AMC SA rotating internship w/o externship

[snippemall]

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I’m a 4th year veterinary student who is unfortunately very late-to-realize that I may want to specialize in internal medicine after completing my 4th year IM rotations. In my ideal world I would complete an internship at AMC but unfortunately with my clinical year schedule already finalized I don’t have time to be able to do an observational externship there before the match. My understanding is that AMC doesn’t consider applicants that haven’t completed an externship. Is this wrong? Otherwise my application will be very strong - I have a 4.0 GPA, leadership positions/extracurriculars in the shelter medicine/accessible veterinary medicine/community medicine realm, and I know that my recommendations will be strong as well. What kind of chances do I have without completing the externship? Does anyone know of anyone who has gotten an internship there without doing an externship? Also, is there anywhere where there are statistics about how many applicants applied for each program and how many spots were filled? I recall seeing this on VIRMP but I can’t find it now. Any advice or insight would be appreciated.

Additionally, does anyone have experience with the ASPCA SA rotating internship? Until very recently I planned to try and complete that internship specifically because it matched closely with my previous career goals, but I am unsure whether it would be enough medicine/specialties compared with a more traditional SA rotating internship with the limited case selection they see. Thanks in advance 🙂

 

[pp9]

I’m a 4th year veterinary student who is unfortunately very late-to-realize that I may want to specialize in internal medicine after completing my 4th year IM rotations. In my ideal world I would complete an internship at AMC but unfortunately with my clinical year schedule already finalized I don’t have time to be able to do an observational externship there before the match. My understanding is that AMC doesn’t consider applicants that haven’t completed an externship. Is this wrong? Otherwise my application will be very strong - I have a 4.0 GPA, leadership positions/extracurriculars in the shelter medicine/accessible veterinary medicine/community medicine realm, and I know that my recommendations will be strong as well. What kind of chances do I have without completing the externship? Does anyone know of anyone who has gotten an internship there without doing an externship? Also, is there anywhere where there are statistics about how many applicants applied for each program and how many spots were filled? I recall seeing this on VIRMP but I can’t find it now. Any advice or insight would be appreciated.

Additionally, does anyone have experience with the ASPCA SA rotating internship? Until very recently I planned to try and complete that internship specifically because it matched closely with my previous career goals, but I am unsure whether it would be enough medicine/specialties compared with a more traditional SA rotating internship with the limited case selection they see. Thanks in advance 🙂

I don't have answers to all of your questions, but program specific data is probably best obtained by contacting the program directly. You can see how many people applied to SA rotatings vs. how many people matched/how many spots were left unfilled, but the data doesn't get more specific than that.

If you have not externed there, what is drawing you to AMC? They have not had the greatest reputation in terms of intern treatment for quite some time, although I believe they are getting a bit better? I would talk to current interns and study the yearly survey results. Although consider how many people actually took the survey each year, sometimes it's hard to trust the data when only 2-3 people take it.

 

[snippemall]

In terms of what is drawing me to AMC, partially it’s that I want to stay in the NY area and moving to the city would be amazing. However, mostly it is the high caseload/high standard of education I would receive there. It seems to be an environment where they are used to having interns and teaching and it is close to having an academic environment with a much higher caseload. They have so many specialists covering many more fields than the other NY area internships I would consider. I’m also very attracted to the research that they do there. And they’re a non-profit which is attractive to me. Not to say that they are cheap but it feels good to know that if something is particularly interesting or has a good prognosis that they are able to work with people, which isn’t really the reality in many corporate specialty hospitals. Additionally a lot of the specialists I have worked with and highly respect are AMC-trained. All-in-all, I’m willing to get my butt kicked for a year if it means that I can get the best possible variety of caseload and the best possible education. It doesn’t make sense to me necessarily to do 80 or 90% of the hours and probably still be very stressed at another hospital. No intern year is easy so I might as well try and pursue the one I would likely get the most out of.

With all that being said please correct me if I am being idealistic or if I’m completely wrong about any of these points.

 

[JaynaAli]

I do think you’re probably romanticizing the intern experience and what you’ll get out of it a good bit, but that’s not totally surprising at this stage of your education.

 

[battie]

No intern year is easy so I might as well try and pursue the one I would likely get the most out of.

There are 3-4 internship trained docs at my hospital group. The one that I feel is the most prepared is the one who did an internship in community med and ER in northern Colorado that I had never heard of until I moved back home to Denver. The other two did internships at very well know hospitals in large metro areas. Based on working with the three of them, I would work with the community trained doc above the other two if I could chose outright. The other two are fine doctors. But they struggle to make finances work and to work as a team. N = 3, so obviously not a huge sample size. But the prestige and access you get with your internship isn't what makes it worthwhile

 

[supershorty]

As Jayna said, you have a highly romanticized view of internship, but that's to be expected. I think pigeonholing yourself into this idea that AMC is THE BEST is setting you up for a significant amount of disappointment that you really don't need. There are many, many, many internships where you'll receive excellent training.

I have no personal experience with AMC, but if the organization itself states that on VIRMP or wherever you saw that that they only take their interns from people who have externed there, I would believe that. On the other hand, you don't have really anything to lose by applying there if you want to and ranking it.

Regardless, where you do your rotating internship won't make or break the career that you want to have. I'd encourage you to contact current interns at programs you're considering applying to, because while it's really easy to say "I can do anything for a year," it's harder to actually do it, and your quality of life IS something you should think about.

 

[pp9]

In terms of what is drawing me to AMC, partially it’s that I want to stay in the NY area and moving to the city would be amazing. However, mostly it is the high caseload/high standard of education I would receive there. It seems to be an environment where they are used to having interns and teaching and it is close to having an academic environment with a much higher caseload. They have so many specialists covering many more fields than the other NY area internships I would consider. I’m also very attracted to the research that they do there. And they’re a non-profit which is attractive to me. Not to say that they are cheap but it feels good to know that if something is particularly interesting or has a good prognosis that they are able to work with people, which isn’t really the reality in many corporate specialty hospitals. Additionally a lot of the specialists I have worked with and highly respect are AMC-trained. All-in-all, I’m willing to get my butt kicked for a year if it means that I can get the best possible variety of caseload and the best possible education. It doesn’t make sense to me necessarily to do 80 or 90% of the hours and probably still be very stressed at another hospital. No intern year is easy so I might as well try and pursue the one I would likely get the most out of.

With all that being said please correct me if I am being idealistic or if I’m completely wrong about any of these points.

Living in/near NYC def sounds amazing until you realize what an intern salary is going to get you in that area. Plus, working 80+ hours a week (that's what their interns in my intern year were doing, anyways) won't leave you any time to actually 'live' in NY. Like I said I believe they have made some progress (I think they are actually giving their interns days off now!), but I also know alumni of their program who would tell you to run. Make sure you are talking to current/recent interns.

I don't have a bone to pick with AMC necessarily, aside from their historically poor treatment of interns, but there are many, many other SA rotating internships out there that will check all of your boxes and possibly more once you consider salary/QOL. You should probably visit/extern before you put all of your eggs in one basket.

Do more research, ask more people, talk to more current interns. Many of us have completed rotatings we'd recommend (or not) too if you are open to it.

 

[_rae_]

And they’re a non-profit which is attractive to me. Not to say that they are cheap but it feels good to know that if something is particularly interesting or has a good prognosis that they are able to work with people, which isn’t really the reality in many corporate specialty hospitals.

You've gotten some good advice from people who have actually done rotating internships. While I can't speak to that, I can speak to this. I worked in a large, non-profit, specialty hospital in a major city for three years. We had a shelter and our own assigned law enforcement officers. While we had funds for clients and used them religiously, we did not "work with" people. You're talking more about $500 here, $1000 there, on a bill that may exceed $7-8$k. Occasionally an outside fund would give more and we had those applications on hand, but still, many people could not afford that level of care. Our interns still got the brunt of the "you're just in it for the money" while being paid a wage that barely covered their loans and their own rent. I loved working in a non-profit and I hope that I'm able to again some day, but do not think a non-profit is a magical land where we could work with everyone. It definitely afforded us a bit more flexibility, but we still faced the same struggles other hospitals do every day.

 

[WhtsThFrequency]

Living in/near NYC def sounds amazing until you realize what an intern salary is going to get you in that area. Plus, working 80+ hours a week (that's what their interns in my intern year were doing, anyways) won't leave you any time to actually 'live' in NY. Like I said I believe they have made some progress (I think they are actually giving their interns days off now!), but I also know alumni of their program who would tell you to run. Make sure you are talking to current/recent interns.

I don't have a bone to pick with AMC necessarily, aside from their historically poor treatment of interns, but there are many, many other SA rotating internships out there that will check all of your boxes and possibly more once you consider salary/QOL. You should probably visit/extern before you put all of your eggs in one basket.

Do more research, ask more people, talk to more current interns. Many of us have completed rotatings we'd recommend (or not) too if you are open to it.

It also doesn't leave you much time or energy to truly learn and absorb what you are doing. If you're running around like a headless chicken from patient to patient, getting poor sleep, eating scraps, etc......you are physically and mentally not going to be at your best, and your retention of any medical knowledge you are acquiring is going to suffer. And if you're so slammed and so tired that you can't learn (and I mean really learn, develop critical thinking - not just memorize stuff)....that kind of negates the entire point of an internship. And if all the attendings there are as busy as you are...how are they going to have the time or energy to invest in educating you either? Or is everyone just a worker bee?

80 hours weeks as a mid-career and capable physician or vet with a solid knowledge/experience base and getting (very) paid well for it is one thing. 80 hours week as a brand new graduate (aka 5th year student) who still has a lot of ropes to learn and who is getting paid crap....that is not a situation that is conducive to well-being or deep learning. Truly learning means having the time, space, and energy to really wrestle with concepts and develop your critical thinking.

I agree with speaking with current/recent interns. Places can and will use "reputation" and "prestige" to work their interns to death just because they can.

 

[mkg323]

Sooooooo SA internships are totally not my wheel house as an equine practitioner, but even I know about AMC’s poor reputation for how they treat interns, it’s right up there with how the larger equine hospital internships are run. You will be there more than 80 hours a week guaranteed. Expect it to be more like 100+, I talked to a SA surgery resident while in school who did her first internship there and she talked about having to stay late to help because of how busy it was, and then by the time she finished her paperwork it was the next day and she had an hour or two before her next shift started. It is rough doing that day after day, it is not a one off occurrence. WhtsthFrequency hit the nail on the head, you will be exhausted, and not learning as efficiently. You will do and see a lot, but maybe not always learn why you’re doing things a specific way if that makes sense. I’ve totally been there, on an externship where I’m treated like **** but it’s the place to be and everyone gets the competitive residency they want, but the reality is you don’t have to suffer to learn, you don’t have to be treated like **** to be a good doctor, and you can learn the same lessons in a safer environment with maybe a lighter caseload or more mentorship than learning in chaos by making a traumatic error with minimal oversight and sleep deprivation. Don’t drink the AMC cool-aid, especially if you haven’t externed.

 

[VIN-Foundation]

Also, is there anywhere where there are statistics about how many applicants applied for each program and how many spots were filled? I recall seeing this on VIRMP but I can’t find it now. Any advice or insight would be appreciated.

The VIRMP does not publish these data for individual program. They do publish total numbers, such as how many applicants for internships, how many matched, and so on. They also publish data based on applicants from each veterinary school.

Regarding how AMC or any other program ranks applicants, I would contact the specific program. Also speak with current/recent interns at the program.

With respect to AMC's rotating internship, it's a great program. But it's not for everyone. Hell, doing a rotating internship is not for everyone. But applying to only one program is going to decrease your chance of matching. I'm not saying you won't match at that particular program. It sounds like you are a strong applicant. But it's just a statistical fact.

When deciding whether or not to rank a program, the question to ask is this: "Would I rather do an internship at this program or not do an internship at all?"

Because that's the decision.

If you consider all the programs, and your answer is "I rather not do an internships at all than work at that program" for every program other than 1 ... then OK, just rank that one.

If your goal is an IM residency, the first step to doing a rotating internship. There are more than 1 program that will fulfill that goal for you.

 

[freedom1414]

I do think you’re probably romanticizing the intern experience and what you’ll get out of it a good bit, but that’s not totally surprising at this stage of your education.

What's a realistic perspective of the intern experience and what to gain from it?

 

[JaynaAli]

What's a realistic perspective of the intern experience and what to gain from it?

Surviving and getting through it. Being an intern is more about paying your dues and crossing the experience off to get to an end goal like residency. They can be useful for making connections because letters of recommendation and who is supporting you can be critical for residencies. Will you learn things and gain confidence as a doctor as an intern? Yes, I’m sure you will. But even if the intent to teach you things is there, when interns are expected to work that many hours and do that many tasks in such a short period of time, learning suffers. Interns are often viewed as cheap labor and paperwork machines, even if places won’t admit that out loud. If places had to pay interns what actual doctors deserve and limit them to reasonable work hours, I suspect far fewer places would offer internships.

 

[battie]

I suspect far fewer places would offer internships.

And more people would probably be willing to do internships, ironically enough.

I didn't do one (and decided not to specialize) cause I wanted to get married and have a baby. That wouldn't have been feasible for my husband and myself during an internship.

 

[pp9]

What's a realistic perspective of the intern experience and what to gain from it?

Going for a more day in the life angle of what I was doing during my internship, and what might be similar to other programs:

4 days of the week, on a specific service:
-12+ hour day, possibly start at 630-7/earlier to get your AM soaps done in time for morning rounds
-8/9-5-see appointments (or be in the OR), maybe a scheduled lunch break depending on how the service runs (usually not)
-530-???-write the day's records, more time here if you are not squeezing in records between appointments
-530-???-callbacks, calls to update owners on hospitalized patients, rounding overnight ER doctors on your inpatients
-530-???-prep for tomorrow's appointments (headstart on records, read histories, brush up on diseases/procedures, etc)

5th day of the week was ER:
-usually a minimum 12 hour shift, which was often more like 13-15 hours once you account for record writing, tying up loose ends with your final cases of the shift, etc. This turns into more like 18-20 hours for some people who are really inefficient with their time
-we had one rotation of FT ER, but we went from 5 days a week to 4 for that (we also did overnights for this at my program)

Weekends depend on the internship and service. We had a 2 day weekend at my internship. my internship was pretty reasonable for intern QOL but I was still coming in super early on my weekends for morning SOAPs on hospitalized patients. I'd then call the clinician with patient updates and adjust treatments/etc, call owners with updates or do discharges, and round the day and night ER clinicians on those patients (because they have to know who's in the building). That could take anywhere from 30min to 2-3+ hours if you had a lot of patients, owners were late for their discharge time, or you had to wait on the ER docs to have a few minutes to round. For surgery rotations, we were often on call over our weekends. If we got called in for surgery, that could either be no cases, 1-2 cases, or so slammed that you didn't leave the OR/hospital for the entire 24 hour on call period.

So a 60 hour week is a conservative estimate for a 'good' week. If you had a bad week with a ton of hospitalized patients/surgeries, it would obviously add even more hours.

Interns are definitely cheap labor, there's no skirting around that. You learn a lot by osmosis - you'll see so many things that you just didn't get the chance to see during 4th year, learn how to be efficient with your time, etc. An internship program absolutely should also have formal rounds for interns which might involve covering specific topics, wet labs, presentations by yourself/fellow interns on cases, etc. A lack of formal rounds/training is a red flag in my eyes, and I'm talking beyond 'orientation.'

Like I said, I felt my internship was reasonable QOL-wise but I still don't think I could pull those hours during a full week of work (week after week, anyways) even 5 years later. It's grueling, exhausting work. Pay is generally better across the board (my internship is paying their current interns more than 2x what I got in 2019-2020) but you obviously aren't making what you'd make as a GP vet. With that said, they are a necessary step to most specialties.

Some of my internmates did a lot with their weekends, some of us spent our weekends trying to repay our sleep debts. A 12 hour day sounds long right off the bat, but there are many more layers of exhaustion to consider - you are constantly doing something, constantly learning, constantly trying to keep up, constantly worrying you're screwing up, and so on. The mental load is often forgotten and is probably the biggest energy suck imo. You'll feel that even years out into practice when you have a particularly rough surgery, a really bad case to think on, etc.