The route to specialisation: step 1- rotating internships
Like many newly-qualified vets, I was interested in the option of clinical specialisation. However, I found there were few resources available for those thinking about this sector. In this article, I hope to give an outline of what specialist training involves, beginning with an overview of internships and then a balanced account of their advantages and disadvantages.
There are many internship programmes available in the UK and they all differ somewhat in the nature of the work they involve and the learning opportunities available. Although a number of practices offer jobs described as ‘internships’ for new graduates, it is expected that you will complete a ‘rotating’ internship if you wish to pursue further specialisation. This means that you spend time working with a number of specialists in different disciplines, such as internal medicine, surgery, anaesthesia, diagnostic imaging, and neurology. Even if you are not interested in all of the subjects included in the rotations, it is important to see the work that other specialists do and become accustomed to transdisciplinary collaboration, which is important for achieving the best clinical outcomes.
"Although a number of practices offer jobs described as ‘internships’ for new graduates, it is expected that you will complete a ‘rotating’ internship if you wish to pursue further specialisation"
I completed my internship at the Royal Veterinary College, which meant that I also worked with final year veterinary students and had opportunities to attend teaching seminars and journal clubs. I also had the opportunity to manage a small number of referred cases under close supervision from specialists. I felt these opportunities were important to increase my skills and knowledge and to help me decide if I wanted to apply for a residency.
What does an intern do?
In most hospitals, interns are primarily responsible for assisting with care of in-patients being managed by specialists. This is a vital role because effective delivery of diagnostic tests and treatments will determine whether individual patients have a favourable outcome. It’s easy to see this role as a glorified dogsbody - but managing patients as their complex needs evolve is often challenging and rewarding, and there is plenty of scope to show initiative and to learn from the experience. In some centres, interns will also receive emergency cases and provide an out-of-hours service for local first opinion practices.
What are the advantages of internships?
- Internships are full of opportunities for professional and personal development
- They open the door to residency applications but can also be an excellent basis from which to develop your career in primary care practice
- The low salary may be mitigated by free or low-cost accommodation and by learning opportunities that are otherwise expensive to obtain through CPD
"It is important to see the work that other specialists do and become accustomed to transdisciplinary collaboration, which is important for achieving the best clinical outcomes"
- There is great enjoyment from participating in very fulfilling work coupled with support from other interns
What are the disadvantages of internships?
- Many people will remember the interns as the people who looked tired or stressed when they were students at vet school, and it can seem like a thankless job!
- The average salary is lower than would be expected in general practice, particularly in universities where interns are often paid a tax-free stipend and classified as full-time students rather than employee
- Timetables for the year are often received at the start of the programme can end up being very restrictive for people who have other commitments. Work is usually organised in shifts, often lasting 12 hours, which can make it difficult to keep up with activities outside of work
- It can be difficult to go back to feeling like the most junior member of a team, and it is also potentially stressful to feel that you have to make a good impression if you want to apply for a residency
I think it’s important to evaluate internship programmes carefully if you’re thinking of applying, in order to establish how many educational and career development opportunities you are likely to have. To help with this, the British College of Veterinary Specialists (BCVSp), whose members include specialists and residents, has produced a set of best practice guidelines for internships which lists the attributes of a good rotating internship programme.
BCVSp is a registered charity that raises awareness among the general public about the benefits of specialist veterinary care when this is recommended by a primary care vet. The College also promotes best practice in delivering specialist care and in training future specialists. More information is available here.
"It’s important to evaluate internship programmes carefully if you’re thinking of applying"
The best ways to find out if you want to proceed with an internship are to speak to someone who has done one and, if you can, visit the centre(s) you are considering and talk to the internship mentors about their programme. If you can shadow a current intern for a shift, then you will receive an accurate account of what the position involves and whether it meets your expectations.
For equine internships, the British Equine Veterinary Association provides an Internship Awareness Programme which is an easy and efficient way to find and compare all current intern providers in UK.