Lexington VA Dietetic Internship Program

The Lexington VA Healthcare System Dietetic Internship Program is a 29-week program with a clinical nutrition concentration focusing on medical nutrition therapy that will prepare graduates to work as an entry level dietitian. Interns will be on duty 40 hours per week beginning in August. Interns will attend weekly supplemental classes taught by subject matter experts on the chosen topics. Our program requires a master’s degree upon admission and interns will be eligible to take the Registered Examination for Dietitians upon completion of the internship. Supervised practice experiences in medical nutrition therapy, foodservice management and community nutrition comprise the program which is divided as follows: 

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

Foodservice Management – 4 weeks

Community – 2 weeks 

Staff Relief – 4 weeks.

The internship will begin with one week of orientation which will include an introduction to the research project and the weekly class schedule. Class topics include TPN management (taught by PharmD), Crucial Conversations (a leadership class taught by Staff Development professionals), feeding difficulties and resources available (taught by Occupational Therapist), and Generation’s training. One week of vacation, in addition to federal holidays, will be granted.

Clinical rotations are sequenced in a manner that progresses from basic rotations (i.e., long term care, cardiology) where the interns become comfortable with medical team interaction and the Nutrition Care Process to more complex rotations (i.e., renal, nutrition support/surgery) where the interns focus on providing nutrition support to patients with a variety of complex medical conditions. 

The end of the program will culminate in a community rotation and staff relief where interns will be able to utilize the knowledge they have acquired during their internship. 

Graduation and program completion requirements

To graduate from the Lexington VA Healthcare System Dietetic Internship Program, interns must:

• Successfully complete all supervised practice rotations, assignments, classes and the research project.
• Successfully meet all ACEND competencies as defined in the program's learning assessment plan.
• Complete all supervised practice hours and the competency requirements. 
• Completion is required within 10 months of starting the program.
• Maintain the professional and ethical code of conduct expected.
• Complete all required rotations, projects and assignments satisfactorily as assessed by the preceptors and/or Internship Director.
• Submit all evaluations of the program and other necessary documentation to the Internship Director.
• Interns who successfully complete the internship program will be issued a verification statement by the internship director. This form confirms the completion of the supervised practice requirements of the program and provides the student with eligibility to write the registration examination administered by the Commission on Dietetic Registration (CDR).

Steps to become a Registered Dietitian Nutritionist (RDN):

1. Earn an undergraduate and graduate degree from an ACEND accredited Didactic Program in Dietetics (DPD). DPD coursework will include prerequisites necessary to be successful in a Dietetic Internship.
2. Complete a supervised practice requirement. Individuals must complete at least 1,000 hours of supervised practice with an ACEND accredited Dietetic Internship program. This step will require applying through DICAS.
3. Pass a national exam for RDNs. Once you complete your internship, you will take CDR's Registration Examination for Registered Dietitians to become credentialed as registered dietetics nutritionist.  Effective January 1, 2024, the CDR will require a minimum of a graduate degree to take the Dietetic Registration Exam. 
4. Meet requirements to practice in your state. Many states have licensure laws for food and nutrition practitioners. All states accept the RDN credential for state licensure purposes. Graduates will need to contact state licensing agency in the state where they intend to work to obtain information about licensure requirements.
5. Stay up to date in dietetics through continuing education. After successfully passing the national exam and earning the credential, RDNs maintain ongoing professional development in order to stay up to date on the latest research, recommendations and best practices.

State Licensure:

As a federal entity, VHA cannot require every dietitian to hold state licensure when not all states have licensure available for dietitians.

Preceptors for the Community Rotation that are not employed by VA will be required to submit a copy of any registration or licensure that is required for their position. This information will be updated in the internship program files on an annual basis. 

For further information regarding other state licensures please visit State Licensure - Commission on Dietetic Registration (cdrnet.org).

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 Healthcare 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.

The mission of the Lexington VA Health Care System Dietetic Internship is to is to offer a supportive learning environment in a challenging and dynamic program with a focus on medical nutrition therapy. Our program is designed to promote progressive, patient-centered nutrition services, which prepare our graduates to be highly functioning, competent entry-level Registered Dietitians. Graduates of the program will be committed to evidenced-based practice, providing high quality nutrition care. Graduates will serve the needs of Veterans, local communities, and the nation by promoting patient-centered care and excellent customer service that encourages innovation, consistent with the VA’s Mission.

The Dietetic Internship (DI) mission incorporates all the I CARE Values that support the VA Mission Statement. 
The DI mission also supports the NFS mission to provide excellent nutrition intervention and foodservices that improve Veteran wellness and experience.

Lexington VA Healthcare System Dietetic Internship Program Goals

1. Graduates will have the skills, knowledge, abilities, and experience needed to obtain professional credentials and enter dietetic practice. 

   a. At least 80% of program graduates take the CDR credentialing exam for dietitian nutritionists within 12 months of program completion. 

   b. The program's one-year pass rate (graduates who pass the registration exam within one year of the first attempt) on the CDR credentialing exam for dietitian nutritionists is at least 80%.

   c. At least 80% of program graduates complete program requirements within 10 months (150% of the program length).

   d. At least 80% of employers will rate graduates as meeting or exceeding entry level performance.

2. Graduates will benefit the VA, other healthcare systems, and the public by becoming multi-skilled, competent dietitian nutritionists to meet the demands of current and emerging practice areas. 

      a. Of graduates who seek employment, at least 80% are employed in nutrition and dietetics or related fields within 12 months of graduation.

      b. At least 25% of program graduates will be employed in VA dietitian positions within 3 years of completing the program.

Program outcome data is available upon request. Since we are a new internship program, we don’t have outcome data to report currently.

Lexington VA Healthcare System Dietetic Internship Program Financial Information

There is no application fee for VA Dietetic Internship Programs. Also, we do not charge tuition to enroll in our program. The VA covers background checks, physical exams, and certain immunizations for trainees. Our program does not cover the costs of application fees, housing, meals, personal transportation, books, professional association dues or meeting attendance, registration exam or supplemental resources.

Costs to the intern may include:

• D&D Registration Fee $55
• DICAS Application Fee $50
• Academy of Nutrition and Dietetics Membership (Student) $58
• Kentucky Academy of Nutrition and Dietetics Annual Conference ~$75-150
• Bluegrass Academy of Nutrition and Dietetics Membership (Student) $11.50
• Living and transportation costs
  • Apartment rental for one bedroom in Lexington range is $700-1000. 
  • Interns must have a car and auto insurance.
  • Parking Fee ~$40month while working at one of our main VA sites. 
• Health insurance
• Reference materials/books
• Educational supplies, etc.

Stipend

Interns starting in August 2024 and 2025 will be considered without compensation. The Office of Academic Affiliations (OAA) works with the VA to provide stipends for trainees, and we are in the application process for this.

This program does not offer financial aid or scholarships. It may be possible to defer student loans while completing the dietetic internship.  The Academy of Nutrition and Dietetics offers a variety of scholarships to dietetic interns. Contact AND ) or check their website https://www.eatright.org/ for further information.

The Lexington VA Healthcare System Dietetic Internship Program Application Information

Interns must complete the online application utilizing the online centralized internship application, DICAS. This application may be accessed at https://portal.dicas.org/ beginning December 1, 2023. The online application must be completed by February 15, 2024, for spring matching. The Lexington VA Dietetic Internship Program will accept 3 interns per year with the program beginning in August.

Admission Requirements

• Applicants must be US citizens.
• Applicants must have completed all DPD requirements from a U.S. regionally accredited university or college program accredited by the Accreditation Council for Education in Nutrition and Dietetics. An original signed copy of the DPD Verification Statement must be provided.
• Applicants must have completed a master's degree from a U.S. regionally accredited university prior to admission to our dietetic internship. Updated transcripts for master's degrees must be received prior to the program start date. FDE equivalent will not be accepted for this internship. 
• Minimum overall GPA of 3.2 with a minimum science GPA of 3.0
• Males must have registered for selective service (or be exempt) to be eligible to apply to this program.

Application Requirements

• Personal statement. Include:  Why you are interested in our program specifically? What makes you a good fit for our program? Why you want to be a dietitian? What are some experiences that have prepared you for this internship? What are your short term/long term goals, strengths, and weaknesses?
• DPD Verification Statement.
• Transcripts from all universities attended.
• Three letters of recommendation - two professors (including the DPD director) and one work supervisor. You may use alternate references with approval from the Lexington VA Healthcare System Dietetic Internship Director. Please call with questions.
• A resume with complete work and volunteer history.

Candidates are evaluated in terms of academic achievement and personal statement as well as work, volunteer, leadership, and research experiences.  Work experience in an area related to dietetics is considered beneficial to the student’s overall preparation for the dietetic internship but is not mandatory. 

Appointees must be physically and mentally able to perform the responsibilities of a dietetic intern safely and efficiently. Appointees will need to provide proof of immunization status including documentation of vaccinations for healthcare workers as recommended by the Centers for Disease Control and Prevention (CDC) including the COVID-19 vaccination. Appointees will be required to undergo a background check and drug screen prior to starting the program.

Program Matching

Applicants to Dietetic Internships must participate in computer matching through D&D Digital Systems. Website at https://www.dnddigital.com/. Students will access the D&D Digital Systems website on match day to review their personal matching results. Students receiving a match to the Lexington VA Healthcare System Dietetic Internship Program must contact the Internship Director by phone at or by email at cassandra.downing@va.gov to accept or reject the appointment by 4:30 pm on match day. 

Lexington blends influences from the South and Midwest to create a cultural identity all its own. Lexington is a college town, home to the University of Kentucky which is the city’s largest school. Lexington is known as the Horse Capital of the World and the equestrian industry is a primary part of the city’s culture. Horse farms surround the city on all sides, many streets are named after Triple Crown winners and horse statues are displayed all around town. The horse industry is so important to Lexington that zoning restrictions are in place to protect hundreds of neighboring farms from urban development.  Lexington was the first city in the US to host the World Equestrian Games, is home to the 1,200-acre Kentucky Horse Park and the #1 Thoroughbred Racetrack in North America, the Keeneland Racetrack. Lexingtonians also love college basketball, locally sourced cuisine, outdoor recreation and of course, bourbon. The region has a variety of industries, a temperate climate and plenty of access to the great outdoors. Residents take advantage of nice weather to hike, kayak, raft and camp in nearby areas like Red River Gorge or Cumberland Falls. Central Kentucky is home to the world’s most elite and legendary Bourbon distilleries. These distilleries supply over 97% of the world’s bourbon and some of these facilities date back over two centuries. Most of these distilleries offer tours along with tasting.