The UAB Dietetic Internship has been a program of firsts since its inception in 1963. What started as a 12-month program with only six students, is now a major influence in nutrition education innovations and healthcare policy reform. We were here before UAB became UAB. We were the first program of its kind in Alabama, one of the first in the U.S. to offer distance education and one of the first to collaborate with Medicine in research. We look forward to watching our graduates' impact for the next 50 years.
History of the Division of Human Nutrition and Dietetics and Educational Programs
University of Alabama Hospital (UAH) and Hillman Clinics inaugurated the Dietetic Internship in September, 1963. It was accredited by the American Dietetic Association at the end of that year. Janet Mastin, MS, RD Director, Dietetic Department, was the founding director of the internship program. Initially, the internship was a 12-month program with 6 students and was hospital based. There were 62 internship programs and 686 interns in the U. S. that year. Dr. E Neige Tod hunter, Dean, School of Home Economics, University of Alabama, and Matthew F. McNulty, Administrator, University Hospital and Hillman Clinics were instrumental in the development of the program.
Initially, key clinical faculty of the internship were: Janet Mastin; Sara Terrell, Administrative Dietitian, University Hospital and Hillman Clinics and later Director, Department of Dietetics, University Hospital; Rebecca Bradley, Outpatient Clinic/School of Nursing Instructor, later Dietetic Internship Director; Harriet Cloud, Nutrition Consultant, Jefferson County Health Department, later Director of Nutrition Services, CDLD (Sparks Center); and Carol Brewster (Craig), GCRC Dietitian/ Acting Director DI 1964-1966, and Director 1966-1980. Subsequent directors were Rebecca Bradley (1980-1998), Gayle Canfield (1998-2002), Amanda Brown (2002-2012) and Susan Miller (2012-2015). Patricia Riester, MS, RD and Susan Wood MA, RD were primary faculty in the division in the 1980’s.
Admission into the Dietetic Internship has always been very competitive due to the number of applicants in relationship to the slots available in the US. Applicants came from almost every state. Criteria for admission were that students must meet undergraduate requirements of the American Dietetic Association (Academy Nutrition and Dietetics). Since 1970, DI graduates have been eligible to take the Registration Examination for Dietitians (established that year) and have consistently rated highly on the examination. Dietetic interns were encouraged to continue in the M.S. Program which required an additional 12-15 months to complete clinical rotations, coursework, research, and thesis/project defense. A large majority of students have elected to complete the M.S. Program. Initially, all clinical rotations were completed within the medical center. Within the rotations, there was an emphasis in inpatient clinical nutrition, foodservice management and outpatient clinics. Clinical sites included University Hospitals and Clinics, Children’s Hospital, Spain Rehabilitation Hospital, VA Hospital and the Jefferson County Department of Public Health. Part time and distance education programs were developed in 1994 with clinical sites in Huntsville, Montgomery and Mobile, and in 1997 in Birmingham and Dothan.
In 1963, the General Clinical Research Center (GCRC) directed by Dr. Clifton Meador opened in the west wing of UAH. It was one of the first five Clinical Research Centers in the United States, a strong asset to the internship program. It provided experience for interns in metabolic research methods patterned after those used at NIH (National Institutes of Health) Bethesda and Massachusetts General Hospitals. They worked closely with investigators and an interdisciplinary team supported by a research laboratory. In the late 1960s, the first Kidney Dialysis Unit in Alabama,directed by Dr. Walker Brown also opened on the third floor of UAH. These two programs provided stimulating collaboration and examples of team development in delivery of patient care, as well as the excitement of being a part of ground-breaking medical treatment and clinical research.
By the 1970’s dietetic practice had expanded to include specialized nutrition care delivery with the concurrent development of rotations funded by United States Public Health Service (USPHS) Maternal & Child Health (MCH) grants. In 1972, the dietetic internship director's office moved from UAH to Volker Hall and was based in the Division of Hematology, School of Medicine, chaired by Dr. C.E. Butterworth, Jr. whose research, clinical interest, and expertise in folic acid and related research in hospital malnutrition were becoming nationally recognized. At that time, he accepted the role of Medical Director of the Dietetic Internship at the request of Clifton Meador, MD, then Dean of the UAB Medical School and continued in that informal capacity throughout his tenure at UAB. This move was a crucial advance in collaboration and interdisciplinary academic and clinical support in the growth of the internship.
Dr. Butterworth, a pioneer in promoting nutrition courses for the medical students. He founded one of the first medical school nutrition courses in the U.S. at UAB. This milieu and the developing scope of practice on a national level for clinical dietitians provided a nucleus for strong, relevant, and multifaceted dietetic programs at UAB. Issues of this period included hospital malnutrition (brought to the forefront by an article written by Dr. Butterworth in Nutrition Today entitled “Skeleton in the Hospital Closet”. Developing methodologies for assessment of nutrition status; initiation of interdisciplinary teams focused on hospital nutrition care delivery; kidney dialysis and parenteral nutrition were seminal factors in the growth and development of educational programs in the Department of Clinical Nutrition and Dietetics.
Department of Clinical Nutrition and Dietetics in the School of Health Related Professions
Although the internship retained close ties to UAH, the Dietetic Internship Program became part of SCAHR in 1974. It was based in the newly developed Division of Clinical Nutrition and Dietetics, Carol Craig, Chairperson (1974-1977). A U. S. Public Health Service Allied Health Training grant was first awarded in the early 1970s. Approximately two million dollars, over a ten year period, was received in Federal monies for the development and/or improvement of the dietetic internship, dietetic technician and MS degree programs. The first two primary clinical instructors were hired in 1972, Rebecca Bradley and Cynthia Williams; Annie Bonney (Cornwell) replaced Cynthia Williams in 1975.
The Dietetic Program was growing and the Dietetic Technician Program was developed and begun during this period, supported by USPHS grants. Classes for this program and interns were housed in the Regional Technical Institute (RTI). Planning and development of the MS Program proposal was done during this period. This was a time of developing relationships with other Allied Health Programs within the school and joining in the development of the University of Alabama in Birmingham (UAB) and Faculty Affairs Committees. These relationships developed over time and resulted in resources for expertise in many related health fields.
Department of Nutrition Sciences
In 1976, an interdisciplinary committee drafted a proposal and petitioned Dr. S. Richardson Hill, Jr., President of UAB to establish a Nutrition department within the Medical Center. Participating in this effort were Drs. Butterworth, Krumdieck, Weinsier, C. E. Hunt, Navia, Mennaker and Carol B. Craig, MS, RD. These faculty members represent a variety of healthcare disciplines. In February of 1977, Dr. Hill announced the creation of the Department of Nutrition Sciences, an undertaking sponsored jointly by three schools: Community and Allied Health, Medicine, and Dentistry. From its inception this department has been based on a philosophy of interdisciplinary collaboration involving many departments and several schools.
This interdisciplinary system of support has provided strength through established resources at UAB and has ensured quality in an atmosphere of rapid growth. A common thread running through all educational endeavors of Nutrition Sciences has been to provide a thorough understanding of the individual roles of each team member in a unified approach to healthcare.
The purposes of the department were to: (1) unify all members of the UAB faculty interested in nutrition and provide for their concerted action and mutual stimulation; (2) provide the academic structure for the development of advanced degree Programs in Nutrition Sciences; (3) provide identity and serve as the element for outside recognition of the nutrition activities at UAB necessary for the recruitment of faculty and students, and (4) securing grant support. The Chairman reported to the Dean of the School of Community and Allied Health and through him to the Deans of Medicine and Dentistry. The Graduate School approved and has oversight of the advanced degree programs (MS and PhD) offered by the department. The department initially consisted of the following divisions: Clinical Nutrition, Human Nutrition and Dietetics, Nutritional Biochemistry, Nutrition and Food Science, Nutritional Pathology, and Overseas programs.
In the 1980’s and 1990’s, in addition to departmental education programs, courses were taught in: Schools of Medicine and Dentistry; seminars were offered at UAH for faculty and staff; and nutrition support services were provided at UAH and Birmingham Veterans Administration Hospital (BVAH). Consultation services were provided at UAB Family Practice Center, Kirklin Clinic, Center for Aging, and the 1917 Clinic.
Division of Human Nutrition and Dietetics
Master’s Degree in Clinical Nutrition
A Master’s degree program in clinical nutrition was approved by Alabama Commission on Higher Education (ACHE) and the University of Alabama Board of Trustees in June 1975. In September of that same year, students were enrolled in the combined internship and graduate program, Carol Craig, founding Director. The internship program became a 9 month clinical program coordinated with graduate courses in 1975. In addition to departmental faculty, the program enjoyed the contributions of a large number of Medical Center faculty from other disciplines. All faculty served as thesis committee members and lecturers, as well as clinical and research mentors. Graduates of the DI and MS programs are serving in leadership positions in both the state and National Professional Associations. They are employed in a wide variety of Dietetic and Nutritional specialties and related fields. The graduate program was revised in 2015 to accommodate current developments in research and practice.
Specialty clinical traineeships coordinated with the internship and master’s degree programs were developed soon after the initiation of the master’s program.
In 1968, the Center for Developmental and Learning Disorders (CDLD) was organized on campus through a grant from the USPHS-MCH to provide interdisciplinary training in mental retardation and developmental disorders. CDLD provided graduate traineeships for students entering the master’s degree program. The traineeships were 12 months in length, provided a stipend, and resulted in a research thesis.
The USPHS grant awarded in 1975 provided up to seven graduate traineeships for dietetic interns who continued in the MS phase in the dual program. These traineeships provided tuition plus an allowance. The grant continued for a number of years and was a great support of the initial phase of the MS program. As many of the students were from out-of-state, this made them eligible for in-state tuition. Some bordering southern states, such as MS., LA., and GA. were allowed reciprocity for in-state tuition status from the Regional Educational Board this was a large factor in retaining interns in the MS phase of the dual program.
Specialty clinical traineeships were developed soon after the initiation of the combined MS internship program began. Trainees received 32 hours of clinical experience in an area of interest, plus approximately eight hours of course work per week. Endowed scholarships were established in 1996 and 1998 and continue to provide six –eight scholarships to intern/graduate students each year.
Numerous clinical specialties and a leadership emphasis provided excellent research opportunities for students. Nutrition students were challenged to work in the community in various agencies such as mental retardation centers, schools, and Children’s Rehabilitation Services (CRS). In many of these agencies, nutrition services did not exist. As a result of the students’ involvement and grants written by the Nutrition Sciences faculty at CDLD: Harriet Cloud, Carrie Ganong and Janet Isaacs. Nutrition services were initiated at CRS. Dietitians served as full time staff in the 14 district offices. In turn, the CRS staff provided training for the UAB dietetic interns in many locations throughout the state.
In the late 1980s, CDLD became the Chauncey Sparks Center for Developmental and Learning Disorders (Sparks Center). A course entitled “Nutrition for the Child with Special Health Care Needs”, co-sponsored by the Department of Nutrition Sciences and the Center for Developmental Disabilities, University of Southern California, Los Angeles. The grant was initially funded by USPHS-MCH in 1993 and continued for ten years. Over 600 dietitians and other disciplines attended the course from all over the United States and Canada. The course became part of the leadership training for the graduate students from Nutrition Sciences.
Other MCH grants were also received by the Department of Pediatrics, School of Medicine based at Children’s Hospital. These included a Children and Youth Project. The Children and Youth Project was replaced with the Adolescent Training Program and the Pulmonary Training Program. These programs provided training stipends for graduate students from a number of disciplines, including nutrition. Faculty for the Adolescent Training Program and Pulmonary Projects were Bonnie Spear and Nancy Wooldridge respectively, both had faculty appointments in the Department of Nutrition Sciences. Judy Bonner was nutritionist in the early Pulmonary Project and also held a faculty appointment in the Department of Nutrition Sciences. Both dietetic interns and graduate trainees were enrolled in these programs.
An important factor in the growth and development in the educational programs was a campaign begun by Dr. Butterworth in the early 1980’s to raise funds for a dedicated building to house Nutrition Science faculty. At that time faculty was spread the campus. An initial gift of three million was given by the Mott Foundation through the good-will of Charlie Webb and his wife Susan Mott-Webb. This gift was followed by others through the efforts of the faculty of Nutrition Sciences and the UAB Development office. Major donors are identified in the main lobby of the Susan Mott-Webb building, dedicated in 1983.
Clinical and Community Activities
The division served the community by providing consultation to public schools, nutrition programs for the elderly and continuing education for health professionals. The development of a Nutrition Outpatient Clinic at the Kirklin Clinic was an initiative of the Division of Human Nutrition and Dietetics and was in operation for a number of years following the opening of Kirklin Clinic. The Clinic served as a center for referral and follow – up of patients with special nutrition problems.
Other outpatient clinic programs were developed and operated for varying lengths of time. Some of those included Obstetrics and Gynecology, Family Practice, Hypertension Research, and the 1917 Aids Clinic. RD faculty provided consultation for physicians and counseling for patients. An ongoing effort by dietitians was the establishment of third party reimbursement for RD’s.
A yearlong study (1983)of nutritional status of overweight children and food service practices at the Institutes for Deaf and Blind in Talledega, Alabama in 1980 resulted in nutrition education of teachers, students and families taught by graduate students under the direction of division faculty, Carol Craig, Annie Cornwell, Harriet Cloud and later Nedra Wilson.
An early community nutrition education initiative, developed in 1980, funded through the Alabama Department of Education, was a collaborative effort between the Division of Human Nutrition and Dietetics and the UAB Theater Department. Nedra Wilson was hired as a consultant to coordinate that project prior to her joining UAB faculty as the Nutrition Information Service (NIS) Director. A musical play, “Nutriworld,” and companion workbooks and videos for grades K through 4 were developed. Thousands of school children in the Greater Birmingham Area saw performances. Videos and workbooks were made available to teachers throughout the state from the Alabama State Department of Education Resource Library. Another project grant from the Department of Education funded stipends for continuing education for public school teachers and an instructor’s salary in the division.
The Dietetic Technician Program was established in SCAHR in 1974 with 5 students. The program was an associate degree certificate program and linked to the Regional Technical Institute and both state and private Junior Colleges. The Directors of this program were Joan Sokol (1974-1975); Linda Godfrey (1976- 1979); Julia Bryant (1979-1982), and Annie Cornwell (1982-1989). This program was initially funded through an Allied Health Training grant to train dietetic technicians in both foodservice and clinical dietetics. This program consisted of a one year curriculum following a year of general education in the community college. Students were eligible to take a registration exam administered by the (then) American Dietetic Association, (now) the Academy of Nutrition and Dietetics.
Nutrition Information Services
The Nutrition Information Service (NIS) was established in 1984 to provide nutrition education activities for the public and continuing education for professionals in dietetics. The NIS was initially developed and operated through the NIH Cancer Center grant and in later years through a cooperative relationship with Oxmoor House and Cooking Light magazine. The NIS was established to provide a nationally available resource for nutrition information through a 1-800 hot –line staffed by dietetic interns, graduate students, and trained volunteers. Bonnie Richards, MA served as the first coordinator.
After the first year, the program was coordinated by Nedra Wilson, MS, RD, who developed a strong community education liaison through on-site presentations and weekly appearances on local television. The NIS, as well as students and faculty were key participants in UAB community education programs such as the Med Wise Health Fair and the development of specialized cookbooks in cooperation with Oxmoor House. A number of departmental faculty participated in concept, recipe development and testing. Books published by Oxmoor House and authored by nutrition faculty included: Delicious Ways to Lower Cholesterol, EatRight, Heart Smart, and Eat Right Lose Weight, 7 Simple Steps. Another departmental cookbook initiative was spearheaded by Dr. Sarah Morgan and was developed for persons with arthritis, The Essential Arthritis Cookbook.
Some of the strengths of this Division and Department were the continued interdisciplinary nature of the initial philosophy, programs, research and patient care. Both medical and dietetic faculty were on the leading edge of research and practice within a dynamic institution. They contributed professional leadership at critical periods serving on local, state and national committees concerning dietetic practice standards; professional standards; internship and graduate curricula; National Registered Dietitian standards and testing; Commission on Accreditation Maternal and Child Health and Adolescent medicine; third party reimbursement for dietitians; school lunch and aging programs.
The Division of Human Nutrition and Dietetics was combined with the Division of Clinical Nutrition in 1997 and became the Division of Clinical Nutrition and Dietetics with Sarah Morgan, MD, RD, as Director. In 2008, the Divisions were dissolved and a matrix leadership style of missions was created; shortly thereafter, the Clinical Nutrition title was replaced with Nutrition Sciences in program name and all degrees granted.
In the fall of 2015, three educational tracks were developed; the clinical track which combines dietetic internship and a MS degree, the research track and the PhD track. Additional tracks are currently under development.
The Beacon, University Hospital and Hillman Clinics, Vol. 7- Number 11, November 1963
Birmingham News, August, 1966
The Beacon, Vol. XII- No. 6, December 1968
Birmingham News, August, 1966
The Beacon, Vol. XV, Number 5, October, 1971
SCAHR Annual Report, 1974-75
Dietetic Technician Program Review, Annual Report, 1980
Department of Nutrition Sciences Brochure 1980
Graduate Program Bulletin Brochure, Department of Nutrition Sciences, 1988
Dietetic Internship Self – Study for Accreditation, 1988
Graduate Program Brochure, Department of Nutrition Sciences 1994 Twenty –Fifth Anniversary, School of Health Related Professions, UAB, 1969- 1994
Brochure of Twenty – Fifth Anniversary of the Dietetic Internship, 1988
Oral Communication: Carol Craig, Rebecca Bradley, Annie Cornwell, Harriet Cloud and Nedra Wilson.
Dietetic Internship Self – Study for Accreditation, 1998
Dietetic Internship Self – Study for Accreditation, 2008
Department of Nutrition Sciences NIH Cancer Center Grant Report, 1988
Department of Nutrition Sciences Graduate Programs Bulletin, 1988
Dietetic Internship Directors
1963 Janet Mastin MS, RD
1964 Carol Craig Acting Director
1965-1980 Carol Craig MS, RD
1980-1998 Rebecca Bradley MS RD
1998-2002 Gayl Canfield PhD, RD
2002-2012 M. Amanda Brown PhD, RD
2012 Susan Miller MS, RD Acting Director
2013 – 2015 Susan Miller MS, RD Director
2016 – Present Carleton Rivers, MS, RDN
Dietetic Technician Program Directors
1974-75 Joann Sokol, MS, RD
1976-79 Linda Godfrey, MS, RD
1979-82 Julia Bryant, MS, RD
1982-89 Annie Cornwell, MS, RD
1977-1996 Carol Craig, MS, RD (Chairman Department of Nutrition & Dietetics for SHP 1974-1977)
October 1, 1996 – December 31, 2009 Sarah Morgan, MD, RD (Division of Human Nutrition and Dietetics was combined with the Division of Clinical Nutrition in 1997 and became the Division of Clinical Nutrition and Dietetics)
January 1, 2010 – August 25, 2012 Jamie Ard, MD
February 8, 2008 - Change to Mission Leaders Occurred: Ard/Clinical, Nagy/Research, Fernandez/Education
January 2012 – Change in Mission Leaders Occurred: Soleymani/Clinical, Gower/Research, Fernandez/Education
1977 - 1988: Dr. Charles Butterworth
1988 - 1999: Roland Weinsier, M.D., Dr.PH
2003 – Present: W. Tim Garvey, M.D