Veterinary internships in the media crosshairs

veterinarians-hawk-blog300x300-3Today, Newsweek published an article, “Veterinary interns speak out against exploitation,” that portrays the negative aspects of veterinary internships. The scenarios presented were worst-case situations which, if accurately described, were unacceptable. But we caution our members and the public against using these examples as representative of all internships.

AVMA research has found no relationship between completing an internship, by itself, and increased lifelong earnings for a veterinarian entering clinical practice. However, our colleagues with positive internship experiences are quick to point out the knowledge, clinical competence, and confidence they gained from their internships. In addition, board certification and some advanced degrees that require an internship may be a new veterinarian’s first stepping stone on a clear path to professional advancement and greater financial earnings.

If your clinic offers internships, this media attention urges you to evaluate your program to ensure that it meets your interns’ needs, as well as those of your practice. Check your program against the guidelines and our disclosure outline, and make changes to improve your program if needed. Seek constructive feedback from past and current interns, and use it to guide your efforts in shaping the future of your colleagues’ careers.

We encourage prospective interns to thoroughly evaluate their opportunities to determine the right fit for them both personally and professionally. An internship is, fundamentally, a job in the veterinary profession, and should be considered as deliberately as any other career position. Check out our veterinary internship resources for more information and guidance to help you make the right choices for yourself.

We’d like to hear about your experiences. Without naming clinics, schools or specific people, what were your internship experiences – either as an intern, or in offering internships? What constructive advice would you share?

17 thoughts on “Veterinary internships in the media crosshairs

  1. I was interested to see this Newsweek article and disappointed to see the AVMA response.

    One year before graduation I asked an AVMA representative about whether they had any plans to oversee internships after hearing some negatives about internships, his reply was that oversight of internships was something the AVMA was not interested in.

    After completing an internship and reflecting on my experience I again inquired from an AVMA representative about internship oversight and was again told that they would not be interested in doing so.

    The response to this article is not what I would like to see from my professional organization, but sadly it is what I have come to expect. Instead of listening to, learning about and considering the experiences of veterinarians and how the profession and field can be improved they typically respond like this.

    “There is no problem”
    “This is how internships work, deal with it”
    “This is an extreme example”
    “We have found no economic benefit to completing internships”

    It would behoove you, the AVMA, to be more open and responsive.

    I completed an Emergency/Critical Care internship. It was a mixed bag. My hours were fair at 75-85 hours a week. I typically got 36-48 hours off a week which was great, but necessary because of the frequent day to night back to day switches. I was paid fine for an intern and they covered my health insurance premium in full. I got 2 weeks of vacation/conference time which was fantastic and allowed me to go to two conferences. I got a 1 week externship in which was also a great experience. There was a non-compete for working in ER or specialty practice, but not for GP – I thought that ridiculous, but understood and was fine with it. I thought that this treatment was fair.

    My problem with the internship was that the promised mentor-ship was not provided. Despite planning for weekly journal club, didactic sessions and learning rounds, most of the time these were cancelled. We ended up running our own M&M rounds without clinicians because they couldn’t be bothered.

    Overall I do not regret the internship. I learned a great deal and came out on really good footing for ER and GP, but most of this was self driven and case-load driven. I probably could have done this over 3 years in practice, but might not have gotten the ER experience.

    If certain things are promised they must be delivered… I lived up to my side of the bargain. I did not get the academic exposure/mentorship that was promised. Someone needs to oversee this. I do not know who the best entity would be, but just as human post-MD/DO medical training is regulated, so does veterinary post-graduate training. Maybe the AVMA or AAVC need to regulate this.

    I was tremendously depressed and socially isolated during my internship. It was a small intern class and the nature of the work meant that we were like ships passing in the night. No one except a few of the techs reached out to me socially. Being thousands of miles from friends/family/fiancee, I had hoped that folks running the internship might have been more socially inclusive, but that was too high of an expectation.

    AVMA – Please take this issue seriously. Failure to meet academic promises is a major problem. Mental health/illness/well-being is a major problem and if it starts during an internship it will continue throughout the career.

    • DC, Thank you for sharing your experience. We appreciate the feedback, and your comments will be forwarded to AVMA leadership.

    • Did you contact the AAVC – VIRMP with your concerns? If you used the match program and felt that the program you entered did not meet the promises made in the program description, you should contact them.

  2. I’m a vet student – and I have heard lots of horror stories about internships. From friends who recently graduated, and from doctors I’ve worked with who did internships themselves. My thinking about this is – we take roughly a $40K pay cut to do an internship. That is around what it cost me for two years of veterinary school education. We should be asking what we are getting (in the form of didactic learning, experiences that we may not get in a general practice, mentoring, etc.) in return for that $40K. If the only answer is “more experience” that isn’t good enough.

    I also don’t understand why residency candidates are evaluated based on these internships, if many of them aren’t providing students with anything more than the same experience they could get without an internship, just in a shorter time frame? What is it about the internship that is preparing them for residency – other than surviving hellish hours without having a breakdown, and a willingness to put up with mistreatment without standing up for yourself? Why aren’t the residency programs looking for more from the internships?

  3. I opted against doing an internship. Some rotations in school simulated what I expected from an internship (excessively long hours, no outside life, minimal sleep, etc.) and I know that is not a recipe for success. Also, as someone who knew that GP was going to be the life I would practice I saw no benefit from doing an internship (which is not usually in a realistic GP type clinic.
    I’m glad I decided against it. Having a life outside of the veterinary world is important to me and I think it is highly underappreciated. The ancient mentality that suffering through long caffeine-fueled days with no sleep builds character needs to be replaced with one that fosters an understanding of appropriate work:life balance. You can still work hard, learn heaps, and contribute to a practice while working realistic hours. Life outside of work helps deal with the stresses of the job!

  4. My internship was in 1994 which was when ungoverned slave labor style internships started occurring as larger private practices realized the could prey on bright young vets desperate to get residencies that didn’t “match” at a University where the vets were “more naturally governed “. They used they to cover ER shifts and if they learned something good for them. We really need a regulatory body for these young people who are at least being used if not abused.

  5. I am apalled at how dismissive this AVMA response is. This is more than the “worst case scenarios”. The worst cases happen when learning fails to happen, but the long hours, the depression, the imposter syndrome, the exhaustion – THAT is the norm. I had a wonderful internship with great mentorship and so much learning/teaching and I STILL felt the exhaustion, long hours and depression. We should not accept mental illness and being the top profession affected by suicide as NORMAL. “because its always been that way” is not an acceptible reason, nor a valid excuse. Internships should be regulated. WHY would it be any different than medical school?

  6. The statement that “the scenarios presented were worst-case situations which, if accurately described, were unacceptable” make’s it sound like the AVMA doesn’t believe these situations are a wide-spread problem, but they are! Interns shouldn’t expect to make a ton of money, but the mentorship should be strong and they shouldn’t have to work 100+hrs a week – that how mistakes are made. Poor young vulnerable vets are being taken advantage of in many places. It’s also unfortunate the article wasn’t written with more discretion, I wouldn’t want my name or practice in that article…

  7. This is why I chose NOT to do an internship. To get paid $2/hr and get treated horribly just as we did as students was not an option for me. The treatment of interns is a well-known fact and has been well-known for YEARS. I graduated in 1998.

  8. I was lucky to have an internship where my mentors cared about my welfare and education. Did I get paid only $23,000/year? Definitely. Did I have my share of 100 hour work weeks? Of course. But I learned so much and gained an immense amount of invaluable experience. I do not regret my internship. I negotiated a higher pay because of my experience. I strongly recommend internships but also to make sure you do research before you apply or accept one

  9. Dear AVMA Community,

    I am the author of the Newsweek story that was posted today. I am so glad to see it getting some traction here. For this story I interviewed around two dozen current and former interns as well as senior veterinary staff across the country and nearly all came to the same conclusion: veterinary internships would benefit from universal outside oversight, just as medical residences do. While some of the anecdotes I chose to include do represent worst-case scenarios, I tried to make clear that these extreme examples are not the norm. Yet the lack of regulations leave open the possibility for exploitation, which seems to occur all too often. And none of the sources I spoke with, even those who spoke highly of their internships, had a completely positive experience. I can only conclude that there there is much room for improvement. Feel free to reach out to me with questions or comments (rachelnuwer at gmail).

    Rachel

    • Thanks for shedding light on the poor and backward state of veterinary education in the US. Unfortunately, multiple studies over decades have shown that the current model fails students and the public by not having realistic standards for the education and training of veterinary practitioners. Compared to human medical and health paraprofesssional training, veterinary education is stuck in producing a factotum rather than skilled practitioners. Honestly, I had to teach myself so much through trial and error that should have been part of a modern veterinary curriculum focused on competency and depth rather than breadth and mediocrity.

    • Hello Rachel,

      Honestly, I find the article to be one-sided and sensationalist. Nearly my entire group of close friends and I went on to do internships after vet school, including both private practice and teaching hospital programs, and none of us had an experience like the one you describe in “Sabrina’s” case. If such a program truly exists, it is a shame and the current and former interns should be strongly warning their future colleagues not to apply there. My private practice internship was very hard work, but my pay was actually higher than I received during my residency and I received plenty of days off and vacation time. Not all internships are terrible and I suspect the majority are not. I wish you had featured a more well-rounded sampling of anecdotes.

      In addition, your point here in the comments section that “none of the sources I spoke with, even those who spoke highly of their internships, had a completely positive experience” is very unrealistic. If you spoke with 24 veterinarians who are engaged in regular practice (not internship) I doubt a single one of them would report that their job is 100% positive either. In fact, I think you’d be hard pressed to find a single career on this planet that features a completely positive experience. Veterinarians don’t go into internships to have fun — we do it with the understanding that we will work our tails off for a year and come out as better doctors.

      I’ll also add that your comment within the article that the situation is “very different” for human docs is untrue. While the restrictions on number of hours worked do exist on paper, they are often ignored in practice. As the sister of an MD currently in residency and the friend of many others, I can assure you that the climate in physician internship and residency programs is similar to that seen in veterinary medicine. Friends have described to me that it’s an unspoken rule among interns that no one mentions or reports the total disregard of the 80-hour mandate. When my brother was selecting a residency program, the common term used amongst his fellow students to describe nasty internships with abusive tendencies was “malignant.” They would rank and discuss programs based on how “malignant” they were. I have heard stories of abuse in MD internship programs that make my hair stand on end. We should definitely not be looking to MD programs as the ideal system.

      I believe at the heart of your article is the assertion that internship programs should be regulated and standardized. I completely agree with this. However, I do not agree with using extreme examples and one-sided reporting to make that point. A realistic and mature dialogue would be more useful and more effective.

      • Hi Sarah,

        Thanks so much for your comments. I’m happy to hear that you and your friends/colleagues had positive internship experiences. I’m sorry you found my story to be sensationalized, but that is what my reporting revealed. Just read some of the comments in this AVMA thread and you will see that not everyone is lucky enough to land an internship like yours. If you re-read the story, you will also see that I do point out that internships are not all bad (see comments by Zack Wells and Eric Fish). That doesn’t mean they don’t need regulations and oversight. While the standards imposed on human medical residencies might not be foolproof, medical residents at least have an entity to turn to in the case of maltreatment or failure of programs to align with the field’s standards and regulations. Finally, I wasn’t speaking literally when I said no one had a completely positive experience at their internship. Of course no job is perfect, just as no life is perfect. However, being promised five days of vacation only to find out you get zero, or being made to work weeks and weeks in a row without a single day off is outside the scope of reasonable demands for any job.

        Rachel

      • I have to say that my experiences as an intern, my thoughts, and the internship my practice offers closely reflect those of Sarah. I also agree from first hand knowledge that human medicine is not the model we are after. I don’t pretend that “malignant” internships exist – they are common – but many good internships also exist. It would be nice to have had a broader range of internship experiences in the article and looked at what made them different … including the selection process. If you couldn’t find a veterinarian who found their internship highly valuable (which is different from enjoyable), you didn’t look very hard. That said, I also understand the concerns regarding the AVMA’s response.
        In my mind, the problem with both the article and the AVMA’s response is that they are focused on the problem, but do not work towards solutions other than to place the burden on another party. The problem clearly is self-oversight. However, in the absence of central oversight of internships, perhaps some advice based on the experiences of those who did / did not value their internships would be enlightening. The result could be a series of columns on how to identify good programs, what to expect, comparison to the human medicine system, the value of the training, etc.
        1) I think all agree that central oversight obviously would be of benefit. It is worth noting, however, that this is not likely in the near future, as no governing body is a good match for this function. The specialty colleges are not likely to oversee a general internship, and the AVMA frankly has never been supportive of veterinary specialists and their training (not that all interns pursue specialty training).
        Barring central oversight, there are other, more immediate solutions:
        A rigorous selection process when applying to internship programs is necessary regardless of whether internships have oversight or not. As with any job, applicants are responsible for selecting a position that suits their needs. Unfortunately, veterinarians often are so passionate about their career that they often completely ignore practical considerations such as cost of education, quality of program, salary, and personal well-being in order to enroll or work anywhere that will accept them. As long as that is the case, we enable the existence of malignant internships. As with any job, candidates need to ask tough questions before applying. UNlike most jobs, interns (and residents) have the unusual ability to interview the outgoing interns. Poor quality programs will cease to exist if they cannot attract applicants (aka market pressure). A rigorous interview is an imperfect process, but will distinguish most benign programs from the malignant.
        3) Realistic expectations. Having been involved in providing a private practice internship, I can say that most of our interns a) are almost surprisingly happy with their experience and recommend it to others and b) obtain placement in residencies or the position of their choice afterwards. That said, it also IS hard work, long hours (up to 10-14 hours a day x 6 days a week is typical, depending on the rotation), and can be stressful. We are up front about this when interviewing candidates; however, some individuals simply do not want to work this hard. That is fine, but their career decisions should reflect these needs.
        Alternatively, candidates should determine and indicate their expectations of a internship program in advance. Above all else, one should never rank any internship they do not want to accept … period.
        4) Lastly, each of us ultimately is responsible for the work-life balance and lifestyle we select, and there always are alternatives. I find that, as a profession, we do an extremely poor job of this … largely out of a feeling of obligation to our patients. (I’m not one to lecture on this, as I struggle with it myself, but I have no illusion that others made these choices for me.) If we really want to improve the QOL of veterinarians, this topic warrants more training (along with practical business and financial education) at the veterinary school level.
        Despite implications to the contrary, there ARE many excellent private practice internships out there … and those who interview applicants for residency programs (another good resource) know the good from the bad. Advice on how to distinguish the benign programs from the malignant, establish realistic expectations, and make career and life choices that help us attain our desired lifestyle would be a helpful and practical start toward addressing the issue until universal oversight can be established.

  10. I completed a 7 month Equine reproduction internship at a private ET facility in 2001. I was compensated $1800/month and regularly worked 60 to 70 hours per weeks, and performed reproductive exams every 6 hour for weeks at a time. Although I gained competence in the work, the state boards do nothing to prevent lay people from performing the job that I learned. It added zero value to my hireability and earning potential. Wage earned was NOT work th the workload.

    • This is a great example of a much broader, and very common, problem. While all your concerns seem valid, all of these issues should have been determined in advance. The compensation, job description, and hours should have been known in advance. The state regulations and job market were already established. So if the program provided no value and was not worth the pay, why do it? Candidates who find themselves in these situations either didn’t put the time into researching the program, understanding the job market, and interviewing prior participants, or they were horribly misled/misinformed (which would be deplorable).

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>