Before I was accepted to veterinary school, I had no idea that internships or residencies even existed. My first exposure to specialty practice was just before my senior year of undergrad, when I had the opportunity to spend several months in a pre-veterinary summer program at the Animal Medical Center in New York. Going into it, I didn’t know that veterinary specialties were a thing – neurologists? Internists? Criticalists? It was a whole new world for me.
After this experience, I knew that I wanted to pursue advanced training. While I wavered back and forth between small animal and equine medicine, I eventually settled on taking the small animal route (note: this article is specific to small animal internships; equine internships are a completely different ball game).
I was fortunate enough to end up getting my 1st choice rotating internship at Wheat Ridge Animal Hospital in my home state of Colorado. I loved my internship and I would go back and do it again in a heartbeat. After finishing my internship, I started down the path to becoming a critical care specialist, but left that program after 6 months. Had I known what I know about that program now, I probably would not have even applied to it (3 people before me also left the program!). Having been through one program that was a great fit, and one program that left me questioning whether I even wanted to be a veterinarian anymore, I have experienced all the highs and lows of post-doctoral training. This article is intended to help you better understand internship programs, and to assist you in finding the internship that will be the best fit for you.
What is the difference between an internship and an externship?
An externship is a block of time in which you visit a hospital while you are still a student. Most externships are done during your 4th year (but can be completed at any time), and usually last 1-4 weeks in duration. Hospitals with internship programs prefer that you visit for an externship first. This is beneficial on both parts; it will give you an idea of what their program is like, and it also serves as somewhat of a working interview for the hospital to evaluate whether you would be a good fit.
An internship is completed only after you have graduated from veterinary school and earned your doctorate. These are typically one year in length. Most internships are structured as a rotating internship, meaning that you spend blocks of time working in different specialty departments (internal medicine, surgery, critical care/ER, neurology, oncology, ophthalmology, cardiology, and radiology are the most common). An internship is required prior to applying to residency programs (but that is a whole different topic).
Some programs, such as our Early Entry Track at VEG, are shorter in length and focused solely in one area of medicine. For example, the EET track is a 6 month intensive program in emergency medicine. (Our program is INCREDIBLE if you are ER-focused and want to join our fabulous VEG family – more info can be found here: https://veterinaryemergencygroup.com/careers/students/#EET)
How do I know if I should do an internship or go straight into practice?
This largely depends on your career goals and jobs available to you upon graduation. If you wish to be a general practitioner, then an internship is not required. However, I would highly recommend that if you take a job as a GP straight out of school, make sure you have an excellent mentor. While you will get good experience during your 4th year clinical rotations in school, it is truly not enough for you to be 100% ready to jump into practicing on your own.
If your goal is to become a specialist, then an internship is the first step toward that goal. For the purposes of this article, I will not be diving into specifics about each specialty or residency programs.
The other reason to do an internship is if your goal is to practice emergency medicine. It is quite rare for a new doctor to go straight into an emergency position without some advanced training first. In my opinion, getting structured training is necessary to be the best ER doctor possible. This can be accomplished either through doing a rotating internship or emergency internship (or both!).
How do I know which internship is right for me?
There are a LOT of internship programs out there. The majority of them are listed on the VIRMP website (Veterinary Internship and Residency Matching Program). You can get an idea about each program based on the descriptions provided, such as the different specialties offered at the hospital, the number of cases seen per year and per day, what percentage of time is spent on day/overnight emergency, how many interns start and finish the program each year, and statistics regarding residency placement.
Pay attention to the numbers: If an internship has 10 interns who start the program every year but only an average of 5 actually finish the internship, there is probably a big issue. If you are looking to be placed in a residency program, be sure to look at the statistics of how many interns apply to residencies every year and how many are matched. Also make sure the specialty you are interested in is offered at that hospital – you are never going to get an ophthalmology residency if you don’t have a letter of recommendation specifically from an ophthalmologist!
Newer programs can be a bit riskier (especially if you want a residency), as you will essentially be a guinea pig. That’s not to say that it won’t be a good fit, but there is something to be said for internship programs that have been around for decades and have a strong reputation.
The biggest piece of advice that I can offer before applying for an internship is make sure you do an externship first. I realize that this isn’t always possible to travel to every place where you might want to apply, but the best way to know if you’ll be a good fit is simply to visit. That way, you’ll be able to interact with the staff, get an idea of how didactic learning is structured, the caseload of the hospital, and you can see exactly what the current interns are experiencing.
I remember being particularly impressed by the interns at Wheat Ridge when I was a visiting extern – not only did it seem like they had been practicing for years when they had only been out of school for a few months, but they were also genuinely enjoying their internship and treated well. Be wary of places where interns are burned out and have lost the joy in being a veterinarian (especially after only a few months!).
If you are not able to physically visit the hospital, make sure you talk to current or previous interns. If the intern coordinator at the hospital is unwilling to share this contact information with you, that is a big red flag. When you speak to previous interns, be candid – ask any and all questions that you have.
Make sure you ask questions about the teaching style and opportunities to learn. If you want to cut ER surgeries, make sure you ask whether you will be trained in this (most internships do not let you be the primary surgeon). If you benefit from lots of didactic learning and structured daily hospital rounds, be sure to inquire about how often these occur.
At the end of the day, remember that you should be picky about where you end up. Your first year in practice is arguably the most formative, and you should make sure that you end up somewhere that values your education. You are not there to be slave labor, only working overnight shifts alone with no mentorship. Yes, you will be working long hours, and yes, it will be hard – just make sure you are learning a TON in the process.
Should I do an academic or private practice internship?
As a general rule of thumb, academic internships tend to be slower-paced and private practices tend to be much busier (the exception to this would be schools that are in larger metropolitan areas). Academic internships will often give you elective time to work on writing a publication or research, which is helpful if you’re going down the residency path. Private practices may have slightly less time focused on didactic learning due to the sheer nature of how busy these practices are. However, they should still have dedicated time for formal learning. For example, Wheat Ridge had hospital rounds with every specialty department each morning for an hour, and once weekly we had 2 hours of additional rounds (M&Ms, journal club, etc).
If you are someone who needs to slowly digest every case, you may be better suited to academic (or a less-busy private practice). You also may not be given as much opportunity to practice your skills at an academic institution, because there are students and residents who need to do the same thing. Therefore, if you are someone who learns by seeing large volumes of cases and by getting more hands-on experience, then private practice is a better route.
What should I expect out of an internship program?
You should expect to come out of an internship feeling confident and ready to pursue whatever career path you choose. Internships should set you up for success by building on your platform of knowledge.
It is not easy. Most interns work 70-90 hours a week, and you will have some work that you need to do at home outside of that (such as reading articles for journal club, preparing for rounds, reviewing cases for M&M rounds, etc). You also earn very little (most intern salaries are around $30,000/year – unless you work for VEG and it’s $100k your first year!). There will certainly be days that you feel burned out, but (hopefully) you will find a great deal of fulfillment in this wonderful world of veterinary medicine.
In regards to VEG’s EET program specifically, we provide significant opportunities for hands-on learning. You will be the primary surgeon, learn how to perform endoscopic foreign body retrieval, and learn a variety of life-saving procedures such as pericardiocentesis and thoracocentesis. You will have the opportunity to travel for conferences, surgery and endoscopy courses. Finally, you will be guaranteed a position as an associate emergency veterinarian with VEG on completion of the EET program.
How do I apply for internship? What are intern programs looking for in their applicants?
Most internship programs use VIRMP (virmp.org), which is a matching program. Do not rank a program unless you are CERTAIN that you would like that program. Ranking 20 programs is likely going to work against you – I think ranking somewhere between 5-7 programs gives you the best chance of ending up somewhere that will be the right fit. Beyond this, it is likely that you are just choosing programs to fill up your rankings. For our EET program, visit https://veterinaryemergencygroup.com/careers/students/#EET
In terms of making application as strong as possible, the biggest piece of this is having excellent letters of recommendation. Of course you need a good GPA, and things like research experience or published journal articles are great too. However, the most important quality is whether you are a team-player and willing to work hard. Make sure you choose carefully when it comes to asking someone for a letter of recommendation, and make sure it is someone who knows you well and can truly attest to both your aptitude and personality.
Still have unanswered questions?
Shoot me an email at firstname.lastname@example.org.