Planning on going into GP - internship necessary?

[red_jellyfish]

I am currently a 4th year veterinary student. I have been debating about doing an internship since the start of my third year. I honestly plan on just going into small animal GP, but many veterinarians that I have worked with so far in my externships and in clinics all recommend doing an internship. The only veterinarians that did not think internships were necessary were those who never completed an internship themselves.... My main reservation is not being able to live on an intern salary and unwillingness to move from my current state (family reasons), therefore limiting my options. However, I do like the idea of mentorship as a new grad. I know that it is possible to have mentorship at a job rather than an internship, but with most internships, mentorship is almost guaranteed (I'm aware that there are better internships than others...). I just wanted to get some advice from those that may have been in a similar situation as me. Do you think your internship helped you become a better GP?

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[JaynaAli]

Disclaimer: Not a GP, but I did an internship in order to specialize in a field that has nothing to do with any of the rotations in my rotating internship. I certainly learned a lot and don't regret doing the internship, but I don't think it's worth it if you aren't planning to specialize. Find a practice with decent mentorship and you'll be fine. Honestly, 80-90% of the cases I saw at my internship were specialty cases I wouldn't see at a GP anyway...they were referral cases there for things the GPs couldn't do for whatever reason. I could manage an intense DKA or traumatic brain injury and things like that, but my internship did not reach me about vaccines, allergies, and other bread and butter things of GP.

I think a lot of time people just advise people to do what they did (GPs without internships say don't do it, specialists you talk to at school did an internship and say to do it). With anything, it's a gamble...that mentorship at a GP might not be good, but mentorship at an internship can be hit and miss based on who you are on with. If you don't want to specialize, go into GP and find a clinic that you've vetted well (no pun intended) that has a plan for mentorship. Take your increased salary, better hours, and actually learn the things you will see every day with help from your coworkers, resources like VIN/DVM social media groups, and plain old experience.

Also, there is nothing 'just' about GP. Own it, be proud! GP is a very important job in our field. I certainly couldn't do it.

 

[Minnerbelle]

I know you’re specifically not asking someone who went into GP who didn’t do an internship, but one thing I’m really glad I did was took the salary differential and put it back into CE that actually would make a difference for me. Things like dental CE, Ultrasound CE, and surgery CE with multiple days of wetlabs cost $2000-3000 each PLUS lodging and travel. If you’re going into gp, being comfortable with soft tissue surgery and dentistry is super beneficial and unfortunately that is where most internships are deficient. Pair that with a rescue that will let you gain experience with those skills in conjunction with CE, and you’ll be way ahead in those areas in 1 year compared with someone who has just completed an internship. Remember that is the more important comparison. Not a new grad straight out of school vs. someone coming out of an internship. It’s where you would be 1 yr out in practice vs. where you would be straight out of internship.

Now the important thing is finding a practice to work at that will both help build you into the clinician you want to be AND support good quality of life as well as quality of medicine. There are so many horrible employers out there. Finding a place you’re happy at is kinda rare esp for your first job. But that’s going to be the same regardless of whether or not you do an internship. And there are a lot of bad internships out there as well. If you end up with a bad one on either side, you’ll probably regret your decision but I’m not sure that’s a fair way to think about it.

At the end of the day, it’s a matter of what you want out of your first year. If you’re terrified of unblocking a cat, managing a dyspneic animal, or sewing up a laceration without having done that in a setting where ultimately someone else is responsible for you, then maybe an internship is for you. Though seriously, as long as you’re not at a job where you are left to sink or swim and there are other doctor support, it’s super doable. Says someone who was left to sink or swim in these situations and still did fine. But if your goal is to be the most self sufficient gp in a shorter period of time, then you may be better off going straight into gp (preferably at a high quality multi-doctor practice where there are always multiple doctors in the building). Much of the stuff you’ll struggle with in gp are not skills you learn in an internship. The chronic diseases and multiple chronic diseases and managing client expectations for these things. The never ending skin/ear/GI/geriatric stuff that sounds mundane but is really an art. And surgery procedures.

And the money isn’t just about the salary differential that first year either. By the time you’ve been in practice for a year, you will have your groove and will have built a clientele, and will have the capacity to book surgical cases, so that year two is going to be much more productive. That can be significant. Though an internship trained gp first year out may be a little more efficient than a new grad, it’s going to take a while to build that clientele unless you’re working at a clinic that is over capacity. And if you want to spend extra money on CE, and you don’t negotiate that with your employer ahead of time, you may not be able to afford it. You don’t necessarily need to go to these CEs, but they can really expedite your skill building.

 

[CalliopeDVM]

I'm a GP who didn't do an internship, but I've work with fresh-out-of-internship vets and fresh-out-of-school vets, and there really isn't that much difference in their prepardness or the quality of their work. You'll learn more useful information and skills in a year working in a GP practice than you will doing a one year internship, and you'll be making more money too. Internships might teach you how to be really well prepared for the occasional 'zebra' cases that you might see 4 or 5 times a year, but not really help you with the bulk of what being a GP is about --- including important things like client and staff interactions, efficient recordkeeping, etc. Being a good GP is challenging work, but it's not something that an internship is going to help you with.

Unless you're planning on doing a residency, don't waste your time or money on an internship. (And, in case anyone's wondering, having an internship will not increase the amount of money you'll earn as a GP).

 

[PippyPony]

Things like dental CE, Ultrasound CE, and surgery CE with multiple days of wetlabs cost $2000-3000 each PLUS lodging and travel. If you’re going into gp, being comfortable with soft tissue surgery and dentistry is super beneficial and unfortunately that is where most internships are deficient.

Slightly off topic, but do you know if there are externships out there that focus on these skill sets? Can 4th years attend these types of CE workshops?

 

[Minnerbelle]

Slightly off topic, but do you know if there are externships out there that focus on these skill sets? Can 4th years attend these types of CE workshops?

Dental practices often will provide externships but the level of hands on experience will vary. There are some places where you are essentially just watching, which can be valuable but not as much when you have 0 experience and don’t really get what you’re watching. The vet dental services in Boxborough is amazing with their externs with lots of hands on learning. Like beyond generous. Absolutely would recommend.

these specialty externships are a big hit or miss. Some make you feel like you should be thankful just being a fly on the wall. Others really think of their externships as teaching opportunities and invest in your learning

Can students participate in the actual CE wetlabs? Usually no. Space is limited so spots go to paying customers.

But for something like surgery, all you need is a cadaver and a doctor who is willing to teach you and motivation on your part. When I work with externs, I’ll often offer to stay late and allow them to do any procedure I know how to do so long as we have a cadaver and the student at least has looked up the procedure.

 

[red_jellyfish]

Hey everyone, thanks for all the advice! They were all very helpful and encouraging. I have honestly been leaning 70% non-internship vs 30% internship, but with so many clinicians telling me I should do an internship, plus many of my classmates in the process of applying, it really made me doubt and question myself on whether I was making the right decision. I do have a relationship with a nearby hospital that had *implied* I would make a great intern and I know I will get great mentorship there, but there are aspects of the program that are lacking in my opinion (not many specialists, with majority being overnight ER, although interns do rotate through their GP department). Plus, I know intern salary isn't great in general, but they were offering $3000-$5000 less than other family hospitals in the state offering internships, and I don't think I can make it work (or it will be REALLY tight) as a single person living in the Bay Area, CA. I'm thinking the extra stress is not worth it.

Another question, any advice on what to ask in regards to looking and interviewing for jobs? I'm fully aware that many places may offer great mentorship and all these amazing things, but then leave you to hang.... Any "red flags" to look for?

 

[red_jellyfish]

I know you’re specifically not asking someone who went into GP who didn’t do an internship, but one thing I’m really glad I did was took the salary differential and put it back into CE that actually would make a difference for me. Things like dental CE, Ultrasound CE, and surgery CE with multiple days of wetlabs cost $2000-3000 each PLUS lodging and travel. If you’re going into gp, being comfortable with soft tissue surgery and dentistry is super beneficial and unfortunately that is where most internships are deficient. Pair that with a rescue that will let you gain experience with those skills in conjunction with CE, and you’ll be way ahead in those areas in 1 year compared with someone who has just completed an internship. Remember that is the more important comparison. Not a new grad straight out of school vs. someone coming out of an internship. It’s where you would be 1 yr out in practice vs. where you would be straight out of internship.

Now the important thing is finding a practice to work at that will both help build you into the clinician you want to be AND support good quality of life as well as quality of medicine. There are so many horrible employers out there. Finding a place you’re happy at is kinda rare esp for your first job. But that’s going to be the same regardless of whether or not you do an internship. And there are a lot of bad internships out there as well. If you end up with a bad one on either side, you’ll probably regret your decision but I’m not sure that’s a fair way to think about it.

At the end of the day, it’s a matter of what you want out of your first year. If you’re terrified of unblocking a cat, managing a dyspneic animal, or sewing up a laceration without having done that in a setting where ultimately someone else is responsible for you, then maybe an internship is for you. Though seriously, as long as you’re not at a job where you are left to sink or swim and there are other doctor support, it’s super doable. Says someone who was left to sink or swim in these situations and still did fine. But if your goal is to be the most self sufficient gp in a shorter period of time, then you may be better off going straight into gp (preferably at a high quality multi-doctor practice where there are always multiple doctors in the building). Much of the stuff you’ll struggle with in gp are not skills you learn in an internship. The chronic diseases and multiple chronic diseases and managing client expectations for these things. The never ending skin/ear/GI/geriatric stuff that sounds mundane but is really an art. And surgery procedures.

And the money isn’t just about the salary differential that first year either. By the time you’ve been in practice for a year, you will have your groove and will have built a clientele, and will have the capacity to book surgical cases, so that year two is going to be much more productive. That can be significant. Though an internship trained gp first year out may be a little more efficient than a new grad, it’s going to take a while to build that clientele unless you’re working at a clinic that is over capacity. And if you want to spend extra money on CE, and you don’t negotiate that with your employer ahead of time, you may not be able to afford it. You don’t necessarily need to go to these CEs, but they can really expedite your skill building.

Thanks for the advice! CE benefits was something I haven't thought about as part of employment negotiations, so that is something I will definitely keep in mind. I do regret not planning for any dentistry and dermatology externships as part of my fourth year rotations, but can't change that now... :\

 

[red_jellyfish]

Disclaimer: Not a GP, but I did an internship in order to specialize in a field that has nothing to do with any of the rotations in my rotating internship. I certainly learned a lot and don't regret doing the internship, but I don't think it's worth it if you aren't planning to specialize. Find a practice with decent mentorship and you'll be fine. Honestly, 80-90% of the cases I saw at my internship were specialty cases I wouldn't see at a GP anyway...they were referral cases there for things the GPs couldn't do for whatever reason. I could manage an intense DKA or traumatic brain injury and things like that, but my internship did not reach me about vaccines, allergies, and other bread and butter things of GP.

I think a lot of time people just advise people to do what they did (GPs without internships say don't do it, specialists you talk to at school did an internship and say to do it). With anything, it's a gamble...that mentorship at a GP might not be good, but mentorship at an internship can be hit and miss based on who you are on with. If you don't want to specialize, go into GP and find a clinic that you've vetted well (no pun intended) that has a plan for mentorship. Take your increased salary, better hours, and actually learn the things you will see every day with help from your coworkers, resources like VIN/DVM social media groups, and plain old experience.

Also, there is nothing 'just' about GP. Own it, be proud! GP is a very important job in our field. I certainly couldn't do it.

Thank you for the advice! To be honest, the regular hours + better hours, etc are a huge factor for me to just go straight into practice. I'm honestly just tired of being poor/living off loans/help from family for the past 8 years.... Yes, I've been told to "just suck it up for another year", but really would rather not do that if it's not necessary.

 

[red_jellyfish]

I'm a GP who didn't do an internship, but I've work with fresh-out-of-internship vets and fresh-out-of-school vets, and there really isn't that much difference in their prepardness or the quality of their work. You'll learn more useful information and skills in a year working in a GP practice than you will doing a one year internship, and you'll be making more money too. Internships might teach you how to be really well prepared for the occasional 'zebra' cases that you might see 4 or 5 times a year, but not really help you with the bulk of what being a GP is about --- including important things like client and staff interactions, efficient recordkeeping, etc. Being a good GP is challenging work, but it's not something that an internship is going to help you with.

Unless you're planning on doing a residency, don't waste your time or money on an internship. (And, in case anyone's wondering, having an internship will not increase the amount of money you'll earn as a GP).

Thank you for the advice! Something that has been disconcerting to me is that most job applications I've encountered so far have stated they want veterinarians with 1-2 years of experience or has completed an internship. I just find this interesting since I believe there is a increasing trend in new grads NOT pursuing internships... To be fair, I've only looked in a very limited area in CA, but also seems like maybe 60% of the 2019 graduating class from my school decided to go straight into practice.

 

[DVMDream]

I went straight into practice. An internship in my opinion is not going to prepare you for GP. It just isn't. Most don't really rotate through a "general practice" setting, some may, but it will be extremely limited. You will get loads of ER experience with an internship which will help some on GP, you still get emergencies on GP, but it won't be near as useful as if you are planning on going into ER medicine.

I really think an internship if you are planning to jump into the GP route is a waste of income potential and a full year of experience in GP.

It is really hard to know if a practice will or won't provide good mentorship. Plus mentorship means different things to different people. So I think the best thing to do is to clarify what a clinic means by "mentorship" because that has a different meaning for everyone.

Some new vets want to just observe at first, then slowly dip their toes into the water, while still having another vet there at all times to help if they get into a pickle. Some new vets are game to jump right on in and just want another vet in the building to bounce ideas off of or to assist/guide for procedures they haven't done before. Exam room mentorship will also differ from surgical mentorship. Some new vets want another vet scrubbed in ready to help for their first few surgeries. Other new vets are fine to dive on in and only call for another vet to scrub in if they need help. BUT, being sure another vet will be available to scrub in is important. It can be hard if the other vets are off in rooms or seeing clients themselves.

So sitting down with a potential employer and having realistic expectations of what you want out of mentorship and what they can provide is very important. Some clinics can spare another DVM to be really hands on and follow you/you follow them, or be available at the ready if a surgery goes sour, some clinics can't afford that. Payments of vets can also make this difficult as vets who are paid on pro-sal can start to "lose out" on income if they are constantly having to stop to mentor you. So being sure there is a good set up for the other vets so they aren't also taking a hit.

I would encourage anyone considering accepting employment to a particular clinic to ask if you can be a fly on the wall and just observe their day to day operations for a few days before you make a decision. People can behave for a day while you are there for an interview. It is harder to hide any staff issues, gossip, drama, interpersonal issues, bullying staff, scheduling issues, overbooking issues, lack of staff/support help, etc if you ask to observe over a few days. One day people can behave, a few days, the "issues" that could be underlying start to rear their heads.

 

[CalliopeDVM]

ask if you can be a fly on the wall and just observe their day to day operations for a few days before you make a decision. People can behave for a day while you are there for an interview. It is harder to hide any staff issues, gossip, drama, interpersonal issues, bullying staff, scheduling issues, overbooking issues, lack of staff/support help, etc if you ask to observe over a few days.

Yes! One of the most important things to job satisfaction, I think, is a good work environment - good morale - and that can be hard to judge from an interview. All the toys or lots of high quality medicine won't matter if you're in a workplace with bullies, drama queens, or a micromanager.

 

[twelvetigers]

And, not to be a party pooper, but I wouldn’t plan to stay at your first practice. It does happen sometimes, but it often takes time to find a good fit. So do the best you can to pick a good one, and if you realize you kinda hate it actually, then... you find somewhere else. Just realize how common that is.

 

[Minnerbelle]

And, not to be a party pooper, but I wouldn’t plan to stay at your first practice. It does happen sometimes, but it often takes time to find a good fit. So do the best you can to pick a good one, and if you realize you kinda hate it actually, then... you find somewhere else. Just realize how common that is.

Ahaha yup. Even as someone who is overall happy to be a gp, I was on job number 4 in just as many years.

 

[DVMDream]

Ahaha yup. Even as someone who is overall happy to be a gp, I was on job number 4 in just as many years.

Yup, I'm on job number 4 in not quite 4 years. This one is going to last decades though, I'm very happy with this one so far. 🙂

 

[CalliopeDVM]

I was on job number 4 in just as many years.

Almost, for me -- three jobs in three years, before I switched to relief work.

 

[twelvetigers]

I’m only on number 2, but I figure I’ll probably stay a while. Not GP anymore though.

 

[Minnerbelle]

For me, it wasn’t so much that I hated my jobs (except for my first one. That was one for the books) as it was that better opportunities came up worth taking. When someone is begging you to work for them, you are in a better position of saying, “so how are you going to scratch MY back in return?” If it was just money, then it’s easy for the original employer to match it, but when you pair with it scheduling and support staff accommodations, it’s easier to leave. When I had stayed <2 yrs on any job, I didn’t feel attached enough to stay.

 

[red_jellyfish]

Thanks everyone! I am leaning away from doing an internship now. Honestly, I was in the mindset that I would not be a "good vet" if I didn't do an internship, especially since most of my vet school friends are applying right now, plus many of the clinicians I've asked have said to do one. I'm thinking that since I have so much hesitation about an internship, it is a sign that it really isn't for me. I want to be 100% committed to what I decide on, and I just don't feel that way about an internship. Job hunting it is then! Again, thanks everyone!

 

[Minnerbelle]

Thanks everyone! I am leaning away from doing an internship now. Honestly, I was in the mindset that I would not be a "good vet" if I didn't do an internship, especially since most of my vet school friends are applying right now, plus many of the clinicians I've asked have said to do one. I'm thinking that since I have so much hesitation about an internship, it is a sign that it really isn't for me. I want to be 100% committed to what I decide on, and I just don't feel that way about an internship. Job hunting it is then! Again, thanks everyone!

I would ignore the chorus within the ivory tower unless you are specifically talking to clinicians who were in GP. Of course they’re going to tell you to do an internship. That’s all they know. To them, the only “good doctors” are those like them and only the ****ty ones reluctantly became GPs because they couldn’t cut it.

 

[PippyPony]

only the ****ty ones reluctantly became GPs because they couldn’t cut it.

...do some people actually think this?

I am concerned about my ability to do ~GP~ because I'm not sure I can cut it, not the other way around 😕

 

[deleted498041]

I would ignore the chorus within the ivory tower unless you are specifically talking to clinicians who were in GP. Of course they’re going to tell you to do an internship. That’s all they know. To them, the only “good doctors” are those like them and only the ****ty ones reluctantly became GPs because they couldn’t cut it.

I work within the ivory tower, and I don't think this 🙁 There are good and bad specialists just like there are good and bad GPs. I try really hard to show my students when I have a good versus bad referral and what makes up the difference.

I felt that, when I was school, my school was a little too pro-internship and people that didn't really need to do the felt obligated to do so. I try to let my students know that they shouldn't feel pressured to do an internship if they're able to find a GP job with good mentorship.

 

[deleted498041]

...do some people actually think this?

I am concerned about my ability to do ~GP~ because I'm not sure I can cut it, not the other way around 😕

I mean, there are definitely some people that do so. I know that I couldn't hack it in GP, that's for sure. Derm, ophtho, cardio, all in the same day? Nope. I wouldn't survive.

 

[WhtsThFrequency]

Another ivory tower specialist here and I adore and admire GPs. I could never have hacked it in GP either. Most clinicians in academia came there because they wanted to teach, not because they necessarily think they are better. Of course there are some egos here and there, as there are everywhere, but I don’t think the a negative attitude towards GPs is that pervasive. At least not at my institution. We know that most students are going to take that path and kudos to them for wanting to be on the front lines.

 

[Rainheart]

I was definitely in your shoes a few years ago debating if I should or not (was considering specializing). I ultimiately decided against an internship and went out into private practice. Absolutely, an internship may have been useful but it wasn't worth the pay cut vs a GP salary and I wasn't going to specialize. I DO agree that an internship will NOT help you in preparing to enter GP; certain cases, yes but the vast majority will not. Plus the whole 'ivory tower' medicine is NOT was GP is like 90% of the time. Get out in practice, enjoy it! I stayed at my first practice for a little over a year and now have been in my second practice for a little over a year. I only moved away from my first one as I wasn't thriled about the area and wanted to be closer to home.

 

[Minnerbelle]

Of course there are some egos here and there, as there are everywhere, but I don’t think the a negative attitude towards GPs is that pervasive.

I don’t think it’s so much that these clinicians look down on GPs as it is that they simply don’t encourage students to go that route. It’s just that when it comes to advising students on what to do with their careers, there really aren’t many who would say “oh cool!” And certainly not right out of school. I don’t know if it’s just subconscious bias, or if it just seems that way because they only speak encouragingly to students seeking internships and dunno what to say to the “other kids” so it just seems that way. But I’ve personally had clinicians say things like, “oh, but why? You’d make such a good intern in fact I would love it if you were in our program!” I know they meant it as a compliment but certainly didn’t make me feel supported in my career choice.

Do you see clinicians giving helpful advice or being as encouraging to their practice bound students as they are with their internship bound students? I think the silence and being ignored is what was most frustrating. I felt rather left out when all discussions about the future revolved around the match and internships as if the rest of us didn’t matter.

 

[deleted498041]

I don’t think it’s so much that these clinicians look down on GPs as it is that they simply don’t encourage students to go that route. It’s just that when it comes to advising students on what to do with their careers, there really aren’t many who would say “oh cool!” And certainly not right out of school. I don’t know if it’s just subconscious bias, or if it just seems that way because they only speak encouragingly to students seeking internships and dunno what to say to the “other kids” so it just seems that way. But I’ve personally had clinicians say things like, “oh, but why? You’d make such a good intern in fact I would love it if you were in our program!” I know they meant it as a compliment but certainly didn’t make me feel supported in my career choice.

Do you see clinicians giving helpful advice or being as encouraging to their practice bound students as they are with their internship bound students? I think the silence and being ignored is what was most frustrating. I felt rather left out when all discussions about the future revolved around the match and internships as if the rest of us didn’t matter.

I work on services that I find are very relevant to students going into GP. I always try to work into conversation how this may be relevant to their future careers, and then I discuss the steps they can take to decide if something is worth referral and how to make it the best referral possible. There are a lot of things in my skillset that GPs are doing, depending on the area, and so I definitely encourage the students to ask questions, participate, and I try to give them tips and tricks and answer questions with "Well, when you're doing this in the future..." One of the clinicians here is also excellent at telling students how to do various tasks without all the bells and whistles that we have in academia, which I think is fantastic. I'm luckily (or unluckily) very spoiled and not as good at communicating or demonstrating those things.

I will say, I am not good at providing life advice to students going into GP because that is simply not my realm. I am not qualified to give advice on what constitutes a good first job as a GP, what to look for in a hospital, or how to negotiate an offer letter. Other than actual medicine relevant to my specialty, I'm not super helpful for those going into GP because I'm now too far removed from that setting.

 

[Minnerbelle]

I work on services that I find are very relevant to students going into GP. I always try to work into conversation how this may be relevant to their future careers, and then I discuss the steps they can take to decide if something is worth referral and how to make it the best referral possible. There are a lot of things in my skillset that GPs are doing, depending on the area, and so I definitely encourage the students to ask questions, participate, and I try to give them tips and tricks and answer questions with "Well, when you're doing this in the future..." One of the clinicians here is also excellent at telling students how to do various tasks without all the bells and whistles that we have in academia, which I think is fantastic. I'm luckily (or unluckily) very spoiled and not as good at communicating or demonstrating those things.

That’s awesome!

 

[VetMedSurvivalGuide]

Some thoughts from a small animal internist:

The answer to your question is going to be highly variable depending on who you ask. Did that person do an internship? If so, did they enjoy or not? Did they have good mentorship or not? Did they spend all their time doing ER work? Does the practice (university or private practice) have a primary care service?

What are your goals? GP exclusively, GP+ER, other?

Some practices will pay more if you did an internship. But not all. And even if they do, does it offset the lower pay for one year and another year in which you made no student loan payments? Hard to say. What about traveling wherever the match sends you?

Also, don't forget that there are community practice internships. Check the VIRMP website. And there are even community practice residencies at certain institutions (Virginia Tech had one a few yrs ago, not sure if still open).

In my opinion (forgetting the financial reasons and assuming you are able to apply anywhere), an internship trained doctor will have a different skill set than one that hasn't done one. You can always improve the skill set that others mentioned above when you then enter general practice. Note that I didn't say one will be a better doctor, but you've seen things others haven't and in some cases, that will allow you to recognize diseases faster, including identifying patients that will benefit from referral sooner. Having said this, there are great GPs that did not do an internship.

The skillset I mentioned above, will be highly dependent on the internship and the candidate. Some internships are simply not good. Or the programs you applied to did not fit your ultimate goals, but you applied regardless.

As in vet school, if you put in the work, you'll reap the rewards. Great communication and time management skills are obtained in both GP and internships. Ultimately, only you can make this decision. Don't let peer pressure guide you one way or the other. I have a blog post that adds a bit more perspective: https://vetmedsurvivalguide.com/matchingprogram-should-i/

 

[CalliopeDVM]

but you've seen things others haven't and in some cases, that will allow you to recognize diseases faster, including identifying patients that will benefit from referral sooner.

Yes, that's very true......but I don't think those are the most important things in GP work. That's the real problem, IMO - the question too many students ask when they think about internships is whether it will make them a better better at diagnosing (to recognize those cases) and perhaps even better at treatment, but they don't really think about whether it will make them a better general practitioner. The fastest diagnosis and the quickest treatment won't matter if you don't have the important other things GPs need: good bedside manner, good communication skills, the ability to build trust in clients and patients. (Without good compliance, the best prescribed treatments are worthless.

Dr. House might have been a great diagnostician (that's debatable), but he was a horrible doctor.

 

[DVMDream]

Yes, that's very true......but I don't think those are the most important things in GP work.

I actually kind of disagree with that part. "You've seen things others haven't"... well, that patient didn't get to the specialty clinic without a GP sending them there for you to see. And the GP is going to follow up and learn what that "thing" was.

Heck I've seen stuff working only GP that I am sure no one else has seen.... renal aspergillosis being my most odd one.

Anything that ends up in a specialty clinic passes through a GP or ER doc first. I don't know any specialists in veterinary medicine that take on patients without a referral from a GP.

Plus for 90% of your patients in GP, they are going to have something that is fairly common and not those rare things that "others haven't seen". So seeing those rare things isn't going to help you with the vast majority of your work as a GP.

 

[VetMedSurvivalGuide]

There are many specialty hospitals where pet parents can schedule appointments without a referral. I'm not talking about seeing plenty of rare things in GP. I was simply comparing someone that did an internship vs someone who didn't - both being recent graduates. That's the comparison that needs to be made and what the original poster is interested in. The person that did an internship, playing the odds, has seen more odd cases in that year than the one that went to private practice. I said nothing regarding who becomes a better doctor.

Good bedside manner, good communication skills, the ability to build trust in clients and patients is something that every veterinarian should strive to obtain, internship trained on not. You can obtain these skills in an internship or GP and will continue to improve on them regardless of your career path. The goal of an internship is not to see rarer cases that will make you a better doctor. You simply can obtain a different skillset and have different mentorship. Ultimately, it really boils down to what you want to do with your career and, if you decide to do an internship, how good is it. The same thing happens if you land on a first job where you have no support and/or poor mentorship.

The decision of doing an internship or not when the goal is to enter private practice is a very personal one. One size won't fit all. A lot of personal factors must be considered.

 

[CalliopeDVM]

Anything that ends up in a specialty clinic passes through a GP or ER doc first.

Yes, but not the same GP -- so there are a couple dozen GPs who might send a patient of theirs to the same internist, so that one internist (or neurologist, or ophthalmologist) will see things that most of those individual GPs haven't seen, even if one of those dozens of GPs has seen it.

 

[CalliopeDVM]

. I was simply comparing someone that did an internship vs someone who didn't - both being recent graduates. That's the comparison that needs to be made and what the original poster is interested in.

I have made that comparison myself, as a vet working with younger associates......and in my experience, while a GP who did an internship may have seen different things, they're not any more prepared for GP work. I thought that how to best be prepared for GP work was the original question. I could just as easily have countered that a vet spending a year working in a remote area without any emergency or referral options will have seen things that their fellow grads working in a reasonably-sized city hasn't seen, for that matter. But, again, not the point.

 

[deleted498041]

Anything that ends up in a specialty clinic passes through a GP or ER doc first. I don't know any specialists in veterinary medicine that take on patients without a referral from a GP.

My hospital is not referral only, so I frequently take on patients without a referral from a GP. I also frequently take on patients with referral from GP 🙂 I make sure I have their primary DVM recorded regardless so that I can communicate with the primary about findings and next steps, even if I'm the first doctor they're seeing for their issue.

 

[nyanko]

I don’t think it’s so much that these clinicians look down on GPs as it is that they simply don’t encourage students to go that route. It’s just that when it comes to advising students on what to do with their careers, there really aren’t many who would say “oh cool!” And certainly not right out of school. I don’t know if it’s just subconscious bias, or if it just seems that way because they only speak encouragingly to students seeking internships and dunno what to say to the “other kids” so it just seems that way. But I’ve personally had clinicians say things like, “oh, but why? You’d make such a good intern in fact I would love it if you were in our program!” I know they meant it as a compliment but certainly didn’t make me feel supported in my career choice.

Do you see clinicians giving helpful advice or being as encouraging to their practice bound students as they are with their internship bound students? I think the silence and being ignored is what was most frustrating. I felt rather left out when all discussions about the future revolved around the match and internships as if the rest of us didn’t matter.

I mean, I will have DIFFERENT conversations with students depending on their goals, and the ones that I personally can empathize with/advise the most are the ones doing the match because that was my personal reality, but I try to tailor the major teaching points in a case to what the student's goals are. We all know that most of the students are going to do GP of some variety, and a fair number will do large or mixed animal. If I know that they want to do GP, I will go over my version of a "quick and dirty" neuro exam and emphasize what parts of the exam should be incorporated into their general physical exam and what really only needs to be done in certain scenarios. I'll show them handling techniques that help in cases where they don't have a whole herd of technicians, other students and clinicians helping them. I'll demonstrate what they need to convey when they want to refer a case and what language to use to make it as painless as possible to talk to us silly neurologists. I really, really try to put my specialty in a context where every student who comes through should be able to pick up SOMETHING that they can use in their careers.

And I ALWAYS make it a point to say that straight up I could not do GP. That's way too many systems for me to deal with. Please just let me have this easy circuit and these reliable synapses. 🙂

 

[racccjlm]

And I ALWAYS make it a point to say that straight up I could not do GP. That's way too many systems for me to deal with. Please just let me have this easy circuit and these reliable synapses. 🙂

This. I feel the same way/just different system.