Tag Archives: specialist

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?

With These 5 Steps, You CAN Pass Your Specialty Board Exam

Photo by Tamarcus Brown on Unsplash

The road to veterinary specialization is a long, arduous one.  First, you have to get into vet school and excel there. Then you do post-graduate training: an internship (for clinical disciplines) and then a residency.  Towards the end of your residency, you have to submit your credentials to demonstrate you are qualified to take the specialty exam. Everything leads up to the exam, which, if you pass, makes you a Board Certified Specialist.

Many board exams have a pass rate around 50%.  So even AFTER all that arduous training, as well as studying for the exam, your odds of passing are like flipping a coin.  Even very smart people sometimes don’t pass boards. Some people, unfortunately, never pass their board exam. Fortunately, passing is not random, and you can take steps to maximize your chance of success.

1) Kick ass during your residency.  “Those who do the work do the learning.”  This is an oft-repeated phrase for classroom teachers, but it applies here.  If you phone in your rounds participation or your resident prep topics, you will have more to study prior to boards.  Take every opportunity to learn during your program. Notice I don’t say ‘work harder’- everyone works hard during their residency.  YOU can work smarter. You are earning low pay in a time-consuming, soul-crushing training program: get what you can from it.

2) Get perspective.  I only spent 3 weeks at a human hospital during my residency, but I learned a tremendous amount during that time.  My experiences during an anesthesia externship in Dublin and a critical care externship in Colorado dramatically improved my understanding of important, universal concepts.  As much as possible, seek out opportunities to learn from a wide spectrum of people during your residency.

3) Get time off.  Wherever you go after your residency, you NEED to negotiate for time off to study.  This should be time off from clinics, teaching, and most other responsibilities. You need to be able to dedicate a solid 6-10 hours a day to studying, and you can’t do that if you’re preparing for a classroom course or covering on call time.  This needs to be IN WRITING before you accept any job

4) Study seriously.  Get organized. Don’t blow off days.  Make progress every day. Find an accountability program or app if you need to.  It seems redundant for me to say “be motivated,” but I have met many people studying for boards who do not seem particularly motivated.  If this describes you, come up with some mechanisms which works for you. Play Minecraft and, during the Minecraft night, study. Read a Cracked article for every hour you study.  I had to go to Jason’s Deli to study because otherwise I had too many distractions. Whatever you need to motivate you, do that.

5) Practice.  Cooperate with others preparing for boards and give each other questions.  They can help hold you accountable. Ask your mentors (or former mentors) for any practice questions they may have.  When the anesthesia college used to do oral exams, my impression is that most people failed because they didn’t have a strategy, not because they lacked the knowledge.

The specialty board exam is the culmination of at least 10 years (and often much more) of higher education.  Why would you not dedicate every single resource at your disposal to successfully passing? Work smart, learn from many people, have dedicated time to study, be serious about studying, and practice.  It’s not a guarantee of passing, but it’s the best chance you have?

Should you do a Residency?

The Vetducator - deciding on doing a residency.
Photo by Paola Chaaya on Unsplash

The residency is the path to specialization.  There are a handful of veterinary specialties you can earn without a residency, but, for the vast majority, a 2-4 year residency is the only path to specialization.  So, really, the question of doing a residency is: Should you be a specialist? Obviously this is a question you need to answer for yourself, but here are some considerations which may help.

Timing.  There are many paths to being a specialist, but the most common is straight from vet school to residency (pathology, lab animal medicine specialties), or from internship to residency (for most others).  Some people may be tempted to go into practice first, and then go to a residency. While possible (and even successful for some specialties- like radiology), read the post about taking time off before deciding on this path- it will be harder than a more traditional path.

Salary.  Most, but not all, specialists make more, sometimes considerably more, than general practitioners.  If you have chronic health issues or family obligations, you may be able to take care of them more easily as a specialist.  Otherwise, the salary shouldn’t factor into your decision-making.

Academia.  Although some universities are figuring out they should hire general practice vets to train general practice-bound students, the vast, vast majority of faculty are still specialists.  If you want to go into academic veterinary medicine, becoming a specialist is really your best bet. And academia is pretty great!

Expertise.  In a study we did interviewing senior veterinary students, those interested in specializing expressed the desire to be considered experts and sought after for their knowledge.  As a general practitioner, you become more knowledgeable and proficient in a wide variety of domains. As a specialist, you become an expert in a single field. Both can be intellectually rewarding, but if you want the social status that comes with being The Expert, becoming a specialist is an easy path to that regard.

Time.  Do you want to spend 2-4 more years of your life on your education?  Or do you need to get on with things? This depends on your own life situation, probably largely determined by your family life.  Along with this is the reduced income you will have as a resident relative to entering general practice. This is only relevant during the residency, though, as your salary will be much higher once you are done.

Flexibility.  As a specialist, there will be fewer places in the country you can work.  General practitioners are needed even in very small towns, but Americus, GA, does not need a board-certified veterinary surgeon.  In general, as a specialist, you will work at a university or in a private practice in at least a small city.

Dedication.  As a resident you will work long hours for little thanks and little pay.  Can you suffer through that? Are you OK being treated as a minion for more time in your life?  It is physically and psychologically tiring, so you have to be dedicated to the pursuit or you will be miserable.

There are a lot of great reasons to do a residency, but it is not without cost, and it is absolutely not for everyone.  Talk to your friends, your family, and your mentors. It’s a difficult, but important, decision.

The Vetducator Podcast- Dr. Diehl

Podcast Episode 5 – Dr. Katie Diehl

Dr. Diehl and I worked together at the same institution and enjoyed discussing and engaging in research. Since I left, we have continued to work together and have some great collaborations. Dr. Diehl talks about the unique circumstances of finding and obtaining an ophthalmology residency as well as what she looks for in candidates and how she likes to help students be successful.

Dr. Coretta Patterson Vetducator Podcast Image

Podcast Episode 4 – Dr. Coretta Patterson

Dr. Patterson was my supervisor at one of my academic positions, and she was a very inspiring, positive, wonderful boss. She has a massive wealth of experience in academic veterinary medicine and mentoring students and faculty. She is compassionate and will also tell you what you Need To Hear in a positive way to make you a better veterinarian. Dr. Patterson talks about raising a family during training, how to progress successfully through an academic career, and what is great about internal medicine.

Links to topics brought up in this episode:

What to Get Out of Doing Research Work as an Undergrad

There is No Ideal Applicant

Words of Caution for the Aspiring Vet Student