Improving the Veterinary Internship Experience

As the popularity of veterinary internships has grown, we’ve also experienced a few growing pains. That’s to be expected, especially when the number of positions available and the number of applicants interested in internships has grown steadily over the past decade.

The AVMA has been aware of the challenges facing both internship providers and new graduates seeking internships for a few years now. As a matter of fact, the AVMA Executive Board approved the formation of a joint AVMA/AAVMC task force in 2009 to assess the status of veterinary internships, identify areas that need improvement and develop a plan to address identified needs. The work of the Task Force on Veterinary Internships, which began in earnest in early 2010 and culminated in a final report last spring, was instrumental in helping us find ways to improve the internship experience for everyone involved.

Thanks to the efforts of task force members, the AVMA Executive Board voted at its meeting last week to approve AVMA policies to help reduce ambiguity and create clear expectations for both internship providers and participants.

The Policy on Veterinary Internships Disclosure Outline, in concert with the Policy on Veterinary Internships Guidelines, establish minimum quality and appropriate assessment criteria, and include specific information to help educate students, student advisers and providers. The Internship Disclosure Form and the Internship Guidelines, which can be found on pages 13 and 18, respectively, in the task force’s final report, will help both interns and providers more fully appreciate the purpose of internships and reduce the potential for different expectations.

We are also conducting research through AVMA surveys that we believe will provide sound data on why students are pursuing internships and the quality of their experience. The surveys will also help us assess the economic value of the internship experience.

Not all internships are created equal, and experiences will vary depending on myriad factors. It’s our hope that studying the veterinary internship experience from all angles, along with providing specific tools to help promote positive outcomes, will enhance the value of the internship experience and help both interns and providers benefit from what should be an educational experience that helps pave the way toward a successful career.

12 thoughts on “Improving the Veterinary Internship Experience

  1. @Brian huss

    Sorry, Dr Huss but you and the majority of veterinary academicians are very mistaken about what veterinary education and training should be. We need to restore the vocational aspect of making students effective in the application of the theoretical knowledge learned during veterinary school. If the opportunities to apply the theoretical knowledge are not provided during school or during internship, where and how are they to be learned in order to make the student’s theoretical knowledge effective in the real world? Are we supposed to let newly graduated veterinarians learn on an ad hoc, teach yourself basis on the animal owning public? Studies from UK show serious stress on new veterinarians from making errors during their first year which is often without adequate supervision or mentoring. The RCVS in 2001 proposed a focused and graduated training pathway that would provide every new graduate to learn the essential technical skills are also as important as intellectual skills in building both the confidence and effectiveness of the newly graduated veterinarians. The problem is that the veterinary academy is too arrogant to learn from others about to train people and change the system for the better. Knowing the theory behind what you do is only half an education.

  2. As Chief of Staff of a referral hospital, I can tell you good internships are very time consuming and expensive to run. That having been said, the intern should be getting value for their lost income in that intern year. Internships are a two way street. Interns need to participate to get the most out of the experience. I don’t feel internships should be vocational training. We try to incorporate techniques training, but more important is the development of critical thinking that will allow the intern to continue to practice state-of-the-art medicine for their entire career. I can teach them how to quickly perform an OVH. What I want them to learn is why they are performing the OVH and at what age, or should they just remove the ovaries, or is it beneficial to do the procedure laparoscopically? Interns don’t know enough about the process to be allowed to have any significant say in changing the process. A regulatory board would be the better way to make certain key objectives are met in a program.

  3. As another commenter above I completed a one year private practice rotating internship after a year in a busy general practice. Had I gone straight from school into this internship I would have learned far less, and I believe even less had this been a tertiary referral facility. That said, much of the learning was through observation, endless unsupervised overnight shifts and my own independent reading. I also stood up for myself demanding evidence based medicine and the journal access advertised in the interview when it became clear this was not forthcoming: needless to say this was not received well.

    My best advice is to speak to former interns prior to applying to a program (not to those still in the midst of the experience). I strongly support regulations with teeth to help us all become better doctors and advance veterinary medicine.

  4. I participated in two rotating internships starting the first after having spent a year in private practice. Private practice spurred me toward the goal of obtaining a residency hence the decision to go back to an internship. The first was in a private referral practice, the second at a university college of veyerinary medicine. I am pleased that the AVMA is taking this important first step because my experiences were so discouraging yet so disparate. Internships need some form of regulation to guarantee that needs are met both for the intern as well as the institution. I also applaud the effort to communicate with potential interns before the decision is made. The one thing both of my experiences had in common was misrepresentation about the program during the interview process. While I cannot deny that I gained a little from both experiences, if it were possible to go back I would not choose to repeat those decisions although I would not be opposed to an internship. The next challenge will be actually imposing regulations and persuading the interns to stand up for change. In my experience, my intern-mates were too frightened that they would not get good recommendations to actually pursue challenging the system. Unfortunately, they were likely wiser than me since I did challenge and could get no good recommendations which undoubtedly harmed my chances for a residency. This will be a long, difficult struggle but well worth the effort.

  5. I agree with Dr Morris on the questionable value of internships yet veterinary academia continually has failed to adapt to “train” veterinarians to apply the theory in a successful manner, leaving that for the world of practice which simply is not realistic because where there are practices that have enough caseload and good standards of practice, there are those that do not and do see new DVMs as ” a dime a dozen” cheap labor. Veterinary education is simply a failure because it tries to teach too much in too short of a time at too high of a cost without really understanding what the true nature of the demand for veterinary clinical services. Current reform efforts like NAVMEC will be a failure also because of the demands for multispecies clinical expertise which the PEW Report on Veterinary Education in 1989 identified as being anachronistic and obstructing real progress in veterinary medicine. Continually producing graduates trained to be “a jack of all trades” will not solve the problem. The veterinary education system needs to be replaced with a new model that understands that the division of labor and specialization are necessary and part of facing economic realities of the demand for veterinary services and the cost of acquiring the knowledge needed to fulfill the demands. Sadly, I have read of deans regarding the technical aspects of providing veterinary services as “vocational” and seemingly not part of the lofty intellectual objectives of a veterinary education. But a veterinary education is worthless if it does not train the graduate to be successful in applying the theory to the real world problems brought to them by clients who are looking for realistic solutions in a cost effective manner. We need to look at if a DVM degree as currently constituted is even worth the cost based on what the educational outcomes the students are getting. Is it now just an intermediate step to further residency or PhD in order to get the needed skills to be successful in the marketplace? I do not think student’s can afford that approach. But we also cannot abide a teach yourself approach to solving real world clinical problems for those who cannot find clinical mentors to coach them in the process of training as I and other have had to do. Veterinary academia may denigrate the “vocational” educational approach yet we know it works and journeyman graduates of apprenticeship programs may be making more than a new graduate of a veterinary school.

    Robert Nix DVM
    Sherwood, OR

  6. @Sheri Morris DVM, DABVP

    I completely agree with you. If given a chance to hire a an 2nd year grad who completed an internship vs a year in private practice at a good hospital. I’d hire the latter. Their skills are more honed for private practice. I am not really all that interested if you know all the ins and outs of acud base balance- but more so that you can communicate effectifely in an exam room with a client, keep up a busy private practice schedule, and effectively diagnose and treat those everyday cases.
    Internships are not created equal. There is no certifying exam (like in human medicine at the end of an internship either.

  7. Thank you, thank you AVMA Leadership. Because I teach veterinary career development and employment contract issues to > 2,000 students/year, I hear from and probably am exposed to more recent grads who have bad internship experiences than anyone else. I am, of course, clearly aware that the vast majority have had good ones. Some of the bad ones are horrible.
    Nonetheless, for the past few years, I have felt like I was merely a voice in the wilderness as I attempted to bring the lack of accountability for internships to the forefront and fix the problems. I am most pleased that actions are now being taken on many fronts to assure that the $10,000 per intern/year “cumulating educational loan interest” and $40,000/intern/year lost employment opportunity cost to complete this fifth year of veterinary school is a good investment. With enough ongoing effort, our new grads and the entire profession will be better off because of this effort. The next big push will be to raise pay for their 60+ hour per week schedules to the point it is higher than the minimum wage. In my mind it is a disgrace that in spite of eight years of college and many working for veterinary practices, they earn considerably less than vast majority of the support staff at the practices at which they work.

  8. most private internships are a mix of good and bad. I was an intern many years ago with Mass ASPCA. 1st six months you are in a high learning curve, then up and running, by the next summer you are cheap labor and good for Emergency call. I learned a lot and practice the same evidenced based medicine, textbook med as I always have.
    My problem is now we have 5 specialty practices around both hospitals. How many can we aborb? Some are struggling and now take cases off the street, do anything they can and do not return the patients (just very large general practices that are competeing. I see us hiring out own specialist (have a dentist, next internal med, as I retire a surgeon). If the schools are correct and 40% of grads think they are going to make millions at home being a pathologist or that we need 1000 more surgeons?
    they have ridden the wave and had high incomes etc, but the wave is about to hit the beach, if we can hire the excess specialist at reasonable % pay. Then no referrals –
    I have owned six, only one now and consult to one of the ones I sold, but I am in the 1/3 of owners who are business people. Internships, and more will not make the average specialist any more money than being an owner. I could see specialist being owners of GP practices, if the two sides are not in conflict, and do very well.

  9. From the perspective of a general practice, I am concerned about so many students pursuing internships. In 17 years of practice I have hired probably 50 veterinarians in our practice, both new grads, and post internship veterinarians. For those wishing to pursue residencies and specialties, I think they are fine. But for those planning to go back into general practice, I think students need to reconsider those internships. Our experience was that the skills that they gained in that year were tertiary in nature, not the primary skills they needed to hone in general practice. Those interns were behind their colleagues that were in general practice after 1 year, FAR behind. They had fewer surgical skills, they were far slower In routine procedures, they hadn’t had much exposure to the general case load they needed to be a general practitioner. They were not worth any more to me as an employer thana new graduate. I encourage new grads that you may not feel you are ready, but you ARE. Get out there and into a good mentoring practice, and you will do fine!

  10. In the heading on the paragraph entitled Internship Disclosure, the word “Disclosure” is spelled incorrectly.

  11. I am glad the AVMA is working to regulate and standardize veterinary Internships. My experience, and what I know from fellow classmates, is that the Internship experience varies tremendously. I believe private sector Internships often use interns to economically benefit themselves and these interns can be +++ overworked and exploited. There are many private sector Internships that don’t use the “Match” to select their Interns and I believe this should not be allowed. There needs to be better regulation of Internships so that all students receive the same level of training, work a standardized number of hours per week, and have a better idea of what to expect when they decide to enter an Internship.

  12. I am curious as to how this was assessed. We were one of the first programs in the U.S. to have a surgical internship and we were never asked to provide data. The program has been tremendously successful and has been extremely helpful in advancing the careers of many veterinarians. In fact, we have more “graduates” than anyone that have gone on to obtain residencies and become boarded surgeons.