Veterinary internships: Examining their value in an era of six-figure debt
To intern or not to intern. For many senior veterinary students this time of year, that is the question. Just as Hamlet felt quite alone in pondering his serious questions of life or death, many of my students feel that the choice is one of professional life or death.
And maybe it is, given the enormous debt burden of a veterinary education. Adding an extra year of indebtedness and interest accrual for some new grads may be just enough to make the difference in their professional success. So what advice do I have for them? This:
- An internship is not a black or white decision.
- There are options other than yes or no.
- Choose carefully, as it is not a cheap choice.
Although many in the veterinary profession look at the decision to sign up for an internship simply as a question of gaining confidence or experience, just like a veterinary education, an internship is actually a commodity. What an intern is purchasing is a year of additional guided training at a cost of $40,000 to $50,000 or more—the difference between associate and intern pay, plus the long-term opportunity cost of delayed full earning.
The real question, then, comes down to this: Do you need that training at that cost or not? In my experience, most students can answer this question decision simply by deciding whether they want to specialize.
For students who wish to be boarded specialists, the choice is relatively easy. The straightest, most direct path to a specialty board certification is through an internship. As long as the student has picked a specialty with a demand for diplomates—and most diplomates are in demand—the decreased income for the years of internship and residency will be greatly offset by increased income generated from specialty practice.
However, this path is not without risk. A percentage of students entering an internship intending to specialize will, in fact, discover during the process that they no longer wish to do so. This will leave them having financed an expensive year of self-discovery with little to no financial gain.
Students should also be aware that an internship, although the most common route, is not the only way to board certification. The American Board of Veterinary Practitioners offers board certification options designed to be completed in a practice setting. And a number of residency programs will consider practitioners with a year or more of high-quality practice experience. Some of my favorite specialty residents have taken this route.
Finding the right fit
Although many students find the decision to specialize quite easy, what’s not so easy is picking a good internship. The first year of practice is a key growth area for new graduates, and many pick an internship specifically because of the structured growth environment. So it’s ironic that this is the only segment of veterinary education where no oversight or uniform standards exist. The AVMA has published internship guidelines, but there is no governing body in charge of internships, nor is it mandatory for any internship to abide by the AVMA guidelines.
This leads to a Wild West-like atmosphere where the intern is at the mercy of the individual program. Some idea of the program can be gained by talking with previous interns, but even that can be problematic, since without uniform guidelines the program can change at the whim of the internship director. A number of internships do have long-standing track records, but many don’t.
All of this leads to some interns stuck unwittingly with the bad apples in the bunch, the predatory internships. These are, in my opinion, despicable operations, luring interns with the promise of mentorship and training and instead financing their own practice profits on the backs of the profession’s future.
Jumping into practice
So after all that doom and gloom, what’s a new grad who would like a structured program of development—but doesn’t want to specialize—supposed to do? First, simply going into practice isn’t necessarily as chaotic and unstructured an experience as some might think. Most practices hiring a new graduate have at least some structure for helping introduce them to the practice. The most thorough will even take several weeks to have the new grad work with various groups around the hospital before they’re even scheduled their first appointment. Employers of new graduates also usually adjust the length of appointments and assign their most experienced staff to help the new grad break into practice.
That said, it’s still possible for grads to unwittingly walk into their nightmare scenario—having the practice owner toss them the keys and saying they’ll see them in three weeks when they’re back from Hawaii. However, even this may not be as horrible as it initially sounds.
My personal experience was something similar, and it wound up being the best possible thing that could have happened. Being on my own caused me to rapidly become more self-sufficient and greatly accelerated my learning curve. It also gave me more time alone with the clinic staff and made some of the standard of care changes I had planned easier to implement. While I wouldn’t have chosen it purposefully, sometimes even the worst-case scenario turns out to be the best.
A solution to explore
After all of this discussion, I imagine there are still a number of new-grads-to-be who are thinking, “But I want both structured guidance and a decent salary with decent hours.” Well, there is an option that provides both the flexibility and salary of an associate’s position with some of the structured experience of an internship. What I recommend to many of my new grads is to negotiate a mentorship contract.
AAHA provides resources for both new grads and employers to structure a mentorship contract with specific standards and recommendations. This helps new grads and employers set specific, actionable, and time-sensitive goals that are tailored to the defined learning objectives of the new grad. These are negotiated like any other employment benefit and are included in an enforceable written contract with complete transparency to both sides. AAHA even accredits practices that meet their mentorship guidelines, which provides indirect oversight and direction that can be missing in the internship process.
So what should a new grad take away from all this? There is no one-size-fits-all solution for the best career track for a new grad. An internship may be right for some but shouldn’t be seen as a solution for everyone, as it comes at a significant cost. Going directly into practice may seem scary, but it could be the best scary thing you ever did. And finally, negotiating a mentorship contract can give both a structured learning environment and the benefits of a practice position if it’s included in a well-defined and binding contract.