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In the United States, medicine is a graduate field of study. Doctors to be almost always acquire a baccalaureate degree first, and they could have studied almost anything in their undergraduate years, from quantum physics to Romance languages to performance music with a concentration in tuba.
To compensate for differences in undergraduate education, American medical schools require all medical students to take an intense year of basic sciences at a graduate level, cramming a four-year university level education into an intense nine months at the beginning of medical school. As little as twenty-five hours in the 2000 to 3000 hours future doctors spend studying basic science, however, is devoted to nutrition.
What Goes Wrong in the Teaching of Nutrition to Future Doctors
The sheer intensity of medical education in the United States may be part of the reason the quality of nutrition education is so poor. While relatively few medical school students actually flunk out (typically just one or two in every entering class of 50 to 200), most medical students feel extreme pressure to spend all their waking hours learning as much as they can. As a result, most future doctors fail to eat regular meals. They may live on vending machine snacks, coffee, and Diet Coca-Cola most of the week, and then binge when they have a little more free time on the weekends.
As a result, doctors themselves never acquire the healthy eating habits they need to be able to explain to their patients. When they graduate from medical school and complete their training, doctors usually defer the task of teaching patients about fooc choices and portion control to registered dietitians.
Who Is a Registered Dietitian?
In the United States, a registered dietitian, or an RD, is an person who has successfully completed undergraduate coursework and an internship in dietetics, the science of creating menus of foods compatible with disease treatment.
The designations "dietitian" and "nutritionist" are not the same. In most states in the USA, anyone can himself or herself a nutritionist. Sometimes a minimal amount of formal training is required to use the title "certified nutritional counselor," or CNC. Many employees of nutritional supplement stores have had at least some college-level training in nutrition and call themselves CNCs.
However, a registered dietitian is someone who has completed a bachelor's degree and who has been certified by the Commission on Dietetic Registration of the Academy of Nutrition and Dietetics (AND), formerly known as the American Dietetic Association.
To further complicate professional credentials, there is also credential for a certified nutrition specialist (a CNS, not a CNC), who is someone who holds at least a master's degree, and possibly a doctor's degree, and who designs programs for nutritional healing as an independent professional. Registered dietitians usually work under the direct supervision of doctors (or their supervisors who work under the direct supervision of doctors), and certified nutrition specialists are usually seen as independent nutritional specialists.