Tag Archives: professional guidance

How To Avoid Making a Damn Fool of Yourself on Externship

I don’t want to write this blog post.  I don’t feel like I should have to. It’s common sense, isn’t it?  It’s a waste of data to send this through the interwebs. Unfortunately, I have experienced veterinary externs who made a damn fool of themselves.  They besmirched the reputation of their home institution, irritated colleagues and faculty, and sank any hope of getting a letter of recommendation or being ranked at the institution.  So, since I have seen it, I am here to help. If you are an RFHB, you may go to the next post.  If not, here’s how to avoid making a damn fool of yourself on externship.

1) You are a guest.  Would you go to someone’s house and denigrate the way they load their dishwasher?  “Man, they’ll never get clean if you do it like that!” Don’t insult your host school in any way.  Don’t talk down about their students or their faculty or their processes. You may make a polite remark like, “Oh, how come you do it like that?” or “Oh, why do you do that” or “Oh, what was your rationale for deciding to do it that way?” if it reflects a genuine interest to learn.  But just because they do things differently doesn’t mean they’re bad. Try to see the good in the differences. Heck, I learned how to place coccygeal art lines at CSU during a 3-week externship which I would have never learned otherwise. Be open-minded.

2) Learn the system.  There is always a painful learning curve the first week, but pay attention and try hard to figure it out.  If you work at it, you will be more effective by the second week. You may not know where the Q-tips are, but at least you can fill out a medical record and find ICU.

3) Show up.  Set two alarm clocks if you have to.  A student at their home institution may get a one-off if they miss a day or show up late.  You don’t have a whole year to impress these people, you have 2-4 weeks. A single day of a bad showing represents up to 10% of the experience these people will have with you.  Make sure you know the route to the hospital and budget plenty of time in the event of an accident or road closure.

4) Work hard.  Come in early, stay late, don’t complain.  You are representing your home school as well as yourself.  You don’t want anyone to have the slightest inkling that your home school trains slackers.  Represent your home school with honor.

5) Smile.  Be pleasant.  Be engaged. Ask polite questions.  Be helpful. Be positive. It’s only for 2-4 weeks.  Even if you are not by nature a particularly outgoing person, you can still appear happy to be there.  Because you SHOULD be happy to be there. You’re in god-damned-vet-school, how amazing is THAT?!? And this place had the good grace to accept you in as a guest!  That is pretty amazing.

6) Treat everyone with respect, especially the technicians.  Obviously, this is true at your home school, but is even more important when you are an extern.  Technicians are amazing; be sure to treat them with the utmost esteem.

7) Be appreciative.  Make sure to thank your colleagues and mentors for the experience.  If you had a particularly good connection or may be interested in a letter of recommendation, a follow-up thank you card may not come amiss.  In particular, thank the technicians.

That’s it.  It seems simple, doesn’t it?  It seems like it shouldn’t need to be said.  But believe me when I say this: it DOES need to be said.  And YOU may be the one to whom it needs to be said.

What to Get Out of Doing Research Work as an Undergrad

You want to go to vet school, you want to maximize your chances, and doing research may help your application.  It isn’t the research, per se, which will help. It is the relationships- mostly with your mentor- and the demonstration of grit that doing research highlights.

Participating in research while an undergrad is a wonderful activity.  You get exposed to the process of scientific inquiry, and maybe that becomes exciting for you.  You get to work one-on-one with a faculty member who can write an excellent letter of recommendation. And you get to demonstrate your willingness to stick to a project to the end- an essential characteristic of any vet student.  Let’s break them down.

1) You get exposed to research.  Hey, you know what? Vet school isn’t for everyone.  Maybe you would be equally fulfilled doing a PhD in biochemistry, and avoiding the mountain of student debt that awaits veterinarians.  Maybe you enjoy doing research but still want to be a vet- so maybe academia would be a good fit for you. Maybe you have a bad experience and decide research sucks.  In any event, getting exposure to this essential domain of veterinary medicine will benefit you.

2) Develop relationships.  I have written countless letters of recommendation for my research students.  Some of them said, “Yeah, this person is fine” and some of them said, “OMG you must take this person they are the best thing since sliced bread!”  Obviously you want to be in the latter group, and working closely with a faculty member can set you up for an excellent letter of recommendation. When you decide to pursue research, make sure you aren’t working for a postdoc; you want the faculty to write you an excellent letter of recommendation.

3) Grit.  Completing a research project- even if you are a cog in the wheel of some post-doc’s 5-year project- demonstrates some level of grit.  I have had students who flamed out after a semester, having never started data collection. I have had others who have two peer-reviewed journal publications to their name.  Which do you think is a better vet school candidate? Finishing a project demonstrates that you can see a project through, which is incredibly important in vet school.

Not everyone should do research during their undergrad years.  If you are struggling academically, you need to double down on your core courses and not get sucked into a 15-hour-a-week research project.  If you’re not intellectually curious, or just want to do the bare minimum, avoid research, because your mentors will expect you to be curious and perform.  If you just want a line on your CV but don’t care about the work, please don’t burden some beleaguered faculty with your poor attitude.

If you can do research during your undergrad time, do so.  You will find out important things about yourself and maybe buff up your application.  You may develop relationships with mentors who will propel your career. Most of all, you will find out if something academic or research-oriented is a path in which you are interested.  And from there the sky’s the limit.

Using Statistics to Decide Your Future

I wanted to be a surgeon.  Specifically, I loved orthopedic surgery.  I wanted to just fix something and not manage a chronic illness for years like internal medicine does.  It was not to be for me, though, and my life turned out grand. I have reviewed applications from people who have done THREE specialty surgery internships, and it makes me sad because they seem to be throwing themselves at an impenetrable wall.  Obviously, you can’t choose what you want to do for the rest of your life based purely on numbers, but let’s start by looking at the numbers.

For the 2018 Match, the specialties with the worst match rate (i.e. most competitive) that routinely participate in the match were exotic/wildlife (2.9%), zoo med (6.6%), and avian medicine (10%).  You would not believe the number of vet student applicants who have told me their life long dream is to be a zoo vet. I feel so bad for them. Their dreams will almost surely be crushed. If you plan to do zoo med, you need a backup plan.

The specialties with the best match rate were lab animal, emergency/critical care, and anesthesia.  Lab animal often pays quite well and allows you to do diverse interesting things. E/CC can be challenging and complex, but be sure to review the specialty board pass rate for the institution- some of them do not train their residents very well.  Anesthesia, of course, is great- you don’t have to talk to crazy clients or haggle over money with clients and you can do small animal, large animal, or both.

Small animal surgery is actually higher than I thought- 20%!  I have heard some programs receive 190 applications for one small animal surgery position.  But the overall statistics don’t seem terrible for small animal surgery.

Obviously, the match rate includes _every_ applicant, even those who are clearly not viable candidates.  So your odds are probably much better, assuming you are reasonably competent and pleasant to work with. You may be able to improve your odds by having a great application packet and doing an interview well, with which this blog will help you.

So what to do with this information?  Well, I would suggest analyzing your future career considering the statistics.  Are you SURE the only thing you could be happy doing would be surgery or zoo med?  A lot of other clinical specialties offer a similar quality of life, intellectual challenge, and freedom.  

The evidence indicates that people can be happy leading life one of three ways – seeking pleasure, doing your best work, or helping others.  You can do your best work doing a lot of different things in veterinary medicine.  If you don’t match the first time for a residency, maybe re-examine your future and consider other alternatives before you waste years of your life pursuing an impossible dream.

How to Choose a Veterinary School

The Vetducator image of vet school debt and satisfaction with value.

It’s the culmination of your lifelong dream- you are finally applying to vet school!  Congratulations! It is an exciting and scary time. You are starting to make substantial decisions which will affect your life and career.  Some people may fret over where to apply to vet school. Fortunately, it’s a surprisingly simple decision-making matrix.

Is there a state school where you live?  If yes, apply there. You do not want to pay more for your educational than absolutely necessary.  Your in-state school is probably the least expensive option.

If there is not a state school, does your state participate in a cooperative program with another vet school, such as Delaware with Georgia or WICHE (Western Interstate Commission for Higher education) with several western schools?  If yes, apply to the associated school.

Is there something odd about your application that may make it difficult to get into your state school?  If yes, you may apply to out-of-state schools, private schools, and overseas schools. Realize that the tremendous financial cost of these options may be a monkey on your back for most of your life.

That’s it.  There’s no consideration of ranking.  You know what they call the person who graduated from the bottom-ranked school in the country?  “Doctor”. You can get a good education anywhere and you can get a bad education anywhere- it is up to the individual student.  This isn’t law or politics. Your employer will not care from where you graduated. Keep your costs down. Graduate debt-free if possible.  Then enjoy your full, free life.

Words of Caution for the Aspiring Vet Student

The Vetducator - caution for vet school applicants and aspirants.

Being a veterinarian is a lifelong dream for many.  Animals are such an emotional part of so many lives when growing up, it’s natural that children want to get a job where they can help animals.  For many, that seed is planted deep and grows, consuming their life’s direction and passion. For others, being a vet seems like a neat idea, just one of many possible professional paths.  Your motivations for going to vet school don’t matter nearly so much as how content you will be with the decision. This is The Vetducator’s What You Should Know About Vet School Before you Apply.

  1. You will work extremely hard.  If hard work and learning isn’t your thing, find a different path.  Some students fail veterinary school. How is it possible, since we’re picking the top students?  Simple: undergrad and even grad school do not prepare you for vet school. Some people can’t handle the time and intellectual pressure.
  2. When it comes to the social dynamics of vet school, vet school is high school.  You will be with the same people all day, every day, for four years. Cliques form, relationships get made and destroyed, egos are built and crushed.  If you think it’s some enlightened bastion of higher learning, think again. It’s not a reason not to go, but you should be prepared.
  3. It is incredibly expensive.  Vet school, if you plan to be a general practice veterinarian, is not a good financial investment.  Ask yourself if you could be happy doing something else. Your instinctive answer is “No! I have to be a vet to be happy!”  I believe this is extremely naive. You don’t know what will make you happy until you get there. In fact, we have very good evidence that humans adapt amazingly well to their experience.  Imagine losing your arm, or your sight- can you imagine yourself being as happy as if you had the arm or your sight? Probably not, but in studies people who experience some ‘adverse’ life changing event are just as happy as those who do not.  Think long and hard about the return on investment. And absolutely do not go to a private school for vet school. Although some of them are fantastic, you will be so incredibly in debt your happiness will be reduced because of it. If you can’t get in to your state school, find a different career.
  4. You may not have a job.  Before 2008, it was believed veterinary medicine is recession proof.  Well, the global financial collapse proved that to be wrong. I remember many years when new graduates did not have jobs by graduation.  Veterinary schools are admitting more students, and more veterinary schools are popping up all the time. The market will be flooded again and, if that aligns with an economic downturn when you graduate, what will you do?  Particularly if you are deeply in debt from going to a private school?

I am tempted to end on some warm-hearted, encouraging note, but I have to be honest with you.  Veterinarians have a high rate of suicide. We work long hours and clients scream at us for being money-grubbers who don’t care about their pets.  Serious injury from being bitten or kicked is not uncommon. You can certainly make a good life being a veterinarian, but you can also make a good life doing a lot of other things.  Academic veterinary medicine has been good to me, but I think I could have been just as happy doing, say, biochemistry. Maybe you could be, too.

Set Your Post-Graduate Success in Vet School

Vetducator - Mean and nice chihuahua dog.

I was chatting with a colleague the other day who mentioned a course we had just converted that semester from a graded course to a pass/fail (at 70%) course.  Apparently students had been harassing the course coordinator for a few points here and there, even though these students were already above a 70%. They couldn’t ‘pass’ any more than they had, yet they were hassling this poor embattled new assistant professor.  

My colleague asked me, “Don’t they realize they will want us to write letters of recommendation for them in a few years?  Do they think we’ll have forgotten how they made our lives unnecessarily difficult?” I’m not saying vengeance will be taken or anything of the sort.  I’m also not saying students shouldn’t ask polite questions of faculty members to improve their own understanding of a topic. But students who want an 89% instead of an 88% in a course which is pass/fail will be noticed.  And remembered.

During vet school, you want to be quietly competent.  Not invisible, but not obnoxious or difficult to work with.  As always, aim for zero. Ideally, faculty members know more or less who you are and if you are a good student.  “Good” in this context does not necessarily mean earning high grades. For a clinician educator like myself, a “good” vet student is one who tries to understand the clinical rationale for decisions and is not just memorizing data.  If you are a club officer, hopefully the faculty mentor for the club knows you and you feel comfortable talking to them.

Focus on the big picture.  I understand it’s easy to get swept along with your classmates who all want top grades, but ask what the important thing is about what you’re learning.  Is the most important thing to get good grades, or is the most important things to become a competent clinician? I distinctly remember the #1 ranked student in a class got to clinics and one of my interns wondered, “How can they be so smart and so dumb at the same time?”  They were academically gifted, but couldn’t handle clinical decision making. Don’t just memorize data. Understand concepts.

I don’t want any student to feel like they can’t talk to a faculty member and ask respectful questions intended to expand their own understanding.  But when the questions are purely to get an extra point or two, ask yourself what you’re really trying to accomplish. And consider the collateral damage you may cause.  Faculty members are, in general, fairly intelligent, with good memories. We will remember the grade grubbers. And they will not get good letters of recommendation.

How to be Successful: Growth Mindset


The Vetducator - Image of plant growing.

Since vet schools care so much about GPA and GRE scores, you would think that being an amazing vet student, intern, resident, or faculty member is largely about intelligence.  Being smart helps, no doubt about that. But it is only one piece of the puzzle, and an arguably small piece at that. The best veterinary professionals aren’t necessarily the smartest.  They are ones who aim for zero, who show up, and, above all, have a growth mindset.

The fixed mindset vs. growth mindset is a relatively recent concept in psychology.  The essential premise is that people with a fixed mindset believe they have certain natural talents which are just innate and they cannot become an expert without these.  For example, I have an amazing sense of direction and, if I believed I was just born with this, I would have a fixed mindset.

Those with a growth mindset believe that you can learn anything- you just have to put in the time.  This is popularly explained as the “10,000 hour rule”, which suggests if you spend 10,000 hours on a skill you can become an expert.  The real value is probably closer to 50,000 hours, but the premise stands. I believe I have an excellent sense of direction because I studied maps as a kid, regularly navigated my environment in challenging ways, and had the ocean constantly to the west, making navigation more intuitive.  I got good at navigating because I practiced, not because I was born with it.

You would assume every competent veterinary professional has a growth mindset, and you would be partly right.  After all, everyone went through vet school and had to learn how to be a veterinarian- they weren’t born being able to be a vet.  But you would also be partly wrong, because countless students say things like, “I’m just not good at physiology! I’ll never get it!”  That suggests a fixed mindset.

When I am working with a student, intern, or resident, I want to work with one who is enthusiastic and willing to learn.  Being open to new ideas is essential to being a great veterinarian. I had a solid half hour back-and-forth with one of my classes about the uselessness of warming intravenous fluids (I know better now how to have this debate, but we all have to learn somehow).  They just couldn’t believe that this standard of practice everywhere they worked was useless for helping core body temperature.

Having a growth mindset is synonymous with making and learning from mistakes.  At Midwestern University, the faculty had a debate about how to handle students who made a grave medical error.  Although some faculty members wanted to punish the students, most wanted to first ask a question: How did the student feel about it?  Did they recognize the mistake, admit to it, and try to correct it? Or did they bury the mistake, blame someone else, or act unbothered by it?  Being willing to learn from mistakes indicates a growth mindset.

You can change your mind to be more in a growth mindset.  I had been teaching martial arts for 15 years and veterinary medicine for 10 before I first heard my best friend say in an instructor training course, “In any situation, figure out what YOU could have done to make it better.”  He also said, “Name a time when something went wrong that wasn’t your fault, but you could have done something to make it better/not happen.” This revolutionized the way I taught and even approached life. Now when my students don’t understand a concept, I couldn’t shuck responsibility.  I had to see what I could do to make things better, so I had to improve my pedagogical skills.

As I began to learn more about human error, cognitive biases, and medical error, I became more excited about learning how we make mistakes and how to learn from them.  I moved my mind to more of a growth mindset so you can, too. The earlier you start, the easier it will be. You can get better. You can BE better. But only if you believe it and only if you try.

Do You Want to do a Specialty Internship?

The Vetducator - Image of intern going to private practice, specialty internship, or residency.

The internship is a one-year experience.  Typically, after vet school, one does a rotating internship, where you get a wide variety of experience in medical and surgical cases.  More and more specialty internships are coming about. These are also one year long, and are focused on a specific discipline, such as anesthesia, cardiology, internal medicine, oncology, or surgery.  You’ve already done one internship, worked long hours for not much money. Why would you do another?

The specialty internship has been around for at least 20 years, and probably longer.  Programs have always had a need for semi-experienced clinicians who could do more specialized work.  Why not create a residency if that is needed? Some programs do not have enough specialists or other requirements dictated by specialty colleges to train residents.  Some institutions do not have the funding to make a 3-year residency commitment, but can make a 1-year internship commitment. In recent years, specialty internships have exploded as the applicant pool has increased.

Most people pursue a specialty internship as a stepping stone for a residency.  Through the VIRMP, you can apply to residencies and internships simultaneously. The VIRMP will first try to match you for a residency.  If you are unsuccessful, it will then try to match you in an internship if you applied to any. A specialty internship fulfills a number of useful roles for the prospective specialist:

  1. It keeps you in the system.  If you finish your internship and do not get matched for a residency, what do you do until you can apply again the next year?  You could go out into practice, but that is fraught with complications.
  2. It gives you more references.  Your references from your rotating internship are good and helpful, but getting more references, particularly from people within your discipline, can be valuable.  The supervisors for specialty internships have also seen a LOT of specialty interns, and can apply that perspective to your performance.
  3. It makes you a better clinician.  You get more experience in your chosen specialty, meaning that a residency which takes you will have a more prepared resident.  Plenty of programs still take applicants out of a rotating internship, but a specialty internship might give you a slight leg up if you need it.

There are some times when doing a specialty internship isn’t helpful, or isn’t right for you.  Some of these include:

  1. Family considerations.  Yet another year spent at a different institution with no guarantee for the future.  It can be tough if you want to settle down.
  2. Financial considerations.  Another year spent not making much money, potentially with student loans looming or, worse, gathering interest.
  3. Academic consideration.  If your vet school performance was poor, it’s possible no number of internships will make you a viable candidate for a residency.  Talk to your mentors and get their genuine appraisal of your situation. I have seen applicants pursue three specialty internships and still not get a residency.  It breaks my heart. I wish I could tell them, “This isn’t going to be your path. Find another one.”
  4. You’ve had it.  You’ve been in school long enough, and you want to have your own time and develop your own professional image.  It’s time to get out of the academic circle and into practice or a different veterinary pursuit.

The specialty internship can be a valuable, rewarding experience.  It can enhance your application and get you one step closer to a residency.  It can also delay you getting to where you want to be in life by another year (or more if you do more than one).  

You should have a very honest conversation with yourself, your loved ones, and your mentors.  How much is this path really worth to you? Could you be just as happy doing something else? I didn’t match for a surgery residency after my internship and ended up doing an anesthesia residency.  I am ecstatically happy now. Professional happiness doesn’t just happen to you- you need to make yourself happy given your circumstances. If you tell yourself, “I can only be happy if I am a surgeon”, I think you are bound to make unwise decisions.  Tread carefully.

Should You Do an Internship?

The Vetducator two paths diverge.

Vet school is difficult.  By the end of four years, many people just Want Out.  They want to start making money, they want to have their freedom, they don’t want to be away from their family at all hours of the day.  Others want to learn more. They want to become excellent clinicians, they want to push their knowledge, and they want to focus their knowledge.  Both paths are fine. You have to know yourself to decide if you should do an internship or not.

First, ask yourself how prepared you feel as a general practice clinician.  Most veterinary schools are excellent at training specialists. They have tertiary care hospitals where specialists see strange cases which are good practice material for residents.  This is not a good setting for training general practitioners. As a GP, you need to know how to handle common situations, not zebras. If you arranged your senior year so that you had plenty of opportunities for primary care experience, you may be ready to practice.  I believe most students graduating from most programs would benefit from further training.

Second, can you afford an internship?  There are opportunity costs because you will be making less than you would in practice.  The actual salary is usually quite low, and supporting a family on one may be difficult. You are also delaying saving for retirement.

Finally, and, most importantly, what do you want out of your professional career?  In a recent study we did, we interviewed senior students who were planning to enter an internship or enter private practice.  Those pursuing an internship were more interested in competence- getting better at being a clinician. Those pursuing private practice were more interested in autonomy- getting to decide how they spend their time and money.  Sit with yourself and contemplate which you want from your life.

Before I left one institution, I told students they should all do internships, because there was so much more they needed to learn to be competent practitioners.  After working at another institution, I have seen a model which prepares students well for general practice, and I believe students graduating from some programs may be competent at the time of graduation.  Don’t assume your first position will train you properly. Every new graduate goes to a practice which promises “great mentoring”. Maybe most of them get it, but we have all heard horror stories of starting a new job and the boss hands you the keys and takes off for Hawaii.  There are bad internship programs, too, so doing an internship is no guarantee of great mentoring. But, in general, you are more likely to get great mentoring from an internship than most private practices.

Although it is not strictly true, it is generally true that, once you are ‘out’ of academia, it is harder to get back in.  As with all major career decisions, talk to friends and family and mentors. Share in the comments what has factored in to your decision-making with regards to internship vs. private practice.

The How to be Successful Series

The Vetducator - Rocky Balboa raising fist in the air.

I have two editors for this blog: my wife and one of my best friends.  They have both commented on my lack of advice on how to be a +1. This is because I generally believe if you aim for zero, and are then a reasonably competent person, you will become a +1.  But my wife specifically told me, after the Aim for Zero post, that I should address people’s concerns that they feel they NEED to be a +1 in order to get the position they want.

So, I started writing some posts about how to excel as a student, intern, resident, and faculty member.  They slowly began to morph into a series of posts which, when taken altogether, would lead you on the path to become a +1.  This is an introduction to that series, following my post about Aiming for Zero. The future of this series includes the following topics:

I’m sure more will come up as I think, read, and continue to counsel clients on their career progression.  My initial thought was that being successful was pretty simple but, the more I thought about it, the more I found was important to articulate.  Why?

I shared the Aim for Zero post with some professional friends and it apparently resonated.  The next day, one of them told me, “Oh my god, why don’t people know this? I get ridiculous demands from students all the time and they have no idea how this is affecting their career.”  So, evidently, lots of people don’t do these things. That means it needs to be spelled out, hence this series. I hope you enjoy.