6/23/11

RD exam "race" report

I suppose it would be uncharacteristic of me to not write a "race" report of my RD exam experience. After spending the last 2 days reflecting on my passing grade (although, I am still in disbelief) I am now ready to write my report.

The days leading up to the exam (after many weeks of serious studying) felt very similar to getting ready for the start of an Ironman. The only difference was that with an Ironman, EVERYONE knows the "BIG" day. In contrast, I only told 2 people that I was taking the exam on Tues June 21st to alleviate any added pressure.
Over the past week, I was filled with emotions and couldn't help but reflect on all the hard work that I did to get to the RD exam starting line.

I viewed this exam as anything else important and worth-while in my life. Anyone can consider training for an Ironman although only a handful reach the starting line. Then there are the select few that reach the finish line (there are no guarantees with an Ironman, no matter how "perfect" you train). For it isn't about fitness ability or speed in reaching the finish line of a long distance race but rather having trust in your plan and being smart about your decisions. The well-known quote, "If it was easy, anyone could do it" is a saying that can be used for many things in life.

I have crossed four Ironman finish lines and have felt very prepared for three out of four of them. Despite being injured on the starting line in Kona in 2007, I still went into the race feeling confident about my swim. As for IMFL, IMKY and IMWI, I was able to predict the times for my "perfect" race and "if something out of my control happens" to the minute, primarily because I trusted my plan and believed in myself. For on race day, I know exactly what my body is capable of doing because I trained it to do so. Having said that, I am well-aware of my boundaries when racing, for if I cross them, I may not be able to reach my ultimate goal(s) because I would be forcing my body to do something that I had not trained it to do in training.

But as for the RD exam, this was a time in my life that I felt extremely nervous and I didn't like the feeling of not being in control. And if my mentality and preparation for an Ironman race describes my enjoyment of focusing on the controllables and not wasting my energy on things out of my control, it would not surprise you that I completely exhausted my options in preparing for this exam and was extremely overwhelmed by the exam.

Just like studying the terrain, weather and logistics of an Ironman race, "training" for the RD exam was only one component of feeling prepared. It was important to me that I knew what the exam was going to look like, example questions that may be on the exam, the set-up/time limits of the exam and what to expect when taking the exam. It was also very important that I did not "exhaust" myself so nutrition, sleep exercise, and not overstudying (per day) were important components as well.

The $365 Inman review course prepared me everything listed above. I knew exactly what I was getting myself into as far as what to expect for the exam because Mrs. Inman knew first hand what the exam would be like. I admit I searched on dietetic forums several times in order to get advice on how to take the exam, but unfortunately I only made matters worse for myself because I doubted my own preparation and began to read posts from people who had failed the exam, 3, 5 or 8 times!!!

I think this is one area where athletes miss the mark. Forums and advice from others is great, but everyone has a different point of view and comes from a different background. Regardless if you have a coach, many athletes do not trust their own training plan and feel the need to obtain last minute advice on the days leading up to an event. While the advice may be helpful, more often in not, last minute advice from others provide last minute fears that you did everything wrong and that your doomed for failure before you even begin.

For example, one person on a forum will tell you that a course is extremely hard and has the scariest descends you will ever see and another person will tell you how beautiful the course is and that it has only a few "bumps". After you stop freaking out on the 2 days before a race (which you signed up for a year in advance) only do you find out that the first reference is from a person from pancake flat Florida and your other reference is from an ex-elite mountain biker who lives in Colorado. Of course, you didn't know that cause you took advice on a forum and now you are scared out of your mind because you feel unprepared for the upcoming "hilly" event.
I'm smiling right now because this sounds like many conversations between Karel and myself. He will tell me that he is going for an easy ride and will ask if I want to come and of course, I'm huffing and puffing trying to stay on his wheel. Easy??? Maybe for the Category 1 cyclist :)

So after taking the review course, I was ready to make the call and set up my appointment date at FSCJ (Downtown Campus) which was one of the 200+ ACT testing centers that provides the CDR RD Exam. The date was set and I was locked in..unless I changed my mind and provided 48 hours before the exam in order to change my appointment. I held myself accountable to taking the exam before July and since the end of my internship I knew exactly when I would be most prepared for the exam and how I would make the most of my 2 months in preparing for the exam.
This entire dietetic journey has been filled with steps and even at the end of my journey, it always seemed like there was always one more thing to do in order to be eligible for the exam.
Here are the requirements in becoming a Registered Dietitian and maintaining your status after passing the exam:
1) Completion of a bachelor’s degree by an American Dietetic Association accredited program (I completed a verification statement since I had previous degrees, but still had to do the same requirements by an accredited University)
(2) Completion of a minimum of 900-1200 supervised practice hours in the areas of management, diet therapy, counseling and research (I think the new number is 1200 hours to be eligible, but my internship was a 10 month, 1200+ hour internship program)
(3) Successful completion of a nationally-administered board examination (YIPPEE....I passed!!)
(4) Completion of 75 hours of approved continuing education credits in their practice area every five years to maintain their registration status. (I will receive my packet from the CDR very shortly, telling me what I need to do to keep up with my credential. Right now I will need to obtain my License from the state because all RD's are required to be Licensed in the state of Florida).
(5) Compliance with a code of ethics established by the American Dietetic Association which conveys to the patient/client a guarantee of ethical and accurate nutrition advice.

I felt as prepared as I could be on the day before the test and after 4 weeks of serious studying (in addition to my 10 month internship which prepared me very well) I went to bed with many positive thoughts. Of course, with the many positive thoughts came the negative ones and I tried so hard to push them out. Not so easy when you feel a lot of pressure to pass a $200 exam.

I did not set on alarm on Tuesday morning and did not feel the need to train/exercise. I wanted to be sure I had every brain cell possible for my exam so the last week has been very casual as far as training. I tried to just go with the flow and do what makes me happy, properly re-fuel and give at least 5 hours a day to studying. So, I let my body tell me what it wanted to do on Tuesday (test day!) and after waking up without an alarm at 6:30 and walking Campy, I decided to do a relaxing 1:15 spin on the trainer (while clearing my mind and watching TV) and one Campy-mile with my furry best friend. Exercise has a fantastic way of lifting emotions but if done too much and without balance in mind, it can also leave you exhausted to the point of no return. Luckily, I have lots of experience with training and I am happy that I have found the right balance at this point in my life.
Karel left early for the beach (to train and work) but he provided several positive words of encouragement which really made me feel at ease.

I showered and tried to eat a protein-rich breakfast but I kinda had no appetite due to stress, nerves and a rush of emotions. I had a tall glass of skim milk and made french toast (smeared with PB) and a side of fresh fruit and yogurt. Nothing more comforting if you ask me...unless you offered me pizza, then I would have happily accepted the second option :)

I gave myself plenty of time to get to the testing center (14 miles away) just as I do with my races. I'd rather be at the race venue, calm, cool and collected rather than rushing around and freaking out. I found my way to the testing center with no problem and took a few deep breaths before I entered the room. Kinda wish I had my HR monitor during this testing experience...my HR was all over the place!

I was asked to sign several papers and they also took my picture. I was placed in a room all by myself (thank goodness because I am not known to be the best test taker especially with distractions) and sat down in a cubicle with a computer. I was given a non scientific calculator which I tested every button to make sure it worked. Based on my experience with RD exam practice questions and my internship, there is one thing that is a necessity if you are a dietitian. You can't do anything without a CALCULATOR!

I had to check several boxes on the computer screen saying that I would agree to the rules of the CDR in taking the exam and at 10:30am, my 2 1/2 hour time limit began.

The test has a minimum of 125 questions and a max of 145 questions. There were 20 pre-test questions which are not counted toward the score but I didn't know which ones they are. I must of spent 15 minutes on the first 4 questions because I was so overwhelmed that I was actually taking the RD exam. I just watched the clock tick away but didn't let it bother me too much.

I finally settled into a grove and with every questions, I carefully read it, re-read it and tried to think of the answer before I read the 4 options. I am not allowed to provide any information about the exact test questions but for future RD's, my best advice is to read the question carefully. I feel that the most important thing in being a dietitian is having good ethics and for many of the subjective questions (community, education and management domains) there wasn't always a RIGHT answer that stuck out (like it would with food service or clinical) but rather you had to think about yourself in the situation in order to select the BEST answer.

In order to give you an idea of the sample questions that I used for the exam, here are a few study guide questions from my review resources (none of which were on my exam):

1) How many #8 scoops of applesauce could be served from a #10 can?
2) The most suitable material for kitchen walls is? (ceramic tile, quarry tile, wallboard, fiberglass)
3) The theory exemplified by managers exerting direct control over their employees is? (MBO, McGregor's theory X, Maslow's Hierarchy of Human needs, McGregor's Theory Z)
4) Inventory, when listed on a balance sheet, is an example of a/an? (asset, liabiliy, loss, new worth)
5) According to a Medicare regulation what is the max time span allowed between a substantial evening meal and breakfast? (8 hrs, 10, 12, 14)
6) Which of the following is not a bacterium associated with fresh meat products? (Clostridium perfringens, Salmonella, Staph aureus, clostridium botulinum)
7) Moist cooking is the method of choice to achieve max tenderness with which of the following products? (rib steak, loin steak, ground beef, round)
8) What sequence below produces the best egg white foam for use in meringues?
9) What is the major difference between a person suffering from starvation and a person suffering from stress after major surgery? (glycogenolysis, metabolic rate, gluconeogenesis, lipolysis)
10) The use of food additives found to be carcinogenic when ingested by man or animal is prohibited by? (GRAD, Delaney clause, Wagner Act, American Cancer Society)
11) Which of the following nutrients is necessary for the metabolism of carbs?
a) copper, phosphorus, iron
b) copper, riboflavin, phosphorus
c) thiamine, phosphorus, magnesium
d) thiamine, copper, iron
11) A patient receives 300 ml of a 5% dextrose solution, how many calories does that provide?
12) The drug isoniazid may cause the deficiency of what vitamin?
a) vitamin C
b) niacin
c) vitamin B6
d) vitamin B12
13) A 1500 calorie diabetic diet with 45% of calories from carbs is prescribed. One third of the carbohydrate requirements can be met with 1/2 cup orange juice, one cup of milk and:
a) 1 slice toast
b) 2 slices toast
c) 2 slices toast and 1/2 cup oatmeal
d) 1/2 slice toast
14) If a patient is receiving MAOI drugs, which of the following foods should be avoided?
a) beef liver
b) corn
c) milk
d) aged cheese
15) Numerical description of how much observations differ from one another are called?
a) sampling distributions
b) measures of variability
c) frequency of distribution
d) standards of deviation


I was told to be prepared for 145 questions and 2 1/2 hours for the exam. But when I approached question #123, there was a chance that I would be finished at question #125. Of course, I was very convinced that I failed because many questions were new to me and I had trouble deciding on the best answer. I suppose these tests have a way of making you narrow it down to two answers, which of course, are so similar it is hard to make the best educated guess if you don't know it.
Luckily, I knew the answers to question #124 and #125 and after selecting the answer for #125, the screen shut off and I was told that I finished the exam.

My heart started beating very fast and I knew what was coming next. My score??? Of course, not.....6 or 8 survey questions about the testing center. So I'm clicking away, not knowing when my results were going to be totaled and with my heart nearly beating out of my chest, the screen I had been waiting for, for the past 3 years finally appeared.

"Congratulations...you passed"

There were a few sections with my scores from the domains and my scaled score of 27. I was convinced that I was taking the exam again in 45 days and even with my results, I could hear myself out loud saying "oh my gosh, oh my gosh, I can't believe it. You passed Marni". I must have sat there for 5 minutes before I went to the main desk to sign-out, give back my white board sheet and calculator and obtain my printed out result sheet.

I imagined myself running to the car to call Karel and my parents but I took my time to soak in what just happened. With my eyes filling up with tears, I was filled with emotions.

These same emotions come to me when I finish an Ironman. I do not feel I deserve anything in life because life isn't easy. But while I may not deserve things, I do feel as hard work provides a person with rewards. It's funny because we can't always recognize the rewards when they happen because we often receive them when we least expect them. But sometimes, they come right at the perfect time.

I have worked so hard for this goal of becoming a Registered Dietitian because I wanted it so very badly. This experience has provided me with an enormous amount of knowledge which allows me to be qualified to legally assess, diagnose and treat medical conditions. There is a large group of Registered Dietitians who have all met the minimum requirements of earning those two letters behind their name and I proud to be one of them. Because there are a lot of "nutrition experts" out there, I am most proud that I took a little chunk of time out of my life to do the right thing. It is in the best interest to the profession of dietitians and to the public, that I adhere to the Code of Ethics (prescribed by the American Dietetic Association) and be professional when providing my philosophy of nutrition and exercise in helping other reach individual weight and fitness goals.