This document summarizes findings from a survey of the first five cohorts of graduates from the Northern Ontario Dietetic Internship Program (NODIP) about two years after graduation. Key findings include: - Two-thirds found employment during their internship and most accepted full-time positions. One-third relocated for their current job. - Over half of graduates worked in rural or underserved areas of Northern Ontario. Important factors in choosing a location were knowledge of and completing placements with potential employers. - While most did not plan to remain in their current position long-term, decisions around relocating reflected both professional and personal considerations like opportunities, salary, and proximity to family/friends.

1. Centre for Rural &
Northern Health Research
Northern Ontario
School of Medicine
1
Distributed Community-
Engaged Dietetics Learning as
the Road to Rural Practice
Examining the impact of the Northern Ontario Dietetic
Internship Program on recruitment and retention of
Registered Dietitians in rural and underserved areas
Mary Ellen Hill, PhD (CRaNHR Lakehead)
Denise Raftis, MEd, RD (NODIP)
Pamela Wakewich, PhD (CRaNHR Lakehead)

2. Centre for Rural &
Northern Health Research
Northern Ontario
School of Medicine
2
COI Disclosure
"I have no conflict of interest to
disclose"

3. The Northern Ontario Dietetic
Internship Program (NODIP)
• Unique dietetic internship with programming and
accountability integrated into the Northern Ontario
School of Medicine (NOSM)
• Using a distributed and community-engaged learning
model, NODIP provides practice experiences in under-serviced
Centre for Rural &
Northern Health Research
Northern Ontario
School of Medicine
3
areas of Ontario’s north
• Also gives graduates skills required to meet needs of
Ontario’s Francophone and Aboriginal populations

4. Centre for Rural &
Northern Health Research
Northern Ontario
School of Medicine
4
Community-Engaged and
Distributed Education

5. Centre for Rural &
Northern Health Research
Northern Ontario
School of Medicine
5
The Tracking Survey
 Developed and delivered collaboratively by Centre for
Rural & Northern Health Research (Lakehead University)
and NODIP program staff
 Results from the first five cohorts (2008-2012) of NODIP
graduates (n = 62);58 completed survey approximately
22 months after graduation (93%)
 Emphasis on understanding how NODIP contributes to
recruitment & retention of rural and northern dietitians

6. Centre for Rural &
Northern Health Research
Northern Ontario
School of Medicine
6
Two Years After Graduation
• Two-thirds found employment during their internship
(n =40); the rest were employed shortly thereafter
• Most found full-time employment (n=51); some also
accepted part-time (n=10) or relief-casual (n=5) work
• Significant numbers of graduates were still in the first
positions accepted after graduation (n = 25)
• One-third had relocated for their current position (n =
22).

7. Rural Non-Metropolitan
Practice
Centre for Rural &
Northern Health Research
Northern Ontario
School of Medicine
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NODIP – Practice in Rural &
Underserved Areas
Practice in Underserved
Areas
Underserved Other areas Out of province
0 15 30
Rural area
Small town
Large town
Regional centre
Large urban area…

8. Centre for Rural &
Northern Health Research
Northern Ontario
School of Medicine
8
NODIP – Recent Employers
20
10
0

9. Centre for Rural &
Northern Health Research
Northern Ontario
School of Medicine
9
Location Choice -
Knowledge of Employers
Completed internship placement with them
Knew people who worked for them prior to
internship
Worked for them prior to internship
Volunteered with them
Other knowledge of employer
No knowledge of employer

10. Centre for Rural &
Northern Health Research
Interprofessional Practice &
Northern Ontario
School of Medicine
10
Location Choice -
Practice Factors
50
25
0
FT Employment & Flexible
Conditions
“Very or Extremely Important”
50
25
0
Continuing Education
“Very or Extremely Important”

11. Community Factors
“Very or Extremely Important”
Centre for Rural &
Northern Health Research
Personal Factors
“Very or Extremely Important”
Northern Ontario
School of Medicine
11
Location Choice -
Community & Personal Factors
0 20 40
Comfortable town
Lifestyle community
Quality phys environ
Cultural-rec opport
Size and population
0 20 40
Proximity family
Home town
Partner employed area
Proximity friends
Educational
opportunities self

12. Centre for Rural &
Northern Health Research
Plan to Remain in Current
Community
Northern Ontario
School of Medicine
12
Retention and Relocation
• Most of the graduates do
not plan to stay in their
current position for long
• Decisions around
remaining or relocating
reflect a complex mixture
of professional and
personal considerations
0 10 20
Less than 2 years
2-5 years
6 years or more
Do not know

13. Less than 2 Years 2-5 Years 0 5 10
Centre for Rural &
Northern Health Research
Northern Ontario
School of Medicine
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Reasons for Relocating
Looking for FT position
Better salary and benefits
Unhappy with current position
Disinterested in current type of work
Not enough opportunities for prof growth
No opportunities to specialize
End of contract and no extension
No other positions with current employer
No other positions for dietitians in area
Anticipated relocation of spouse or partner
To be closer to family
To be closer to friends
To experience life in different community

14. Centre for Rural &
Northern Health Research
Northern Ontario
School of Medicine
14
Next Steps …
• CRaNHR team will produce 5-year report detailing early
career experiences of first five cohorts of NODIP graduates
• Additional follow-up surveys and publication planned,
resources permitting; for further information:
– Denise Raftis, MEd, RD; Program Manager, NODIP; Email
denise.raftis@nosm.ca
– Mary Ellen Hill, PhD; Senior Researcher, CRaNHR Lakehead;
Email: maryellen.hill@lakeheadu.ca