Becoming a veterinary specialist is difficult. I don’t say this looking for sympathy, as I am well aware I chose this career, and the stresses I’ve sustained thus far are primarily of my own doing. But there are times when I do question my path.
There are days where it seems no matter how late I stay to make phone calls, or how many times I am willing to discuss the same recommendations with an owner, or how many times I try to battle the misconceptions surrounding cancer care for animals, I feel my efforts are not valued and I’m left feeling a bit purposeless.
I knew from a very early age I wanted to be a veterinarian when I "grew up." As a child, my aspirations were to heal sick animals, relieve suffering, and discover new treatments for previously incurable diseases. With the optimism and creativity only afforded to the very young, my career goals were lofty and impractical, lacking the specificity and applicability that comes with age. I remember being told, "how hard it was" to become a veterinarian, and though family, teachers, and friends supported my decision, I still can hear the concern in their voices centered around the "what if it doesn't happen?" option.
t’s not as though they didn’t know what they were talking about, and I experienced firsthand exactly how tedious the process of gaining admission to veterinary school could be. Some people are fortunate to be admitted after only two years of undergraduate work. I needed a Bachelor’s degree, a Master’s degree, and a few years of a PhD before becoming the "ideal" candidate to start applying.
Once graduated from veterinary school, after passing a national board exam, new veterinarians are considered capable enough to finally begin "practicing." Individuals who begin working immediately after graduation are typically referred to as general practitioners. They are skilled in the diagnosis, treatment, and management of all aspects of veterinary medicine, and often their skill set encompasses multiple species as well as disciplines. General practitioners need to maintain licensure within the state in which they practice, and depending on particular state requirements, they may need to pass one or more state mandated exams and will likely need to maintain a certain amount of continuing education credits on an annual basis.
I had no personal concept of what specialty medicine entailed until I started veterinary school, and it was always my intention to become a general practitioner. Once I began learning what veterinary internists, cardiologists, radiologists, surgeons, neurologists, dermatologists, behaviorists, nutritionists, and, yes, oncologists did on a daily basis, I began rethinking my future. Specialization appealed to my academically driven personality; always wanting to achieve and attain the "above and beyond," but more so, specialization meant the opportunity to favor depth over breadth and really understand one particular aspect of veterinary medicine to an "expert" degree.
For veterinarians, it is optional to pursue an internship after graduation. Most internship programs are about one year in length, and for those treating primarily small animals such as dogs and cats, internships typically consist of rotations though a variety of subspecialties of veterinary medicine. Some veterinarians will decide on an internship as a means to expand their practical knowledge and gain more experience before heading out into the "real world." Internships are also required before pursuing most residencies, so for some it’s a means to an end. Internships vary in difficulty and stress level. The rigors are designed to strengthen skills and it’s often stated the internship year is equivalent to five years of work in general practice. My internship year helped solidify my choice to specialize, as well as to help me decide upon oncology as my chosen field.
Most residency programs are a minimum of three years duration. Individuals apply to programs through a "matching" system, where ultimately the decision of where you will wind up training is not really your own. During a residency, veterinarians spend the majority of their time training in their field of expertise, with some time allotted for rotations in other specialties. Most programs require veterinarians to participate in the teaching of underclass veterinary students as well as "house officers," which is the term used to describe interns and residents in other training programs. Veterinary residents are usually also required to complete at least one original research study before obtaining board certification. There are also many on-call hours, required attendance, and presentations at national conferences, and a less than minimum wage salary to consider.
The typical "end all be all" of veterinary specialization is the board exam, which ultimately decides whether a resident is successful in obtaining board certification (or not). Although there are so many other hurdles we go through during the process, board exams loom as the main obstacle in attaining the almighty diplomate status. It doesn’t matter that you’ve completed veterinary school, passed a national exam, endured the rigors and emotional tolls of an internship, persevered through a residency program, published at least one research paper, spent countless hours studying and on call, and managed hundreds of cases related to your area of expertise. What stands between you and your ultimate goal of specialization, is yet another test.
It seems trivial that adults who have proven their academic talent for a minimum of 12 years of post-secondary training, performed hundreds of procedures, and spent thousands of hours focusing on one particular area of interest would have their future depend on correctly answering a few dozen questions. Fortunately for most of us, it works out in our favor and the exams are passed and board certification is achieved. It's a rigorous road, leading to a relatively undervalued lifestyle, yet we pursue it voluntarily and without regret. We’ve worked harder than you probably could imagine getting to this point — so maybe tread a little lighter when making statements about us being in it for the money, or that we "torture" animals, or how we’re not "real" doctors.
I would like to dedicate this post to my wonderful husband, who spent the last two days enduring the toll of his own specialty’s board exam. I can not only feel your pain, but have endured it as my own, and look forward to FINALLY being able to start our life together after so many long years apart. Wishing you all the luck in the world, and cheers to the best of our years to come.
Dr. Joanne Intile