2:00 pm Christmas afternoon – only ten more hours to go. I was a first-year resident at the Animal Medical Center (AMC) in New York City, running the hospital and overseeing 20 interns on the one major holiday I was required to cover during my residency in avian and exotic pet medicine. The AMC was normally staffed by over 100 veterinarians, but on this day, it was just me and the interns managing dozens of pet owners and their animals, wedged side-by-side in the reception area seats, waiting to be seen for emergencies. Cats that ate tinsel, dogs that ate chocolate, birds that got tangled in Christmas ribbon, and bunnies that were injured from overzealous children – all waiting to be treated by the same overtired, underpaid, harried interns. The hospital was literally a zoo with animals of all kinds in every conceivable type of carrier on the floor, on countertops, and in their owners’ laps. I had been on for six hours already and still had ten more to go until my shift was supposed to end. Unfortunately, I would have to stay until the last case admitted before midnight was taken care of, which I knew would likely be long after midnight. So, I plowed forward, moving from intern to intern, to see what I could do to help them.
Christmas day was the hardest day of my residency; yet even on this crazy day, I was still grateful to be there. Not all veterinary students are fortunate to get internships and even fewer are lucky enough to get residencies. It had taken me two attempts to obtain my residency position, so even with the long hours and minimal salary, I was happy to be there.
My typical day started at about 8 am with the interns and my supervisor doing rounds to go over in-hospital patients. Then we saw appointments from 9 am to the early afternoon, downed a quick lunch, and headed off to do surgery, take x-rays, or perform whatever procedures were scheduled. Then it was back to appointments from about 3-5 pm and to rounds again on inpatients to make sure they were all set for the night. We usually finished at about 7 pm, unless of course, there were a lot of new patients admitted following afternoon appointments that needed more workup and stabilization before we could go home. Unfortunately, most bird and exotic animal owners don’t bring their pets to the animal hospital for regular check-ups but instead typically wait until they notice they are ill. Since many exotic pets are prey species that hide signs of illness until they can’t anymore, most exotic pets are pretty sick once their owners finally notice their signs. Thus, many exotic pet appointments are brought in on an emergency basis and require immediate care. So, at the AMC, we often didn’t finish until 8 or 9 pm. Days were long, vacation time was non-existent, and I was perpetually tired, but I would do it all over again, even knowing now how hard it would be.
Residency is an important time of transition for new veterinarians. It is the span between internship and specialization – a time when a veterinarian is expected to know a lot but not everything and is still allowed to make an occasional error under the mentorship of a more experienced specialist. It’s a time of learning to juggle in-hospital casework with studying for specialty boards and dealing with everyday life tasks. It’s also the first time most veterinarians learn to teach others (interns), as well as teaching themselves, and to apply book knowledge to live animals. Residents start to see the same types of cases over and over until they develop their own library of experience to draw on in the future. They start to feel like grown-up veterinarians and no longer “newbies.”
Many new veterinary school graduates are anxious to be done with the classroom and rush out to join a practice. They don’t realize how little they know until they are facing actual paying clients and must develop their own diagnostic and treatment plans. A small number of them appreciate the value of an internship – an additional year of learning and confidence-building – before they go out on their own. An even smaller number decide to specialize and invest another 1-3 years in residency training if they are fortunate enough to achieve a coveted, competitive residency position. Many young veterinarians have no idea what they might want to specialize in until their internship year when they typically get a chance to work closely with specialists in different fields to see what being a specialist is like. I had no idea I wanted to specialize in avian and exotic pet medicine until I was an intern.
I would encourage all veterinary students to pursue an internship to gain additional post-graduate training and to be open to the opportunity of doing a residency. Internship and residency can be grueling and exhausting, but as any veterinarian who has completed these programs will tell you, you will not only be a more skilled, confident, and marketable doctor after you do but also change the entire future course of your career.
Return next month for Dr. Hess’ next post.