Finding Focus Among Endless Opportunities

By Alexandra Long

The story of two sisters was being projected on the screen in front of me. Both were born with the same disease; however, one was able to live a normal life while the other suffered severe damage to her brain and nervous system. The difference in their outcomes came down to one thing: diet. “This is where the RD is the rock star,” said our presenter, Danielle Starin, of the Rare Disease Institute of Children’s National Medical Center (CNMC).

For one of UMD’s dietetic internship joint class days, I had the honor to attend the CNMC Pediatric Nutrition Symposium. Having never worked with children, part of me was questioning if I would find the subject matter intriguing. Aware of this, I made sure to enter the symposium with the positive mindset of learning something new and remaining open to the world of pediatrics.

Another part of me knew, however, that I would like everything about the symposium. That’s my hang up. Throughout the course of the internship, I’ve liked everything that I’ve come across in rotations ranging from clinical work in a hospital to community work at a food bank. This may sound like an ideal scenario, but for me I felt like I was becoming lost in the world of dietetics. In what direction should I go? Where do I focus my network? The profession of dietetics may be small, but the opportunities are endless.

DURdBsEVwAANLME  *UMD Dietetic Interns at CNMC Symposium

It’s always been in my nature to plan: plan my day, my week, the next five years, and even into retirement. Without having a clear goal and vision of what my dream job in dietetics would be, plans for my future seemed to be at a standstill. Being in a dietetic internship is a wonderful opportunity because interns are exposed to so many types of dietetics jobs. The goal of my job as an intern is to gain experience, learn as much as I can about these jobs, and to grow as a dietitian. Recently, however, I have started to think about my career after the internship. I couldn’t be happier with the profession I chose, but I was starting to worry that I would “just end up somewhere” in the profession without finding my true passion.

The symposium started off well. Maybe I could work with kids after all. The key role that dietitians played at CNMC was evident; the speakers worked in an array of specializations including pediatric nutrition support, diabetes, weight management, cystic fibrosis, the NICU, and gastrointestinal disease. As always, I found myself interested in every topic. I could see myself working in any of these areas. Did that mean I would be on the right track if I followed clinical dietetics in general? Is pediatrics what I should try? I normally have a strong gut feeling when I make important decisions, so being left with such ambiguous thoughts to decide my career path didn’t sit too well with me.

We were nearing the end of the day, and there was one presentation left. This was a breakout session, and we could choose between the options of two lectures to attend. The first choice was to go down the hall in a separate auditorium for a lecture on eating disorders, and the second option was to stay put and attend the lecture on inborn errors of metabolism. I perked up at the mention of this second option. In my undergraduate program, these rare diseases were maybe covered in one lecture in my medical nutrition therapy courses. I didn’t realize that that you could specialize in their study, and that there were jobs available for dietitians to work solely with these patients.

A lightbulb moment occurred only one slide into the presentation. Illustrated was the genetic defect in a disease commonly called PKU. In PKU, the enzyme which breaks down a specific protein, phenylalanine, malfunctions. This can lead to a buildup of phenylalanine that can eventually cause neurological problems, as in the case of the two sisters. The younger sister was diagnosed with PKU at birth, whereas the genetic testing was not in place when the older sister born. The difference? The younger sister was placed on a strict, low phenylalanine diet and was able to develop normally without the same neurological problems as her older sister.

Of course! My two favorite courses in school were clinical biochemistry and microbiology where we studied genetics and their resulting biochemistry. Dietitians working with inborn errors of metabolism directly apply genetics and biochemistry to develop treatment plans to give patients a better quality of life. My vision of working in this field was strong, so much so that I felt the need to explore this field further. This was the gut feeling I was waiting for.

The symposium was just a week ago, yet I’ve already started my planning. The questions I am asking myself now are more targeted, such as, “Do I get my MBA to start my own practice or a Master’s in Human Genetics?” and, “Should I expand my study to nutrigenomics?” It’s as if that one lecture renewed my excitement to plan for my future career in dietetics. My experience is a testament to being open to new opportunities that come your way. Having a focus area to explore adds to this exciting time in my career, and I look forward to what future opportunities await.

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