What should I be doing while in school if I'm considering doing an internship?

[zenarcade]

I'm a current third year. I've been pretty set on GP this whole time until recently when I began entertaining the idea of doing something else... potentially specializing or ER. I still haven't made up my mind, but if I do end up wanting to do an internship, do I need to be doing anything differently while I'm in school? I feel like if I did want to specialize, I've fallen behind at this point as I haven't done anything to work towards it.... I haven't done any research, no special connections with any faculty. Is research experience important for a rotating internship? Since I won't have any summers off any more, I've kind of missed the opportunity to get involved in summer research projects like some of my classmates have. And I've read that a big determinant in getting into a program is having good LORs- do most people make these connections with faculty during 4th year? A 2-3 week rotation seems like a short period of time to get to know someone well enough to get a good LOR from them.

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[MixedAnimals77]

Do you have an idea of what you would want to specialize in? Or are you looking to specialize in ER? You've still got time. If you know what area you might want to go into you can still go join clubs and go to events, just go hang out in the VTH on that rotation if you want. If you want to specialize I would try to prioritize that rotation early on so you can get to know the clinicians. At the end of the day you're going to want LORs that know you and 2 weeks on 4th year is likely not going to be enough. If you are thinking IM or Onco definately take Dr.Sellon's elective if he still offers it, I think it's in the spring. At least there used to be an ortho elective too so if any of those are of interest I'd recommend signing up for those if you can

ETA: Definately be reflective in possibly changing. Talk to interns and residents about what life is like. Ask yourself why specalize vs continue on to GP. If you just have a special interest I'd recommend staying with GP and then focus on that specific area. If you've found yourself in love with a topic start forming those bridges now.

PPS Dr. Golden LOVES cardio if that's what you're thinking and I'm sure she would be happy to have you hang out on cardio. ER is a super easy place to go hand out and get put to work too, that place was usually a zoo when I was a student so if that's what youre considering go hang out in the ER

 

[zenarcade]

Do you have an idea of what you would want to specialize in? Or are you looking to specialize in ER? You've still got time. If you know what area you might want to go into you can still go join clubs and go to events, just go hang out in the VTH on that rotation if you want. If you want to specialize I would try to prioritize that rotation early on so you can get to know the clinicians. At the end of the day you're going to want LORs that know you and 2 weeks on 4th year is likely not going to be enough. If you are thinking IM or Onco definately take Dr.Sellon's elective if he still offers it, I think it's in the spring. At least there used to be an ortho elective too so if any of those are of interest I'd recommend signing up for those if you can

I was kind of thinking IM. I'm maybe also interested in working in ER but I don't think specializing. I am taking the clinical reasoning elective in spring. I might try to spend some time in the VTH as well. Thanks for the reply!

 

[MixedAnimals77]

I was kind of thinking IM. I'm maybe also interested in working in ER but I don't think specializing. I am taking the clinical reasoning elective in spring. I might try to spend some time in the VTH as well. Thanks for the reply!

The IM people are great. Was probs one of my favorite rotations. You could always reach out to Dr. Guess , Haines, Sellon or whoever and see if theres any like data sorting or something along those lines to help them with research since you don't really have time to do a research project, doesn't mean you can't be involved. Glad you are taking the elective it should be good. If you start hanging out then you can get a feel too for if it's for you and you can always take a rotation more than once which if you're wanting to pursue internship would be helpful for that aspect.

 

[JaynaAli]

The most important factors are your GPA and your LORs for sure, but the internship match rate is like 65%, so a majority of people who want one can get one. And that’s not counting the scramble, I don’t think. I feel like there’s enough unmatched positions each year that even candidates with what are regarded as “below average” stats still usually figure something out. It may not be a fancy big name program, but small or little known programs aren’t necessarily bad. I enjoyed my time at a small private specialty hospital. Well, as much as one can enjoy internship lol. I liked it being small, I got to do more.

I agree with the advice to do rotations where you might want a LOR early on, since you need time to build those relationships. Three weeks is a short period of time though, so I’d start making your face known around the hospital now if at all possible. Then wow them on rotations. But it’s not unheard of to ask for a LOR when you’ve only been on for a rotation. Keep your grades as high as you can. Research isn’t really necessary. Nice to have? Sure, but not a ‘must have’ to me.

 

[battie]

I'm maybe also interested in working in ER but I don't think specializing.

Just to briefly touch on this as a non-internship trained ER doc, specializing isn't necessarily necessary for ER work, but going to tag @cdo96 for her take on the advantages of being boarded in ER. I would also argue it isn't necessary to go through an internship *if* you can find an ER clinic with good mentorship. The obvious advantage is the case load and simply having the exposure. Whether or not having that accelerated first year out is worth the cons (low pay, high hours, etc.) is an individual choice. I honestly feel like my opinion is in the minority amongst my classmates

 

[cdo96]

Just to briefly touch on this as a non-internship trained ER doc, specializing isn't necessarily necessary for ER work, but going to tag @cdo96 for her take on the advantages of being boarded in ER. I would also argue it isn't necessary to go through an internship *if* you can find an ER clinic with good mentorship. The obvious advantage is the case load and simply having the exposure. Whether or not having that accelerated first year out is worth the cons (low pay, high hours, etc.) is an individual choice. I honestly feel like my opinion is in the minority amongst my classmates

I’ll see this and play devil’s advocate. Third year ECC resident for context.

Some hospitals, especially tertiary level hospitals, won’t hire an ER doctor if they didn’t do an internship, and definitely not within the first 5 years of graduation. I personally think everyone should do an internship of some sort, especially in ER. If you have an inkling of wanting to do a specialty, do an internship. It’s so much easier to come back to a specialty if you did.

I’ve worked with a lot of ER doctors, and I do see the difference between internship trained and non internship trained, especially with sicker cases. You can still absolutely be a fantastic ER doctor without one, but imo it takes much more work that most people aren’t willing to put into it.

 

[zenarcade]

I’ll see this and play devil’s advocate. Third year ECC resident for context.

Some hospitals, especially tertiary level hospitals, won’t hire an ER doctor if they didn’t do an internship, and definitely not within the first 5 years of graduation. I personally think everyone should do an internship of some sort, especially in ER. If you have an inkling of wanting to do a specialty, do an internship. It’s so much easier to come back to a specialty if you did.

I’ve worked with a lot of ER doctors, and I do see the difference between internship trained and non internship trained, especially with sicker cases. You can still absolutely be a fantastic ER doctor without one, but imo it takes much more work that most people aren’t willing to put into it.

Yeah since I'm considering speciality (probably IM?) but also open to ER, I figured an internship would allow me to go either way.
Really appreciate everyone's advice in this thread.

 

[pp9]

I personally think everyone should do an internship of some sort, especially in ER.

I’ve worked with a lot of ER doctors, and I do see the difference between internship trained and non internship trained, especially with sicker cases.

+1000. OP - my background is rotating internship at a corporate specialty hospital, then stayed on working ER/sorta CC for a few years. You will find a split in opinions on this topic and everything I'm saying here is just my opinion.

1. Spending time with specialists is valuable for many reasons, a huge one is just understanding what the average ER or GP should (and should not!) refer. Understanding when you are in over your head, or when you should not just automatically boot a case, is important. I've seen some **** and could talk about this for hours.

2. My internship absolutely whipped me into shape. I was a clueless lump of a veterinarian at graduation. By the end of my intern year, I was taking on the sickest cases and doing it very well. That wouldn't have been possible without the experience with criticalists, surgeons, etc. With that being said, an internship is still not for everyone. I don't think the new grad going into GP should worry about not doing one, but deciding to do one does not hurt (except financially).

3. It's already been said, but if you think you might want to specialize, do the internship. You'll either stay on that path and have already completed the first step (the rotating internship), or you'll realize you don't want to specialize after seeing the day to day of specialty medicine. I think ~half of my internmates went on to GP and didn't regret the internship. Most of that half were planning to do GP after the internship, some decided not to pursue specializing.

 

[Trilt]

I’ll see this and play devil’s advocate. Third year ECC resident for context.

Some hospitals, especially tertiary level hospitals, won’t hire an ER doctor if they didn’t do an internship, and definitely not within the first 5 years of graduation. I personally think everyone should do an internship of some sort, especially in ER. If you have an inkling of wanting to do a specialty, do an internship. It’s so much easier to come back to a specialty if you did.

I’ve worked with a lot of ER doctors, and I do see the difference between internship trained and non internship trained, especially with sicker cases. You can still absolutely be a fantastic ER doctor without one, but imo it takes much more work that most people aren’t willing to put into it.

And I think every ER doctor and specialist should do a year or two of GP. So they see the hundreds and thousands of day in day out **** that we manage that *doesn't* end up at the ER, and the average budget and client we're dealing with. And actually knows about common things that don't as often make it to secondary/tertiary care.

The problem is it's impossible to simultaneously do both at graduation. 😉

 

[pp9]

And I think every ER doctor and specialist should do a year or two of GP. So they see the hundreds and thousands of day in day out **** that we manage that *doesn't* end up at the ER, and the average budget and client we're dealing with. And actually knows about common things that don't as often make it to secondary/tertiary care.

The problem is it's impossible to simultaneously do both at graduation. 😉

I don't think CDO is saying that people in GP should have done an internship, but that people heading to ER should absolutely consider doing one (and that was the context of my post as well). The ER vs. GP pissing contest doesn't really have a winner. Both jobs can really suck, lol

 

[Trilt]

I don't think CDO is saying that people in GP should have done an internship, but that people heading to ER should absolutely consider doing one (and that was the context of my post as well). The ER vs. GP pissing contest doesn't really have a winner. Both jobs can really suck, lol

Next month I'm coming up on my fourth year in ER (after four full time years in GP + part time work for two years after), so yeah, have definitely seen it sucking on both sides.

But man it just absolutely kills me when people say you should do an internship before working GP when the majority of our current internship options are absolutely, absurdly so far removed from what a typical person is doing in GP.

While I don't disagree people learn a ton in internships and I absolutely see value in having guided learning and feedback, the question of how relevant that knowledge is to 98% of the cases you treat is *important.*

You learn a lot your first year in practice, too. The opportunity and financial cost of internship - not doing much derm, dentistry, typical surgeries, chronic disease management and working with GP level budgets for a year PLUS making ****ty money - is not small.

 

[pp9]

But man it just absolutely kills me when people say you should do an internship before working GP when the majority of our current internship options are absolutely, absurdly so far removed from what a typical person is doing in GP.

Yep, I agree with this. If my goal is GP and I have no intention of specializing, I wouldn't do an internship either.

typical surgeries

My lack of surgical experience is one of my biggest concerns, although other ER people will have a ton of surgical experience.

I do actually hate surgery with a passion, but I also have never done anything beyond several spays/neuters (not counting the countless lac repairs in this context). I'm sure we've all discussed this before, but you don't get much surgery during vet school unless you play your cards right - I graduated with one spay and one neuter from junior surgery. I've assisted in almost every surgery I can think of, but that's no where close to being primary.

 

[battie]

I'm sure we've all discussed this before, but you don't get much surgery during vet school unless you play your cards right - I graduated with one spay and one neuter from junior surgery.

This is arguably the greatest failing of vet med education in comparison to expectations of day 1 baby vets. It's the number one thing I would change.

 

[pp9]

This is arguably the greatest failing of vet med education in comparison to expectations of day 1 baby vets. It's the number one thing I would change.

The stories I've heard from the older vets I've worked (graduates from the 80s-90s, maybe early 2000s)...they did so much more than we did/do now. If I wanted to put my tinfoil hat on, I'd say it's all some roundabout way to continue pushing for specializing, and gradually making us more in line with the structure of human medicine.

Even the classmates of mine that got a 'lot' of surgical experience did it in the context of the shelter med rotation, so still spays/neuters. I don't think anyone was primary on a foreign body, C-section that wasn't technically just a terminal spay, etc.

ETA: I've totally derailed at this point. Honestly, I think the newer generation is missing out on a lot beyond surgery compared to previous generations of vets. When you consider how big class sizes are getting, and how short some rotations are getting (like two weeks at U of I...), the odds are already against you that you'll ever get to pull a calf, place an equine catheter, manage a sick foal, get a seat on dentistry or ophtho, and so on. The clinical skills labs are not the same, despite what schools want their students to think.

 

[battie]

ETA: I've totally derailed at this point. Honestly, I think the newer generation is missing out on a lot beyond surgery compared to previous generations of vets.

Going to continue the derailment:

One of our 2023 grads that joined our hospital last year was part of the final class that did terminal surgeries at CSU. She did pretty much everything in that class, including nephrectomies and such. She honestly has more experience with surgery and way more confidence than me (particularly since my board complaint is about a surgery I did 🙄). Setting aside the ethics discussion of terminal surgeries, it's invaluable experience at this point.

I'm currently watching CSU's CE registration as they have weekend surgery courses. I'll be taking one of those courses hopefully next year. I don't like surgery and just do it to be helpful to the hospital. But there are at least 2-3 doctors who don't do surgery. If we get to the point where no one is alone except from 2-7am overnight at all three hospitals, I'll likely never do surgery again, cause I'll offer it to the people who like it. We aren't production based, so doesn't matter to me.

On the topic of missing out beyond surgery, I do think having 2 years didactic and 2 years clinics would be an improvement. Mizzou and Miss both already do this. Illinois's structure isn't as useful now that I'm on the other side; definitely rotation vacation in hindsight. And unless it's mandated by the industry itself or legally, internship year will never be required as you'll have too many folks who straight up say no. So we need to go farther backwards in education to make up the education deficit I think we all agree is present.

 

[Trilt]

My four-five hour terminal surgery lab (on a pig) was absolutely invaluable - probably the most I learned in an afternoon in vet school - and I was extremely frustrated to hear they no longer do it.

 

[battie]

My four-five hour terminal surgery lab (on a pig) was absolutely invaluable - probably the most I learned in an afternoon in vet school - and I was extremely frustrated to hear they no longer do it.

I helped to run the tours on interview day every didactic year of vet school. It was amazing to me how many students were going to make terminal surgeries a single reason to not attend a vet school.

 

[pp9]

I helped to run the tours on interview day every didactic year of vet school. It was amazing to me how many students were going to make terminal surgeries a single reason to not attend a vet school.

I feel like the terminal surgeries topic resurfaces every few years. Prior to/during vet school, I was neutral. Post vet school, looking back it would have been nice to do some things that you wouldn't necessarily do to an animal you're going to recover (mock GDV, lacerate a large vessel and try to control the bleeding, etc.). Some large animal stuff would have been great too. Can't say I feel I would have really benefitted from more advanced surgeries (like nephrectomies, specifically). If the average GP would be doing nephrectomies, it makes sense to be doing them though.

To some extent, I can respect why people get upset about them. I also think the general assumption is that animals are being bred and raised for terminal surgeries...which is only sometimes true. You do a ton of cadaver stuff in vet school and people don't complain about that, and the only difference is the animal was already euthanized before it got to you. Some of the cadaver animals are definitely born/raised to become cadavers.

 

[Trilt]

I feel like the terminal surgeries topic resurfaces every few years...we've talked about it before for sure. Prior to/during vet school, I was neutral. Post vet school, looking back it would have been nice to do some things that you wouldn't necessarily do to an animal you're going to recover (mock GDV, lacerate a large vessel and try to control the bleeding, etc.). Some large animal stuff would have been great too. Can't say I feel I would have really benefitted from more advanced surgeries (like nephrectomies, specifically). If the average GP would be doing nephrectomies, it makes sense to be doing them though.

To some extent, I can respect why people get upset about them. I also think the general assumption is that animals are being bred and raised for terminal surgeries...which is only sometimes true. You do a ton of cadaver stuff in vet school and people don't complain about that, and the only difference is the animal was already euthanized before it got to you. Some of the cadaver animals are definitely born/raised to become cadavers.

Except that assumption is usually absolutely wrong... our pigs were part of a joint study. So they were being euthanized for that, anyway, and their limbs harvested. We just got great experience prior to their euthanasia.

I absolutely would agree with anyone being able to opt out with no repercussions, but just throwing away the whole concept makes me sad. I had sutured gut prior to graduation... I never would have, otherwise. We had a sudden bleed from a loose ligation during the splenectomy and we fixed it! All things that were so helpful to future me.

I was lucky to actually get quite a bit of spay/neuter surgery experience (>100 sx) prior to graduation and was fairly confident as a new grad, but still found that super invaluable.