RDs in the Military

RDs in the Military

practice applications BUSINESS OF DIETETICS RDs in the Military W ith close to 230 registered dietitians serving in three branches of the US milit...

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BUSINESS OF DIETETICS

RDs in the Military

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ith close to 230 registered dietitians serving in three branches of the US military today, the roles they fill vary widely, from running health care facilities stateside and abroad, to filling teaching and research positions, to creating health and wellness programs (1-3). Since the 1940s, when the demand for dietitians in the military grew, registered dietitians (RDs) have been tapped to fill critical roles, oftentimes moving to positions of leadership within and outside of the medical realm (4,5). With starting salaries in the mid$40,000s and a comprehensive benefits package, military dietitians can expect to be rewarded for the service described by many interviewed for this article as an opportunity for adventure (1-3). WHAT MAKES A MILITARY DIETITIAN? In the United States, the first military dietitians were actually civilians. During World War I, dietitians worked as part of the American National Red Cross Dietitian Service, working with sick soldiers in military hospitals and helping ration critical food supplies (4,5). But civilian status was a thing of the past when World War II erupted, and there was a sudden increased need for dietitians to serve in a larger capacity. This caused the US government to grant military status to dieThis article was written by Jennifer Mathieu, a freelance writer in Houston, TX. Mathieu is a former editorial assistant for the Journal and her writing has appeared in The Washington Post, Houston Chronicle, Miami Herald, The Kansas City Star, and several other publications. She has received awards from the Association of Alternative Newsweeklies, the Dallas Press Club, the State Bar of Texas, and the Gay & Lesbian Alliance Against Defamation for her writing. doi: 10.1016/j.jada.2008.10.038

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titians, many of whom worked overseas in allied field hospitals and had to learn to substitute foods under certain ration conditions (4,6). Today, military dietitians must possess that same can-do attitude. “As an undergraduate, I was a member of the student dietetic association on campus, and a dietitian from the Air Force made a presentation to our group,” remembers Lt Col Mari Chamberlain, MS, RD, currently working as chief of medical training systems for the Air Force. “She was so young, but she had so much experience and confidence. I was impressed.” While Chamberlain believes that “most personalities will find a niche in the military,” there are certain key traits that those seeking a military career should possess. People who are natural leaders, enjoy working in a team environment, and are goal-oriented find success in the military, say those interviewed. “We realize we’re not 9 to 5ers, but we have a different calling,” says CAPT Martie Slaughter, MS, RD, FADA, head of clinical dietetics at the National Naval Medical Center in Bethesda, MD. “Military dietitians are high-energy go-getters, and lifelong learners.” Being willing to travel and acclimating successfully to new environments are also important attributes to have. “We want mature, flexible people who can adapt to change,” says COL George Dilly, PhD, RD, and the US Army’s chief dietitian, whose own military career has taken him everywhere from Belgium to Bosnia. Dilly adds that while many believe military careers are all about following orders, in reality, they are really about developing personal strengths. “People think they only get a highly structured regimen in the Army,” says Dilly. “But it’s actually an organization that presents autonomy and opportunities for personal and professional growth.” No matter what your

Journal of the AMERICAN DIETETIC ASSOCIATION

career goals may be, however, a desire to serve is often found among members of the military. “It’s a culture that can be different from the civilian sector,” Dilly adds. “It’s not about who drives the most expensive car or has the nicest watch. It’s about dedication and service.” RECRUITING REQUIREMENTS AND DIFFERENCES IN THE BRANCHES OF SERVICE Currently, the US Army, US Air Force, and US Navy are the three branches of service that employ RDs, with the Army employing the most at 135 full-time, active duty dietitians. While all three branches offer strong benefits packages and have similar requirements, there are a few differences of which to be aware. After World War II, the Army established a dietetic internship program in partnership with the American Dietetic Association to better prepare dietitians for military service (4). A version of that internship program exists today, with the US Army and US Air Force both offering internship programs for dietitians who have completed their undergraduate education. Army interns also receive master’s degrees in nutrition simultaneously, whereas Air Force dietitians may earn some graduate credits during their internship and can choose to complete their master’s later on. Interns are commissioned as officers complete with a full-time salary and benefits. In partnership with Baylor University, interns participate in foodservice systems, medical nutrition therapy, and community nutrition rotations as well as hands-on, practical training at Camp Bullis, TX, where interns live and work in a field environment (7). “I thought, this is great, I can get paid a full salary while I’m doing my internship,” says Chamberlain, one of about 60 registered RDs working for the Air Force. Army and Air Force interns with no prior service start at a base pay of

© 2008 by the American Dietetic Association

BUSINESS OF DIETETICS around $44,000, which can increase based on an intern’s marital status and duty location (1,2). The US Navy, which currently has 31 RDs on active duty, hires those who have already been certified as RDs. “We look favorably upon dietitians who have completed registration,” says Slaughter. “We feel it increases diversity.” Navy RDs also enter the service as officers, with those who have their bachelor’s degree earning around $44,000, while those who have their master’s degree start at around $50,000 (3). While most RDs entering the military are in their 20s or early 30s, age waivers are available and RDs can enter the service as a second career. Age limits vary by branch and can change depending on need, say those interviewed for this article. Background checks and interviews are all part of the process of becoming a military officer. For undergraduates, having a well-rounded resume that includes volunteer work and team sports can increase your chances of being selected, says CAPT James Jones, PhD, PA, an Army physician assistant who currently works to recruit highly-qualified candidates for the Army’s Medical Specialist Corps, of which Army dietitians are a part. Once a service member, RDs in the military enjoy a host of benefits.

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“We have the best retirement package in the US,” boasts Jones. In addition to retirement, military RDs also have extensive health benefits for themselves and their family members as well as opportunities for tuition assistance. With benefits, of course, comes a required amount of service time. All three branches require roughly a minimum of 3 years of active duty service. While it is possible to earn advanced degrees while serving, if the military picks up the tab, RDs should prepare to add more years onto their required service time. Those interested in a part-time military career should keep in mind that all three branches offer opportunities for those interested in being part of the Army, Navy, or Air Force Reserves. WHAT DO MILITARY RDs DO? Many civilians may believe that military RDs work primarily to develop meals for other members of the military, but that is not the case. Typically, those duties are contracted out to civilian companies, although military RDs may act in a consulting capacity at times, say those interviewed for this article. Military RDs primarily work in a medical capacity, usually starting out

in a military hospital working with inpatient and outpatient programs. Or they may manage the foodservice operation in a smaller community hospital. “We generally start them at hospitals,” says LTC Sarah Flash, MBA, RD, a nutrition staff officer with the Army. “There are 27 Army hospitals stateside and abroad.” This can include combat support hospitals, with RDs serving in Iraq and Afghanistan. Over time, military RDs can move into management, working to run not just departments, but entire hospitals, says Dilly. “There is definitely upward mobility,” he says, and military RDs can go so far as to compete for the position of US Surgeon General. “There are some amazing assignments out there.” Adds Slaughter, “Dietitians in the Navy can work in many supervisory roles, [from] working with entry-level dietitians and supervising civilian and enlisted foodservice personnel to running an entire health care facility.” Military RDs also take part in a variety of humanitarian efforts both stateside and overseas. In 1999, for example, Army RDs deployed to Thailand to take part in a long-term public health improvement project in rural villages, educating approximately 5,300 individuals in nutrition classes

BUSINESS OF DIETETICS to combat malnutrition, anemia, diabetes, hypertension, goiter, and poor appetite (8). RDs have also taken part in humanitarian efforts during military operations such as Operation Just Cause in Panama (9). “Hospital ships like the USS Mercy and USS Comfort provide global aid everywhere,” says Slaughter, who herself worked to adapt menus for Haitian refugees at Guantanamo Bay Naval Base in Cuba in the mid 1990s. RDs in the military can also work to promote wellness on military bases. In the Air Force, for example, RDs can work at health and wellness centers on bases to develop educational programs and promote good nutrition, says Chamberlain. Beginning in the 1980s, Navy RDs began initiating several programs aboard ship, providing nutrition counseling for both crew members and culinary specialists who operate and manage the Navy messes (10). Navy RDs are currently involved in the ShipShape program, a program that provides active duty personnel with information on nutrition, stress management, and physical activity all in an effort to help them maintain an acceptable body weight (11). OPPORTUNITIES FOR GROWTH AND CHANGE While most military RDs begin with clinical work in a hospital environment, the opportunities to grow and try new things are almost limitless, say those interviewed. Many military RDs can end up utilizing their skill set outside of the medical realm and go into teaching or research positions. Military RDs may compete for jobs as professors at the United States Military Academy at West Point, the United States Naval Academy, and the United States Air Force Academy, say those interviewed. “Over time, there are opportunities to go outside the medical realm because dietitians have skills that make us valuable team members,” says Chamberlain, who currently works as test director for operational testing of medical technology, a position she had not considered when first starting out in a more clinical assignment. “You can really decide if you want to pursue the clinical, research, or management route.” Military RDs can also participate in

partnerships with other governmental agencies and the civilian sector. According to Dilly, Army RDs have even worked with athletes at the US Olympic Training Center. MILITARY RDs LIVE A MILITARY LIFESTYLE While the benefits and opportunities can be rewarding, interested candidates need to remember that a military career will contain certain elements a civilian career might not. Perhaps most different is that military RDs often move regularly. “My family jokes about when we’ll have our ‘real home’,” laughs Chamberlain, who has lived in Mississippi, Nevada, Texas, Maryland, and Washington, DC, and traveled to Canada and Iraq. While the Air Force will consider input from the RD, she says, ultimately “they will place you in an area of greatest need.” That goes for the Navy and Army as well. “There is a dialogue in terms of where you may be sent,” says Slaughter. “But we sometimes need to take orders according to the needs of the Navy. However, I can safely say that in my 22-year career, there was only one assignment that I wasn’t the most happy about, and then it ended up being one of the best opportunities of my life.” Recruiters don’t “sugarcoat” the possibility that RDs may be deployed to places overseas, including places like Iraq and Afghanistan, says Jones. Still, he adds, “we want people to be satisfied, and there is a dialogue that goes on,” when determining where an RD will be stationed next. As officers in the military, RDs may have to have minimal weapons training. However, it’s “less than 1 percent of what we do,” says Dilly, adding, “They certainly don’t have to be Rambo.” Perhaps the biggest difference for an RD working in the military rather than the civilian world can be the sense of being part of something bigger than themselves. “It really is a family,” Dilly says proudly. “When you’re in it, you know it, and when you’re not, you want to be part of it.”

References 1. Medical Specialist Corps: Corps Careers & Jobs. GoArmy.com Web site. http://www.goarmy. com/amedd/m_spec/corps_careers.jsp. Accessed August 28, 2008. 2. Healthcare Careers: Biomedical Sciences Careers—Dietitian. US Air Force Web site. http:// www.airforce.com/careers/job.php?catg_id⫽3& sub_catg_id⫽4&af_job_id⫽220. Accessed August 28, 2008. 3. Clinical Care Providers: Dietetics/Food Management. Navy.com Web site. http://www.navy. com/careers/healthcare/medicalservicecorps/ clinicalcareproviders/dietetics/. Accessed August 28, 2008. 4. Office of Medical History, Office of the Surgeon General. Army Medical Specialist Corps. Office of Medical History Web site. http:// history.amedd.army.mil/booksdocs/histories/ ArmyMedicalSpecialistCorps/frameindex.html. Accessed August 28, 2008. 5. Hodges PA. Perspectives on history: military dietetics in Europe during World War I. J Am Diet Assoc. 1993;93:897-900. 6. Hodges PA. Perspectives on history: Army dietitians in the European, North African, and Mediterranean theaters of operation in World War II. J Am Diet Assoc. 1996;96: 598-601. 7. Baylor University. US Military–Baylor Masters Program in Nutrition: Program Overview. Baylor University Web site. http://www. baylor.edu/graduate/nutrition/index.php?id⫽ 53672. Accessed August 28, 2008. 8. Kemmer T, Podojil R, Sweet LE. U.S. Army dietitians deploy in support of Cobra Gold: A humanitarian mission. Mil Med. 1999;164: 488-494. 9. Craig MJ, Morgan WA. The Army dietitian in Panama: Military hospital feeding and humanitarian efforts during Operation Just Cause. Mil Med. 1996;161:723-725. 10. Gray DP. Many Specialties, One Corps: A Pictorial History of the Medical Services Corps. Virginia Beach, VA: Donning Company Publishers; 1997. 11. Hunt A. Nutrition makes a stand in Navy fitness. United States Navy Web site. http:// www.navy.mil/search/display.asp?story_id⫽ 22279. Accessed August 31, 2008.

ADDITIONAL RESOURCES http://www.todaysmilitary.com/careers/job-listings/ dietitians http://www.goarmy.com/amedd/m_spec/corps_ careers.jsp http://www.navy.com/careers/healthcare/medical servicecorps/clinicalcareproviders/dietetics/ http://www.airforce.com/careers/job.php?catg_id⫽ 3&sub_catg_id⫽4&af_job_id⫽220 US Air Force Contact Capt. Kristina Porsi 210-292-5737 [email protected] US Army Contact Capt. James Jones at 1-800-714-4059 [email protected] US Navy Contact Lt. Cmdr. Kim Zuzelski [email protected]

December 2008 ● Journal of the AMERICAN DIETETIC ASSOCIATION

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