Internship or good mentorship?

[ali9280]

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Hi everyone! I am almost two months into my 4th year, and just completed my externship at a speciality hospital, where I spent time with several different departments. I really enjoyed it, especially ER and Surgery. Going into vet school, I never thought I'd do an internship. My plan was always small animal GP with good mentorship, then maybe transition into ER after a few years. However, my ECC rotation and time in the ER/ICU during my externship reminded me why I wanted to be a vet in the first place (I was losing the why during my 3rd year). I know I have some time, but I would like some outside perspective. I have read through some of the old threads on here about internships and looked at the VIRMP website as well. The idea of a private practice internship interests me, and I don't care as much about "prestige" as I don't see myself pursuing a residency currently. The ER doctors and criticalists I've worked with have strongly recommended that I do an internship since I have an interest in ER. Now I am not sure what is best. My school doesn't give us a GPA, and I'm not sure what my class rank is. I'm guessing that I'm fairly average, probably lol. But so far, I have gotten great evaluations and feedback from my rotations and externship. I have heard people say that an internship is worth 5 years out in general practice, but how true is that really? And I have heard that some ERs would rather you have an internship done? So, are the long hours and little pay for a year worth it for what I want to do? And would I even have a shot at an internship if I went that route? 🤣Thanks in advance for any and all help, as I am having a mini crisis.

 

[JaynaAli]

If you might want to do ER or specially, doing an internship right after graduation is probably worth it. It would be better to do it and get it over with and get that rapid experience if there’s a possibility you want to specialize. It’s possible to go into ER after time in GP and be good at it, but internships are designed to get you that experience quickly and in a structured environment that may or may not be present later if you just go get an ER job. In the past, most ERs are desperate enough for staff that they didn’t really care about your experience even if they might prefer someone with more experience. But the job market is changing and ERs are closing after that big COVID boom. Going back to intern salary after a few years at a full time vet salary would be rough if you realized later on you did want to do an internship rather than just going right into ER without more experience.

If your goal is to be in GP, an internship probably isn’t the best place to learn those skills. You see so many cases in an internship, it’s more experience than you’d get in one year of GP work, but the caseload is completely different. An internship might make you more confident triaging or dealing with an emergency case, but it’s not going to teach you about vaccines, preventative medicine, and skin disease that you’ll see daily as a GP. So if your end goal is GP, I’d find a GP with good mentorship.

We do have a couple people who went from GP to ER (and now back to GP for one of them) so hopefully @Trilt and @battie can chime in.

If you decide you do want to do ER, There’s also those programs like NERD, EmERge, or whatever they’re calling them nowadays, where they give some formal mentorship for a period before you’re a “regular” doctor, so that may also be an option to consider, though I don’t have personal experience with the programs so do your own research on the program and what requirements they have of you post-training period.

 

[battie]

Hi! I'm the GP --> ER -> GP weirdo!

So, if you think at all that you'll want to specialize, do the internship. Just hands down. You'll get the exposure to the specialists, you'll figure out if living like an intern/resident for 3-5 years is worth it to you, etc. Don't go straight into practice if you think you'll want to specialize. The lifestyle creep of Big Doctor Money is real.

If you think you'd want to go into ER, I would say that an internship is probably going to be better than the ER corporate mentorships at this point. Corporate ER is currently just flat trash right now. 6 ERs have closed in Denver since November, as an example. One private facility is opening soon though. Part of the problem though, is that plenty of private practice ER internships are also corporate. So there's definitely a catch 22 there.

If you think you'll want to do GP, skip the internship. The abuse isnt worth what you'll learn.

Now that I've done GP as a new grad (corporate, ER-GP hybrid with mediocre mentorship program) to ER (sold to corporate that exploded and is burning within the last year) to GP again (privately owned), I honestly don't know what I would have done differently cause home priorities took precedence. I wanted to be a mom ASAP and did not want to go through pregnancy/LD in internship or residency. I simply wouldn't have had the support system to do it.

BUT!!!!! If I **hadn't** wanted to be a mom, then I kinda wished I would have done an internship.

 

[supershorty]

I agree with both Jayna and battie, as per usual - but wanted to add that if you're going to do a private practice internship, make sure you research it and that it's a reputable one where they're really training their interns and have things like didactics, case rounds, etc. I had a very good friend get taken advantage of by a practice that had an "internship," but the reality was that they just treated her like an associate and paid her half as much as their associates got paid.

 

[pp9]

My school doesn't give us a GPA, and I'm not sure what my class rank is. I'm guessing that I'm fairly average, probably lol. But so far, I have gotten great evaluations and feedback from my rotations and externship. I have heard people say that an internship is worth 5 years out in general practice, but how true is that really? And I have heard that some ERs would rather you have an internship done? So, are the long hours and little pay for a year worth it for what I want to do? And would I even have a shot at an internship if I went that route? 🤣Thanks in advance for any and all help, as I am having a mini crisis.

Agree with all said above, just wanted to add on that I wouldn't stress a ton about your GPA. You'll most likely be fine if you are not dead set on an academic program (it sounds like you aren't) or one of the competitive PP programs. Even if you didn't match to your top choice or needed to scramble, you WILL be able to get a rotating internship. Scrambling can be a bit challenging because you have limited time to figure out whether or not an unfilled position is at a decent program or not, but otherwise there are consistently more internship positions than there are applicants.

Some ERs probably do prefer internship-trained vets, sure, but not all care. As an internship-trained former ER doctor, I will say that I think a rotating internship heavy in ECC is extremely beneficial and would likely help you earn more production money out of the gate, simply because you'll be able handle more cases at the same time/be a hospitalist/etc. You might be a more attractive applicant at specialty hospitals as well. PP internships generally are paying significantly better than they did even when graduated just 7 years ago too, so it's become a bit of a better tradeoff financially.

 

[ali9280]

Thanks so much everyone for the advice! I really appreciate the detailed replies!

 

[WonderingStudent]

Hi everyone! I am almost two months into my 4th year, and just completed my externship at a speciality hospital, where I spent time with several different departments. I really enjoyed it, especially ER and Surgery. Going into vet school, I never thought I'd do an internship. My plan was always small animal GP with good mentorship, then maybe transition into ER after a few years. However, my ECC rotation and time in the ER/ICU during my externship reminded me why I wanted to be a vet in the first place (I was losing the why during my 3rd year). I know I have some time, but I would like some outside perspective. I have read through some of the old threads on here about internships and looked at the VIRMP website as well. The idea of a private practice internship interests me, and I don't care as much about "prestige" as I don't see myself pursuing a residency currently. The ER doctors and criticalists I've worked with have strongly recommended that I do an internship since I have an interest in ER. Now I am not sure what is best. My school doesn't give us a GPA, and I'm not sure what my class rank is. I'm guessing that I'm fairly average, probably lol. But so far, I have gotten great evaluations and feedback from my rotations and externship. I have heard people say that an internship is worth 5 years out in general practice, but how true is that really? And I have heard that some ERs would rather you have an internship done? So, are the long hours and little pay for a year worth it for what I want to do? And would I even have a shot at an internship if I went that route? 🤣Thanks in advance for any and all help, as I am having a mini crisis.

I did a (private practice) rotating internship. It is a year of hell but I do feel it did make me a better doctor and allowed me to better handle most situations that come in through the ER following my internship. Yes, it would be great to find a good mentorship so you can get paid a good wage right out of school but that is difficult to find the unicorn clinic. Multiple of my friends who went straight to GP with "promised mentorship" didn't receive what they were promised and have questioned if they should go into a structured ER program to get what they didn't get. It's difficult to ensure that you will get the mentorship promised and is somewhat a gamble. Rotating internships also can be a gamble and not all are the same. For any practice/internship you pursue, I would recommend talking to current/past interns to learn about their experience and better understand if the program/job would be what you are hoping for.

There is a lot of value to learn from specialists when you are the primary clinician (ie being an intern at a specialty hospital and being able to get a drive by consult for a CHF pt that doesn't have the funds to transfer to cardio). You may have those experiences in vet school but it's very different when you are the one needing to make the decisions. Not every case is the same and navigating the grey area is difficult as a baby doctor and beyond.

FYI there are also 6 month structured ER mentorship programs through places such as VEG and Ethos. This would be good if you are set on ER and don't think you will want to do a residency in the future. Specialty internships/residencies typically require rotating internships (depends on the program though! I've seen some that do not require such). Caveat is that I am wary about these 6 month programs - A (corporate) hospital I worked for had this type of program that didn't seem that well established/structured and did not feel that the mentees were getting enough value out of the experience.