General Information

The Frances Stern Nutrition Center offers a 20-month program which meets the requirements for nutrition therapy emphasis in dietetics with additional experience that includes a unique mixture of clinical nutrition, community nutrition experiences and graduate education. Successful completion of the internship portion of the program fulfills requirements for eligibility to take the Registration Examination for dietitians in the spring of senior year. Successful completion of the entire program results in a Master of Science degree from the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University. Clinical experiences and academics are integrated in a concurrent and correlated sequence; therefore it is not possible to complete one component without the other. The program does not offer a dietetic internship separate from the Master's degree. Thus, graduates of this program acquire both the practical experience and formal education that make them very attractive candidates in a competitive job market.

The Programs area of emphasis is Nutrition Therapy and includes: provision of nutrition care to individuals, development of nutrition programs for population groups, management of financial resources, marketing of services and products related to practice, teaching dietitians and professionals/students, conducting research, and nutrition therapy management of food.

Graduates are prepared to work as nutritionists in a variety of settings. These include ambulatory nutrition services, inpatient dietetics, community nutrition programs, industry, and a variety of non-traditional careers. During the advanced portion of the program (after January of senior year until graduation), students have an opportunity to pursue an area of special interest.

Because the clinical nutritionist functions as a counselor, teacher, consultant and manager, our program is structured to offer instruction in basic techniques and methods of education, communication, counseling and program planning. It also provides in-depth knowledge of the science of nutrition and applied nutrition. Interns have the opportunity to develop skills in teaching individuals and groups, lay people and professionals. They also develop managerial skills needed in clinical settings.

The clinical experiences and affiliations prepare interns to adapt to the rapid changes in applied nutrition and health care. Included are experiences in handling important concerns of patients both in and out of the hospital. During clinical experiences at Frances Stern Nutrition Center, the student becomes familiar with the philosophy, function and administration of the Center. Students learn the techniques and skills of interviewing patients, assessing their needs, and of adapting, refining and applying knowledge of nutrition and diet therapy to diet counseling.

Students have a unique opportunity to provide follow-up care to patients and thus can become skillful at adapting care to meet patients' changing needs. Students also have experiences in the inpatient acute care setting, in a variety of ambulatory specialty clinics, Jean Mayer USDA Human Nutrition Research Center on Aging, in community agencies, and in the food service department. Emphasis is placed upon developing skills needed to assess needs, plan and deliver quality nutrition care in a variety of settings, and to evaluate the effectiveness of the nutritional care.

While much of the intern's time during clinical experience is spent with patients, the student also observes and participates in discussions and classes, learns a variety of computer applications in nutritional care services, assists in planning and preparing teaching aids,works on special projects, attends medical conferences and Grand Rounds, and participates in weekly seminars and journal review sessions. The opportunity to conduct a small research project with the approval of Dr. Johanna Dwyer, Director of the Frances Stern Nutrition Center, provides more in-depth specialization. Opportunities also exist to co-author articles suitable for publication in professional journals or the lay press.

The Frances Stern Nutrition Center (FSNC) has always emphasized the nutritionist's role in a variety of health care settings and in the community. Our immediate "community" in the geographical sense is Boston's Chinese community. However, patients represent various ethnic and socio-economic backgrounds with a diversity of health problems, learning disabilities, and support systems.

The Nutrition Center is located in the Tufts Medical Center (T MC ) complex. The Tufts Medical and Dental Schools and the Jean Mayer USDA Human Nutrition Research Center on Aging adjoin the complex. FSNC is one of over 30 clinics extending services to patients. We work closely with clinicians at Tufts Medical Center and the Floating Hospital for Children. The Jean Mayer USDA Human Nutrition Research Center, which specializes in nutrition and aging, offers some affiliations for our interns.

The Frances Stern Nutrition Center is the unit responsible for ambulatory and in-patient nutrition services at TMC. It is an income-producing unit with a staff of 10 nutritionists with secretarial support. Facilities include a suite of offices and a small library. The Center provides individualized nutrition services to patients of the hospital. Patients are also seen at the Center by private referral from physicians in the community. The staff nutritionists are skilled in correlating patients' nutritional needs with their medical and psychosocial needs. Our staff is qualified to provide normal and therapeutic nutrition to children and adults on an inpatient and outpatient basis.

Each staff member has expertise in a clinical specialty. Among the more frequently encountered medical conditions are hypertension, diabetes, cancer, hyperlipidemia, failure to thrive, and gastroenterological problems such as lactose intolerance, constipation, malabsorption, ulcer and inflammatory bowel disease. We also handle less common problems including disaccharide intolerance, therapeutic adjustment for vegetarians, and eating disorders. Weight reduction treatment programs based on behavioral and nutritional principles are offered for obese patients.

Our students also benefit from the expertise of a number of other highly qualified registered dietitians who supervise affiliations outside of TMC, including WIC programs, FLIK Independent Schools, Community Servings, the Elder Service Program, and the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University.

FSNC has extensive experience with computer applications in nutrition services. Students and staff use computer programs for nutrient analysis, estimating current and required nutrient intake, and planning and analyzing recipes. Students also prepare patient education material on a variety of topics. Programs are available for designing presentations and reports.

Nutritionists at FSNC provide consultations to local, state and federal programs. Staff members at FSNC have been consultants for a state school for the developmentally impaired, a rural health delivery program in Maine, an interdisciplinary education program in Western Massachusetts, and a number of other projects. Staff members at FSNC are also involved in teaching at both the Tufts University Friedman School of Nutrition Science and Policy as well as at the Tufts University Medical School, collaboration on grants, in giving lectures at the Dental School. Such services are provided to other hospitals and educational institutions in the Boston area as well.

Research activities of the Center concentrate on applied nutrition. Johanna Dwyer, D.Sc.,R.D., Director of the FSNC, is currently collaborating on grants from the National Institutes of Health on nutrition in hemodialysis patients. June Leung, M.S., R.D. is working with her and others at Tufts Medical Center on this project. We have a long and fruitful collaboration with the nutrient data laboratory of the Agricultural Research Service in Beltsville, MD, the flagship USDA laboratory for food composition. In addition to contributing as coauthors on the latest USDA releases of several food composition tables on the flavonoids, interesting bioactive substances in foods with possible health significance, we are engaged in a large number of related studies. These include a study of the effects of flavonoids among women on low and higher fat diets undergoing treatment for breast cancer, and studies of differences in intakes of flavonoids and the prevalence of various chronic diseases.

Working with her are doctoral students with expertise in dietetics and clinical nutrition on such diverse topics as energy needs of critically ill children in surgical intensive care units and the effects of dietary supplements on outcomes in hemodialysis patients. Other research is on the associations between diabetes self management and outcomes in patients with diabetes, and quality indicators for food and nutrition services in assisted living facilities. A final topic of great interest is nutritional quality of life in hemodialysis patients and among the elderly.

Dr. Dwyer also serves as Senior Nutrition Scientist at the Office of Dietary Supplements, National Institutes of Health, part time, where she leads the effort to develop analytically verified databases for dietary supplement use, explores motivations for dietary supplement use, and develops ways to better assess total dietary intake.

Carole Palmer, Ed.D., R.D. continues her work and research on nutrition in preventive dentistry, with particular attention to pediatric nutrition and oral health concerns. She also continues her work on developing and assessing multimedia educational materials for addressing the dental and nutritional needs of children with special needs.

Kristy Hendricks, Sc.D., R.D. has ongoing research in the area of HIV, with particular attention to lipodystrophy and its possible drug and dietary determinants in these patients, as well as more general aspects of HIV and nutrition. She is also actively involved in the FITS (Feeding Infants and Toddlers) project, and in analyses of dietary data on children in that study.

Several recent graduates of the Friedman School of Nutrition Science and Policy who did doctoral studies under Dr. Dwyer and who are closely associated with the FSNC have received their doctoral degrees here but continue their involvement with the Center. Irene Olsen, Ph.D., R.D. of the University of Cincinnati College of Medicine continues collaborations with our group on surveys of dietitians in neonatal intensive care units. Dr. Kathy Prelack of the Shriners Burns Institute continues to collaborate on her work with burned children and also teaches in our program. Haewook Han, Ph.D.,R.D. is now working in the General Clinical Research Center of Tufts Medical Center after completing work on the effects of diet in renal disease. She is currently working on various studies including obesity and popular diets, chronic kidney disease, and HIV related diet studies. Dr.Yasmin Almubarak is now on the faculty of medicine in her home country Saudi Arabia, where she works on dietary determinants of cardiovascular disease.

The FSNC staff is active in many professional associations, including the various practice groups of the American Dietetic Association, the American Society for Parenteral and Enteral Nutrition, the Society for Nutrition Education and the American Society for Nutrition Sciences. Dr. Dwyer is past president of the Society for Nutrition Education and also past president of the American Society for Nutrition Sciences (formerly American Institute of Nutrition). She was also past secretary of the American Society for Clinical Nutrition, and is a member of the Institute of Medicine, National Academy of Sciences, where she served on the Council from 2001-2003. During 2001-2002 she served as Assistant Administrator, Human Nutrition, Agricultural Research Service, US Department of Agriculture. Combined with her NIH experience and prior work as a staff member in Congress, Dr. Dwyer brings some relevant perspectives to thinking about food and nutrition policy. Dr. Palmer is active in the American Dietetic Association and the American Dental Association. Dr. Hendricks is active in the American Dietetic Association, and serves on the Research Committee of ADA. Dara Borto and Kelly Kane are Certified Nutrition Support Dietitians through the American Society for Parenteral and Enteral Nutrition and are active members of the Society.

Accreditation & Degree

The Frances Stern Nutrition Center has been accredited by the American Dietetic Association since 1936 as a dietetic internship specifically designed for the training of clinical nutritionists. Nutrition therapy is the area of emphasis of this program. Upon satisfactory completion of the program, the student is eligible to take the examination to become a Registered Dietitian and to become a member of the American Dietetic Association. In addition, the student receives a Master of Science degree from Tufts University. After completion of the program, it may be possible to continue on in pursuit of a doctorate.

Sequence of Program

Immediately following an orientation period, students begin their affiliations under the supervision of preceptors. To promote participation and learning, only one or two students are assigned to a specific affiliation at a time. During the first Fall semester, four and half days per week are spent in the clinical area and one half day is spent attending courses for Tufts credits and non-credit classes pertaining to the clinical area. Spring semester of the first year is spent taking courses full time at Tufts University. Most of the second year is spent in clinical affiliations, with time arranged to complete course requirements including the Senior Project.

An Optional rotation of three weeks' duration in an area of special interest to the intern is usually planned. This time is application oriented, whereas the Senior Independent Study (Senior Project) is more research oriented and is usually designed toward producing a publication. Optional rotation choices must be discussed with and approved by the Nutrition Education Coordinator.

Interns

Eight interns are selected each year. These highly qualified individuals are well-motivated students representing a variety of colleges, ages and backgrounds. Upon completion of the internship portion of the program, FSNC students tend to score well above the national average on the RD examination.

Verification Statement

The combined Dietetic Internship/Masters' Degree Program offered by the Frances Stern Nutrition Center, Tufts Medical Center and the Friedman School of Nutrition Science and Policy at Tufts University, is a 20 month program. Successful completion of the internship portion of the program fulfills requirements for eligibility to take the Registration Examination for dietitians in Spring of the second year of the program (senior year). The Verification Statement is issued by and signed by the Program Director after the student has demonstrated satisfactory completion of at least 900 hours of supervised practice. This statement is issued in the spring of the second year of the program. If a student has not satisfactorily completed the designated supervised practice, a Verification Statement will not be issued.

Career Choices

• Graduates of our program hold a variety of positions in community nutrition and nutrition education. Some of these include:
• Faculty member, coordinated undergraduate program in dietetics
• Nutrition in ambulatory services of a teaching hospital or general hospital
• Nutritionist for neighborhood health centers, health maintenance organizations, or maternal and infant care centers
• Consultant for private health organization, group practice, extended care facilities, and day care centers
• Teaching in colleges, universities and schools of nursing
• Nutritionist in rehabilitation institutes
• Full professor in a Dental School
• Nutritionist on inpatient nutrition support team
• Clinical nutritionist in community and teaching hospitals
• Research dietitian
• State food and nutrition specialist (cooperative extension)
• Director of clinical nutrition services
• Nutritionist in the private sector - food industry
• Director of Dietetic Internship
• Nutritionist at a Health Center or Athletic Facility
• Nutitionist in an outpatient weight loss center