Country - Turkey
Nutrition and Dietetic (N&D) education started at 1962 in Hacettepe University in Ankara. Up until 1998, Hacettepe University was the sole institution that gave N&D education with 50 graduates every year. In 1998, Eciyes University (Kayseri) and in 1999 Baskent University (Ankara) started N&D education. As of 2011, there are 30 universities giving this education all around Turkey each of which give approximately 50 graduates every year. Correspondingly the number of graduates has increased in the last ten years.
Even though there are differences in the content of the curricula, N&D education is bachelor’s degree (four years and a voluntary preparatory year for English education) in all institutions. First three years constitute of practice supported theoretic education and the fourth year is internship at hospital and kitchen settings. In the curriculum, in addition to nutritional courses such as fundamentals of nutrition, food chemistry, community nutrition, clinical nutrition, pediatric nutrition and mass catering systems, there are medical courses such as anatomy, physiology, biochemistry and social courses such as sociology, psychology and economy.
Today there are approximately 2500 graduates working in public and private sector. Main working areas are hospital clinics and catering firms although food industry is also an emerging working area.
SWOT Analysis of the N&D Education in Turkey
- Settled bachelor’s degree education programme. Even though, there are many different universities that give this education, they all give bachelor’s degree after four years.
- Settled occupational organization. Turkish Dietetic Association (TDA) is the main representative of the occupation recognized by Ministry of Health and other authorities. When it was first constituted there was only the head office in Ankara and as the number of dietitians in bigger cities increased, branches have been formed in İstanbul, İzmir and Antalya. TDA is also a member of EFAD and ICDA.
- Journal of Nutrition and Diet. The dietitians started publishing Journal of Nutrition and Diet in 1970. Since then this journal had been published twice a year.
- Standards of the occupation. Dietitians were defined and standardized first by International Labor Organization in 1961. In April 2004, Turkish Standards Institute, defined and set the missions of a ‘dietitian’. Eventually in 2011, ‘dietitian’ was defined in the Law of Health Care Personnel and now in order to be called as a dietitian one must study N&D for four years.
- Community awareness. In the last 50 years the Turkish community has learned that there is a special occupation dealing with nutrition apart from the physicians, nurses and food engineers. It is a popular and favored occupation nowadays.
- Opportunity for higher education. N&D graduates may continue higher education (masters and PhD) in nutrition area as well as public health and physical education departments. Hacettepe University may be counted as the main higher education centre with three masters and one PhD program.
- Academic staff who teach at many N&D departments. For forty years N&D education was given by dietitian academic staff, parallel to the philosophy ‘dietitians must be raised by the dietitians’. In Turkey, we have approximately 30 professors teaching at N&D departments with many assisted professors and research assistants associated with the departments.
- It is not obligatory to become a member of TDA. Unfortunately after graduation not all dietitians join TDA. Thus, participation to in-service education is voluntary. TDA can’t impose any sanctions on ethical issues besides excluding his/her membership.
- Even though dietitians work in many different areas, they are not enrolled in primary health care facilities. In the four service compartments of health - prevention, improvement, treatment and rehabilitation - dietitians work in hospital clinics and services, mainly in treatment compartment. However, our main concern should be preventing disease. Dietitians should work in primary health care setting and teach people how to consume a healthy and balanced diet.
- In private sectors dietitians can’t have a consulting room by themselves; they must work under a physician. Even though dietitians are educated for four years on nutrition we are not allowed to have our own consulting rooms. Legally in Turkey, only physicians may have a private consulting room. Because of this, dietitians who want work privately make an agreement with a physician.
- Nutrition has an emerging importance. In order to be healthy, people seek advice on nutrition. World Health Organization and Ministry of Health emphasize on healthy nutrition and healthy life style. Media is also open to this topic; every new discovery on nutrition is debated on TV screens right away.
- Many new N&D departments mean many new young scientists and ideas. In last ten years many new N&D departments have been opened. These departments are trying to build their academic structure. Many youngsters have taken up higher education hoping to be an academician in one of the new departments.
- Many new N&D department without proper groundwork. Opening of too many N&D departments rapidly around Turkey has caused some problems. In some of the faculties there is no dietitian as an academic staff and other disciplines (biochemist, nurse, physician, food engineer etc.) try to teach N&D to the students. In some of them there is no laboratory for students to practice. In a few of them there is no proper hospital for students to practice on cases or to do their internship.
- Unstandardized education. In Turkey, there is no standard education program for N&D departments defined by the Higher Education Council. Each department may construct its own curriculum and there’s no authorized body. TDA has no right to conduct a central examination for dietitian to become a ‘registered dietitian’.
- Unemployment within 5 years.From 1969 up until now, there were roughly 2500 N&D graduates in Turkey. We estimate that our graduate numbers will double within five years. Even though nutrition is an emerging area, we might be facing unemployment issues soon.
N&D education has strengths, weaknesses, opportunities and threats. We, as the dietitians, should try to solve our weaknesses and convert threats to opportunities.
Turkish Dietetic Association
Ege University İzmir Ataturk School of Health, Dept. of Nutrition and Dietetics