiences. Interns are involved in a competition, where they develop a new and healthy recipe. The recipes are judged for taste, texture, appearance, adaptability for service at Mass General, nutrition profile, cost, and cooking technique.
Patient and customer satisfaction is the focus of the patient food service and retail service rotations. In patient services, interns work with the management team to ensure patient satisfaction. Interns engage in process improvement projects for patient care units, trayline and the department's data center. In the retail rotation, interns spend time at one of the Mass General cafes or cafeterias. While there, interns conduct customer and competitor research, introduce a new menu offering or a process improvement, and measure its success.
Underlying all experiences is an emphasis on cost controls, personnel supervision and the development of an individual management style. Interns also gain experience with human resources management including interviewing, payroll, scheduling, and the corrective discipline process.
Research (1 week)
The Mass General Clinical Research Center designs and runs a wide range of nutrition and health studies. Interns build an understanding of study design, data collection, and research protocols. The Clinical Research Center team of RDs work with interns to perform anthropometric measurements, indirect calorimetry using a metabolic cart, and DEXA machine scans. In addition, interns will spend one day at both Brigham and Women's Hospital and Children's Hospital for futher exposure to a metabolic kitchen and pediatric research. The rotation includes the opportunity for interns to work with several nutrient analysis software programs.
Business Plan (3 weeks)
Interns work in teams to develop a business plan for a proposed venture that has a real possibility of implementation within the nutrition department at Mass General. Each team presents its business plan to the Director of the Department of Nutrition & Food Services, RDs, managers and fellow interns.
Examples of business plans for the class of 2013:
Sliders: The first hospital-associated food truck
The Happy Belly: Allergy Free Kitchen
Tea Leaves on the Green: A renovation project for Tea Leaves and Coffee Beans
Concentration Rotation (6 weeks)
The Mass General Internship Program has a long history of strong preparation for entry level dietitians in both clinical and management areas. Dietetic interns decide on an area of professional interest within either the clinical or management field and work within that area for six weeks. The goal of each concentration is to take an intern from the core level of competence to a higher level, one where the intern will demonstrate independence, confidence and competence. Both the clinical and management concentrations provide the intern with depth of knowledge and skill in an area of the intern's choice.
Interns select their area of concentration after the first 18 weeks of the program. These 18 weeks provide interns with experience in food production/menu development, retail or patient food service, outpatient counseling and inpatient medicine and surgery, which helps interns make an informed decision about the area of concentration. The internship director and senior managers in the concentration areas, will strive to meet each intern's goals for the concentration rotation.
- Clinical Concentration: Clinical concentrations occur in one of the following areas: Pediatrics, Medicine, Surgery, Oncology, Renal, Neurology, Cardiology, Research, Diabetes, Prenatal Nutrition, Wellness/Health Promotion or Weight Management.
- Examples from the class of 2013: A Literative Review Addressing Perioperative Nutrition in Surgery Patients, Inpatient/Outpatient Oncology Nutrition, Malnutrition Coding in the Acute Care setting, A Review of Cystic Fibrosis Protocols in the Pediatric Population
- Management Concentration: Management concentrations occur in one of the following areas: Retail Food Service, Catering, Production, or Patient Food Services.
- Examples from the class of 2013: Compass Group USA (corporate wellness), Tufts Campus Dining, School Food Service in Somerville, MA
Staff Relief (6 weeks)
During the internship year each intern spends six weeks functioning as an entry-level dietitian in one or two units of the Department of Nutrition & Food Services. This experience affirms the intern's self-confidence and ability to practice in dietetics.
Class days are an opportunity for Mass General dietetic interns to connect with interns from other programs in the Boston area. Class days introduce interns to outstanding professionals in a variety of specializations that include community nutrition, clinical nutrition, nutrition support, sports nutrition, public health and policy. Classes are usually scheduled on Mondays. Interns meet at Mass General on non-class days for a tutorial with the program director. Tutorials focus on medical nutrition therapy, nutrition support, culinary skills, human resource management. Tutorials also serve as a forum for interns to share events and experiences.