Tag Archives: veterinary

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!

Avoid the Biggest Mistakes Made during The Match

Making your professional life successful is as much about what NOT TO do as it is about what TO do.  The Match is probably the highest-stakes professional selection in academic veterinary medicine- even more so than getting into vet school in the first place.  As a result of this pressure, people make a lot of mistakes which adversely affect their professional future. This is not an exhaustive list, just the most prominent ones I have encountered.

1) Trying to game the matching algorithm.  Please don’t do this.  I know it’s tempting. I did it because I was foolish, didn’t talk to anyone wiser, and the internet was barely a thing.  Rank the place you most want to go #1 and then move on to the next.

2) Not reviewing your application materials.  How is it possible there is a misspelled word in your letter of intent?  You have spell-check on your writing program, don’t you? Run basic diagnostics and read and re-read your materials.  Simple errors like this suggest to me that the applicant isn’t really all that interested in the position. If they were, they would have spent more time on their application.

3) Not sending out your application materials.  You must get others to read your letter of intent and CV.  Preferably veterinary academics who have looked at many such applications.  However, even your friends and family can be helpful. Tell everyone to be brutally honest.  Your goal is to get the best application possible, not to assuage your ego. You don’t have to take everyone’s suggestions.  In fact, if you send it out enough, you will start to get conflicting suggestions. But you must have others review them. You would not believe the poorly written letters I have helped people improve.

4) Not getting your ducks in a row in time.  Hopefully, you strategized your time to maximize your match success.  And you did give those writing letters of recommendation plenty of notice, didn’t you?  And you have gotten all your materials in well before the deadline, right?

5) Not preparing for interviews.  If you apply to institutions which hold interviews, you must do your research and study up on how to do a successful interview.  Failing to plan is planning to fail.

6) Delaying the decision.  I know some students and interns who waffle on whether to apply to the match and then make a decision at the last second.  That is unacceptable. If you THINK you may want to apply, set up everything as if you will. You don’t have to submit your rank list until January.  If you put in applications but don’t rank any institutions, you won’t match anywhere.

It’s not a long list, but you would be surprised at the number of people who continue to make these mistakes- hence this post.  Try to avoid being one of them and let me know if you need help!

Podcast Episode 7 – Dr. Jarred Williams

Dr. Williams and I worked together at an institution and spent many a night doing colic cases together. He has insight into the world of veterinary equine medicine and equine surgery. I hope his insight is helpful to those of you interested in that path!

Making Research in Vet School Work For You

The Vetducator: Stand back I'm going to try science.
Credit xkcd.

Now that you’re a vet student, you have it made.  You’ve achieved your life-long goal and just have to graduate.  But what if there’s something more? What if you want to do post-grad education, or work in public health, or contribute to society other than taking care of dogs, cats, and horses?  Maybe there is the opportunity to do research.

Conducting research during vet school opens a lot of doors.  You get to engage in scientific inquiry which hopefully has some ultimate effect on a patient’s outcome or quality of life.  You get to work directly with a faculty member who is (hopefully) interested in mentoring you. You get to build your CV and demonstrate to future programs that you are dedicated, responsible and focused.

Getting involved in research during vet school can be surprisingly challenging.  Undergraduate students often have whole offices dedicated to their success. For vet students, you have two easily accessible options: do a fellowship or volunteer your time.

A summer fellowship is often supported by various industry groups and provide a stipend.  A summer fellowship is a good first step, but it is unlikely you will finish a project in that amount of time. You may be a cog in the wheel of benchtop research, or you may start your own research project. If you want to continue to be a part of the project, you will likely have to volunteer once the summer is over.

Volunteering your time is also an option.  You may seek out a mentor who is doing something interesting or a mentor may announce that they are looking for students to help with research.

No matter how you get involved, before you start, you should talk openly with your potential mentor to make sure you are a good fit.  The experience needs to be positive for you and for your mentor, otherwise ill feelings can creep in.  First, you need to determine what you want out of doing research:


Experience.  You just want to try research to see if it is something that may engage you.  This is great- tell your prospective mentor(s) this. You don’t need to commit to what you want to do for the rest of your life at this point.

Relationships.  Doing research often puts you in closer contact with a faculty member than in the normal course of vet school.  You often work closely with them and meet with them regularly. You now have a mentor- you can ask them for advice, for help with letters of application and CVs, and for letters of reference.  Mentors are incredibly important in your career, and identifying and working with one through research can be a strong bond.

CV Building.  If you intend to go on to further education after graduation, research may bump your application slightly.  Be aware that almost every serious applicant I have reviewed for internships has some research experience. Just engaging in research doesn’t do much to set your CV apart.  Having a paper which is submitted for publication or, even better, accepted for publication is more remarkable. If you are buried in an author list, that is not particularly memorable.  If you are the first author on a peer-reviewed publication, evaluators may take notice. In general, having research experience and publications in your internship application won’t make or break it, but it may give you a slight edge.  If you intend to pursue a graduate degree, demonstrating some interest and experience with research during vet school is key.

An example of an improved CV from vet school research.

Second, you need to kick ass doing research.  If you want to secure a positive recommendation, just doing what you are asked/told is not enough.  You need to identify opportunities to do more. Answer emails promptly. Complete tasks eagerly and rapidly.  Many vet students do research. If you want to excel, you have to stand out. Follow a project through to the end or, if you absolutely hate what you’re doing, be clear and upfront with your faculty mentor.

Finally, make use of the resources you developed with this experience.  Don’t hesitate to ask your faculty research supervisor for help with applications.  If possible, make progress on a publication which has your name on it. The world helps those who help themselves.  Don’t just expect everything on a silver platter because you helped with a research project. Make use of the skills and connections you made.

Research during vet school can be rewarding and illuminating.  If you have the slightest inkling that you may want to do something other than primary care medical practice, dip your toe into research.  You may find out something about yourself.

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.

Vetducator Dr. Waitt Podcast on a Horse

Podcast Episode 6 – Dr. Laura Waitt

Dr. Waitt and I worked together at the same institution and we met when, on her first day on the job, she jumped in to help with the anesthesia OSCE. She is also a WSU grad and a terrific person with whom to work. She has insight into the equine veterinary world which I don’t have which she shares during this episode.

Making the Most of a Residency Interview

The Vetducator - residency interview image.

Your application is compelling enough for a program to spend the time interviewing you- congratulations!  Many residency programs conduct interviews, and it can be a significant variable in the decision making. Sometimes these are by phone, sometimes by video, and sometimes in person.  Obviously, you should follow the general guidelines for each of those interview types as well as prepare so you can present your best self. More specifically, here’s how to make the most of your residency interview experience.

This is not only a chance for them to learn about you but for you to learn about them.  If you get matched for a program but will be miserable, you may not finish. Every year there are residents who drop out of their long-dreamed-of specialty because the program wasn’t a good fit for them.  You need to make sure this is somewhere you can be happy for three or four years. Here are some questions to ask the program directors or existing residents to help you decide:

Both program directors and existing residents:

  • What’s it like to live here?  What do you like about it? What do you dislike about it?
  • What are the students/interns like?  What are the interaction with them and the residents?
  • What are the responsibilities of the residents?  Do they do general ER duties or call or only do specialty emergency duties?
  • What is the interaction with other specialties like?
  • What is the strategy for ensuring residents successfully complete a research project?  Are there opportunities to do more than the required project?
  • Are there opportunities or requirements to teach in lab or classroom or rounds room?  What kind of support is available to help nurture resident teaching skills?
  • If you could change anything about the program, what would it be?

Program directors:

  • What do you do to ensure resident success?
  • What are the plans for program improvements?
  • What have you learned from previous residents that has caused you to change the program?

Existing residents:

  • What have been your challenges with this program?  What did you like about it?
  • Would you have chosen this program if you knew then what you knew now?
  • What would you change about this program?

Asking incisive questions will ensure that the program knows you are serious and engaged.  What else can you do to impress them during your short interview time? Remember, their goal is to determine if you will be successful in their program.  You want to assure them you are competent, dedicated, and enthusiastic.

You need to have examples from your experience that demonstrate your best characteristics.  Are you willing to come in odd hours- tell a story during your clinical year or internship when you did and had a great time.  One of my best days in vet school was 22 hours long and started with a hemilaminectomy and ended with a GDV. The resident on duty said excitedly, “Well, what else would we be doing on a Friday night?” and I was in enthusiastic agreement.  Just saying, “Yes I work hard and I would love to be your resident” is not enough. Demonstrate you have those characteristics with stories.

Each residency program is different, but characteristics that are generally looked for include (in no particular order): curiosity, willingness to work hard and long hours (no laziness or cutting corners), detail oriented, compassionate, humble, teachable and willing to accept and use feedback/criticism, able to handle setbacks, good at managing stress, pleasant to work with/positive, ethical, good critical thinking skills, knowledgeable, effective at communication, enthusiastic, dedicated, and cooperative and helpful.

The residency interview is a difficult experience to navigate.  You need to get information to make sure you would be happy there while assuring them you would be happy there and a great catch for them in a very short amount of time.  Have a plan ahead of time. If you fumble asking questions or coming up with examples of how you’re awesome, you’re sunk. It’s a fairly high stakes experience. You spent undergrad, vet school, and maybe an internship to get here.  You can’t just hope it will work out. You must prepare.

How to Be Successful: Show Up

The Vetducator - success by opening doors by showing up.

Show up.  That’s it.  End of blog post.  You can believe me and stop reading or you can read on if you need more convincing.

Living in the South is strange in so many ways.  One which you would not expect is the approach service workers (plumbers, electricians, roofers, contractors, etc.) take to showing up.  That is, maybe they will and maybe they won’t. Not just being late- that’s any service worker. You make an appointment, and they never show or call to reschedule.  This is distinctly different than in other parts of the country in my experience. It seems like a simple arrangement- you show up to do a job, I give you money. Don’t you like money?  Apparently, laborers in the South do not. Every now and then you find one who actually shows up, and they get all my business and my friends’ business. Until they also eventually start to not show up.  It’s a weird way to run a business, but this was a huge sign I had of how important it is to show up.

Teaching martial arts for 20 years, I see this constantly.  Who are the black belts? The best students? The most competent, the stellar athletes?  Not at all. The black belts are the students who showed up. They came to class and kept coming to class, slowly learning and progressing.  The most amazingly athletic students- they were aiming to be a +1– they fell off because they actually had to apply themselves to progress rather than rely on their raw talent.  The slow, steady, quietly competent and attentive students were the ones who became terrific martial artists. They showed up.

The best vet student, intern, resident, or faculty isn’t necessarily the smartest.  Smartness helps, as does wisdom, but to be excellent you first need to show up. If you’re a student, be there before anyone else on your team and leave after everyone else on your team.  Offer to take extra on-call responsibilities. Study when you get home. One vet student with whom I worked answered a call to participate in a research project. She was so capable and engaged that she became integral to other projects, and now she has her name on three published research articles.  Those who put the time in, get the rewards.

This goes all the way up.  The most productive faculty aren’t necessarily the smartest or the most ruthless.  I know some faculty members who never come into their office when they are off clinic duty.  They’re fine faculty members, but they won’t ever be amazing until they start showing up.

We’ve talked before about how to avoid being a -1: aim for zero.  Here is where we start to see how you can go from a zero to a +1. Start by being quietly competent. Then show up.  The world is run by those who show up.

How to Choose Your Internship

The Vetducator- screen shot of the VIRMP matching program website.

Where you got to vet school does not substantively affect your internship prospects, but the institution where you do your internship may affect your future residency prospects.  Selecting the most appropriate internship position is particularly important for those bound for residencies. For those bound for private practice, the primary goal is to avoid a bad internship.  Internship programs change in quality over time, so there is not a reliable database of bad internships. These are some variables you should keep in mind as you consider your future.

First, I am very evidence-motivated and fact-oriented, so I made a table.  This table had each program as a row, and column headings for important variables, some of which are listed below.

Specialties.  If you want to do an ophtho residency, of course you have to go somewhere which has ophthalmologists.  Otherwise, you want to have surgery and internal medicine at a bare minimum.

Number of interns.  If you are one of two interns, you may not have as many opportunities for collaboration and support in the program.  If you are part of a 28-intern mob, you may become just another faceless, poorly-paid doctor. Decide where you want to fall in this spectrum.

Amount of emergency work.  Every intern’s salary is justified by the ER work they do.  Some programs provide good backup for their interns on ER so that they learn quite a lot.  Some leave them to sink or swim. The more time you spend on ER seeing cases, the less time you may have with specialists who are focused on teaching you.  Be cautious of anything over 25% ER time.

Cost of living/Salary.  Most interns get paid poorly, but being paid poorly in Athens, GA is different than being paid poorly in Philadelphia, PA.  In Athens, you can get a decent duplex in a safe part of town. In Philadelphia, you’ll probably be longing for those self-defense courses you took in undergrad.

Reputation.  This is only relevant if you are interested in a residency.  In general, academic internships have a better reputation, mostly because their faculty are ‘plugged in’ to the post-grad system and know people at other institutions.  The reputation is not necessarily related to the actual quality of the program. If you get an internship in a small private practice with one surgeon and one internist, it may be harder to get a residency than if you get an internship at, say, the University of Tennessee.

Geography.  Most people I know ignore geography, and it’s understandable as to why.  It’s only a year- you can dig yourself out of snow every day for that short amount of time.  For a rare few, this is an important variable. For most people, though, geography is (and should be) irrelevant.

Identifying an actively bad program is a different decision tree, and requires personal contacts at a large array of institutions.  Assuming most programs aren’t bad, the characteristics listed here are the ones I think are most useful in deciding where to go. What are other variables you think are important in internship program selection?

Internship Letters of Recommendation Flowchart

Last week we did a whole series on letters of recommendation. One of the most complex is for those applying for internships. Therefore, I created a (relatively simple) flowchart to help you decide what letters of recommendation you should get for internship applications.  

Core disciplines are internal medicine, surgery, and emergency/critical care.

Ancillary disciplines are cardiology, neurology, oncology, anesthesiology, and radiology.  

Peripheral disciplines are anyone outside your species focus (e.g. you are applying for a large animal rotating internship and the letter-writer is a small animal internist), ophthalmology, dermatology, pathology, behavior, theriogenology, and ABVP specialties.

The Vetducator - internship letters of recommendation flowchart.
Click for larger image.