Category Archives: Resident Applicant

Behind the Scenes: How I Read a Residency Application

Image by Larisa Koshkina from Pixabay

I thought it would be helpful to share my personal process for reading a residency application.  Evaluators will vary widely in what they are looking for, and this is especially true of residency applications.  Others go about the process very differently, but I think it would be helpful to give a deep insight into my process, so you can get some perspective.

First, the residency application is organized in this way: standard application information (entered when you apply through the VIRMP), letter of intent, CV, transcripts, letters of recommendation.

The interesting information in the standard application is the education and references.  For education, I want to know if they graduated from an AVMA-accredited school or not. While I check the class rank, I don’t put much stock in it.  I glance at the references to see if there is anyone I know. If so, I make a note to contact them about the applicant. Unless there is some remarkable red flag- like graduating 10 years ago from a non-accredited program, having no letters of recommendation from anesthesiologists, or having no letters of recommendation from their current employer, I don’t make many decisions from the standard application.

I use the letter of intent as one of the most important ways to categorize applicants.  If the letter is more than one page, I may still evaluate the candidate, but they are fighting a real uphill battle getting a positive review from me.  I will read it in detail, making note of any grammar or spelling mistakes or any odd word or sentence structure choices. Once I decide the person paid an appropriate level of attention to detail to their application, I will read it for content, mostly trying to determine if they are humble, willing to work hard, and get along with others.

After the letter, it is on to evaluating the CV.  Here I check their professional progress to make sure they have the requirements for ACVAA credentials- specifically a rotating internship, which many international applicants do not have.  I make sure they have a clear professional progression. I look to see if they have teaching experience or substantive research experience, since both of those are important for a resident at an academic institution.  I also see if there is leadership experience in vet school or elsewhere in life. I also make sure they have some extracurriculars and make note of those for potential interview discussion inspiration.

The transcripts I ignore unless they are from a non-U. S. institution.  Then I review them enough to understand them and make sure the person didn’t get a batch of Ds or Fs.

The letters of recommendation are most useful from people I don’t know personally.  If I know the recommenders personally, I will reach out to them via email or phone to discuss the applicant.  Mostly what I look for in the letter of recommendation is who the writer is and how they know the applicant and what they have to say vis-a-vis the applicant’s personality.  My theory is I can teach any halfway competent veterinarian but, if they have a difficult personality, I CAN’T change that during a residency.  I want someone who is teachable, engaged, pleasant, positive, enthusiastic, and humble.

At the end, I will usually go back and skim the whole thing to make sure I didn’t miss anything important.  We don’t have many applicants in anesthesia, so I don’t usually make a complicated spreadsheet- I can keep track of the details of all the applicants without it.  Then I sit down with the other faculty and go through each applicant and decide to place them into one of four buckets: do not rank, or rank in one of three strata: top, middle, and bottom.

That’s my entire method.  It works for me but, again, may not be how everyone does things.  Particularly for those in high-demand specialties, I suspect their process is very different.  Talk to your mentors to find out if they think there is something particularly important, and post in the comments with your thoughts and concerns.

Behind the Scenes Series

I was inspired to write a short series on how applications get evaluated throughout the academic process- for vet school, internship, residency, and faculty positions. Realize that these are idiosyncratic- my process is definitely different from other people’s processes. Nonetheless, I think it may be helpful/insightful. Enjoy these for the next two weeks!

You Must Stand Out

Photo by Rupert Britton on Unsplash

I can’t emphasize enough how much you should try to aim for zero– show up, be competent, don’t try too hard.  On the flip side, if you are forgettable, marginal, or just merely acceptable, you won’t ‘wow’ anyone and you won’t get letters of recommendation.  Obviously, you should read and adhere to all of the How to be Successful series of posts. In addition to those concepts, here are some which will help make sure you Stand Out.

1) Ask questions.  There can be a difficult balance between annoying, constantly questioning/bugging and curious, thoughtful, and engaged.  Asking thoughtful questions indicates you understand the material and are interested in learning even more. You may ask any questions you like, and this is a great way to learn, but if you haven’t done the basic reading and work to understand the foundations of the topic at hand, you probably won’t stand out when you ask your questions. Conversely, try not to ‘wow’ people with the questions you ask- esoteric data and minutia can be all well and good, but whenever a student asks me a question like this, it is obvious that they are trying to suck up or stand out.

2) Help out.  You may think faculty don’t notice all of your hard work, and maybe some of them don’t, but most of us keep a close eye on how hard working the students are.  Help your classmates out whenever they need it. Teamwork is an essential skill for veterinary medicine- demonstrate that you care more about the team than yourself.

3) Don’t be silent.  You don’t have to be the most outgoing, gregarious person but, if you are silent, you will almost surely fade into the background.  You should be engaged when things are happening and learning opportunities occur. Be prepared to answer when you are asked a question.  If you don’t know the answer for sure, you can hazard a guess. It is far preferable to make an educated guess than to be sitting in silence while the faculty waits for an answer.  Participate participate participate.

4) Be energetic.  Again, you don’t have to be an extrovert, but you DO have to look like you are happy to be working and learning.  You’re in vet school or an internship or a residency- isn’t that AWESOME?!? You can’t be excited 24/7, particularly with some of the long, mentally taxing hours we work, but you CAN do your best to express your enthusiasm as often as possible.  Students who are energetic and seem happy to be there make a far better impression than those who seem like they are just putting in their time.

5) Study.  This may seem self-evident, which is why it’s not in the How to Be Successful series, but I am often amazed when students go home and then don’t study.  Yes, you may be able to pass and do a fine job. But do you expect you will be able to excel, to stand out from the crowd? All vet students are above average and all interns much more so- if you want to stand out, you have to work, and part of this is studying when you go home or have down time.

I don’t want you to STRIVE to be outstanding or above the crowd- doing so will almost surely set you up for failure.  However, I do want you to be AWARE of what you can do to be a remarkable student/intern/resident. Find the opportunities to do these things as they arise, but don’t force it into situations.  If you had a long, tiring shift and try to force yourself to be energetic, it will come off as false and disingenuous.

These are some of the characteristics of the students whom I notice and for whom I am inclined to write positive letters of recommendation.  What are some other characteristics you believe are important?

Sample Vetducator Corrections for 2019 Letters of Intent

Image by Anne Karakash from Pixabay

I thought I would share with you the way I have worked with students in the past and the sorts of comments I provide.  In general, I try to offer the writer the perspective an evaluator will have. This sometimes comes off as blunt, but I’m trying to genuinely share what goes through my mind.  You can see that I don’t rewrite things, just offer suggestions, so it is still the original author’s work; their work with added editing and expert advice. These are all anonymous and submitted with the author’s permission.

Podcast Episode 9 – Dr. Rachael Kreisler

Dr. Kreisler and I worked together for a couple of years and did a research project and continue to collaborate in research. She is an INTJ like me! She has a fascinating perspective on veterinary medicine as she has wanted to do shelter medicine since before she got to vet school. I’m sure you’ll learn a lot- I certainly did!

Examples of Poor Letters of Intent

The Vetducator- Bad Apple
Photo by Maria Teneva on Unsplash

We have previously given examples of good stories in letters of intent, so I wanted to take the opportunity to show some examples of poor letters of intent.  These examples are from letters which were overall evaluated as “unrankable” for internships, but they apply to any stage of your professional progression. Although the entire letter was given a low value, I wanted to sample the specific segments I think are most illustrative.

“Whether it’s researching alternative therapies for treating an incontinent cat, working a busy ten hour shift in the ER, or consoling an upset client, I really enjoy my work. I am positive, hardworking, determined, organized, and good at working with others. I love to research and think outside the box when it comes to addressing challenging cases. I love working with cats, dogs, and pet exotics. I particularly enjoy emergency medicine, internal medicine, and companion exotic animal medicine.  Being on the verge of completing veterinary school at Unseen University in the top 10% of my class, I want to pursue further study with a one year internship followed by a residency in exotics. I am looking for a rigorous small animal internship in which I can have primary case responsibility, a heavy and varied case load, and the opportunity to continue learning under the guidance of veterinary specialists.”

As an opening paragraph, it is an abrupt start.  A little bit of a lead-in would be nice. It is highly self-promoting: telling the reader how amazing the author is.  They give some indication of what they want, but not why.

“An internship will provide me an opportunity to expand my knowledge base under the guidance of mentors and will continue to grow my veterinary school technical education. It is my desire to be trained by committed and passionate people who are experienced in helping interns to develop a good medical judgment and clinical skills. Likewise* the high volume of clinical cases in specialty practices will assist me to learn and manage multiple cases efficiently. A private practice internship will also enable me to provide optimal care for patients, learn to maximize customer service, and provide opportunities to develop interpersonal relationships with clients.”

What in the world does this entire paragraph tell me?  Of course an internship will help you grow. Everyone wants to be trained by great people.  The high volume is a good detail- I know this person would be a better fit for a busy practice than a slow, cerebral one.  I think ANY job would help you provide optimal care for patients, work on customer service, and work on interpersonal relationships.

“As there is increasing public interest in exotic and nontraditional companion animals* I have exploited every opportunity to continue my education and clinical training with species beyond those routinely presented to the Unseen University Teaching Hospital.  As a zoological and wildlife intern at numerous institutions I was responsible for patient care, heard health, public health, animal husbandry, and patient medical records. Through my direct interactions with chief veterinarians at esteemed zoological institutions I participated in numerous procedures, as listed on my C.V., and attended journal clubs and quality of life meetings.  Professional collaboration was essential in these settings as I discussed patient care and wellbeing with multiple individuals whom were all invested in the same animal, yet possessed differing degrees of medical knowledge. I have knowledge of avian, reptilian and mammalian wildlife, including proper handling and restraint through my experiences caring for these species at the Nature Center and Unseen University Wildlife Ward.”

Let’s analyze each sentence:

1 – Convoluted.  How have you exploited them?  Exploited is not a good word choice.

2 – Misspelling error in ‘heard health’.  Also, how is this different from anyone else?  Of course you’ve done medical records. What do you want, a cookie?

3 – Great, if it’s on your CV, why is it here?  I HAVE your CV, why waste valuable letter space on this?

4 – I can’t even unpack this sentence. “Whom” should be “who”.

5 – Great, you have skills.  I’m not too interested in skills- I can teach you what you need to know.  How are you to WORK with? Based on this, self-promoting and superficial.

* – Missing comma.

I know these applicants were sincere and dedicated and really wanted a position.  I do not want to dismiss their passion. Unfortunately, passion is not enough. They didn’t reach out to mentors and friends for feedback, resulting in relatively poor letters.  I hope you can learn from them, and avoid these missteps.

Effectively Manage the Transition Between Positions

Moving on from one step of your professional life to the next is exciting!  You’re going forward, pursuing your passion, hopefully at an institution you like.  There is invariably down time between positions and there are important Work and Life details you need to take care of.  We are in the middle of a move as I write this, which is both exciting and scary. Here are some suggestions to help you make these transitions less scary, specifically with regards to Time, Housing, Moving, Insurance, and Licenses.

Time

Between undergrad and vet school you have at least a whole summer, between vet school and internship at least a month and possibly more, between internship and residency a couple of weeks or more, and between residency and faculty position as much or as little time as you like.

Between undergrad and vet school, work or travel.  There’s not much point in trying to prepare for vet school- that’s what vet school is for.

Between vet school and internship, travel or, if they’ll have you, stay on at the institution from which you graduated.  I spent an additional 3 weeks after graduation hanging around the surgery service acting as a super senior or a junior intern, depending on your perspective.  It was a great experience and helped prepare me for my role as an intern.

Between internship and residency, study.  The more you know about your discipline before you start, the better off you will be.  Of course, they’ll teach you what you need to know during your program, but the faster you get up to speed, the more you will learn.  I read the Vet Clinics of North America issue on anesthesia as well as Physiology and Pharmacology in Anesthetic Practice and it was tremendously helpful.

Between residency and faculty, travel.  You already know enough to be an entry-level specialist, and you can’t do any meaningful work in the amount of time you have.  You will rarely be so unencumbered as you are once you finish your residency. I have _never_ been able to travel between positions and I wish that I had.

Housing

Once you know where you are going, you need to secure housing.  This can be challenging in some college towns. For example, in Athens, if you didn’t have a place secured by April, you would be getting the scraps, and people who want the best places secure their lease in February.  In contrast, in Phoenix, you can show up whenever and get almost any apartment you want. I encourage you to live within walking distance of the institution if at all possible. If you can also walk to the market and the pub, all the better.  I like using Google Maps, Apartments.com, and Zillow to find places which would be a good fit.

Hopefully the lease of your current place is ending close to when you will be moving.  If you need an extra week or two, you can always ask your landlord. In some place, such as Athens, this will be problematic- almost every lease turns over July 31st- but you can at least ask.  If you need to leave your lease early, notify them as soon as possible and just pay the fee. In the best-case scenario, your current lease ends the day after you pack everything up and move out.

Moving

Use this opportunity to REDUCE YOUR SHIT.  I am really serious about this. I showed up for my residency with two duffel bags and that is it.  When we left Athens, we gave away almost everything in our 2400-square foot house and it was WONDERFUL.  I assure you, your life will be so much better with less stuff. Particularly when you go to an internship- it’s only for a year.  Do you really want to be schlepping all of this stuff all over the country? No. Get rid of it. Donate it to friends, charity, or sell it on Craigslist.  You may NOT rent a storage unit because that is the height of ridiculousness.

Once you have less stuff, your options for moving are: DIY, hire help, or a combination of the two.  I have never heard a story of hiring a company to move things which ends well. So, in general, I would advise not hiring a moving company entirely.  To load your shipping device, you can get friends to help or hire local movers. We have had great success hiring local movers– they are relatively inexpensive, fast, and professional.

For shipping, you can rent your own truck (like a U-Haul and other competitors) or a device which someone else drives (PODS or U-Pack).  After driving a U-Haul for 2000 miles along I-40, I decided my life was worth more than I was saving by driving myself. Plus the gas cost was incredible.  Hiring U-Pack was about the same price as renting a U-Haul for a one-way trip, and was much less stressful.

Insurance

What happens if you get into a car accident when driving to your new home?  What if something catastrophic happens to your stuff in transit? How do you handle renter’s insurance?  Do you have to re-insure your car in your new state?

Let’s start with health insurance.  You should check with your current position about when your coverage ends.  Does coverage end on your last day or the end of the month? In any event, you should have an option to enroll in COBRA, which allows you to extend coverage.  This extension should be enough time to cover you until your next position coverage starts. If you can’t get COBRA, you may need to research individual coverage for the gap time.

Stuff insurance.  Why do you even have this?  Do you own something besides a house or car worth more than $1000?  Why? You already downsized your stuff, so you shouldn’t need insurance for it.  If it all goes up in a fireball, that would be sad but not catastrophic. You can pack any small, expensive items (instruments, computer, guns, etc.) in the car you personally drive.

Renter’s insurance is straight up absurd.  Why the hell should the apartment owners care if we have insurance to cover our very own stuff?  I’m not going to sue them if I get broken into. I wish I could opt out of this, but, unfortunately, in a lot of towns, this is required.  It is relatively inexpensive so, if you need to get it, find the cheapest policy that satisfies the rental company. Alternatively, several times now I have convinced the rental companies that my umbrella liability policy is sufficient.  I strongly recommend umbrella insurance for everyone so, if you have it, you may not need separate renter’s insurance.

Car insurance coverage is generally dependent on the zip code where the car is garaged.  Obviously, the insurance company doesn’t know when you move. But, if you get into an accident, they may make a fuss about it.  I would recommend talking to your insurance company/agent about this when you are researching moving.

Licenses

You will need a license to practice veterinary medicine wherever you go after graduation.  Some states have arrangements where you can get a ‘faculty license’, which has pretty minimal requirements for someone working at a university.  Many places have a single point person to help facilitate this. Figure out the license situation before you leave for your new position.

There are a lot of moving parts involved in moving to a new position.  To keep it simple, follow these rules: reduce your stuff, make a plan ahead of time, don’t leave anything to the last minute.  The sooner you figure things out, the less stressful the actual move will be.

Should you Do a 4-Year Residency?

Ridiculous switchbacks at Angel’s Landing in Zion remind me of the path to residency.

Most residencies in veterinary medicine are three years, with a handful of two-year programs out there for some specialties.  In recent years, the four-year residency has become more common. This is typically a residency in a highly competitive specialty, such as surgery.  In effect, the institution is getting you for an extra year for very little pay- they get a reasonably competent specialist for resident pay as opposed to faculty pay.  The advantage for the applicant is that a 4-year residency may be less competitive, because some applicants are not willing to sacrifice another year of their life for low pay and delaying their career.  So the rub is, should you apply for a four year program?

The principle advantage of pursuing a four-year program is that there are fewer applicants for such programs than for three-year programs.  So, you may be more likely to be accepted into one than into a three year program. The consequences are that you have another year as a resident, instead of getting to start your career as a specialist.  You delay moving to your next destination. Maybe you delay finding relationships (romantic and fraternal). You delay earning Real Money. If you are fanatically dedicated to the discipline and don’t care about the consequences to your life and career, a four-year program may be acceptable.

The disadvantage of a four-year program is primarily time.  In a three-year program, you would be done and then earning a decent salary by your ‘fourth’ year.  You would also be considered a specialist, and able to apply for private practice or university positions.  A four year position is adding 33% of your residency time to your life timeline. Another year may not seem like much now, but you will never get that year back.

Ultimately, four-year residencies are designed to take advantage of the competitiveness of some disciplines and take advantage of those applicants who are desperate.  The institutions get a year of low-cost high-skilled labor from your fourth year. You get a residency you may not have otherwise gotten. It’s a difficult balance and exemplifies the principles of capitalism: a balance between supply and demand.  What you need to ask yourself is: Are you willing to be inexpensive labor for a year in order to get a residency?

How to do Proper Interview Preparation

Preparation is always the key to a successful endeavour. Photo by Melissa Gogo.

Regardless of the position to which you apply, if there is an interview, you need to prepare.  Well, you don’t NEED to prepare. But others who are interviewing WILL prepare. Do you want to be competitive with those who are preparing?  Then you need to prepare, as well. Failing to prep is prepping to fail. So let’s assume you actually want the position for which you are interviewing and let’s discuss what you need to do to prepare.

First, you have to know about the position to which you are applying.  If it is a job, get the job description down cold. If it is for vet school, talk to every veterinarian you can about what it is like.  If it is for an internship or residency, read the position description and talk to your mentors about the position in detail. I advised an anesthesia residency applicant this year by giving them a 2-3 sentence assessment of each program in which they were interested. If possible, talk to people currently in the program to get an insider’s look.

The website for the institution to which you are applying may be incredibly detailed and helpful or not so much.  You should at least know their mission statement, what the program is like based on the official materials, and any other data you can find (e.g. applicant numbers or expectations).  This should take at least 30 minutes and up to 2 hours, depending on how much data they have online. Mine that data. You won’t actually know what the position entails until you have done it, but you should know as much as possible so you can interact intelligently with the interviewers.

Second, you need to practice.  You wouldn’t walk into an ice skating competition and expect to do well without practice, would you?  Unless you have been going on interviews every week for the past few months, there is no life experience that has prepared you for an interview.  So, practice. Get friends to ask you questions in a simulated setting. Studies have shown visualization activates similar pathways to actual practice, so run through questions and scenarios in your mind.  The more you practice the specific skill of interviewing, the better.

Third, you need to study.  Watch TED videos about effective interviews and discussion skills (the body language talk is revolutionary).  Read forum posts about interviews. Read this blog from beginning to end, taking notes all along.  Research potential interview questions and write down possible responses. You would study for months for the NAVLE, wouldn’t you?  How is an interview dictating the next step of your professional life any less important?

I cannot impress this upon you enough: just waltzing into an interview isn’t going to impress anyone, and it will significantly harm your chances of a positive outcome.  You’re a veterinary professional, for god’s sake; you’ve spent countless hours studying for classes and applying to programs and everything else involved in this demanding field!  Don’t tell me for one second you can’t do interview prep. If every applicant did good interview prep, I would be over-the-moon happy. Please help make that happen.

Internship/Residency Rankings Done Right

After you’ve chosen the programs in which you are interested, sent in your application materials, and done an interview (if applicable), you are now ready to rank the programs.  The rank order list is due in early January. What does it mean and how do you do it?

The mechanics of the match are described in detail elsewhere.  Put simply, you rank the institutions and the institutions rank the applicants.  Then an algorithm runs and matches the applicants with the institutions.

Some people try to over-complicate the match process.  They think, “Well, I doubt I will get into place X, so I won’t ‘waste’ a high level spot for it.”  Don’t assign value to the actual rank spot. Instead, you should rank purely on one criteria: Where do you want to go?  Rank in order from YOUR highest picks to your lowest, without regard for your likelihood of them wanting you. The system is designed to be treated this way; you’ll mess up your chances if you try to second-guess the algorithm.

How many institutions should you rank?  It depends primarily on how happy you can be in a given circumstance.  For example, have you decided that literally the only way you can have professional fulfillment is to be a surgeon?  First, I’m sorry for you. But if so, then you have to rank every single program. On the other hand, if you’ve decided that you would very much like to do surgery, but not at the expense of your physical or mental health, then you should only rank the programs where you would be happy.  That’s difficult to know a priori, but it is possible if you do your research and talk to current or former interns/residents

The second consideration for number of institutions to rank is financial cost.  There is a substantial step up from 10 to 11 institutions ranked ($90 to $250 in 2019).  However, this is your future, the next step in the rest of your life. Even the highest step ($350 in 2019) is not particularly expensive, matched against your entire education to date and your professional future. My advice therefore is to rank more.

The next consideration is how good of an applicant you are.  If you know you will be a top choice at a few schools, you only need to rank a few.  If you are a good candidate but not sure where you stack up, you will want to hedge your bets and rank many more institutions.

The final and most important consideration is how to decide how to order your rankings.  Being an analytical sort, I made a table. It looked something like this:

Program# InternsSalaryElective TimeSpecialists% ER TimeResearch Notes

Your table may have other variables, such as: geographic location, # cases, equipment, license requirements, rounds, or % primary care time.  Some of this information you can get from the position description, some will come from your research on the position. At the end, organize the programs according to the most important variables for you.

My general advice is to rank every institution where you think you could be happy.  The cost is not very significant, it minimizes the risk of not matching and having to do The Scramble, and is fairly efficient.  Rank them in order of where you want to go. That’s it! Tell me what you think and how it goes!