“Choose your residency wisely.” – A wise old veterinarian
Truthfully, I can’t remember who to ascribe the above quote to, but during my residency, I remember those words repeating in my head like a refrain from a bad song you just want to forget.
It was approximately 11 p.m. at night and, as a rotating intern, I was accustomed to powering through some very late nights. I had responded to a call from the hospital about a dog who presented with an acute abdomen. Unfortunately, this dog was pale, moderately responsive, and was trying her best to stay in good spirits. Reflexively, she would wag her tail the moment you touched her head, which made it even more heart wrenching to see her in that condition. I was standing near the ultrasound table with the radiologist after having just completed her abdominal ultrasound. The results of the ultrasound were not good. This incredibly cute five-year-old Labrador had a bleeding mass on her spleen and she was going to need a splenectomy. But there was a problem. The surgeon on call wasn’t answering his phone. We both had been waiting close to 45 minutes and still there was no response.
The dog was surprisingly stable considering the circumstances, but having free blood in her abdomen made her situation more pressing with each passing minute. The critical care department had already initiated fluid resuscitation, but she was still awaiting the most critical element of her treatment plan: surgery. Suddenly, the phone broke the din of hospital conversation with a loud ring and on the other end was the surgeon. I spoke to him, updated him on the case, and we agreed that a splenectomy was in her immediate future. He sounded defeated, frustrated, and borderline annoyed about the situation. It was understandable. The week had been long and he was exhausted from the workload… but before we hung up, he assured us he was on his way. After the call, I looked at the radiologist who had been close enough to overhear our conversation and he repeated those same four words to me, “Choose your residency wisely.”
So, I carried that message with me for years. I was deeply passionate about diagnostic imaging and fervently pursued a radiology residency. For five years, a residency was my only focus. But, alas, the wild and unpredictable journey of veterinary medicine guided me towards becoming a surgeon and the rest is history. It turns out surgery is more aligned with my inherent talents than radiology, but I still deeply enjoy both.
One of the biggest decisions you will make in your professional life is choosing what discipline or specialty to dedicate your life to. Your natural inclinations are so important that it tops the list of my top three ways to narrow your focus in veterinary medicine.
Using your professional pince-nez: Three ways to narrow your focus as a veterinary student
At first glance, the most striking feature of the pince-nez (a style of glasses) is the lack of temple arms. That distinguishing feature allows the user to see the world around them. There is nothing obstructing the view of their peripheral vision. That is an appropriate metaphor through which to understand veterinary medicine. Although you may have a main interest that grabs your focus, continue to be aware of, and enjoy, other veterinary disciplines. Those other disciplines will likely compliment your major interest of study. The variety of interests you currently have may be one of your strongest attributes.
1. Natural talent.
Although mindfulness and presence are popular words in today’s conversational lexicon, the essence of what undergirds those words is truly sublime. Conceptually, both of those terms get to who you really are: your authentic self. When I started veterinary school, I rarely had anyone ask me about my natural talents or gifts, in large part because I was still trying to figure out what those were. Everyone has natural gifts and talents. Take a deep look at who you are, your inner strengths, and what led you to this moment of success in your life. What you like doing may not directly translate to what you choose to study but it’s a great start. For example, understanding you are not a people person may steer you towards disciplines that have slightly less contact with clients like radiology, pathology, research, or anesthesia, to name a few. If people always have complimented you on your ability to listen to their concerns, then a specialty that requires an abundance of patience—which is pretty much every specialty—like internal medicine, dermatology, surgery, and oncology may be your forte. If you’ve always been technically gifted with your hands (i.e. woodworking, arts and crafts, and yes, video games) then you may find a discipline that has a large surgery component (surgery, neurosurgery, ophthalmology) more enjoyable.
2. Species specific.
This is truly the beauty of veterinary medicine. After a rough exam in vet school or a long day in the hospital, it may not feel beautiful that the breadth of your knowledge encompasses so many species. However, once you rest, recharge, and reflect, you realize it’s a blessing that we get to treat different species. There is no other medical specialty quite like it. When I started veterinary school, I wanted to open the first all bovine-canine practice. Those were the two species I loved but, in the end, I had to choose between the two.
So how do you choose which species to study?
Clinical experience. If actions speak louder than words, then experiences are life’s megaphone. Your personal experience with a chosen species or in a particular discipline will guide you more completely than a textbook.
Research. To be sure, researching your chosen species plays a very important role in the decision making process. Continue to read about your species of interest in your down time or as a personal independent study. The more knowledgeable you are as you enter those experiences, the more valuable your experience will be. Join a club that aligns with your interests (i.e marine animal veterinary club, etc.) Attend online lectures or sign up for virtual CE (or in-person CE) especially if you are having trouble finding a professor to shadow.
Introspection. Finally, as much as the decision may seem like it’s rooted in the inherent qualities and features of that particular species, the decision really comes down to who you are. A healthy amount of introspection will be helpful in making your decision. On your most challenging and arduous work days, ask yourself, “Can I see myself doing this the rest of my life?” If the specialty excites and captivates you even in moments of extreme exhaustion, then you may have found the species through which you want to practice medicine. Do you find you are studying and learning about that species without having to be cajoled into doing it? If so, you may be close to making a lifelong commitment to that species. As you often hear clinicians say, “When you hear hoof beats, think horses, not zebras.” Meaning, common conditions occur commonly and unusual cases are as rare and, perhaps as exotic, as zebras. The ‘horse cases’ —meaning the common ones—should be the main impetus for you to choose to work with a particular species. That “meat and potatoes” theory to medicine—meaning, you may be doing a lot of the same thing—applies broadly to most veterinary disciplines no matter the species you choose to work with.
3. Get a mentor.
This may sound like an obvious suggestion, but mentors at this stage in your professional career could serve a greater role than a symbolic aspiration. A mentor at the earliest stages of your education should be able to help you narrow your focus using an algorithmic approach towards defining your career path. At the end of each semester, they should be able to ask you personal questions like:
- What classes or scientific areas are you the most passionate about?
(i.e. anatomy class → surgeon; physiology → internist; histology → clinical pathologist, etc.)
- Do you enjoy the clinical environment or a research environment more?
(ie. enjoy performing equine lameness exam → equine surgeon; enjoy studying mechanisms of disease → Public Health; epidemiology, etc.)
- What are the goals for your life outside of veterinary medicine?
It may be difficult to think about now but your career can be draining. Right now, you are so focused, driven, and determined, that an 11 o’clock study night may feel like you’re just getting started. Long hours may not exhaust you like the surgeon depicted in the introduction, but as you get deeper into your career, having a work-life balance may become the most important factor in your life (i.e. starting a family). Having unpredictable hours and constant upheaval in your schedule may not fit your overall life goals. According to the Merck Wellbeing Study II1 , veterinarian burnout scores were nearly 40 percent higher than they were in our physician counterparts. The factors having the strongest associations with burnout scores were lack of work-life balance, not enjoying work, not finding work invigorating, and having personal conflict with 1 or more work associates.
- What don’t you like about a chosen species or discipline?
At this stage in your career, where the default answer is to say “yes” to every learning opportunity, it’s okay to not like something. Everyone at your stage loves all animals but not liking a species doesn’t mean you detest them collectively, it simply means you don’t want to dedicate your entire life’s work to them. It’s important to keep a mental log about what detracts you from a specialty or species in case these dislikes are immutable. For instance, if you don’t like spending long hours on your feet you may want to reconsider a career as a surgeon. If you don’t like emotionally challenging patient outcomes, then pursuing oncology may be less desirable. Or, perhaps you don’t like waking up at the crack of dawn, dairy medicine may not be the discipline of choice for you.
Factors that should be less important in your decision
Compensation. According to U.S. News & World Report, the average median salary for veterinarians was $93,830 in 2018. Your salary as a veterinarian may vary depending on your specialty, geography, ownership, and other factors. Prioritizing the money you’d like to make over your true passion and interests may lead to career burnout.
Glory. There are certain disciplines that tend to garner more attention from your colleagues or adoration from pet owners. For instance, a radiologist may strongly influence a medical outcome by providing a diagnosis, but the internist may receive more of the gratitude when the patient improves. Candidly, there is a certain “cool factor” for some specialties. The appeal of those “cooler” disciplines may not be long-lasting or it may not represent the reality while working in the field. What one person views as glorious, you may view as extremely stressful. (i.e., surgery).
Zebra cases. I remember gathering around an exam table, or at the door of the surgery suite, huddled with my classmates straining to see an unusual or atypical case. We were in rapt amazement at what we were witnessing. Indeed, those unique cases can be so fascinating that they may persuade you to consider working within a certain specialty or with a particular species. However, those zebra cases may not represent the bulk of what will constitute your career.
Finally, it cannot be overemphasized to keep an open mind during this selection process. Similar to my journey of considering an all bovine-canine practice, to pursuing a radiology residency, to finally becoming a small animal surgeon, there are countless stories of veterinarians who change their mind along the often circuitous journey toward their final professional goal. According to a survey administered to Western College of Veterinary Medicine graduates, two years after graduation, only 32.7 percent to 41.0 percent of respondents had remained with their initial employer, 2 indicating that even after veterinary school, many graduates change their mind. Having broad and all-encompassing interests should be considered a gift, not a detriment to your career.
5 Insights to finding your profession pince-nez
- Find a mentor
- Gain experience
- Consider your natural talents/interests
- Keep an open mind
Narrowing your focus should be a fun and incredible part of your educational experience. Enjoy the wealth of knowledge and the diversity of experiences that you will have during your tenure as a veterinary student. When the time comes, don’t be afraid to use your professional pince-nez.
1Executive summary of the Merck Animal Health Veterinarian Wellbeing Study II
John O. Volk, BS1; Ulrich Schimmack, PhD2; Elizabeth B. Strand, PhD, LCSW3; Judson Vasconcelos, DVM, PhD4 and Colin W. Siren, BA5
2.Western College of Veterinary Medicine Class of 2005 2-Year Follow-up Survey, 2006. Available from: Associate Dean of Academics, WCVM, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5B4.