Why Are We Here?

I was watching an interview with my favorite role-playing game GM, Brennan Lee Mulligan, and something he said made me literally sit up in my chair.  I thought, “This.  This is why I teach students.”  And if students understood it, life would be so much easier for themselves and for me.  First, though, a quick story.

I was teaching ECGs in the cardiovascular system course this semester, and got to 2nd degree AV block.  One of the students asked, “I’ve heard about different types of 2nd degree AV block.  Can you talk about those?”  My answer: “Good question!  However, that is clinically insignificant.  I recommend you focus on being able to identify the arrhythmia and determine if it’s a problem.”  My answer was informed by years of working with general practice veterinarians who often worried when their patient developed a 2nd degree AV block, even though everything else was fine.  Here’s the deal: if you can’t even determine if a 2nd degree AV block isn’t a problem, you don’t need to waste space in your brain worrying about Type I vs Type II.

What was Mulligan’s advice?  Here it is:

“I’m not here to raise your top, I’m here to lift up the bottom. …  Your worst show is pretty good.”

I spend a lot of time thinking about competence, medical error, and patient safety culture, so this exchange spoke deeply to me.  I’m happy when a student does a procedure quickly and expertly.  I’m pleased when the residents make a tough diagnosis.  But I am MUCH more interested in making sure that BAD things don’t happen regularly.  Bringing up the bottom.  When you’re tired, frustrated, irritated, and distracted, I still want you to be able to be a reasonably competent doctor.

This is just an extension of Aim for Zero.  It’s fine to want to be an amazing clinician, but I am MUCH more impressed by students who are consistently competent.  Their lows are still pretty good.  During their worst case, they at least know what to do and TRY to do it.  Medical error is the third leading cause of death in the US.  Anything we can do to raise up the bottom improves patient care and patient outcome.  Focus on bringing up the bottom, not trying to raise the top.

Writing a Cover Letter for a Letter of Recommendation

Once you’ve identified mentors to write you a letter of recommendation (LOR), the next step is to reach out to them to ask that they write said letter.  In that process, you might want to write a cover letter which provides them with some information to help them write the LOR.

Why write a cover letter?  The cover letter provides some information to the individual writing your LOR.  In some instances- such as if you’re having a specialty faculty member write an LOR for an internship or residency- this is unnecessary.  The writer knows the deal, knows the positions, and hopefully knows you.  In other instances- such as if the writer isn’t a veterinarian or you’re applying for a unique position- it can be very helpful.  The writer needs direction about what, exactly, to say.  When in doubt, ask your mentors if they think a cover letter COULD be useful.

What to include in a cover letter?  It doesn’t need to be long.  In fact, the shorter, the better; one page should be your maximum.  I would start with thanking the letter writer for being willing to write you a LOR.  Next, introduce the position to which you are applying and why you are applying.  Give a description of the position or a link to the position description.  Next, indicate what you believe would be most valuable for the letter writer to include.  For example, “If you can speak to my reliability and independent work, that would be particularly valuable.”  Finally, conclude with more appreciation and any deadlines which are relevant.

I think a cover letter could be valuable for any applicant for any position before, and including, vet school.  For internships, residencies, and faculty positions, you shouldn’t need one.  Keep it simple, to the point, informative, and appreciative and you help your letter writers provide exactly what you need for your applications.

Examples of Good Letters of Intent

I’ve spent a lot of time writing about personal statements.  There are general rules, which I’ve written about here and here.  Also, there are important and simple grammar rules to pay attention to, like these and these.  I’ve provided some examples of poor letters of intent, so now it’s time to look at some good examples.

These were all applicants for our internship program, and I obtained their permission and have removed identifying information.  Go and read each one, and then I will provide my analysis of why I like it.  As always, evaluators are highly variable, so don’t take my perspective as the gospel truth- just one perspective.

First Example

The first paragraph is simple and solid.  It expresses appreciation- of which I am a huge fan- and makes it clear who they are and for what they are applying.  I get the impression that this person is interested in oncology, but isn’t totally fanatic about it, the latter of which can be off-putting.

The second paragraph has some narrative elements in it, and I love that they acknowledge the bad part of their interest (oncology is sad) while explaining why they don’t think that’s the most important aspect of it.  I love that they talk about supporting clients, connecting with them, and helping them.

The third paragraph is a delight to me.  They show that they know what specialty medicine is and also what they can bring.  They don’t do so in a boastful way.  I also like that they’re specific.  They don’t say “I’m a good leader”; they say “oral communication”.  They share some of their experiences and what they’ve gotten from those.

The fourth paragraph talks about celebrating good things.  It’s a very positive message.  They share that they have a variety of perspectives from living different places, which is tremendously valuable to be a self-actualized human being.  They acknowledge they have learned a lot and have more to learn and grow.

Overall, I find the message is very positive, earnest, and insightful.  I feel like I know this candidate a little bit.

Second Example

The first paragraph clearly shows what they want in a program and what they feel their positive characteristics are.  They mention a specific interest, but don’t obsess over it.

The second paragraph is all about communication.  It doesn’t use “communication” as a buzzword.  They clearly articulate what their experience is and how that affected them.

The part of the third paragraph I like the most is “safe and inclusive learning environment”.  But, again, it’s supported by their experiences.  I believe that this writer understands what that means, rather than just, “yeah, yeah, this is something we’re supposed to say.”  I believe their experiences WILL help them make a positive learning experience for those around them.

The fourth paragraph is similar- they give experiences they have had, how they learned from those, and how they grew.  Great stuff.

The final paragraph has me convinced that they have a growth mindset and are humble.  They want to learn more and are willing to listen.  They acknowledge the difficulties an internship entails, so they have some idea of what they’re getting into.

Third Example

Once again, the opening paragraph is descriptive, clear, shows their professional interests, but isn’t overly aggressive.

The rest of the letter uses examples from their experience to highlight their own skills and professional ambitions.

The final paragraph emphasizes their interest in learning, which makes me think they have a growth mindset.  Appreciation expressed when closing the letter is also nice.


1) Be genuine, authentic, and earnest.

2) Use examples from your experience to highlight your skills and how you have grown.

3) Demonstrate that you have a growth mindset and are enthusiastic.

4) Be positive.

5) Don’t go overboard or try to be too much.  As always, aim for zero.

Two Types of Imposter Syndrome

Photo by Chris Yang on Unsplash

Imposter Syndrome is the feeling that you are in a certain position but don’t deserve to be.  Someone made a mistake somewhere- you’re not as good as people think you are.  You feel inadequate as a consequence of this belief.  Even though there’s external evidence of your success (e.g. getting a job, getting good annual reviews, getting good student evaluations, getting a publication), you believe that you are incompetent.  You also feel like you don’t belong where you are.

There are a variety of imposter syndrome quizzes online and, whenever I take them, I score fairly highly.  But when I think about it, I don’t FEEL bad.  I don’t feel like I shouldn’t be where I am.  I’m doing _exactly_ what I think I’m good at- being an academic!  I feel accomplished and happy in my professional position.  I contrast this with some of my academic friends, who have told me they don’t feel secure in their position and that they don’t “deserve” to be there.  What’s going on here?

In looking at imposter syndrome quizzes, there are a lot of questions that I believe relate to humility.  “I hesitate to brag about my accomplishments” and “I don’t like drawing attention to my successes.”  I think humility is a very important quality, particularly for people who are going to be effective in a team and be effective leaders.  I try to embrace these aspects of humility, so that’s how I perceive it, rather than an imposter syndrome characteristic. Note that humility is different from false modesty. False modesty, or pretending you’re not as competent as you are, is a form of dishonesty. It’s important to show confidence and competence as a DVM to your clients so they feel comfortable with your recommendations. 

There are other questions like “I believe the success I’ve had is a fluke” and “Even when I do well, I don’t think I really deserve it.”  I believe these questions are addressing the question of privilege.  EVERYONE who’s been successful has been a fluke!  Luck has a tremendous impact on success.  And I’m a tall white man raised in an upper middle class socioeconomic status household with two loving parents in the richest country in history.  I have every advantage imaginable- of COURSE I don’t “deserve” success.  It’s an accumulation of genetics, my upbringing, and how society treats me. I definitely worked hard (see below), but there are people out there who worked much harder than I did but may not have been able to achieve the same results due to being in a less advantageous situation.

Then there are questions I absolutely don’t identify with, like “ Success doesn’t come easy for me; I have to work at it” and “I worry about feeling overwhelming shame if my incompetence is ever revealed.”  Success HAS been easy for me.  I have realized in recent years that my ability to work long hours and enjoy doing so is yet another privilege because for some people working hard is HARD.  And I don’t feel incompetent, so I don’t worry about anything being discovered there.

I don’t know, maybe I do have imposter syndrome.  But I don’t FEEL like I do.  I feel like I am humble, appreciative of all the things in my life which have led to my success, and recognize the important part luck plays in our success.  That seems to meet a lot of the criteria for imposter syndrome, but I genuinely believe those questions miss the mark for me.  Maybe I’m in denial.

Grade Inflation Is Bad

I believe that grade inflation hurts everyone- admissions committees, faculty, and parents.  But, most importantly, it hurts students.  To understand why, we have to examine the purpose of grades and what grade inflation is.

Why Grades?

There are two types of assessments.  Formative assessments are designed to provide feedback to the student so they know what they need to learn/improve on.  Summative assessments are designed to measure the student’s performance against a certain benchmark to determine if they can do (or know) a certain thing.  A grade is primarily a summative assessment.  Although a student who earns a C on an assignment may intuit that there is something that was missing, it doesn’t provide them much specific feedback, so it doesn’t really help the student improve.  So the grade is illustrating if the student’s performance is adequate or not.

We need both summative assessments and grades in order to determine if students learn the material and, most importantly for your professional progression, to be able to compare student academic performance with other students.  It is assumed that a student with an A grade is more academically competent than a student with a B grade.  This does not mean the A grade student is smarter, worked harder, or knows the material better!  Any academic worth their salt knows that assessments are imperfect and really only measure one thing: how well the student could perform on one particular assessment.  However, there is some decent evidence that GPA correlates with successful completion of veterinary school, and performance on certain standardized exams also predicts future success.

So, we need grades to compare students, so we can select the ones most likely to be successful.  One of the worst things for any vet school is to have a student be dismissed because of poor academic performance.  Ideally, that student shouldn’t have been admitted in favor of another student who could successfully complete the program.  This required the admissions committee to know who is likely to be successful, and grades are an important (but certainly not the ONLY, and probably not THE MOST important) way to determine that.  What happens if every applicant has gotten all As and has a 4.0 GPA?

Grade Inflation

Students want to earn higher grades, because it is an external validation of their abilities (which every human likes) and because it makes them more competitive for future position applications.  So, if they don’t get the grade they believe they deserve, they grumble.  To their parents, to the faculty, to administration.  In the face of that grumbling, faculty members have two choices.  Stand firm, continue to assign the grades they believe the students earn, and continue to get student evaluations which are poor ONLY BECAUSE OF THE GRADES BEING GIVEN.  Or, give in to the grumbling and give students higher grades, often resulting in “easy As”.  

The students are happy- they get to have the grade they think they deserve.  Parents are happy- their beautiful snowflake IS a wonderful student!  Administrators are happy because students and parents aren’t grumbling to them.  The faculty member collects decent student evaluations, but perhaps there is some nagging feeling that they aren’t actually being an educator, just a rubber stamper. Problem solved.  Or is it?

Grade Inflation is a Problem

Believe it or not, humans like to be challenged.  According to self-determination theory, three things motivate humans: autonomy (the ability to do what we want; freedom), competence (getting better at skills; mastery), and relatedness (interaction with others; socialization).  Let’s look at the competence piece.

Why do people learn to play musical instruments?  There are surely a variety of reasons, but I doubt one of them is “because it’s easy.”  Why do people play competitive sports?  Nearly no human pursuit which requires a degree of skill is pursued because it’s easy.  Why would a student pursue an academic course that’s easy?  What sense of satisfaction would that student have?  If every course is an easy A, does the student feel accomplished for earning that 4.0 GPA?  Maybe some students do.  Maybe they want the easy path.  But every year I get student evaluations along the lines of, “This course was hard, but I learned a lot, and I appreciate it wasn’t just a walk in the park.”  Some students, at least, recognize the value of hard work and earning their grade.

There are some vet schools where the #1-10 ranked students in a class all have a 4.0 GPA.  How does that help internship programs which use GPA as a selection criteria?  Are they really ALL equally good at academics?  How come this happens year after year at the same vet school, but doesn’t happen at other schools?  This is an example of systemic grade inflation.  The faculty have caved over the course of years and decades to the whims of the students, and now the GPA has lost any utility in distinguishing student ability.

Grade inflation removes a genuine challenge for students, makes the point of grading obsolete, and undermines the whole academic system.


What about pass-fail courses?  Do students brush those off because they don’t get a grade?  Well, it depends.  Are the other courses they are taking that semester graded?  If yes, then they will ABSOLUTELY brush off the pass-fail course so they can focus on the graded courses.  What about if the whole institution is pass-fail?  Now you’re starting to move into the realm of competency-based veterinary education (CBVE), which is a terrific direction to go in.  In CBVE, the main question is CAN THE STUDENT DO THE THING?  It’s a yes-no variable, just like pass-fail.  This gets away from grades and towards the question of competency, which I think is a good idea.

What about courses which are TOO hard?  We all know courses where the average on the first exam is 50%.  I think this is up to the instructor to set clear expectations.  I typically tell students that a B grade is an average performance, a C grade is below average, an A grade is dramatically above average, and a D or F indicates they did not learn the material.  The problem is, most applicants to vet school are above average.  Compared with undergraduate students.  Once they get to vet school, the average resets.  Now an average vet student is expected to earn a B (according to my rubric).  But, guess what, those students aren’t accustomed to feeling average and are accustomed to getting As and so rail against getting a B or, god forbid, a C.  Is my class “too hard” or are their expectations of their performance not aligned with what I describe as my expectations?  If every student in my class earns an A, fantastic, I believe they have earned it.  That is statistically unlikely, but not impossible.  I don’t think grading on a curve is appropriate.  Set the expectation so the students know, then they perform to that expectation.

“I think the work I did was worth an A!”  I hear this all the time.  Often there are complaints that the exam questions were too hard, or weren’t related to the material, or there was too much to study, etc. etc.  Here’s the unfortunate truth.  As I mentioned earlier, grades do not evaluate how much work you do, how smart you are, or how well you learn the material.  They ONLY evaluate how well you do on the assessments.  Some students are “good test takers” so will perform better than students who are not good test takers.  There’s nothing to be done about it.  We can’t do an fMRI of everyone to see the neural connections being made when they are contemplating a problem.  Assessments measure what they measure, which is the student’s ability to answer the question the instructor created.  This is one reason we use OTHER metrics to evaluate applicants.  The GPA is imperfect.  It doesn’t perfectly predict a student’s future performance, it maybe only predicts ~20% of it.  The rest is not captured by grades. My wife has a theory that some students who routinely get As on exams have memorized the material but don’t necessarily retain it long-term, whereas students who make Cs may have really learned 70% of the material and will retain it for longer, because the portion they did learn they learned well. 

What To Do

To students: accept that your grade may not reflect your actual ability.  I did terribly in the preclinical courses in vet school.  I was on the cusp of the bottom 25% of my class rank.  But when I got to clinics, I could answer questions most of my classmates could not because I learned what was clinically relevant rather than the ridiculous minutiae which comprises most vet school exams.  I stayed in the clinic later than most of my classmates, volunteered to take their call shifts, and otherwise worked hard and got fantastic letters of recommendation for my internship.  I rinsed and repeated through my internship and residency.  You can be successful without amazing grades.  Focus on actually LEARNING the material rather than memorize and dump.  And you really can’t do anything about how the professor grades.  Focus on your circle of control and let it go.

To faculty members: stay strong and create clear expectations.  Maintain high standards- the students actually DO want to be pushed to learn.  Explain to them on day one that you are fighting grade inflation and expect them to have to WORK if they want an A in your class.  Make sure you are on their side and not opposing them.  Be prepared for the students to grumble.  Believe that, nonetheless, you are making the world a better place.

To parents: let your children be independent, self-actualized human beings and stop trying to live their lives for them.  Maintain interest and inquiry and encourage them and be supportive, but don’t go to bat for them.  They are adults, they need to learn how to handle life without you holding their hand. Some of the most confident adults I know learned early on that, as long as they did their best, they didn’t need to worry about their grades. They learned not to rely on external validation for their sense of self.

To administrators: realize that some faculty members probably need some coaching in setting and maintaining clear expectations (that is, some of them may WANT to fail a majority of the class and need guidance on that).  If a course is difficult, but the students perform well grades-wise nonetheless, be sympathetic to the students and validate their feelings without necessarily validating their beliefs that the course is unfair.  Be supportive of faculty who are trying to do the best thing for the students, and provide guidance if the faculty aren’t sure what the “best thing” is.  Particularly be supportive of efforts to combat grade inflation.  Maintain high standards, set clear expectations.

I can’t remember what inspired me to add this topic to my list of blog ideas, but I obviously feel passionately about it.  I do get frustrated by students who seem to focus only on the grade rather than learning the material.  In an ideal world, if they learned the material, their grade would reflect that.  I suppose I could do a 2-hour intensive oral exam with every student…  that would probably solve the problems with the assessment not accurately measuring their knowledge.  But I doubt most students would consent to that, and I don’t have the time to do that for 130 students. 

Grade inflation is a systemic problem, like racism. It can’t be solved with a single individual, or a single institution. This isn’t an ideal world, and never will be.  So we need to acknowledge the problems with grade inflation and work to prevent it.  Otherwise, one day, an A won’t mean anything at all.

Why We Declined Vet School Applicants Last Year

I participated in the interview and selection process for a vet school this year, and we had another amazing pool of applicants.  Nonetheless, the three faculty conducting the interviews generally agreed to place some applicants on the “do not offer” list.  This is not out of any malice- we just needed a way to reduce the pool to a manageable number, because there were so many amazing applicants.  

On a fundamental level, the admissions committee wants to make sure that students succeed and graduate.  The worst outcome for us is to have a student who fails or drops out of school.  The student has spent a ton of money by that point, the institution has invested tremendous resources, and another applicant who could have been successful was passed over.  So that is the admissions committee’s primary goal: find applicants who will get through vet school.  We have several secondary goals, like making sure the student body (and hence profession) is diverse in skills and backgrounds, but those goals can’t be met if the first goal isn’t met.

I went through and reviewed the themes of the applicants we chose not to extend an offer to, and am sharing those insights so you might know why you didn’t get an offer or so you can strengthen your own application.  I lumped them into five categories: experience, interview, academics, extra-curriculars, and references.


Everyone knows you need a certain number of experience hours to be competitive for vet school.  Most schools have a minimum number to be considered for an interview, and then an average number for those actually admitted.  Evaluators differ, but I like to see that an applicant knows what they’re getting into.  What if they get in and then hate it?  Working as a tech at a single practice for three years may or may not hit that goal.  I personally like to see a diversity of experience- spending time at several different practices, even just shadowing, would provide the applicant different perspectives from different veterinarians.  Also, I prefer to see current experience.  Having worked in a vet clinic eight years ago isn’t as meaningful- the profession has changed since then, and will change over the four years they are in school.  Recent, diverse experience (preferably including a variety of species) is what I look for.


Depending on the institution, the interview may be non-existent, a minor piece, or a major piece of your application.  The things we noticed during interviews which detracted from the application included speaking too much, not having thoughtful answers, not being enthusiastic, acting immature, lacking perspective, and being disheveled.  You’ll notice all of these are highly subjective.  I often found myself thinking, “This person ‘presents’ to me as immature, but their letters all indicate they are very mature.  What do I do with this information?”  All I can say on this point is to get some practice interviewing, research how to do a good interview, and do your best.  Don’t worry about it TOO much, though. Different evaluators look for different things, and you can’t be all things to all people.


Vet school is academically challenging, so we are looking for _evidence_ that the applicant can handle it.  If the applicant never took a regular-to-heavy course load (e.g. over 14 credit hours), if they had consistently poor grades, if they had a series of W over several semesters, and if they otherwise don’t have evidence that they have academic resilience and grit, we worried about their application.  In vet school, students routinely take 18-22 credits.  If the applicant has only ever taken 12 credits AND didn’t have something very time-consuming outside of school (full-time job, being in the orchestra, being on a college sports team), what evidence do we have that they can handle that 18-22 credit load?  If they have consistently poor grades, will they earn a D or an F, causing them to leave the program?  If they had one W, or a semester with several Ws and a reasonable explanation as to why, no worries.  But if they had several W over several years without a rationale, that makes us worry.  There’s no withdrawing in vet school- if you don’t do ALL the required classes, you don’t go on through the program.


This might just be me, but if you’re a straight A student with tons of hours of veterinary/animal experience but NOTHING ELSE- no hobbies, no leadership, no research, no pursuits of any kind other than school- I’m not sure I want to work with you or that you’ll be a good vet.  You’ll probably be a good student, so I don’t worry too much about this applicant making it through the program.  The problem is, there are dozens of other applicants who are straight A students, have tons of hours, and were ALSO captain of the dance team.  As a veterinarian, I believe you are a leader.  You can learn to be a leader during vet school, but if you have SOME kind of experience beforehand, I think that makes you a better applicant. You have probably heard a lot about the importance of work-life balance in general, and especially in the veterinary profession. If your whole life so far has been focused on the singular goal of getting into vet school, I worry about your ability to establish a good work-life balance in vet school and as a vet. Extra-curricular activities demonstrate that you can find things outside of work or school that you enjoy and can help you maintain that balance.


Nearly all of the references were glowing, “This is the best person I have ever worked with in 20 years”.  It’s hard to make much distinction when all of the letters say that.  So, even one bad letter is really obvious.  Also, if the letters are primarily not from veterinarians, or not from supervisors or professors, I wonder a little bit.  Does the applicant really know what they’re getting into?  As I’ve mentioned before, don’t send letters from family friends, even if that family friend is ALSO the veterinarian who has employed you since you were a 15-year-old kennel worker.

Looking back through the list of applicants we definitely DID offer a position for, I see a lot of these taken as notes.  That is, we ADMITTED many applicants whom I made a note, “not much veterinary experience”, “tends to go on a bit”, “only worked at one clinic”, “not a lot of extracurriculars”, “no large animal experience”, “academics questionable”, “references not great”, “not a heavy course load during school”, “doesn’t present as very mature”, “not insightful answers to questions”.  All of that is to say that you don’t have to hit ALL of these to be a good candidate.  But if you lack something from the above in your application, you should make sure that all of the rest of your application is amazing.

Financial Advice for Interns, Residents, and New Graduates

Photo by Jp Valery on Unsplash

The other day a work friend of mine and I were chatting about student loans and the current forbearance for student loans.  They are working in academia partly to get Public Service Loan Forgiveness (PSLF), which pays off all loans after 10 years of working for a qualifying charity or government organization.  Unfortunately, they didn’t contribute during their residency years, so instead of having 7 years of academic work to reach PSLF, they have the full 10 years.  

We were lamenting the fact that new house officers and graduates are told very little about how to manage their financial life.  I gave a presentation to our incoming house officers in 2022 on how to manage their finances, and wanted to share some top tips with you all.  If you expect to have significant student loan debt on graduation (more than 2x your income), these tips are essential for you.

  1. If at all possible, go to an academic internship and residency.  Your 4+ years of training can be credited towards PSLF, reducing the number of years you would “need” to work for an academic institution to get your debt forgiven.
  2. DO NOT PUT FEDERAL LOANS INTO FORBEARANCE OR DEFERMENT.  The system automatically sets up deferment for your first 6 months.  You will need to consolidate your loans in order to start paying as soon as you can.  Here’s why.  If you are doing an income-driven repayment (IDR) scheme for student loans (IBR, PAYE, REPAYE, PSLF), your payment is calculated on your discretionary income.  Discretionary income is equal to taxable income minus 150% of the poverty line ($19,320 for a single person in 2021).  Average intern salary was $35,423 in 2020 and you only earn money for the half of the year you’re an intern (the other half of the year you were finishing school).  The standard deduction for a single person was $12,550.  So your 2020 taxable income would have been $35,423/2-$12,550 = $5,162. This is below the poverty line, so your discretionary income is $0.  PAYE charges 10% of discretionary income.  $0 * 0.10 = $0 per month.
    1. Basically, you can get credit towards paying off your loans by paying zero dollars.  So for PSLF you will only have to work 9 years after your internship, and for PAYE you’ll only have to work 19 years, as opposed to 10 years and 20 years.  You get 6 months of credit for FREE.
    2. After the new year of your intern year, your income is still probably going to be very low. You can get credit towards PSLF or other IDR by paying very small amounts of money. It’s better to make payments when your salary is low and accumulate the credits for those payments rather than defer payments and have more payments to make later when your salary is higher, because your payments will be much higher.
  3. For new graduates (or anyone, really) doing IDR with a higher salary (average about $100k in 2021), put money into tax-deferred retirement plans (401k, 403b, IRA).  IDR is calculated based on your _taxable_ income.  Money put into a 401k isn’t taxed.  Here are two examples.
    1. No 401k contribution. $100k (salary) – $12,550 (standard deduction) – $19,320 (150% poverty line) = $68,130 (discretionary income).  For PAYE, $68,130 * 0.10 = $6,813/12 = $568 per month.
    2. 401k max out.  $100k (salary) – $12,550 (standard deduction) – $19,320 (150% poverty line) – $20,500 (401k contribution) = $47,630 (discretionary income).  For PAYE, $47,630 * 0.10 = $4,763/12 = $397 per month.
  4. For everyone, if your salary is relatively lower than you expect it to be in the future (all house officers, some new graduates), contribute to a Roth IRA if at all possible.  Your tax rate in internship/residency will be incredibly low.  For a Roth IRA, you pay taxes now (when your tax rate is very low) and that money never gets taxed again (i.e. in the future when your tax rate goes up as you earn more money).

That’s it- it’s not a lot, but it can be a little bit complicated.  If you need help, be sure to seek out good advice at a fair price- a flat fee financial advisor who specializes in student loan issues.  But you need to make these decisions ASAP.  Not figuring these steps out can cost you hundreds of thousands of dollars.  Use your time in advanced training to your maximum advantage financially!

What I Learned Reading Intern Applications Last Year

Although time consuming, I greatly enjoy reading the intern application packets we get.  They are packed full of interesting stories, and the accomplishments of these applicants honestly amazes me.  Many of them have faced serious personal hardship- cancer diagnoses, generational poverty, fleeing war-torn countries.  Many of them are truly inspirational.  Most of them are just fine, and a few have some serious flaws in them.  I am going to share some things I noticed reading applications this year which I hope help your own application.  Realize these are my own personal idiosyncrasies and may not represent the majority of evaluators.

CV Considerations

Don’t use a fancy format for CV with information within side panels.  It makes it hard to follow and it alters the display of the PDF.  An example is displayed here. 

DO use a standard CV template and separate out information into appropriate sections.  Don’t have “CE” listed under “Education”; give it its own area.

Including veterinary job descriptions in the CV tells me you don’t know veterinary medicine

Do not list references as “Character references”.  These are professional references.  Why describe them at all?  Just label them “References”.

I expect SOME leadership and/or research experience.  Most applicants have been Treasurer or President of a vet school club or did some tutoring or did a summer research project.  If an applicant has none of those, I make a note of such.  It isn’t a fatal flaw, but it makes me worry that all they did during vet school was study, and maybe they’re not great with people.

I ignored the GPA this year and barely glanced at class rank.  Even when I did know the class rank, I don’t think that knowledge affected my decision.

Personal Statement Considerations

Excellent letters are rare but very impressive to me.  They are well written and tell me about the candidate.  I suspect most of the writers of truly excellent letters have some non-scientific skills (i.e. scored higher on the English than Math portion of the SAT).

Well-crafted phrases are a joy.  “…create a safe and inclusive learning environment…”  “As someone who benefits from a feedback-driven learning environment”  “…the importance of tailoring communication to everyone by never applying judgement…”  “…I am dedicated to creating an environment that celebrates what every clinician, student, and client can bring to the table…”

Terrible letters are recitations of the CV, disconnected stories, stories that don’t go anywhere, and blocks of text.  I have a hard time reading every word of these letters and frequently score the applicant down for them.

If you have something weird in your CV (missing a year of activity, moved countries), it needs to be explained in your letter.  If you jumped around jobs a lot, that has to be explained in the letter.  If you have worked at five different places for only 3-6 months, I’m going to assume you’re hard to work with.  If there was some legitimate reason, you need to explain that behavior.

Letters of Reference

A truly glowing letter of reference (“This person is brilliant, pleasant, and humble, and is the best student I have worked with in the past 5 years”) can balance out a poor CV and letter, but can’t get you back at the top with me.  If you have a poor letter or CV, you’re not going to be in my top third.  Other people may feel differently- I know some evaluators look almost exclusively at the letters of recommendation.

Those are the primary thoughts that jumped out at me as I was reading application packets last year.  I hope these help you in your journey!

On Writing

I turned out to be a huge Stephen King fan as an adult.  Growing up, my sister loved his horror stories, but I don’t really like horror, so I never read any King. Until, that is, I read The Dark Tower.  That sold me.  Now Stephen King is a go-to for me, particularly when I’m going on a long drive and want an audiobook I can expect to enjoy.

A few years ago, I read his book On Writing.  It guides many of my writing decisions to this day, including a post about being well-spoken in a letter.  I just re-read On Writing and wanted to share some more detailed insight I think will help you write a better letter.


“One of the really bad things you can do to your writing is to dress up the vocabulary, looking for long words because maybe you’re maybe a little ashamed of your short ones.”

I see this ALL THE TIME in letters of application.  I suspect it’s because the writers think that they need to use a big vocabulary to demonstrate they are intelligent applicants.  I would argue the effect is exactly the opposite.  Most of the time, I assume the writer hit the thesaurus to find a bigger word, not necessarily a better one.  King’s advice is to use the first word that comes to mind, and I absolutely agree.  Keep it simple.  Your goal is to get your point across, and the best way to do that is with straightforward language.

Adverbs and Passive Verbs

“I’m convinced that fear is at the root of most bad writing. … If, however, one is working under a deadline-a school paper, a newspaper article, the SAT writing sample- that fear may be intense.  Dumbo got airborne with the help of a magic feather; you may feel the urge to grasp a passive verb or one of those nasty adverbs for the same reason.”

As a general rule, use active words.  Avoid adverbs.


“It’s hard for me to believe that people who read very little (or not at all in some cases) should presume to write and expect people to like what they have written, but I know it’s true.”

If you want to be a decent writer, you have to read a lot.  The best case is if you can read lots of letters of intent.  This is pretty difficult to do, but maybe not impossible.  At least do an internet search for examples of letters of intent to get a sense of how they should flow.


“You can’t aim a book like a cruise missile, in other words.”

You never know who will be reading your application.  Maybe they are someone like you.  Maybe they love to see a bit of an arrogant attitude in an applicant.  Maybe they are a pushover and give everyone five stars for their letter.  You don’t know what your audience wants, so you can’t tailor your letter perfectly.  Instead, make it YOUR LETTER.  Make it good, but make it something that is authentic to you.  Don’t just do what you’re told.  Write what you feel.


“Your job in the second draft- one of them, anyway- is to make that something even more clear.  This may necessitate some big changes and revisions.”

Don’t be afraid to get a first draft just to get SOMETHING on paper, then do a serious slash and burn with subsequent revisions.  You don’t need to keep anything from your first draft- although some good snippets should probably survive.  I helped a student this year with their VIRMP application and their final version was _dramatically_ different from their first version.  And, I believe, dramatically better.  There were some ideas and specific sentences which survived from the first version, but it was almost unrecognizable.  You SHOULD make serious changes to your second draft.

Be Kind to Yourself

“Screw-ups happen to the best of us.”

It’s OK if you realize after your first draft that you forgot to include something important.  Or to realize that the whole tone is off somehow.  It’s fine.  Writing is never perfect.  Even once you have revised it and had others review it, your letter may have flaws.  Hopefully the spelling and grammar, at least, is correct.  But if you realize your letter is flawed after submission, grant yourself a pardon.  Everyone makes mistakes.  Just make sure you learn from it for next time.

What’s the Point?

“What I want most of all is _resonance_, something that will linger for a little while in Constant Reader’s mind (and heart) after he or she has closed the book and put it up on the shelf. … Most of all, I’m looking for what I meant…”

What are you TRYING to communicate?  That you’re the best applicant, sure.  But how?  By sharing stories of your qualities?  What do you want the reader to walk away thinking?  This is complicated, but it’s the path from a good letter to a great letter.  I have read numerous good letters and my feedback is often, “This is good.  It’s solid, clear, good language, etc.  You could submit this as-is and I think you would be a strong candidate.  If you want to make it better, you have to think about what the POINT of each of these sentences is, and what you want the reader to KNOW about you at the end.”  If a student takes me up on the challenge of writing a great letter, the final is often substantially different from that first draft.  And I think the major difference is asking yourself, “What’s the point of this sentence or paragraph?”


“In the spring of my senior year at Lisbon High- 1966, this would’ve been- I got a scribbled comment that changed the way I rewrote my fiction once and forever. … ‘Formula: 2nd Draft = 1st Draft -10%’”

Cut, cut, and cut some more.  Trim out all the excess fat.  Get rid of the adverbs.  Get rid of sentences which don’t have a point.  Cut until the product is so clean, so tight, that everything has a place and is there for a reason.  This will help you stick to the 1-page limit of many letters of intent.

Those are the lessons I noticed re-reading On Writing that I wanted to share with you.  If you haven’t read it, I encourage you to.  There’s a lot of good advice in there, particularly for those writing fiction.  But these are the gems which I think are most helpful for my own readers.

Significant Other’s Job During Academia

With only 38 accredited veterinary schools in the US and Canada- and many of those in small rural towns- starting vet school, internship, residency, or a faculty position can be a distinct strain on a romantic partner’s ability to get a job.  Within the US, I count about 10 veterinary schools in a decent-sized city where jobs may be varied and plentiful.  Otherwise, most of the towns are college towns, often far in the countryside, where getting a skilled job may be difficult.  How do you handle your significant other’s job when you move to a town with a veterinary school?  I see three potential solutions- chime in if you have more!

1) Location-independent job.  This is probably the best option, so I’m putting it first.  Since the pandemic, many companies have realized they don’t actually need people on site to do their job.  Some jobs have become completely location independent.  So your significant other can move with you freely, wherever you want to go!  Best case scenario.

2) Local job.  This seems obvious, but can be a challenge depending on the industry/profession your significant other is in.  If they’re in banking, for example, I’m not sure any of the cities with a veterinary school would be satisfactory.  Your significant other may need to compromise on their own career progression while you work on yours.  

This happened with my best friend in college.  His wife was going through vet school, and he was working as an administrative assistant in one of the departments on campus.  The deal was that, once she graduated, he would go to school to get his PsyD.  This has all sorts of repercussions- from personal satisfaction in work to financial consequences of “starting late” for saving and retiring.  In my friend’s case, they got divorced so he didn’t get his “side” of the deal (he still went to PsyD school, it was just much more difficult financially).  My wife ended up being a lab instructor for a year- earning a pittance and far below her two-doctorate-qualifications- primarily to stay “in academia” so her CV didn’t have a big hole in it while I worked at a vet school in a new city for us.

3) Spousal hire.  This is only an option for a faculty position.  I have addressed it before, but the principle is to get a job offer at the university, then leverage that offer into an offer for your (obviously qualified) spouse.  It’s far from a sure thing, though, so I would definitely not make this “Plan A”.

Ideally, your significant other can find something they want to do wherever you are.  But I think this is harder, given the few numbers of vet schools and where they tend to be located.  Work fills an important role in many people’s lives, not the least of which is financial.  Going off to vet school, internship, or residency without your significant other is difficult.  Accommodating their job prospects is an important consideration in the whole process.