As a final year dietetics student at IMU University, I had the wonderful opportunity to complete my Specialised Focused Area (SFA) placement at the only public tertiary hospital in my home country: Indira Gandhi Memorial Hospital (IGMH), Male’, Maldives.

The SFA placement is a four-week posting at a site of our choosing, following eight weeks of clinical placement at government hospitals in Malaysia and another eight weeks at community placement sites in Malaysia. It marks the final step of our Dietetics Practicum 2 in the last semester. By this stage, I had already developed key clinical and community dietetics skills, and I saw SFA as an opportunity to apply and further build on what I had learned, especially in a context that was familiar, yet professionally new.

At IGMH, the Dietetics Unit is housed under the Internal Medicine Department, as the profession is still growing in the country. There is currently no food service system in the hospital, so dietitians focus on clinical nutrition care. Their responsibilities include providing inpatient and outpatient services, conducting ward rounds, offering individualised counselling and education, and planning and managing enteral and parenteral nutrition.

With only three dietitians serving the entire hospital, the unit has developed nutrition protocols that guide other healthcare staff whenever a dietitian is unavailable or delayed and act as the first line of nutrition care while awaiting formal dietitian input.

Becoming familiar with these protocols showed me how dietetic services are maintained when manpower is limited and how clinical decisions remain structured and consistent. I was fortunate to learn from a team of dietitians who were resourceful, committed and passionate about providing quality care to patients.

Throughout the placement, I had the opportunity to observe and participate in various aspects of clinical nutrition care, while also learning how to adapt the knowledge and skills gained from my previous placements to the healthcare setting in my own country. Since my earlier placements were all based in Malaysia, working at IGMH gave me valuable insight into how dietetic care is delivered within a different healthcare system, including differences in hospital structure, policy and administration. It also deepened my understanding of how cultural practices, local food availability and national health and insurance policies affect nutrition planning and patient care.

One of the key takeaways from this placement was learning to be flexible and realistic when resources are limited. I saw how dietitians made the most of what was available while still prioritising patient needs. For instance, when disease-specific enteral formulas were not available, which was often the case, they prepared blended tube feeds using recipes they have developed and tailored to each patients’ condition.

In addition to general inpatient and outpatient exposure, I had the opportunity to work with ICU patients for the first time and learned to navigate their complex and evolving needs in this context. I also gained hands-on experience in planning and administering parenteral nutrition, a responsibility that falls within the dietitian’s scope of practice at IGMH but not in Malaysia. These experiences challenged me to think more critically and helped expand my clinical skills.

At the same time, I became more aware of areas where access to care could be improved, such as the limited availability of disease-specific nutritional products or the fact that certain essential items, like oral nutrition supplements and enteral nutrition formulas, are not yet covered under the national health insurance scheme. Rather than seeing these as limitations, the experience encouraged me to think more broadly about my role as a future dietitian. It helped me understand that clinical care and policy-level advocacy often go hand in hand. I now feel more motivated to not only provide individual care, but also to contribute to strengthening nutrition services and expanding access to quality dietetic care in the long term.

Completing this final chapter of my undergraduate journey in Maldives was both personally and professionally meaningful. It allowed me to apply what I had learned throughout the programme in the setting where I plan to practise, while also preparing me for the realities of the local healthcare system. More importantly, it gave me clarity on the kind of dietitian I want to become, someone who is adaptable, informed and committed to making care accessible and relevant to patients’ real lives. The insight, growth, and direction I gained through this placement would not have been possible without the opportunity to return home and experience it firsthand.

Written by Sofiyya Hassan