A career as a Registered Dietitian (RD) or Registered Dietitian Nutritionist (RDN) offers diverse opportunities to promote health and well-being through nutrition. However, navigating the educational, experiential, and licensing requirements can be complex. This article provides a detailed overview of the steps required to become a registered dietitian, with a particular focus on South Carolina and New York State, while also addressing nationwide standards and variations.
Understanding the Registered Dietitian Pathway
The path to becoming an RD/RDN involves a series of steps designed to ensure competence and expertise in the field of nutrition and dietetics. These steps typically include completing accredited education, supervised practice, passing a national examination, and obtaining state licensure, if required.
Educational Foundation
Bachelor's Degree (Historical Context)
Historically, a bachelor's degree in dietetics, nutrition, or a related field was the standard entry point into the profession. Programs accredited by the Accreditation Council for Education in Nutrition and Dietetics (ACEND) provided the necessary coursework to qualify for a dietetic internship. For instance, in South Carolina, institutions like Clemson University, South Carolina State University, and Winthrop University offer ACEND-accredited Didactic Programs in Dietetics (DPD) at the bachelor's level. These programs include coursework in areas such as food and nutrition, human biological sciences, and social and behavioral sciences.
Graduate Degree (Effective January 1, 2024)
As of January 1, 2024, ACEND requires all new RD exam candidates to hold a graduate degree to be eligible to sit for the Commission on Dietetic Registration (CDR) examination. This significant change necessitates either:
- Completion of an ACEND-accredited graduate program that combines coursework with supervised practice hours (a degree-granting program).
- A bachelor’s degree in dietetics, followed by a graduate degree and a separate dietetic internship.
This requirement extends the educational timeline to approximately 5-6 years, reflecting a commitment to advanced training in medical nutrition therapy, research methods, and evidence-based practice.
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Coursework Requirements
Accredited programs must include a specific number of credit hours in particular subject areas. For example, in New York State, programs must include at least 45 semester hours of coursework in the professional dietetics/nutrition content area and at least 20 semester hours in the human biological sciences and social and behavioral sciences content area.
Supervised Practice: The Dietetic Internship
After completing the required education, aspiring RDs must complete a dietetic internship (DI) approved by ACEND. This involves supervised practice experience, typically around 1,200 hours, over a period of 8 to 24 months. The DI offers hands-on experience in various areas, including:
- Clinical nutrition
- Community nutrition
- Food service management
- Specialty areas.
Many internships offer rotations in hospitals, outpatient clinics, public health departments, and private practice settings.
Dietetic Internship Application Process
Applying to dietetic internships is a competitive process that utilizes a centralized computer matching system. Key aspects of the application process include:
- Application Timeline: Most internships use DICAS (Dietetic Internship Centralized Application System) with deadlines typically in February for summer/fall start dates.
- Competitive Selection: Programs receive many more applications than available positions, with match rates varying by program.
- Cost Considerations: Dietetic internships often cost between $5,000-$20,000 in program fees, plus living expenses during the unpaid or minimally paid experience.
National Examination: CDR Credentialing
Following successful completion of a dietetic internship, candidates are eligible to sit for the Commission on Dietetic Registration (CDR) examination. This computer-based exam assesses knowledge and competency across all domains of dietetic practice.
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Examination Content
The exam covers four main domains:
- Principles of Dietetics: Foundations of nutrition science, food science, and dietetic practice.
- Nutrition Care for Individuals and Groups: Assessment, diagnosis, intervention, and monitoring/evaluation in diverse populations.
- Management of Food and Nutrition Programs and Services: Leadership, quality improvement, and resource management.
- Foodservice Systems: Menu planning, food production, food safety, and sustainability.
Preparation and Format
Candidates should utilize official study materials provided by CDR, including comprehensive study outlines, handbooks, and practice questions. The exam is computer-based and includes multiple-choice questions. The passing score is determined by CDR and may be subject to change.
State Licensure
In addition to national certification through CDR, many states require licensure to practice as a registered dietitian. Licensure ensures that practitioners meet specific state requirements and adhere to professional standards.
South Carolina Licensure
The SC Panel for Dietetics requires all practicing dietitians or tele-dietetics professionals to hold a valid SC license. Licensure may be granted by registration (requiring a current CDR credential) or by examination (requiring passage of an approved exam and holding a bachelor’s or graduate degree in a related field of nutrition).
New York State Certification
In New York State, individuals seeking to become a Certified Dietitian-Nutritionist must meet specific education and experience requirements.
Read also: Explore Registered Dietitian Careers
Education Requirements
- A program in dietetics-nutrition leading to a baccalaureate degree or a higher academic credential that is, at the time you completed the program, registered by the New York State Education Department as qualifying for certification in dietetics-nutrition or accredited by the Accreditation Council for Education in Nutrition and Dietetics (ACEND), or is the equivalent of such a program.
- The program must include at least 45 semester hours of course work in the professional dietetics/nutrition content area and have at least 20 semester hours of course work in the human biological sciences and social and behavioral sciences content area.
Experience Requirements
- Completion of one-half of a full-time equivalent year of planned work experience (800 hours), which could have been a structured part of your educational program. Otherwise, the experience must have followed the completion of your educational program. Planned work experience means continuous work experience in dietetics-nutrition, which reflects increased levels of professional growth and is under the supervision of a New York State Certified Dietitian-Nutritionist or someone who is registered by or a member of a national dietetic or nutrition association acceptable to the New York State Education Department.
- To qualify, the experience must include: assessing nutrition needs and food patterns, planning for and directing the provision of food appropriate for physical and nutrition needs, and providing nutrition counseling.
Alternative Pathway in New York State
An alternative pathway exists for those with an associate's degree in dietetics-nutrition:
- Education: Completion of a program leading to the associate's degree in dietetics-nutrition that is, at the time you completed the program, registered by the New York State Education Department as qualifying for certification in dietetics-nutrition, or the equivalent of such a program. The program must include at least 30 semester hours of course work in the professional dietetics-nutrition content area and have at least 15 semester hours of course work in the human biological sciences and social behavioral sciences content area.
- Experience: Completion of a combination of ten full-time equivalent years of education and supervised experience within the fifteen years preceding your application for certification. If your education was undertaken within the last fifteen years, you will be credited with one year of credit for every 30 semester hours of acceptable education up to a maximum of two years. A full-time equivalent year of work experience in dietetics and nutrition is 1,600 hours. To qualify, the experience must include: assessing nutrition needs and food patterns; planning for and directing the provision of food appropriate for physical and nutrition needs; and providing nutrition counseling. The experience must include at least two and one-half full-time equivalent years of planned work experience. Planned work experience means continuous work experience in dietetics-nutrition, which reflects increased levels of professional growth and is under the supervision of a New York State Certified Dietitian-Nutritionist or someone who is registered by or a member of a national dietetic or nutrition association acceptable to the New York State Education Department.
- Endorsement: Obtain the endorsement of three acceptable dietitians-nutritionists; i.e., a New York State Certified Dietitian/Nutritionist or someone who is registered by or a member of a national dietetic or nutrition association acceptable to the New York State Education Department.
Application Process in New York State
To become a Certified Dietitian-Nutritionist in New York, you must submit an application for certification and the other forms indicated, along with the appropriate fee, to the Office of the Professions at the address specified on each form. Fees are subject to change, and other payments must be made by personal check or money order payable to the New York State Education Department.
Maintaining Credentials
Continuing Education
Both state licensure and national CDR credentials require ongoing continuing education to ensure that RDs stay current with the latest research and best practices in the field. South Carolina, for example, requires registered dietitians to renew their license every two years, though statutory language allows the Panel to adopt additional continuing competency requirements under regulation. CDR requires recertification every five years.
Specialty Certifications
RDs can pursue specialty certifications to demonstrate advanced knowledge and expertise in specific areas of practice. Popular certifications include:
- Board Certified Specialist in Gerontological Nutrition (CSG)
- Board Certified Specialist in Oncology Nutrition (CSO)
- Board Certified Specialist in Pediatric Nutrition (CSP)
- Board Certified Specialist in Renal Nutrition (CSR)
- Board Certified Specialist in Sports Dietetics (CSSD)
- Certified Diabetes Care and Education Specialist (CDCES)
Career Opportunities and Salary
Registered dietitians find employment in a variety of settings, including:
- Hospitals and medical centers
- Outpatient clinics
- Long-term care facilities
- Public health departments
- Universities and schools
- Private practice
- Sports nutrition
Salaries for RDs vary depending on experience, location, and specialization. In South Carolina, the average salary for nutritionists and dietitians was $67,590 as of May 2024, with early-career professionals earning approximately $56,970 and experienced dietitians earning $90,600 or more.
The Evolving Landscape of Nutrition Professionals
It's important to note the distinctions between different types of nutrition professionals. While registered dietitians undergo rigorous training and credentialing, other titles such as "nutritionist" or "certified nutritionist" may have varying requirements depending on the state. Some states have no specific requirements for practicing as a nutritionist, while others require licensing or certification.
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