Changing Courses

The author and his dog.

This is a guest post from a reader who reached out to me for advice on pursuing an internship and residency. When I followed up a year later, he had changed courses. I asked if he could share his experience, and this is what he wrote. Enjoy!

Like most of you, I had a very clear idea of what I wanted to do with my DVM (or VMD) before I set foot in the door. And like most of you, that idea changed. And it changed again, just for good measure. The DVM, although largely a clinical degree, is quite a versatile degree. This has been discussed ad nauseum at conferences, symposiums, professional development courses, and guest lectures so I won’t belabor the point here. Initially, I dismissed this as a nice idea that didn’t ultimately mean anything. After all, why would I train as a veterinarian if I wasn’t going to be seeing patients?

Something people often overlook when discussing the versatility of our training is exactly what the training entails. Certainly, learning how to diagnose and treat disease in animals is the primary focus of our education. More than anything though, veterinary school reinforces the inductive (or clinical) reasoning used to make reasonable conclusions from the available data. This, in my opinion, is where the versatility lies.  

One of my first interests was public health, which gradually transformed into laboratory animal medicine. A summer internship in this field, however, tempered my enthusiasm. It was mostly a good experience, but it would have been a poor fit for a number of reasons, primarily the lack of opportunities to collaborate on basic science research without additional training. After this came an interest in diagnostic imaging, a specialty that could allow me to maintain a research and clinical career. Until my 4th year, I was convinced that this was the right choice for me, so my efforts were focused on putting together a competitive application to match for rotating small animal internships.

The summer after my first year, I participated in the NIH T35 program, which trains veterinary students in hypothesis-driven research (an experience I recommend). A seminar in this program was focused on alternative career paths for veterinarians, and one of these was the NIH T32 program. This program helps train DVMs to become independent investigators by awarding a select few institutions generous grants. These grants are then used by the institutions to provide a competitive stipend to DVMs pursuing a PhD. As I started to write my personal statement for the VIRMP, a question kept hounding me. Do you really want to do this?

Pursuing a clinical specialty had been my goal for quite some time because it would allow me some time for research, teaching, and clinical service, especially if I were to find a position in academia. However, after witnessing a problematic situation with a brand-new faculty radiologist and the expectations our school had regarding their appointment, I started to wonder what this would really look like. There were other considerations that introduced doubt, but this was fresh in my mind.

Small animal rotating internships are great for learning, networking, and becoming an excellent doctor, but they are inherently not a fun experience. I won’t lie and say this didn’t factor into my decision not to pursue specialty training. Another significant problem I started to contemplate was the time investment that this advanced training in diagnostic imaging would require. A small animal rotating internship is required before applying to any diagnostic imaging residency, unless years of experience are substituted. The match rate to diagnostic imaging residencies has been sitting at around 15% for years, so most applicants must also do a specialty internship if they hope to match. Most of these residencies are three years, but there are more four-year programs popping up. The total time spent in this advanced training could range anywhere from 4-6 years, depending on skill, connections, and a good deal of luck. Of course, there is also the issue of being paid very little for the duration of this training, more in private practice certainly, but the residency programs are fairly uniform. For a person passionate about diagnostic imaging, these might not be insurmountable obstacles, but I realized I was not that person. So, what was I passionate about?

A recurring theme through all of this was research, so why not start there?  Thinking back to my time in the NIH T35 program, I started to consider doing a fellowship through the NIH. Browsing through the list of participating institutions, and going through those institutions to find participating mentors, I found someone whose research interests in wildlife epidemiology, antimicrobial resistance, and emerging zoonotic diseases very closely matched my own. This mentor was a DVM/PhD to boot! After a Zoom meeting, we agreed that I should submit an application, start re-learning some technical skills like programming, and plan to start working in her laboratory. The entire process felt much more natural and less anxiety inducing than The Match.

There are many reasons I chose to do a post-DVM PhD rather than pursue specialization, but it is worth noting that some of these are very personal reasons that may not be important to you.

  1. Money: Certainly, obtaining board certification in diagnostic imaging would have been a more lucrative career choice. Matching for a residency though, is no guarantee. The prospect of potentially going through two years of advanced training, on a low salary, without something tangible to show for it was not appealing. The salary I will make on an NIH T32 fellowship is about twice what I would make in any of the academic post-graduate clinical training programs.
  2. Time: Becoming a radiologist is an enormous time commitment, taking up to six years depending on the caliber of your application and where you end up matching. For me, this is almost untenable both financially and professionally. My fellowship will take no more than three years to complete, largely because this is the length of the grant but also because my mentor expects high productivity from me.  
  3. Research: This program will train me to be a researcher. Almost all of my time will be spent doing research, teaching, and learning how be successful in science. Post-graduate clinical training programs include some degree of research, but the primary focus is understandably on developing advanced clinical knowledge, skills, and abilities.
  4. Versatility: Holding a PhD as well as a DVM will open many sectors for employment that might be unavailable without this credential. Academia would be my preferred destination for many reasons, but there are many high-quality research programs in government and in the private sector as well.

If you are considering a career in research and you have any questions, please feel free to contact me at mbrooks1821@gmail.com.

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