Learning Experiences and Schedule Overview

In this initial rotation, interns:  

• Rotate with 3 preceptors on different service lines over the 19 weeks and get exposure to different patient populations and types of medical nutrition therapy. 
  • Service lines include transplant, neurology, surgery, cardiology, psychiatry, malignant hematology, and general medicine. 
  • MNT interventions include oral, enteral, and parenteral nutrition support.  
• Learn to consistently apply the Nutrition Care Process with all patients:  
  • Assessment 
  • Diagnosis 
  • Intervention 
  • Monitoring and Evaluation 
• Practice interview skills, navigate the electronic health record, and work closely with the interdisciplinary team to optimize the nutrition status of admitted patients. 
• Learn about the larger system in which they are providing care and get experience in coordinating nutrition plans for discharge with case managers, community providers, and homecare companies.  
• Are expected to take responsibility for their patients, following them closely throughout their admission, analyzing assessment data, and adjusting the plan of care. 

After completing the clinical nutrition core, interns move on to the critical care units (also known as intensive care units or ICUs). In this rotation, interns:  

• Practice applying the Nutrition Care Process with critically ill patients who are less stable and may need more frequent adjustments to the nutrition plan.  
• Learn to incorporate critical care treatment modalities such as continuous renal replacement therapy, mechanical ventilation, and ECMO into their nutrition plan.  

After completing the clinical nutrition core, interns move on to pediatric inpatient units. In this rotation, interns:  

• Practice applying the Nutrition Care Process with pediatric inpatients and their families, incorporating growth requirements into their nutrition interventions.  
• Participate in walking rounds with the interdisciplinary team where interns can learn more about medically complex conditions and practice advocating for nutrition care. 

In this rotation, interns learn to lead and participate in department projects in a large-scale patient and retail food service operation across three sites. Projects include:  

• A theme meal from planning to execution 
• A business plan for a real business need 
• An InService for staff on a relevant topic  
• Individual projects that range from evaluating new kitchen equipment to establishing emergency procedures to writing clinical competencies.  

Experiences take place in our large, room service/on demand kitchen at Parnassus and Mission Bay campuses.

Interns participate in daily operations and work on projects related to department needs such as analysis of systems, development of policies and procedures, performance improvement and quality control, special cafeteria and patient menus, and employee training.

The Diabetes Ambulatory Care Rotation focuses on expanding interns’ knowledge of and experience with nutrition counseling and education in the outpatient setting. Interns also have the opportunity monitor their own blood sugar trends during the week.  

Interns will be able to participate in leading group classes as scheduling allows.  

For the Off-Site Community Rotation, interns select a community program or agency of interest in the San Francisco Bay Area. These sites may include:  

• Nutrition education programs in community healthcare clinics  
• Food access programs  
• Outreach education and program planning  

The specific learning experiences vary by the selected site and services provided. Interns may gain experience with community-based screening and assessment, participate in program development and evaluation (including development of education materials), and conduct education for target populations under the supervision of the dietitian or program manager. 

Elective rotations are designed to provide the intern with a chance to apply skills from previous rotations in a new setting or explore additional settings for nutrition providers.  

Within UCSF Health, interns have the opportunity rotate with an outpatient specialty clinic where they can practice nutrition assessment in an ambulatory setting. Interns have demonstrated competence in nutrition assessment for stable adult inpatients and are at least approaching entry-level competency for adult critically ill and pediatric inpatient populations. The elective rotation at an outpatient specialty clinic allows interns to use these skills while working with patients in a home setting. This gives interns the opportunity to address new types of barriers patients may face and further practice nutrition counseling skills.  

Interns may choose to rotate at an off-site location, schedule allowing and if an affiliation agreement can be established. Sites and learning experiences must be approved by the DI Director. 

Interns participate in several additional activities throughout the year to support their learning and develop additional skills:  

• Formal clinical case study presentation 
• Creation of nutrition education video 
• Take action on nutrition policy and/or advocacy area of interest 
• Observe and provide feedback to peers  
• Create and promote a recognition activity for an interdisciplinary team member 
• Professional development classes  

Interns are scheduled to work an eight-hour day and a forty-hour week, usually Monday through Friday. Hours will vary depending on the work assignment. Classes are usually scheduled into the forty hours but may occur outside of the regular daily schedule. After demonstration of competence in the inpatient clinical nutrition core rotation, interns provide weekend coverage and on-call coverage from 5:00 p.m. to 8:00 p.m; this responsibility is rotated among interns. Interns earn time off for days worked.