To Specialize or Not to Specialize

[BansheeCat]

As second year for my husband is coming to a close, we have been having a lot of discussions about whether or not he is going to pursue a specialty (internship + residency, likely in surgery) or not. We have started looking at differences in salary long-term while also considering other factors like: income DURING the internship + residency period, wanting to start a family after graduation, anecdotal evidence of vets who are not boarded but received a lot of mentorship in Sx and thus reap a lot of the income + experience benefits of performing more complex surgeries.

There are so many other things to consider too-- I am hoping that opening a discussion here with those who may be facing similar thoughts in addition to vets who have already moved beyond this decision will help shed more light on what to do!

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[MixedAnimals77]

Is there a specific question or discussion you're looking for?
There are alot of interns and residents in my program. Yes they work long hours. Yes the pay is terrible. Yes some of them have families. I will say alot of them that have families their SO often works to help support the family.
You can go out and get lots of mentorship and do complex surgeries, but the reality is imo that vet med is becoming more specialized and in order to do some of those more complex surgeries with the proper equipment he will likely need to be in a larger practice and that practice will very likely have specialists doing those surgeries and not the gp. Even if he is doing more complex surgeries he likely wont be able to charge the prices specialists can charge.

At the end of the day to specialize or not is a huge decision and a very personal one too. Sx from my understanding is one of the more competitive residencies as well meaning he may be looking at 2 years of internship before getting a residency. I think if he is interested in it it's good to explore now, but 4th year changes people, their goals and aspirations and willingness to continue to pursue further specialization. You guys have time and even have time during 4th year. I had lots of my classmates dead set on internship and residency only to get into 4th year and decide it wasnt for them. I also had some other classmates not wanting to pursue internship/residency and change their mind in 4th year. There's no easy answer because it depends what your goals are as individuals and as a family and what sacrifices you are all willing to make.

 

[finnickthedog]

Sx from my understanding is one of the more competitive residencies as well meaning he may be looking at 2 years of internship before getting a residency.

Or more. I've seen multiple people going down the surgery path who did two or three specialty internships (in addition to their rotating) before getting a residency.

 

[BansheeCat]

Is there a specific question or discussion you're looking for?
There are alot of interns and residents in my program. Yes they work long hours. Yes the pay is terrible. Yes some of them have families. I will say alot of them that have families their SO often works to help support the family.
You can go out and get lots of mentorship and do complex surgeries, but the reality is imo that vet med is becoming more specialized and in order to do some of those more complex surgeries with the proper equipment he will likely need to be in a larger practice and that practice will very likely have specialists doing those surgeries and not the gp. Even if he is doing more complex surgeries he likely wont be able to charge the prices specialists can charge.

At the end of the day to specialize or not is a huge decision and a very personal one too. Sx from my understanding is one of the more competitive residencies as well meaning he may be looking at 2 years of internship before getting a residency. I think if he is interested in it it's good to explore now, but 4th year changes people, their goals and aspirations and willingness to continue to pursue further specialization. You guys have time and even have time during 4th year. I had lots of my classmates dead set on internship and residency only to get into 4th year and decide it wasnt for them. I also had some other classmates not wanting to pursue internship/residency and change their mind in 4th year. There's no easy answer because it depends what your goals are as individuals and as a family and what sacrifices you are all willing to make.

Not really asking a specific question- but just getting feedback from others. I feel like our discussions have become repetitive or stuck in a loop since we have only been speaking with each other.

We've definitely already seen how quickly interests can change-- His have already changed a few times since he began school, or at least he is considering more options at this point.

As far as being in a larger practice to do more complex surgeries/ being boarded in order to be the surgeon actually cutting, we would ideally (long-term) like to live in a rural area. So while that may reduce/ eliminate that option maybe it also presents a different perspective of smaller clinics being more self-sufficient due to limited veterinary care options within a reasonable distance for clients. And if, after a few years of gaining experience (without becoming boarded) he could be forth coming with clients that while he is not boarded he is experienced/ comfortable with surgery allowing people the option to have more complex surgeries done for their pets without needing to travel farther distances to specialty clinics. Which may in turn allow him to charge more (maybe not as much as specialty clinics, but likely more than most GPs).

^these are the types of things we've been discussing, but not sure of the reality/ feasibility of it.

Or more. I've seen multiple people going down the surgery path who did two or three specialty internships (in addition to their rotating) before getting a residency.

I am starting to find this out more after looking into the requirements/ path to get to a specialty. My husband is concerned about this as well-- that the timeline might be more than an additional 4 years. So trying to consider that in our planning as well.

Probably the biggest factor we are evaluating is the financial aspect. Is the long-term potential income difference of being boarded worth the continued income sacrifice now (for another 4+ yrs)? And I suppose that being a boarded surgeon does not guarantee a higher income than that of an experienced, top performing GP. And another consideration is that ideally we would like to own a practice, long-term. My experience/ skills would allow me to contribute significantly to the administrative side of things in practice ownership and we have always worked well together in our personal as well as professional lives, so it makes sense to continue doing that.

 

[SocialStigma]

I'm a boarded surgeon, feel free to PM if you have any specific questions. I did 4 years (1 year rotating internship, 3 year residency) post-vet school, and am a few years out of my residency now. For me it was definitely worth it, however I did have to put my personal life on hold to achieve this career goal (ie. getting married, buying a house, having kids, etc). I can say pretty confidently that being a boarded surgeon definitely guarantees a higher income than a GP with a special interest in surgery. I've seen job ads/received random recruitment offers listing $300k base salaries for boarded surgeons in some practices. It would be extremely hard for a GP vet to top that unless they were also a practice owner.

 

[BansheeCat]

I'm a boarded surgeon, feel free to PM if you have any specific questions. I did 4 years (1 year rotating internship, 3 year residency) post-vet school, and am a few years out of my residency now. For me it was definitely worth it, however I did have to put my personal life on hold to achieve this career goal (ie. getting married, buying a house, having kids, etc). I can say pretty confidently that being a boarded surgeon definitely guarantees a higher income than a GP with a special interest in surgery. I've seen job ads/received random recruitment offers listing $300k base salaries for boarded surgeons in some practices. It would be extremely hard for a GP vet to top that unless they were also a practice owner.

I PM'd you! Thanks!

 

[JaynaAli]

I'm a boarded surgeon, feel free to PM if you have any specific questions. I did 4 years (1 year rotating internship, 3 year residency) post-vet school, and am a few years out of my residency now. For me it was definitely worth it, however I did have to put my personal life on hold to achieve this career goal (ie. getting married, buying a house, having kids, etc). I can say pretty confidently that being a boarded surgeon definitely guarantees a higher income than a GP with a special interest in surgery. I've seen job ads/received random recruitment offers listing $300k base salaries for boarded surgeons in some practices. It would be extremely hard for a GP vet to top that unless they were also a practice owner.

This. But ESPECIALLY as a rural vet. I live in a very rural area. A few GP vets (mostly mixed animal vets) I have worked for do more “advanced” surgeries like plating fractures, extracapsular cruciate repairs, diaphragmatic hernia repairs, etc. Despite doing these surgeries on occasion, their salary in rural practice doesn’t even approach an urban GP, much less a board certified surgeon. People in rural areas that I know personally do these out of necessity for their patients and interest, not the financial aspect. Maybe you don’t mean a place as rural as where I live but just thought I’d throw my experience out there.

 

[BansheeCat]

This. But ESPECIALLY as a rural vet. I live in a very rural area. A few GP vets (mostly mixed animal vets) I have worked for do more “advanced” surgeries like plating fractures, extracapsular cruciate repairs, diaphragmatic hernia repairs, etc. Despite doing these surgeries on occasion, their salary in rural practice doesn’t even approach an urban GP, much less a board certified surgeon. People in rural areas that I know personally do these out of necessity for their patients and interest, not the financial aspect. Maybe you don’t mean a place as rural as where I live but just thought I’d throw my experience out there.

Thanks! It's nice to hear more about the rural aspect of things. We may end up living rural and having my husband commute somewhere more suburban/ urban, if needed. Or way out in the future, we would love if he was set up to alternate working several months and then having a few months off and we could split our time between a small home near wherever he's working and a rural secondary home. (A LOT of things would need to be come into place for something like this to happen, but hey-- we can dream right?)

 

[battie]

I lived in a 5000 person town where the closest target was 100 miles away. The vet in town was mixed obviously and did a lot of more complex stuff. His charges were probably a third of what the closest urban center would have charged by a GP and easily a fifth of a boarded surgeon. That's obviously an extreme. But something to keep in mind. If yall want to live rural, it will negate part of the benefits of getting boarded.

The people I know who have gone for surgery have been unsuccessful. One girl from our class of 2020 is starting her second specialty internship this June. Two guys in my hospital did rotating and specialty internships. They were both accepted for surgical internships again, but went into private practice because they would be paid 3-4× an intern salary while still learning more complex procedures with our mentorship. One reapplied for residencies and didn't land anything.

I considered getting boarded in several different things, and the now husband and I discussed it Thanksgiving of third year. Husband was on board for trying with the caveats of living together and having a realistic end point (rather than repeatedly trying over and over).

 

[BansheeCat]

I lived in a 5000 person town where the closest target was 100 miles away. The vet in town was mixed obviously and did a lot of more complex stuff. His charges were probably a third of what the closest urban center would have charged by a GP and easily a fifth of a boarded surgeon. That's obviously an extreme. But something to keep in mind. If yall want to live rural, it will negate part of the benefits of getting boarded.

The people I know who have gone for surgery have been unsuccessful. One girl from our class of 2020 is starting her second specialty internship this June. Two guys in my hospital did rotating and specialty internships. They were both accepted for surgical internships again, but went into private practice because they would be paid 3-4× an intern salary while still learning more complex procedures with our mentorship. One reapplied for residencies and didn't land anything.

I considered getting boarded in several different things, and the now husband and I discussed it Thanksgiving of third year. Husband was on board for trying with the caveats of living together and having a realistic end point (rather than repeatedly trying over and over).

Rural: That's something we are trying to do more research on/ figure out realistic stats for. We may also consider delaying our rural dreams for some amount of time in an urban area to allow us to build a more solid financial foundation.

Multiple internships: Before diving into this process more, I had no idea that it could be so difficult to get matched/ that the process could take much longer than 4 years for specializing. We've been sacrificing for a long time already in order to pay for vet school and I'm not sure that I want to continue doing that without a guaranteed end point... But I also want to support my husband in his career goals.

There are just so many influencing factors to consider and it's difficult to make a decision when there are also a lot of unknowns at this point. I know my husband and I will have to continue having a lot of conversations about what matters to us and what sacrifices we are willing to continue making!

 

[DrinkWater95]

I know a vet in Australia who has opened his own practice and specifically does orthopedic surgery, however, they aren’t specialised. They just rent out a theatre from a local hospital and they bought all of the equipment for that theatre. They charge about 2/3 of what a specialist would. So they make somewhere between a GP and specialist income. I’m guessing around $150-200k AUD.

 

[britzen]

There's also the possibility of specializing and then making relationships with various clinics to travel to them and do surgeries. Basically own your own small business as a traveling surgeon.

I interviewed with a few clinics that brought in a board certified surgeon say once every few weeks or once a month to do more complicated surgeries for their clients.

Not sure it would work for your family, but just throwing it out there as a possibility you could explore. It may allow you to live rural but have better income potential. Drawback being some time on the road for your spouse, or having to live a somewhat reasonable commuting distance to a large urban area.

 

[finnickthedog]

Multiple internships: Before diving into this process more, I had no idea that it could be so difficult to get matched/ that the process could take much longer than 4 years for specializing. We've been sacrificing for a long time already in order to pay for vet school and I'm not sure that I want to continue doing that without a guaranteed end point... But I also want to support my husband in his career goals.

You could also discuss and agree upon an end point. Like, that he will do a maximum of X internships and if he doesn't get a residency at that point then he'll move on. Just because you start off pursuing surgery doesn't mean you have to be in it until the end. Of course if he didn't get a residency it would suck not to get the larger salary after the years invested, but might alleviate the "what if" feeling of not having tried.

 

[BansheeCat]

There's also the possibility of specializing and then making relationships with various clinics to travel to them and do surgeries. Basically own your own small business as a traveling surgeon.

I interviewed with a few clinics that brought in a board certified surgeon say once every few weeks or once a month to do more complicated surgeries for their clients.

Not sure it would work for your family, but just throwing it out there as a possibility you could explore. It may allow you to live rural but have better income potential. Drawback being some time on the road for your spouse, or having to live a somewhat reasonable commuting distance to a large urban area.

I came across one article a couple weeks ago interviewing someone that did this-- traveling surgeon. Sounds intriguing! As long as he could get enough business to maintain an appropriate income. And yes, as long as our lifestyle suited him traveling often. But I suppose if we place ourselves in an area that geographically fits with this idea, it could work quite well!

You could also discuss and agree upon an end point. Like, that he will do a maximum of X internships and if he doesn't get a residency at that point then he'll move on. Just because you start off pursuing surgery doesn't mean you have to be in it until the end. Of course if he didn't get a residency it would suck not to get the larger salary after the years invested, but might alleviate the "what if" feeling of not having tried.

We would definitely agree on an end point should he truly pursue this specialization route. We did that for vet school as well after he didn't get accepted the first year he applied. Just struggling with the idea that we might continue to sacrifice 1+ years post-graduation and it not be productive (outside of gaining more experience/ mentorship before going into private practice). But that is a risk we will have to decide to take if needed- just like everyone else.

 

[WhtsThFrequency]

I'm a boarded surgeon, feel free to PM if you have any specific questions. I did 4 years (1 year rotating internship, 3 year residency) post-vet school, and am a few years out of my residency now. For me it was definitely worth it, however I did have to put my personal life on hold to achieve this career goal (ie. getting married, buying a house, having kids, etc). I can say pretty confidently that being a boarded surgeon definitely guarantees a higher income than a GP with a special interest in surgery. I've seen job ads/received random recruitment offers listing $300k base salaries for boarded surgeons in some practices. It would be extremely hard for a GP vet to top that unless they were also a practice owner.

Oof. Don't get me wrong, I love my specialty, but when I see figures like that sometimes I wonder if I should have done something else rather than 3 years of path residency and 5 of PhD after vet school to make ~120k. Then again, I'm academia so that's why. I'm sure if I went into industry it would be much more. The work-life balance is pretty good in academia, to be fair. But yeah....

 

[SocialStigma]

Oof. Don't get me wrong, I love my specialty, but when I see figures like that sometimes I wonder if I should have done something else rather than 3 years of path residency and 5 of PhD after vet school to make ~120k. Then again, I'm academia so that's why. I'm sure if I went into industry it would be much more. The work-life balance is pretty good in academia, to be fair. But yeah....

It's a double-edged sword for sure, the pay is generally quite good but the work-life balance for a surgeon will never be as good as a non-cutting specialist. It's committing to a lifetime of being on call, missing holidays/important events, looking at fracture radiographs for ER on weekends, etc...I'm in my early 30s and already I'm wondering how I will make it through being on call when I'm in my 50s ha.

 

[that redhead]

@BansheeCat a lot of good points brought up. One thing you haven’t mentioned that @SocialStigma brought up is work/life balance, especially if you’re planning to have kids. Boarded surgeon hours aren’t going to be cushy until potentially much later in the career trajectory. Pair that with business ownership and it’s going to be really tough on you, especially working at the same small business. Practice creation, cultivation and ongoing ownership all all big hurdles on their own. Not to say impossible, but it’s a lot when paired with young kids. Just food for thought.

 

[BansheeCat]

@BansheeCat a lot of good points brought up. One thing you haven’t mentioned that @SocialStigma brought up is work/life balance, especially if you’re planning to have kids. Boarded surgeon hours aren’t going to be cushy until potentially much later in the career trajectory. Pair that with business ownership and it’s going to be really tough on you, especially working at the same small business. Practice creation, cultivation and ongoing ownership all all big hurdles on their own. Not to say impossible, but it’s a lot when paired with young kids. Just food for thought.

Obviously we don't actually know what it's like to have kids yet, but we are definitely used to working long hours/ not seeing each other for long stretches of time. We went through a period when we were each working 80+ hours a week. But it is definitely something to keep in mind-- potentially starting a business and managing life at home with kids!
Ideally if we get to the point of practice ownership, it wouldn't be a typical clinic. Before vet school we were both working at a preclinical testing facility that conducted non-GLP and GLP studies for human biomedical companies. This field of vet med is something we both found intriguing and may be interested in going back to.

 

[KCgophervet]

Obviously we don't actually know what it's like to have kids yet, but we are definitely used to working long hours/ not seeing each other for long stretches of time. We went through a period when we were each working 80+ hours a week. But it is definitely something to keep in mind-- potentially starting a business and managing life at home with kids!
Ideally if we get to the point of practice ownership, it wouldn't be a typical clinic. Before vet school we were both working at a preclinical testing facility that conducted non-GLP and GLP studies for human biomedical companies. This field of vet med is something we both found intriguing and may be interested in going back to.

You may want to float lab animal specialty instead of surgery if you're thinking of opening up a CRO or something similar. Has some other benefits like no need for internships (typically), slightly better work-life balance, and higher paid (for residency itself, not so much afterwards).

 

[BansheeCat]

You may want to float lab animal specialty instead of surgery if you're thinking of opening up a CRO or something similar. Has some other benefits like no need for internships (typically), slightly better work-life balance, and higher paid (for residency itself, not so much afterwards).

The facility we worked at previously used dogs and pigs primarily and most of the studies required complex surgeries-- that's why he is thinking of going the surgical route and not lab animal. In our 3 years at that facility we never had to work with rats or mice.

 

[KCgophervet]

The facility we worked at previously used dogs and pigs primarily and most of the studies required complex surgeries-- that's why he is thinking of going the surgical route and not lab animal. In our 3 years at that facility we never had to work with rats or mice.

I guess it depends on what the end goal is. Purely for a CRO, knowledge of regulations around animal research, different models, etc would come in handy moreso than knowing how to do TPLO surgeries. A lot of lab animal surgeries are either things like VAPs (vascular access ports) or models that have been invented purely for the research being performed, so not something that would necessarily be learned or taught in a surgical residency. Not saying they would be taught in a lab animal residency either but if the end goal is surgery in animal research there are just a few different angles to consider. If not already familiar I would have him look up the Academy of Surgical Research - it's a good source for this type of work.

Edit: not that its purely relevant but just as an FYI I'm a full time lab animal vet and I also am not currently working with mice or rats. I also interviewed for a separate surgery position at a facility that has no rodents and was preclinical device testing. Lab animal doesn't mean just mice and rats...

 

[BansheeCat]

I guess it depends on what the end goal is. Purely for a CRO, knowledge of regulations around animal research, different models, etc would come in handy moreso than knowing how to do TPLO surgeries. A lot of lab animal surgeries are either things like VAPs (vascular access ports) or models that have been invented purely for the research being performed, so not something that would necessarily be learned or taught in a surgical residency. Not saying they would be taught in a lab animal residency either but if the end goal is surgery in animal research there are just a few different angles to consider. If not already familiar I would have him look up the Academy of Surgical Research - it's a good source for this type of work.

Edit: not that its purely relevant but just as an FYI I'm a full time lab animal vet and I also am not currently working with mice or rats. I also interviewed for a separate surgery position at a facility that has no rodents and was preclinical device testing. Lab animal doesn't mean just mice and rats...

Thank you- definitely some good points that I will pass along to my husband. I guess our knowledge and assumptions about lab animal versus surgery is being based off the facility we worked at. It was owned by a couple- both vets and both boarded surgeons (the wife was also boarded in anesthesia). For the type of work we did with them and the fact that we may be interested in modeling a future facility after theirs, it was their recommendation to pursue surgery. But yes, for the specific and unusual surgeries that are required- that likely won't be taught in a surgery or lab animal residency.

Do you like your current position? What type of animals are you working with? I think my husband said he doesn't want to work with primates either... not sure how common that is though.

 

[KCgophervet]

Thank you- definitely some good points that I will pass along to my husband. I guess our knowledge and assumptions about lab animal versus surgery is being based off the facility we worked at. It was owned by a couple- both vets and both boarded surgeons (the wife was also boarded in anesthesia). For the type of work we did with them and the fact that we may be interested in modeling a future facility after theirs, it was their recommendation to pursue surgery. But yes, for the specific and unusual surgeries that are required- that likely won't be taught in a surgery or lab animal residency.

Do you like your current position? What type of animals are you working with? I think my husband said he doesn't want to work with primates either... not sure how common that is though.

Surgery can also be a good route, I just think it's a lot of extra steps (and years and lower income) if you're not planning on using it for private practice. You could apply surgical techniques learned in a residency to novel surgical models and I'm sure it would be useful, just not the only route available. And you will need to learn/know about the regs and research aspects of things if you open a CRO.

Double edged sword question. I often love my job, but there's a lot of outside factors right now that are making work stressful (short staffing, undertrained staff, and research booming). Not to mention I'm studying for boards right now so that's a whole new level of stress added on top. Right now I'm working with pigs, sheep, cats, and occasionally NHP (I'm the vet for the NHP quarantine at my facility so I only have them right when they arrive for a few weeks). I love working with nonhuman primates but I know a lot of people don't enjoy it. I think its easier to avoid NHPs than it is to get the chance to work with them. Most of my animals are used in surgical models, so I work closely with a lot of surgeons (primarily human, but do their research in animal models).

 

[that redhead]

And I’m over here ONLY working with NHPs The lab animal field has a lot of different nooks and crannies; you can find some super niche things and some more generalized stuff. But still mostly going to be centered in non-rural areas.

What does he actually want to DO for his work? You can do surgery in many different contexts, but is that what he’s actually excited about doing every work day for his career?

 

[pinkpuppy9]

You could also discuss and agree upon an end point. Like, that he will do a maximum of X internships and if he doesn't get a residency at that point then he'll move on. Just because you start off pursuing surgery doesn't mean you have to be in it until the end. Of course if he didn't get a residency it would suck not to get the larger salary after the years invested, but might alleviate the "what if" feeling of not having tried.

This is what my husband and I had discussed. This most recent cycle was my first time applying for zoo internships. We discussed trying two, maybe three times before I would be willing to settle down more and start talking about having a kid.

You could, quite literally, apply to something every year for the rest of your life and never get it. In the meantime, life happens around you.

Oof. Don't get me wrong, I love my specialty, but when I see figures like that sometimes I wonder if I should have done something else rather than 3 years of path residency and 5 of PhD after vet school to make ~120k. Then again, I'm academia so that's why. I'm sure if I went into industry it would be much more. The work-life balance is pretty good in academia, to be fair. But yeah....

Yeah I've had the same thoughts. I just got a bump to $150k in corporate ER, no production. The surgeons I work with are on something like 20% production and crank out 4-6 average surgeries per cut day, and each surgery averages $5-7k (they can take a decent hit to their quality of life, but we have enough surgeons that on-call is rotated frequently). Radiologists are also on the 20% production and do sometimes up to 10-15 $560 ultrasounds per day, while simultaneously reading out CTs/MRIs/rads. Unfortunately, both of those specialities make me gag, soo... In another life, I'd like to be a radiologist (human or animal) working from home in Hawaii or something. But for now, my dumb a** is goinginto zoo med, which is one of the worst paying specialties haha.