How to Become a Registered Dietitian

By: Dylan Jones, MS RD, CD, CES

Last Updated: December 16, 2018

Registered dietitians share the increasingly important goal of improving health through good nutrition. As experts in human nutrition, these professionals work in a variety of settings to help people prevent and manage disease by eating the right foods. They often work closely with nurses, physicians, chefs, business owners and others to promote good health in people’s lives.

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Registered dietitians’ expertise in food chemistry, disease process and metabolism helps them to create personalized nutrition plans for patients and clients with a wide variety of nutritional goals. In medical settings, they help patients:

• Gain or lose weight (obesity, pregnancy, elder care)
• Prevent and reverse common diseases (cardiovascular diseases, diabetes, osteoporosis)
• Manage chronic conditions (high cholesterol, high blood pressure, obesity)
• Withstand the rigors of treatment regimens (dialysis for kidney failure)

Registered dietitians (RDs) can take many different career paths. Some work in hospitals providing medical nutrition therapy to the sick and injured. Agencies such as the Women, Infants and Children (WIC) nutrition program employ these professionals to assist with client education, planning and policy-making. Other dietitians oversee food service programs at hospitals, schools and correctional facilities.

Many diseases and their life-altering consequences are preventable through small daily adjustments to diet. Certain diseases like cardiovascular disease can even be reversed through guided healthy eating. RDs play a large part in helping people make the important nutritional changes that improve their health and quality of life now and in the future.

Workplace Details

Dietitians who provide medical nutrition therapy to patients are called clinical dietitians. In this role as an integral part of the medical team, they work closely with physicians and other professionals to treat patients with special nutritional needs. Their role often involves adjusting the person’s intake of vitamins, fluids, nutrients or calories. Clinical dietitians are expected to be highly proficient in human physiology and critical thinking, as their treatments often must take into account various disease states along with medications and other factors.

Many dietitians work outside the health care industry too, in a vast range of settings, especially where food is being served. Corporations, school systems, correctional facilities and other large institutions employ these professionals to help them meet the nutritional needs of the people they serve. RDs in these roles often oversee kitchen staff, manage ordering, balance budgets and continually ensure that balanced meals are being served. These settings are preferred by dietitians who have a particular passion for working with food. Furthermore, there’s a growing body of RDs with training in culinary arts.

With the high rates of chronic disease such as obesity and heart disease, many dietitians now provide health coaching to individuals making lifestyle changes. This requires additional training in communication modalities such as motivational interviewing or positive behavior support in order to encourage healthier behaviors. RDs who provide health coaching need to be good listeners and exude patience in their roles, as they counsel their clientele.

In almost all work environments, RDs will be educating the people with whom they work. Community-involved roles require teaching the public about healthy nutrition practices; RDs in medical settings train patients to manage their diseases; and managers will be informing staff of healthy procedures that affect customers. If a dietitian earns an advanced degree, he or she often teaches at colleges, performs research or works with the government to shape public health policy. RDs are natural teachers.

Lastly, with the large expanse in job diversity, dietitians now find job opportunities in new and exciting areas. Some of the most recent opportunities include working with customers in grocery stores, partnering with chefs to create healthier menus or developing health-related products to be sold.

Hover over any state to explore local income and job growth data.

According to the Bureau of Labor and Statistics report, the median annual salary for registered dietitians is $58,920. Among the industries with highest employment of RDs, dietitians in outpatient care settings tend to earn a higher average salary ($65,860), while RDs tend to earn lower average salaries in local government positions ($51,980).

The Bureau of Labor Statistics predicts that employment of registered dietitians will increase by 16% from 2014 to 2024, a rate that is significantly higher than the average for other occupations. The growing rates of chronic diseases such as diabetes and heart disease, along with the expanding elderly population, are factors driving demand for qualified RDs.

Becoming credentialed as a registered dietitian requires a bachelor’s degree in dietetics, nutrition or a related field from an accredited university. Those aspiring for certification will take high-level courses in biochemistry, physiology, food chemistry, anatomy, culinary arts and nutrition science. About half of all dietitians hold a master’s degree or doctorate; even though this is not currently required for certification, it’s strongly encouraged.

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To be eligible for the RD credential, students must complete a 1,200-hour post-bachelor’s internship under the supervision of a licensed dietitian. This training takes six months to a year. The Academy of Nutrition and Dietetics (ACEND) maintains a list of approved dietetic internships on its website. Students often complete these 1200 hours in different sectors of medical care, community outreach and food service.

Candidates who hold a relevant bachelor’s degree and have met the internship requirement are then qualified to sit for the national RD exam administered by the Commission on Dietetic Registration. Some states may also require additional certification or licensure to practice locally.

RDs with advanced degrees command higher salaries and have a more diverse choice of career paths. (A doctorate in nutrition, for example, opens up careers in research and academia.) Those working in food service and clinical care often advance into management positions with higher salaries as well. RDs can also increase their advancement opportunities by relocating to an area with a shortage of health care professionals.

Established professionals can also earn higher wages by becoming proficient in their chosen field. The Commission on Dietetic Registration provides several continuing education opportunities including becoming a certified sports specialist dietitian, a specialist in pediatric nutrition or a specialist in gerontological (older adult) nutrition. Many dietitians use these additional training opportunities to obtain higher wages and advancement.

There are two basic pathways to becoming a registered dietitian.

• Complete a 4-year Didactic Program in Dietetics leading to a bachelor’s degree followed by a 1-year Dietetic Internship (5 years)

• Complete a Coordinated Program in Dietetics, which integrates the bachelor’s degree and internship programs (4 years)

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In order to meet the requirements for Registered Dietitian certification, all educational programs must be accredited by ACEND, the Accreditation Council for Education in Nutrition and Dietetics.

Didactic and coordinated programs in dietetics can be found at many four-year colleges and universities. Dietetic internships are sponsored by universities, hospitals, and public health districts. For a searchable list of accredited programs, visit ACEND’s website.

No matter which pathway you choose, your first two years of study will focus on courses in general education, natural sciences, math, and writing. At some schools, students must apply for admission to the dietetics program at the end of Year 2.

Beginning in Year 3, the instruction shifts to diet and nutrition. Common dietetics courses include:

In coordinated programs, students complete their clinical rotations during Years 3 and 4. When possible, these experiences are integrated with coursework. (For example, the medical nutrition therapy class and clinical are completed during the same semester).

Students who graduate from a didactic program spend an additional year completing a 1,200-hour Dietetic Internship. Interns rotate through areas like food service, clinical nutrition, and community nutrition. Their responsibilities and independence increase with experience.

To become certified as a registered dietitian (RD) by the Commission on Dietetic Registration (CDR), you must hold a bachelor’s degree from an ACEND-accredited program, complete 1,200 hours of accredited clinical experience, and pass an exam. CDR also offers five specialty certifications for registered dietitians. Candidates must document clinical experience in the specialty and pass a knowledge exam.