Autonomy

I’m reading a book right now about habits– how and why they form and how to use them.  In it, the author cites a study in college students where they are put in a room with freshly baked cookies and told not to eat them for 5 minutes.  Then, they have to complete a willpower test.  There were two groups.  One was asked to please not eat the cookies and was treated kindly, with respect, and they were asked to share any ideas about how to improve the research.  The other was ordered to not eat the cookies, and that is all.

Neither group ate the cookies.  But the group who was ordered to eat the cookies performed much worse on the willpower test.  The researchers supposed it was because participants had a small degree of autonomy in the research.  When students were treated like machines, they didn’t do as well as when they were treated like humans.

Humans LOVE autonomy.  We HATE being told what to do.  This is one of the core tenets of Self-Determination Theory (SDT), which I have discussed before.  Study after study has demonstrated that, when you take people’s autonomy away, they perform worse, and when you give them autonomy, they do better.

For example, one study had college students construct Erector sets.  One group was given a variety of options for approaching construction and the other was given very specific steps and goals to meet.  The group with the greater autonomy reported more interest, satisfaction, and persistence than the group with less autonomy.  This study was published over 40 years ago, and there have been hundreds confirming the results since then.  So why do we keep telling people- for The Vetducator context, students and veterinarians- what to do and how to do it and with whom to do it?  Why in the world don’t we embrace autonomy?  I have some ideas.

First, America has Puritanical underpinnings and the protestant work ethic pervades our culture.  I’m not a sociologist, but my impression is that these beliefs often focus around punishment and rewards, and doing what you are told to do.  Puritans have rules, and by gum we will follow them.

Second, restricting people’s autonomy and telling them what to do “makes sense”.  It’s assumed that those in positions of power are better, and therefore more able to dictate how to do a thing.  I’m the expert, or the teacher, so I know best, and you do what I tell you.

Third, it feels good.  Who doesn’t love ordering others around?  Have your every whim met?  There’s a reason slavery predates written history and was practiced in almost every ancient civilization; when people focus more on their individual interests than the collective good, it’s easy to fall into the habit of exerting your will over others’.

Fourth, restricting autonomy works… in certain circumstances.  On an assembly line, you want everyone doing their correct steps.  In the operating room, you want everyone following the checklist.  It reduces error and improves outcomes.  However, an important caveat is that the _best_ systems ALSO incorporate autonomy with strict rules.  For example, the ability to shut down an entire assembly line if a worker feels something is unsafe or not working.  Toyota used this to great effect when they embraced the principle of Kaizen.

Fifth, we tend to see things in black and white.  Humans love right and wrong, yes and no.  Total autonomy?  All chaos!  Total control?  Absolute smoothness!  But that’s not what giving autonomy is.  In the Toyota example, they still had to follow the rules, but just that little bit of extra autonomy made all the difference.  You don’t have to go whole hog, even a little more autonomy makes people feel more in control of their lives.

All right, so autonomy is awesome and we should do more of it, but humans are not great at embracing autonomy.  So what do we do about it?

Teachers – Give students as much choice as possible.  Let them choose from a variety of assignments.  Let them choose the topic to cover.  Let them decide who to work with (including only themselves!).  Give them choices for which questions to answer.  The ACVAA specialty written exam embraced this principle years ago- you had to answer 5 out of 8 essays.  Consider giving them the choice on when to submit assignments.  Wherever you can and it makes sense, give students choice.  I realize that all of this might read as “chaos”, but I assure you it can be done in a controlled manner which does not throw your entire semester into disarray.

Bosses – Allow employees to decide how to spend their time, what to work on, with whom, and how.  Maybe not all the time, probably not for every task.  For clinical faculty, someone has to be on clinic duty- we can’t all be off doing different fun research projects, but the faculty can decide who is going to cover that block.  Again, it’s not all or nothing.  Give credit for peer-reviewed publications regardless of the “impact factor” or “robustness” or if it’s medical or educational in focus.  This allows faculty to explore their interests, rather than feeling compelled to constantly pursue projects that will only get into high impact factor journals.  Let people set their own schedules and deadlines.  Wherever it’s not absolutely essential, do not impose rules.

Students – Unfortunately, you don’t get a lot of control over your own autonomy.  Sorry.  So, try to do what you can within the confines of the rules you have been given, and find autonomy wherever you can. Enjoy looking through and choosing electives. When sitting in a restrictive class, remember that you CHOSE to go to vet school.  Choose when to study, how, and with whom.  Recognize that you control when during the day and week you work on a project, even if it has a specific deadline.  On a group project, work with the others to choose roles most suited to each member.

Once you realize the importance of autonomy, you start to see everywhere- situations where people have autonomy and where they don’t.  You can see people who don’t have a lot of autonomy- they’re just going through the grind day to day, almost with a sense of hopelessness.  When you see people who have some autonomy, you see that they engage with their tasks in a more substantive way.  Having autonomy isn’t a panacea- there are still days that suck- but having some is better than having none.

Writing External Letters for Promotion and Tenure

Photo by Scott Graham on Unsplash

We just went through P&T “season” in academia and I was asked to write about a half dozen external letters and I read several dozen written for our many faculty who were going up for promotion and tenure.  I learned some lessons I wanted to share to make the process easier for you, when the day comes when you get asked to write an external letter.

What is an external letter?

At most institutions, one of the criteria for promotion from Assistant Professor to Associate Professor is developing a regional and national reputation.  For promotion from Associate Professor to full Professor, it is developing a national and international reputation.  There is a lot of data that contributes to this distinction, but one of the most important is external letters.

External letters are solicited from faculty at other institutions, in your discipline, at or above the rank to which you are promoting.  That is, if you are promoting to Associate Professor, external letters from other Associate Professors or Professors will be solicited.  They may know OF you and possibly know you personally but have not worked substantially with you.  This is because the point of the letter is to find out what an unbiased individual in your field knows about you and your work.  In almost all cases, external letters are solicited by the department chair, although one private institution I know of has their faculty contact possible letter writers.

Once an email is sent to a potential letter writer, they respond yea or nay.  If there is a potential or actual conflict of interest, it is brought up at this time.  For example, one faculty member for whom I was asked to write a letter has done several research projects with me and currently had a couple of projects ongoing.  I told the department chair this in replying to their solicitation and they agreed this was too much of a conflict of interest so went on to ask someone else.

The letter writer usually gets the department’s promotion and tenure guidelines and the faculty member’s CV.  They may be given student evaluations, an explanation of what to write, and other supporting documents.

How to write an external letter

If you are provided with directions, follow those carefully.  Some institutions specially ask “would this person be promoted at your institution” and others explicitly direct you to NOT indicate if the person would be promoted at your institution.  Some will provide specific items they want you to comment on.  Some will give you very little direction.  Read and follow the directions.

Something I noticed in several letters I read this year and appreciated was opening with a brief note of thanks.  Something along the lines of, “Thank you for providing me the opportunity to review Dr. X’s application and provide this letter of support.”  It struck me as gracious and generous and I’m going to start doing it.

You should start with how you know the candidate.  Have you ever worked with them on a committee?  Met them at a conference?  Worked on a paper with them?  Know them purely by reputation?  This allows the reader to put your letter into context and make sure a conflict of interest does not exist.

As usual, I like a five-paragraph essay format, so the final sentence in the opening paragraph lists the major items you are going to cover.  This is almost always teaching, research, and service.

Each paragraph then summarizes what the letter writer believes are the most salient points in the applicant’s career that makes them suitable (or not) for promotion.  This assures the reader that the writer actually evaluated the candidate’s application packet.  It also highlights important parts of the candidate’s career so the reader can put the information in context.  Personal experiences and perspectives can reinforce some ideas.  For example, one letter I read this year said, “Dr. Y was the “it” professional at this national conference.”  That suggests the candidate has a solid, wide-reaching reputation.

The conclusion paragraph should include the letter writer’s ultimate recommendation and summary.  Usually, this is “I enthusiastically support Dr. X for promotion to Professor based on…”

If you decide to not recommend the candidate for promotion and/or tenure, you should be explicit and declarative.  The department head needs to be able to understand your reasoning so they can advise the candidate and the faculty at the candidate’s institution.  A negative external letter is a pretty big deal.  It’s not impossible to successfully go through promotion and/or tenure with a negative letter, but it’s going to make the process much more challenging.

Conclusion

Writing external letters is a professional responsibility higher-ranked faculty members have as part of being in academia, similar to doing peer reviews for journals.  It’s an important and serious responsibility which can have significant consequences on the career of other faculty members.  If you agree to write an external letter, take it seriously and make sure to follow the instructions.

You Found This Blog Too Late

Photo by Vicky Sim on Unsplash

What do you do if you have found this blog after you have submitted your application materials, or after you did an interview, or after you scheduled your clinical year?  You read some of the advice and realize, “Uh oh, I didn’t do that.”  Well, now what?  Fortunately, all is not lost.

First, realize that the information on this blog is just one person’s opinion.  I have a lot of experience, but different people look for different things.  If you read some piece of advice and think, “Dang, I didn’t do that, everyone will think I’m terrible!”  The truth is, they won’t.  There are many people in this world and they all prefer different characteristics in mentees, students, future colleagues, etc.  Don’t beat yourself up because you didn’t do something you read on here.  It’s very likely the people you are interacting with value things other than what I value.

Second, it’s in the past, so it’s beyond your circle of control.  If you’ve already scheduled your senior year and you won’t have essential specialties before the VIRMP applications are due, there isn’t a lot to be done about it.  Your schedule is set.  So don’t stress about it.  It is what it is, make the best of it.

Finally, take whatever advice you CAN apply now and start to do so!  If you feel you didn’t do well on an interview , work on improving for the next time.  If you messed up your schedule, try to do the best you can with what you have.  There are very few things you can do in your veterinary progression which are fatal flaws.  Almost anything can be dealt with.  Find the advice which can work for you, adapt it for yourself, and apply it for next time.

Veterinary Locums Work

Image of a plane flying overhead.
Image by Leszek Stępień from Pixabay

The White Coat Investor blog recently published an article about locum tenens work in human medicine, and it made me realize there are some notable differences from veterinary locum work.  Many people may not know about locum opportunities, and it’s a benefit of academia I’ve mentioned before.  For those who are interested in academia, or even those in private practice who want to spend time teaching, this is an introduction to veterinary locum tenens.

Locum tenens literally means “place holding” and is a short-term work commitment.  Many locums are short- 2-4 weeks- while others are long enough to cover maternity leave- 6-9 months.  Let’s break down how to find locum jobs, what the process is like, and advantages and disadvantages.

Finding Locum Jobs

Most locum jobs will be found in academia, although private practices will also sometimes employ locums, particularly when they’re also searching for a full-time and hard-to-get specialist.  Finding locum positions depends on the discipline.  In anesthesia, an email gets sent out to ACVA-L, to which most anesthesiologists are subscribed.  Other disciplines without a universal listserv may use more specialized listservs (e.g. Society of Veterinary Soft Tissue Surgery), post on Linkedin, post on social media, or put the listing up on the specialty’s job board website.

Personal connections are also a valuable source for locums.  About half of the time I do a locum, it’s because I get an email from someone I know who needs a locum for a specific time frame.  Many institutions which have an open position posted for a new faculty member will be amenable to locums- you just have to email the contact listed on the full-time position posting or reach out to the department head and ask if they are interested in you providing locum coverage.  Some universities may list locum positions on their employment site, although this is uncommon.  As far as I know, there are no third-party companies facilitating locums like there are in human medicine.

Locums Process

At least in anesthesia, once an email goes out to ACVA-L, you only have maybe a day or two to reply before the locum position has been booked up, in my experience.  So you have to be ready to jump on an opportunity that comes up.  Usually, institutions are looking for a locum for specific dates.  If it lines up with your availability (you’re off clinics and don’t have major teaching/research responsibilities), you email the contact person and indicate your willingness to help.  Sometimes, the details of the locum will be provided up front (e.g. pay, what expenses the institution pays vs. what you pay), but many times you have to ask in the email.  Most locums pay between $5-10k/week, and some of them cover your expenses (travel, lodging) while others do not.

Here’s a really important note: some employers will pay you as a W-2 and some will pay you as a 1099.  If you have to pay for your own expenses, and they pay you as a W-2, you CANNOT write off those expenses on your taxes!  I have no idea how institutions justify paying you as a W-2 employee (since you’re obviously a casual contractor, which is what 1099 is designed for), but I paid about $1k more in taxes one year than I had to because of that classification.  Ask before you agree: does the institution pay for your expenses and, if not, are you paid as W-2 or 1099?  At this point in my career, I’ve stopped taking any job which pays me as a W-2 and doesn’t take care of expenses.

Once you have agreed to do the job, some places will send you a contract.  They will walk you through the licensing process. Getting a license in another state can be a significant pain.  You have to get a letter from EVERY state you’ve EVER had a license in to indicate you didn’t do anything bad in that jurisdiction.  The AAVSB can facilitate this- for a fee, of course.  I’ve found it easiest to just pay the AAVSB fee rather than go through the hassle, but if you only have one or two state licenses, it may not be too bad for you to DIY.

If the institution is going to take care of your expenses, they may book lodging for you or you may book it and get reimbursed.  Sometimes, they have a lodging budget so you could book a nicer place and just pay for the difference yourself.  Usually, you will book your own flights.  If you have to pay for a license, you’ll usually get reimbursed.  If there are visa issues (e.g. locum in Canada), the institution’s lawyers will generate the paperwork and get everything set for you.  You may have to pay the fees at the time of the visa (obtained when clearing customs), but they will reimburse you.

If the institution doesn’t take care of your expenses, you have to pay for it all out of pocket and, hopefully, they give you a higher pay to compensate for everything.  I usually budget $1500/week for expenses, although this is highly location- and individual-dependent.  If you don’t mind AirBnBing a room in someone’s house, your expenses will be much lower compared to staying in a hotel.

When you show up on Monday before 8am, you should have a contact person to call who will escort you where you need to go.  Most locums start at 8am on Monday with orientation and paperwork and pharmacy access, then you start clinic responsibilities some time mid-morning.   If you’ve locumed there before, they may skip those steps and you can go right to the clinic area and get started.

Some locums require you to do primary emergency duty, some require you to be back-up to their residents/staff, and some have no emergency requirements.  Most will require 7-days-a-week coverage of clinic responsibilities, just like your “usual” job.  That is, if you have patients to discharge on Sat or Sun, you have to take care of them.  Some will require you to be on call until 8am the Monday after your week, making it impossible to do a locum week and then do a clinic week back home.  You may be able to finagle things- such as starting the locum on Sat or Sun before your official start date so you can leave on the Sun at the end of the time- if you have worked there before and know the people.

Some locums will give you the specialized communication devices the hospital uses (e.g. Vocera) or a dedicated cell phone for use during your time there.  They’ll provide you with access cards and maybe a name tag.  Some will provide scrubs, but I always bring my own anyway because they usually don’t have many sets in my size.  Otherwise, you should bring your own lab coat, stethoscope, and similar paraphernalia you use in your regular day-to-day clinic work.  Don’t forget to return everything they gave you before you leave on the last day!

You will have set up direct deposit with the institution at some point.  When the pay period after your locum rolls around, presto, the money gets deposited into your account.  If it was a W-2 locum, they will have taken out taxes.  If it was a 1099 locum, you’ll have to pay taxes when you file next year, assuming you have a regular full-time W-2 job.  If all you do is 1099 jobs, you’ll need to file estimated quarterly taxes. 

Advantages

  1. No committee work, politics, classroom teaching, equipment issues, or anything else not related to clinical teaching and patient care.  If all you want to do is be on clinic duty, teach house officers and students, and then leave the job without worrying about everything else normally associated with academia, locum jobs are perfect.
  2. Good pay rate.  If you do 50 weeks of locum work a year, you could earn in the $250k-$500k range.  On a practical level, that’s unlikely given the sporadic nature of locum offerings and coordinating the schedule.  
  3. Working vacation.  Whenever I do a locum, my wife comes along for at least part of the time, and we have a nice little trip.  We obviously can’t go on a hike 4 hours away from the hospital, or take a river cruise, but we can have a grand fun time nonetheless.  We love doing locums in Saskatoon– it’s now one of our favorite places to visit in the summer!
  4. Different types of practice.  I learned to place coccygeal arterial catheters when I spent time at CSU.  I learned how to do TAP blocks at UMN.  Remifentanil is cheaper than fentanyl in Canada, so I use it for large dogs when I’m there and get more experience with it. It’s fun to see how everyone practices differently and try out some drugs and approaches you don’t regularly have access to.
  5. Appreciative admin and coworkers.  Usually, you are solving a problem when you do a locum job that everyone appreciates.  Without you, the full-time people would have had to work more, or a service would have to close, or students wouldn’t get to be on the rotation.  My experience is that people are happy to see you.

Disadvantages

  1. No benefits.  You don’t get a laptop or an office or healthcare or any of a myriad of other benefits associated with full time academic employment.  If you have a regular job, this isn’t a problem.  But, if you’re only doing locums, you have to consider those other expenses in your budget.
  2. Away from home.  If you have pets at home, they will need to be cared for.  If you have children and you can’t bring them with you, or any other responsibility that requires you to be home, it’s hard to do locums.  If everyone comes with you, it can be a grand adventure.
  3. Questionable continuity of care.  You may pick up patients you don’t know about and you may work on patients which you then have to transfer.  I think this is pretty similar to most academic jobs where people rotate being on and off clinics but, at home, you can at least chat with the other specialists since they’re around.
  4. Minimal acclaim.  You won’t earn any teaching awards, or “clinician of the year” awards, or getting approval from your department chair, or similar external validation.  You do the job, you get paid.  That’s it.

One of the many benefits of an academic position is that we get consulting time when we can pursue locum opportunities without having to take annual leave.  At one institution, I had 20 days a year I could do consulting.  At another, I had one week a semester.  This is time you can spend generating extra revenue on top of your already perfectly sufficient academic salary.  You can supercharge your savings, or progress to financial independence, doing locum work.  It’s also a nice potential bridge to early retirement.  I could do 3-4 months of locum work a year to pay for all our expenses, and delay having to dip into my retirement savings.  Even doing 1-2 months would be a significant benefit in terms of income in a partial retirement.  If you haven’t tried it, I definitely recommend it!

Be OK Saying “no”

A couple of weekends ago, I presented a CE talk.  It was a one-hour talk which I’ve done before.  I enjoyed giving the talk- the attendees laughed in all the right places and I felt like I dispensed some good advice and information.  The talk was preceded by a four hour drive, and followed by a four hour drive.  All told it was ~9.5 hours out of my day- it took up my entire Sunday.  I didn’t get paid for it.  As I was driving down, I thought, “What in the world am I doing?”  I wasn’t OK saying “no”.

A common problem in veterinary medicine is that generally we are giving people.  We want to help.  We want to contribute.  We are all leaders, and the best leaders lead from the front- taking on tasks, solving problems, and making things better.  As a result, a lot of veterinarians end up taking on a lot of responsibilities.  Early career faculty members are especially bombarded with doing things, but even those who get to Associate or full Professor rank often have significant miscellaneous responsibilities.

We chair committees.  We’re on patient review boards.  We do CE for our staff.  We write communication materials and blogs for our clients.  We have hospital director or section chief duties.  We lead interviews.  There’s a whole bunch of Stuff that happens which we take responsibility for, even though it’s largely beyond the scope of responsibilities for our job.  I think it’s because we want to help and we have a hard time saying “no”.

I think saying “no” is hard because we don’t want to let others down.  When someone comes and asks us to help do something, maybe we feel flattered.  “Hey, they asked ME to help!  That means they must think well of me!  I should return that positive regard with a positive answer!”  Maybe we feel we need to have a reason to say “no”, that the default answer should be “yes” unless there’s a “good” reason.  Sometimes we may even feel busy and burdened already and yet say “yes” regardless.

Nearly every email that comes into my inbox I read and think, “Can/should I do that?”  Judge the undergrad poster presentations.  Take on an intern mentee.  Fill out a survey.  Give a CE talk.  Take a locum gig for a few weeks.  Provide feedback to the COE on accreditation standards.  Serve on this regional veterinary symposium subcommittee.  Do an external evaluation for someone’s promotion & tenure.  The asks are nearly endless.

And, until the past year or so, almost all of these I said “yes” to.  They sounded interesting, or I wanted to help, or I felt bad for the organizer because I thought they wouldn’t get many volunteers.  This had several significant effects on my career and life.  One, I had a lot of neat opportunities and interactions and learned a lot of different things.  Two, I kept very busy, with very little downtime.  Three, I sometimes did things that built up my CV and supported my career.  Four, I got a reputation for being someone who is willing to help and take on tasks.

Note that not all of these consequences are bad.  In fact, a lot of them are good.  Perhaps the most important to consider is #2, staying busy.  As a general rule, I’d prefer being more active than more idle.  In contrast, my best friend is unhappy if he has to work more than 20 hours in a week.  So this is something that will differ by person and is worth reflecting on.  I’ve also discovered that it can change.  Early in my career, if I wasn’t in my office most of Saturday and part of Sunday, I don’t know what I would have done with my time.  Nowadays, I like having time for walks or reading or other brain-downtime activities.  So, I have learned to start to say “no” more often.

Now I am being far more selective about the things to which I say “yes”.  I don’t have hard-and-fast rules (those would probably help this process a lot), but now when I look at an email I generally think, “This isn’t my responsibility.  Someone else can do this.”  I don’t think the world will collapse without my participation, but it’s hard telling myself that. Additionally, at this point in my career, I don’t NEED to bolster my education, CV, or reputation. In the example from the beginning of this post, I could have referred the CE opportunity to a junior faculty member who would benefit much more from giving the talk. As we advance in our career, we can say “no” in order to let the newer generation of vets say “yes”.  

It’s OK to say “yes”.  It’s ALSO OK to say “no”.  If you ALWAYS say “no”, I think you may miss out on some cool opportunities.  If you ALWAYS say “yes”, I think you may get burned out.  So, it’s a balance.  But most veterinarians have a harder time saying “no”.  So I encourage you to reflect on that and give yourself permission to say “no”.

Four Year Anniversary!

Well, the blog is going well even though, honestly, I haven’t been doing as much as I would like to do with it.  It looks like we’re reaching more people, which is fantastic.  I’ve had some positive emails from people who have gotten faculty positions and house officer positions who found the blog valuable.

I’m still mostly reaching pre-vet students through the Facebook APVMA group.  There’s no centralized house officer group to reach out to, unfortunately.

I have lots of ideas and think there’s still more advice to give.  I would love to write several “Complete Guide” posts which summarize everything for people applying to vet school, internships, residencies, and faculty positions.  I only got 14 posts in this year, which is definitely not enough to keep traffic continuing to flow.  I thought I was posting less because I wasn’t flying as much, and I originally wrote the blog when flying.  But I’ve done several long trips lately and still nothing.  

I’m not sure why.  Maybe it feels a bit more like work than fun, and I feel all my best advice is already out there.  Here’s to hoping this next year brings some fresh inspiration and enthusiasm to this endeavor!

Thank you all for reading and if any of you would like to contribute a Guest Post, please let me know!

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.

Conclusions

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.