Description of Program Rotations
Ambulatory Care & Community Nutrition (7 weeks)
Dietetic Interns work with Registered Dietitians in the Ambulatory Nutrition Services at MGH and in the MGH Neighborhood Health Centers. Nutrition education and counseling to individuals and groups are emphasized, 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 includes working with a large client base in a Women, Infant & Children (WIC) Supplemental Foods program. Interns work with clients from many cultural and ethnic backgrounds. Interns give classes to community groups, participate in the MGH wellness "BeFit" program, write newsletter articles, provide nutrition services promotion activities, and compare MGH WIC data to the state database. Interns also gain exposure to the RD's role in a long-term care facility.
Inpatient Clinical & Acute Care Nutrition (11 weeks)Dietetic Interns complete rotations in the acute care setting emphasizing medical nutrition therapy. General medicine, general surgery, pediatric, and intensive care units are focal points of the acute care setting and are areas where interns are able to complete in-depth focused looks into the relationship between illness and nutrition.
Dietetic Interns practice with physicians, nurses and other professionals who are leaders in their fields. Writing electronic notes and being able to access electronic medical records is an advantage of working at MGH, allowing multiple care providers to access patient information simultaneously.All medical nutrition therapy experiences focus on comprehensive assessment and evaluation of patient nutritional needs, and on the development, implementation and evaluation of the nutrition care process.
Food Service Systems Management (12 Weeks)The MGH's management rotations are second to none! Dietetic Interns work alongside the chefs in a production kitchen that prepares 20,000 meals daily. Food quality and cost control measures are studied and applied in purchasing, receiving, storage, ingredient assembly and distribution of foods. Food production and food service principles are applied in conventional production and in a cook-chill system.
Culinary skills are taught through tutorials and 'hands on' in the kitchen. Interns are involved in an "Iron Chef/market basket" type competition, where they are challenged to develop a new "Be Fit" recipe to meet the nutrient parameters for wellness. The recipe is judged for taste, texture, appearance, adaptability for service at MGH, in addition to the nutrition requirements. Cooking technique, food cost and budget are also part of the judging. All recipes developed should be suitable for addition to the MGH menu. The winner receives a gift certificate to a local restaurant.
Patient/customer satisfaction is the focus of the patient and retail service rotations. In patient services, interns work with the management team to assure patient satisfaction. They are involved in data collection for process improvement projects on patient care units, trayline and the department's data center. MGH will be adding approximately 150 beds in a new building scheduled to open in 2011. This addition of new beds is leading the department to pursue a new patient food service system.
Underlying all experiences is emphasis on cost controls, personnel supervision and the development of an individual management style. Emphasis is also placed on human resources management including interviewing, payroll, scheduling, and the corrective discipline process.
School Food Service (1 Week)Interns gain food service management and nutrition education experience working with the RD food service director of the Braintree Public School System. Experiences include nutrition education to students and staff in the cafeterias, working with/standardizing recipes, analyzing sales records and participating in the responsibilities of the director.
Research (1 Week)The MGH Clinical Research Center is the setting for the Internship's research rotation and affords exposure to a variety of research protocols & studies. Dietetic Interns utilize anthropometric measurement tools, perform indirect calorimetry using a metabolic cart, learn how to use a DEXA machine, and work with several nutrient analysis software programs.
Business Plan (3 Weeks)Interns work in teams to develop a complete business plan for a proposed business venture with the real possibility of implementation within the nutrition department at MGH. The plan results in a comprehensive proposal that is presented to the Director of the Department of Nutrition & Food Services, RD's, managers and fellow interns.
Concentration Rotation (6 Weeks)The MGH Dietetic Internship offers two concentrations: "Clinical" and "Management". The program has a long history of strong preparation for entry level dietitians in both clinical and management areas. Each concentration will include a 6-week rotation in one area. 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 concentration will provide the intern with depth of knowledge and skill in an area of the intern's choice.
Each intern must choose one concentration. The choice of concentration will be made after the first 18 weeks of rotations. These 18 weeks will provide each intern with experience in food production/menu development, retail or patient food service, out patient counseling and inpatient medicine and surgery, providing actual experience in each area – helping the intern make an informed, knowledgeable decision regarding their choice of concentration.
Once the concentration choice is made each intern will be asked to choose their top 3 locations / areas where they would like to focus. The internship director, in accord with the senior managers in the areas involved, will strive to match the availability of the area with the intern’s choice.
Interns will continue rotations to meet the remaining requirements after making a concentration choice. The 6 week concentration rotation will be scheduled during the last quarter of the program.
Management Concentration Competencies
Manage the daily operations of a unit for 6 weeks independently, efficiently and effectively. Demonstrate an understanding of department standards of practice. Internalize, interpret and apply standards to meet the needs of the day. Effectively handle employee issues applying hospital and department policies and procedures.Demonstrate competence in food cost analysis, merchandising and cash systems.Keep unit within budget during time as manager. Demonstrate creativity in menu development that will meet the needs of our customer's with-in established budgetary constraints.
Management concentration placements in one of the following areas: Retail Food Service, Catering, Production, or Patient Food Services
Clinical Concentration CompetenciesManage the nutrition services on an assigned inpatient unit or outpatient area of focus. Articulate the evidence base of practice that supports nutrition management of the patients they see. Demonstrate skill in searching databases for information about diseases and evidence to support practice. Critically evaluate the literature; ground practice in evidence.Present one practice guideline with its evidence for one disease state and demonstrate where the evidence was found. Meet productivity standards of 6 to 8 patients daily; benchmark individual data against staff data. Independently enter documentation into hospital and department electronic systems.
Clinical concentration placements in one of the following areas: Pediatrics, Medicine, Surgery, Oncology, Renal, Neurology, Cardiology, Research, Diabetes, Prenatal Nutrition, Wellness/Health Promotion or Weight Management.
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 DaysClass days provide interaction with Dietetic Interns from other programs in the Boston area and exposure to outstanding speakers in a variety of specializations including, community nutrition, clinical nutrition, nutrition support, sports nutrition, public health and policy. Classes are usually scheduled on Mondays. Interns meet at MGH on the every other Monday 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 to share events, experiences.
Holidays & Time OffInterns are scheduled to work a 40-hour work week.Interns rarely work weekends. Monday through Friday the intern is expected to work eight hour shifts beginning as early as 6:00 AM and starting as late as 12:30 PM. Interns are scheduled off on the nine MGH recognized holidays, as well as 2 weeks vacation. One week of vacation is scheduled during the Christmas holiday and one is scheduled in the spring. While interns are scheduled to work a 40-hour week, assignments, projects, and readings often require additional time.
Graduate Course OptionsWe encourage interns to begin a master's program during the internship.We have affiliations with three of Boston's best educational institutions— Simmons College, Suffolk University, and Tufts University. If your interest is in nutrition, nutrition communication, public health and/or health promotion, check out the Tufts and Simmons programs. If your interest is in business, management, public policy, or healthcare administration, check out Suffolk's program. Click on this link, graduate classes, for more information.
