Dietetic Internship Program

Program Rotations

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Clinical Nutrition –17 weeks, rotations include medicine/oncology, cardiology, long term care, renal, nutrition support/surgery, outpatient clinic and diabetes.

Long Term Care – 2 weeks. Interns will focus on providing nutrition care of patients with wounds, chronic infections, dementia as well as those receiving chemotherapy/radiation and Hospice care.  Interns have a specific assignment regarding oral nutrition supplements and assistive feeding devices. They will also teach a class to PTSD/Addiction group.

Cardiology – 3 weeks. Interns will focus on nutrition care of patients with cardiac disease states including valvular diseases, CAD/CABG, heart failure, cardiac cachexia, and cardiogenic shock. Interns must follow a 2000 mg Na+ diet for two days and write a short summary of lessons learned. They will also observe a heart catheterization.

Medicine/Oncology – 3 weeks.  The interns will focus on general medicine patients with a focus on dysphagia, liver disease, enteral nutrition, and oncology care. Interns will conduct swallow screens as well as other Dysphagia team activities. They will observe a PEG placement and consult with patients in outpatient oncology clinic for tube feeding follow up.

Renal – 2 weeks.  Interns will provide nutrition care to patients with various stages of renal disease. They will work with patients on different dialysis modalities and teach a nutrition-focused component of CKD classes. Interns will complete a “Renal Food Challenge” where they must follow a renal diet for 2 days, a dialysis focused assignment which centers on all types of dialysis and NIDDK education modules. They will also teach Healthier Kidneys through your Kitchen class.

Nutrition Support/Surgery – 2 weeks. Interns will become proficient in assessing nutrition support and surgery patients focusing on parenteral/enteral support, drug therapy, fluid/electrolyte requirements and nutritional monitoring primarily in the critical care setting. Interns will have several assignments specific to tube feeding including explaining the steps involved in placing an NG or nasoenteric feeding tube and assist (if available) in the placement of an NG tube.  The intern will also have assignments specific to TPN including a case study and numerous calculations.

Outpatient Clinic – 3 weeks. Interns will become competent in nutrition counseling and education using multiple modalities in the ambulatory care setting. Interns will use motivational interviewing and behavior change techniques to facilitate healthy lifestyle change. Interns will utilize the Inbody machines to assess body fat, muscle, and total body water in a select group of patients. Interns have assignments specific to counseling skills and motivational interviewing which addresses stages of change, SMART goals, OARS, teach back and the Inbody machine.

Diabetes/Specialty Clinic – 2 weeks. Interns will become proficient in interviewing and developing meal plans for patients with diabetes focusing on the patients’ specific nutritional needs and the impact of diabetes medications.

Foodservice Management – 4 weeks

Foodservice management – Interns will become proficient in food production, purchasing, inventory management, menu management, personnel management, financial management and other administrative activities. The interns will conduct safety and sanitation inspections, participate in training activities for food service employees, develop a Holiday menu, conduct plate waste studies and taste panels.

Community – 2 weeks

Community – Interns will become competent in nutrition education in a variety of community settings. Interns will learn about local, state, and federal programs as well as issues facing those with limited access to healthcare and food insecurity. Interns will develop culturally and age-appropriate education materials.

Staff Relief – 4 weeks.

Staff relief – The intern will demonstrate their ability to work independently as an entry-level dietitian upon graduation. The intern will be expected to function in place of the dietitian in all daily duties.

The Lexington VA Health Care System Dietetic Internship Program does not require interns to locate their own supervised practice sites or preceptors.  There are no distance education components, all rotations will occur in our facility or local affiliate sites. No credit will be given for prior learning experiences or classwork.

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