My Journey

I regularly get asked how I became a dietitian by people who are interested or those who would like to become a dietitian themselves. Most recently a lot of people have asked me particularly as they have been considering career change. The one thing I would like to point out at this stage is that you can’t do a ‘quick course’ which I have been asked by so many people! Sadly (or not so sadly) dietitians have worked hard for their qualifications and you can trust their advice. The industry is absolutely saturated which means that if you are going to do it, do it properly. No short cuts!

To be a registered dietitian you have to have done a four year bachelor of science degree in dietetics, or you will need to have done a two year masters/post graduate diploma in dietetics following on from a science degree. There are several courses across the UK but you should know that these courses are very competitive. The best way to stand out is to have a clear interest in nutrition, dabble with nutrition writing, volunteering in the industry, or even better - you have managed to spend time shadowing a dietitian in practice (very very difficult to land this one). Shadowing a dietitian is your trump card as it shows the university that you know what a dietitian career entails; many people think of dietetics as glamorous and I can assure you most of the time it is far from it!

To give you an idea of my journey let me start at the beginning… I have always had an early interest in food like most dietitians. Of course we all love food (we wouldn’t survive if we didn’t!), but there is loving food and then there is baking a cake a day for many years (which somehow my mother allowed me to do). I have always adored food, and learnt from a young age that it is a science. I remember very clearly trying to master a crumbly fudge recipe and I very rarely got it right. Alter the temperature, quantities, movement just a smidge and you would make a toffee like consistency. Not a crumble in sight.

For high school, I went to an all girls grammar school in Wallington; which as you can imagine was packed with unbelievably intelligent girls. I spend many years of my life feeling unintelligent and inadequate (though in the grand scheme of it completely average). I struggled to succeed with may subjects namely maths and languages. When it came to choosing my GCSE’s I chose food technology as I had always loved cooking (along with all the other mandatory subjects). After achieving my A* in GCSE Food technology, I went on to study food technology for AS and A-level. The curriculum included a lot more science and nutrition which I grew to love. I remember learning about the chemical structure of foods for example the role gluten played in the rising of bread, and how the degree of hydrogen saturation of fat could determine the quality of a biscuit. During my AS level, I volunteered for a year at MENCAP where I supported mentally handicapped individuals in the kitchen to help them master basic cooking skills as well as helping them make their evening meal. This was so rewarding but also would have been noticed by the Universities when applying for my dietetics masters degree.

This passion grew and I knew I wanted to continue with food technology and pursue a career in this field. I looked round several universities for their degrees in food technology; I looked at Leeds, Sheffield and Northumbria University. After results day I chose to study Food Science and Nutrition BSc at Northumbria University. Though not before taking a year out to work two and a half seasons abroad. This was a short summer in Lesvos Greece, a winter season in Les Deux Alpes, and a summer season in Lemnos Greece. I just worked as a waitress, bar tender and housekeeper; here I learnt a lot about the holiday industry but more importantly I learnt a lot about myself.

After my time abroad, I returned to the UK to start my degree in Newcastle. I can’t for the life of me remember all of my subjects but they included topics such as anatomy and physiology, nutrition, ethics and biochemistry. During my second year we had a mandatory 6 week placement as part of out course. For the entire cohort they were offering just one dietetic placement, which I asked the lecturer immediately if I could have it (which she gave me!). During this placement I shadowed the Newcastle community dietetics team and got taste of community work including group education, community neurological hospitals and health promotion work at primary schools and at St.James’ park football stadium.

After my three (very fun and very boozy) years in Newcastle, I graduated with 2:1 and a first class dissertation. When I left Northumbria, I spent weeks and weeks applying for jobs; realising quite quickly that applying for a job was a full time job in itself! I was applying for very corporate roles, and I remember after a huge day of job applications I decided to slip one last application in for a not-so-corporate role (VIP SKI for one last ski season). I went on to be offered the role of chalet manager which I grabbed with both hands and soon flew off to Val D’isere for 6 months. Before I went away I applied for a couple of dietetic courses as this had interested me since my placement.

Whilst working in France I received an offer to study a masters degree in dietetics at Queen Margaret University, Edinburgh (which I accepted - and my parents paid for this as it was a huge expense I couldn’t afford!). After my winter season I made the most of my last summer before studying, and I decided to travel around Australia, NZ, Vietnam, Thailand, Cambodia, Singapore and Bali for 4 months with a best friend. Many hilarious stories later and a lot of Oreos, I returned to the UK with just one week to get myself to Edinburgh.

I actually had a bit of a ‘rocky’ start in Edinburgh as I couldn’t find anywhere to live and found myself living in a hostel for a few weeks. Not what you want when you are studying a masters degree! The course was intense and I met a very good friend on the course who helped the days and weeks fly by. We had an equally strong work ethic (and taste in clothing) ergo many days at university wearing matching clothes! The modules and essays were back to back for a solid whirlwind 8 months, very little social life and very hard work (but do-able). After Christmas we had our first clinical placement - all dietetic students from both undergraduate or postgraduate courses will have three clinical placements: A (Awareness) B (Building) and C (Consolidation. Though in the UK they’re called placements 1, 2,3.

Attractive scrubs on and PENG handbook in hand (a dietitians bible!!) I began my placements. For placement A, I was with a girl from university and we were placed in a mental hospital in Aberdeen. My goodness this opened our eyes to dietetics! A lot of mental health medications (for example olanzapine) can cause significant weight gain. We spent a lot of time shadowing 1:1 reviews with patients on forensic wards - for patients who were very mentally unwell and may have committed crimes. I remember a dietitian saying to us “If you feel unsafe just trust your gut and leave the room” which terrified the two of us, but did actually happen during out stay! We also spent some time here shadowing eating disorder dietitians which was fascinating. After a few more months back at university it was time for B placement, where I was placed at Roodlands community hospital on the outskirts of Edinburgh. B placement is where you start to take consultations yourself so the learning curve is steep. I started doing reviews of patients in the community, seeing patients in community hospitals, I took parts of clinics and did a lot of domiciliary visits (patients homes). During this placement I did a lot of nutrition support, general clinics (things like anaemia, coeliac, diabetes), a bit of tube feeding, mental health and group education for weight management.

After passing 3 months at B placement, I moved to Glasgow for my C final placement; this placement was also a community post. I will just point out that most dietitians’ placements are a mixture of community and acute, though community hospitals will give you a similar experience. Most community hospitals will be for things like mental health, neurology rehab or rehabilitation hospitals for step-down after hospital (a lot of elderly patients and orthopaedics). At my C placement I delivered a lot of clinics including regular diabetes clinics, general clinics and domiciliary visits. During this placement I learnt the hard way to double check someones date of birth when calling them into a clinic! After trying to interrogate a student about her bowel habits after she had come to get her BCG injection!! (what are the chances there would be two Sarah Smiths at the same place at the same time! - ps. not her real name). After passing my C placement I graduated with a post graduate diploma in Dietetics and was able to practice as a dietitian which meant I was able to register with the HCPC (health care and professionals council). At this point you can leave university however I decided to continue and finish a dissertation to give me a masters degree.

I decided to stay living in Glasgow and commute over to Edinbugh for the start of the dissertation. After about a month I started looking at locum roles to help me get my foot in the door (necessary for lots of dietitians - and helps you get your first permanent job). I was offered a position at Southport hospital for two months which I accepted! At this point (though I have no idea how I pulled this off) I moved into a single room in nursing accommodation at the hospital, worked my first band 5 job during the day and wrote my dissertation at night. This was not only my first job, but it was in a busy hospital which I had not trained in. Steep learning curve doesn’t cover it, as I spent my evenings also researching anything I had come across that day that I didn’t know. Here I covered cardiology wards, general surgical, diabetes, care of the elderly and stroke. Memorably it was at this role where I asked a patient if I could speak with her as she had her curtains pulled. She agreed and we did a full consultation…. after about 20 minutes she asked if I could “sort bed pans” to which I answered would you like me to get someone who can get one for you and she answered “no i’ve finished!”….

Just 4 months later (I think?) I submitted my dissertation and received a masters degree with merit. If you are interested, my dissertation was on the visual identification of overweight and obese patients by health care professionals. I was offered my first permanent band 5 role in Hertfordshire and moved down to north London. Here I was working 3 days in community hospitals and care homes, and 2 days acute at the Lister hospital. This role was very heavy on nutrition support and was very lonely as I spend a lot of time working with dementia patients and was in the car alone a lot driving between care homes. I felt a lot like I was fire fighting in my band 5 role and came across the huge issues in the NHS for dietitians. Particularly other HCP’s (health care professionals) not respecting the role, or our opinions. But also, that in a hospital your advice is only ever as good as the hospital menu. As a dietitian there will be some patients you will never forget, and as this job there are several I will never forget. The main one I will never forget was a man who was dying and we ended up talking about death; he told me he wasn’t scared but he was so sad to say goodbye to his family as he didn’t want to leave them behind. He died the next day.

After just 7 months I took on a role at a private weight loss clinic where I specialised quite quickly as a weight management dietitian. After a year here I moved on to set up my own clinic, and now I work full time at Guys and St.Thomas hospital as a specialist obesity and bariatric dietitian whilst supporting private clients online, doing consultancy work, creating social media content and selling wellness planners. Oh and did a health and wellness retreat (using my season experience and my dietetic skills).

What I will say is that for anyone just starting out, a band 5 rotational post can help you to work out what you like and don’t like. Most dietitians dont know what they would like to specialise in, even if they are already a specialist in an area! Thats ok - if you can work out what you don’t like then that is a great starting point. Most dietitians work in the hospital which is busy, requires focus and requires confidence and knowledge. It also requires a strong stomach (with smells like diabetic feet and stools), a strong bedside manner and a strong heart as you will be helping patients who often die. It is a rewarding role however I have found that I like working with outpatients as people tend to be more well, and I have more scope to advise on what they’re eating as they have control over it (rather than three options on a hospital menu!). I also get to see people make changes on a longe term basis which I love. Other roles in the industry include working for companies and brands, consultancy, community, clinics and outpatients.

Hope this was helpful!

Jo x

Joanna Hollington