Veterinary post-grad education has never been so popular -- or controversial SCHAUMBURG, Ill. — Dr. Caroline C. Tonozzi, a 2003 graduate of the University of Illinois College of Veterinary Medicine, had no idea that she was a member of one of the fastest growing segments of the veterinary workforce—those who pursue post-graduate education. Interested in a career in an intensive care unit, a "last minute" decision to take an internship would cut her first-year income by about two-thirds and require many late nights and weekends at work.
Why did she do it? There is a lot of speculation about why new veterinarians are pursuing post-graduate education like never before, but it's extremely common. Last year, almost 40 percent of graduates from veterinary schools matriculated into post-graduate education, primarily internships and residencies, according to an American Veterinary Medical Association (AVMA) study published in the Journal of the American Veterinary Medical Association (JAVMA). It's a rising trend. In 1995, only 15 percent of graduates opted for more education.
Certainly, one motivating factor driving these young applicants into residencies is the promise of additional income in the long term. According to the 2007 AVMA Report on Veterinary Compensation, board-certified veterinary specialists earned a median income of $139,000 in 2005 compared to the median income of $79,000 for private practice veterinarians with no post-graduate education.
According to AVMA research, there were 8,510 active, board-certified diplomats on Dec. 1, 2006, up from 6,983 in 2001. Furthermore, there were more than 500 candidates waiting to take certification exams in the 20 recognized veterinary specialties. |
"It was really challenging but I'm really glad I did it. I got a lot of experience in a short amount of time. I wanted to work in an ICU, and, after my residency, I was able to get a day job," Tonozzi says, who moved on to a three-year residency in Emergency and Critical Care at the Animal Emergency Center in Glendale, Wis. "One of the reasons I wanted a residency was that I wanted to teach, and today I'm in charge of interns."
An AVMA survey of the class of 2008 shows that at least 696 new DVMs decided to forgo a job for more education this year.
"Internships have quadrupled and residencies have doubled in the past 20 years," said Dr. Michael S. Garvey, a Pennsylvania veterinarian who has run the Veterinary Internship and Residency Matching Program for the American Association of Veterinary Clinicians (AAVC) for over two decades. In 1986, when he began overseeing the AAVC matching service, there were 179 internships and 130 residencies filled through the matching service, for a total of just over 300. Last year, there were 883 total—250 residencies and 630 internships.
It's clear that overwhelming demand for these programs is driving these increases. Applicants for post-graduate posts often outnumber the positions 20, 30, sometimes even 50 to one. Dr. John Berg, chair of the Department of Clinical Sciences at Tufts Veterinary School, says that the school receives about 100 applications for their two surgical residencies each year. "Of those, generally about 70 applicants look outstanding on paper, so it's very hard to determine the most deserving of the applicants," he said.
In fact, Kim Soehnlein, director of credentialing at the American Council of Veterinary Surgeons (ACVS), said it's not uncommon these days for ambitious interns to contact diplomates directly to persuade them to oversee their residency, thus opening up new residencies at private practices.
"More students are graduating from school and realizing that it's important to get more education," said Dr. Larry Berkwitt, who runs an internship program at the Vet Referral and Emergency Center in Norwalk, Conn. His hospital started its intern program in 1983 with three specialists and two interns; today, they have 14 faculty members, including 10 specialists, and 16 interns. "There are some specialties that are so sought after that people are completing general internships, applying for a residency, and, when they don't get the residency, they are applying for specialty internships in order to make themselves more attractive for the residency," he said.
Surgical Interships
Dr. Heidi A. Hottinger of Gulf Coast Veterinary Specialists (GCVS) said that post-graduate education has become so popular that GCVS helped pioneer the practice of offering surgical internships. These internships are offered only to those who have already completed a rotating internship but who have yet to be accepted into a surgical residency program. In order to help them achieve that goal, the internship offers significant surgical experience and, hopefully, the opportunity to be published.
"The surgical residencies have become so competitive that landing a residency right after a rotating internship is getting difficult," she said. "When I went through, you were expected to publish something after you got into your residency program, but that's changed. The competition for residencies has gotten to the point that interns are now expected to be published because so many of their peers are already published."
Dr. Berkwitt voices the opinion that, if students are demanding more post-graduate education for additional training or improved career opportunities, veterinary medicine should supply it. "I think that internships are great, but there is a larger problem today in that so many people who desire an internship don't get into one," Dr. Berkwitt says. "It would be a good idea if we could improve and expand our matching program so that it was more like human medicine, where everybody gets matched."
"Something has to be done"
Dr. Betsy M. Charles, a member of the AVMA Council on Communications, says that when she graduated from veterinary school at Washington State in 2003, she knew exactly what she wanted to do—work in radiology and imaging at an equine practice. She was excited when she got an internship at a California equine radiology center. "But, at the end of the internship, I decided I was not going to be a veterinarian anymore," she saiys. "I thought if this is veterinary medicine, then I want no part of it."
Dr. Charles complains that she received very little mentoring or oversight, worked nearly round the clock in an abusive environment and did not come out of the internship with the experience or skills she expected. "It affected my health, it affected my mental health, it affected my marriage," she says. "One of my classmates, who also worked at that practice, quit and no longer practices equine medicine. I know my experience is at the far end of the spectrum, but it's definitely an area that must be dealt with."
Dr. Donald J. Klingborg, an associate dean at UC Davis School of Veterinary Medicine, said that he believes that Dr. Charles experiences are not unique. He said many students and veterinarians are concerned about the use of interns as low cost or "slave" labor. "In many cases, the interns get paid a third of what an associate makes, and in most states, an intern must be licensed," he said. "The difference between an intern and an associate is very little, so I tell all my students to ask a perspective internship, 'what am I going to get [out of this internship experience].' "
Dr. Klingborg adds that in the private sector the only oversight is that of the AAVC matching program, which means there is no oversight at all. "The only oversight that I can see is if the $40 check you wrote to get your internship listed on the matching program didn't bounce," he complains.
Dr. Garvey, who runs the AAVC matching program and, in fact, started it decades ago, agrees. "Residencies are not a problem because they are regulated, but anyone can start an internship program. Internships are not regulated at all and that can be a problem."
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