Internship Mission Statement:
The mission of the Small Animal Clinical Sciences internship program at Texas A&M University College of Veterinary Medicine & Biomedical Sciences is to create a confident, experienced, and marketable veterinarian who will have the very best chance to be accepted into a residency program, graduate degree program, or associate veterinarian position of his or her choice.
The majority of our interns who pursue a residency or specialized internship do so successfully. Those who enter into the private sector are highly sought after and report feeling confident in their practical veterinary medical skills upon completion of the program. To achieve our mission, we ensure that our interns receive hands-on clinical training, ample primary case responsibility, and a consistent didactic learning program, and that they are taught the highest and most up-to-date quality of veterinary medicine from specialists and seasoned veterinarians. As a Texas A&M small animal rotating intern, you will be exposed to numerous specialties and will work side-by-side with experts in their fields. We emphasize that our senior faculty will be present on the clinic floor challenging the intern to improve their practice as well as serving as invaluable resources for case management.
Internship Training Objectives:
The training objectives of internships vary with the clinical area and are as follows:
- To train the intern to effectively triage emergent patients and perform appropriate life-saving therapies.
- To provide the intern with opportunities to develop clinical proficiency in surgical diagnosis and surgical patient management, and to observe state of the art operative techniques.
- To provide the intern the opportunity to develop diagnostic acumen, and a problem-oriented approach to medical management of veterinary patients.
- To enable the intern to improve patient care and evaluation by utilization of recent knowledge from medical and surgical research.
- To prepare the intern to be a competitive applicant for either a private veterinary practice position or for further training in a residency or research degree.
- To prepare the intern to exchange information with others in a concise professional manner in rounds, seminars, lectures, conferences, and laboratories.
- To present opportunities for the intern to develop teaching skills.
- To allow the intern to develop communication skills with professional colleagues, technical staff members, clients, and the general public.
- To introduce the intern to the scientific method, research approaches, scientific publications and presentations, and the evidence-based practice of veterinary medicine.
- The majority of the time is allocated to those rotations in which interns have primary case responsibility for medical and surgical problems applicable to any career or specialty.
- Time is also consistently allocated to rotations in which the specialized nature of the discipline, its procedures, or service logistics necessitates that the primary clinician has expertise in the field. On such rotations, a greater proportion of the interns’ responsibilities may be devoted to a secondary role in case management
- Opportunity is also granted for elective rotations in areas of interest.
Texas A&M Veterinary Teaching Hospital Facilities:
The Veterinary Medical Teaching Hospital is a spacious facility with sophisticated diagnostic and patient care equipment, including color-flow Doppler ultrasonography, 4D transthoracic and transesophageal echocardiography, digital fluoroscopy, scintigraphy, computed tomography, 3T MRI, flexible and rigid video endoscopy, nuclear imaging, direct and indirect blood pressure monitors, acid-base/blood-gas analyzers, standard coagulation as well as TEG and PFA analyzers, intraoperative cell salvage machine, phacoemulsification system, short- and long-term pediatric and adult patient mechanical ventilators, stereotactic neurosurgery, high-flow oxygen therapy, peripheral nerve stimulators, and multifunction patient monitors. Radiation capabilities include TomoTherapy and iridium implant brachytherapy. Surgical instrumentation allows complex orthopedic, thoracic, and abdominal procedures. A catheterization laboratory with C-arm fluoroscopy allows for highly advanced cardiothoracic procedures. Strong support services including nuclear medicine, clinical pathology, radiation therapy, clinical microbiology, anesthesiology, radiology, and physical rehabilitation promote optimal patient management and clinical investigation.
Texas A&M Veterinary Teaching Hospital Faculty
All faculty, residents, and specialty interns present on the clinical floor will support the small animal rotating internship in order to provide a teaching experience on every case. Board-certified faculty members in direct support of the program include internists, cardiologists, oncologists, neurologists, anesthesiologists, criticalists, radiologists, surgeons, general and emergency medicine practitioners, dermatologists, ophthalmologists, zoological medicine specialists, a radiation oncologist, a behaviorist, a nutritionist and a dentist. You can learn about the teaching hospital and clinical faculty by visiting http://vethospital.tamu.edu/small-animal-hospital.
The clinical program:
Interns will be scheduled on 20 two-week core rotations including internal medicine, soft tissue, orthopedic and general surgery, day and overnight emergency duty, anesthesia, neurology, and oncology. Interns will be able to also select 3 two-week elective rotations from services including zoo medicine, ophthalmology, dermatology, clinical pathology, radiology, or critical care.
- Anesthesia: During this rotation the intern will be under the supervision of the anesthesiologist on-duty and will be given primary case responsibility. This involves pre-anesthetic work-up, perioperative anesthetic management, and student teaching responsibilities. The degree of case difficulty will be determined by the attending clinician. Interns will be required to attend daily case/topic anesthesia rounds.
- Emergency Duty (day): Interns will be assigned to primary ER duty from 7 AM to 7 PM and see both walk-in primary emergency cases as well as cases referred to a specialty service that are admitted through the ER. Currently, TAMU is the only emergency hospital in an 80 mile radius. Interns will be supported by at least 1 experienced ER clinician or board-certified criticalist during the day ER shift and will share caseload as needed with ECC residents. Interns will be responsible for thorough history-taking, physical exams, generating problem lists, pertinent differentials, and performing emergent diagnostics or interventions. Interns will also be expected to teach and work closely with 4th year DVM students on the problem-oriented approach. Clear client and referring DVM communication skills will be emphasized.
- Emergency Duty (overnight): While on overnight duty, interns are responsible for triage, assessment, and treatment of incoming emergency cases with the support of trained technical staff, students, and the on-call residents and faculty. Interns are also expected to help supervise and troubleshoot ICU patients and patients requiring overnight intervention.
- General Surgery: The intern will have primary case responsibility of surgical cases commonly seen in private practice settings with oversight by a senior clinician. The intern will assess patients prior to surgery, generate an anesthetic and post-operative analgesia plan, perform surgery, oversee and assist student surgeons with procedures, and lead rounds discussions with students.
- Internal Medicine: The intern will have primary case responsibility for internal medicine patients referred to the VTH on a scheduled or emergent basis, and will work closely with a supervising board-certified internist on each case. For each patient, the intern will work with an assigned fourth-year student to obtain a patient history and perform a physical exam, then will generate diagnostic and therapeutic plans which will be reviewed and discussed with the supervising faculty member. The intern will ensure that finalized plans are carried out, including making daily adjustments to plans based on changing patient status, and communicating directly with client owners and referring veterinarians.
- Neurology: During the neurology rotation interns will have primary case responsibility. Interns will see both new and recheck cases, and will take transfers from emergency. Interns will work with 4th year students performing physical exams, neurologic exams, and developing therapeutic plans. All cases will be seen under the direct supervision of the senior clinician, and interns will be given the opportunity to perform CSF taps and scrub into all neurosurgeries. While on the rotation, interns will be expected to have consistent communication with the owners as well as the referring veterinarian.
- Oncology: Interns will work under the supervision of the oncologist on clinical duty. They will be given primary case responsibility including new cases as well as recheck/chemotherapy appointments and radiation therapy patients. Most of our patients are treated on an outpatient basis but many radiation therapy patients board with us for the duration of their treatment. Interns will have support from the senior clinician who will approve all recommendations and treatment plans. The interns will also have teaching responsibility by working with students on each case. Interns will be required to attend daily case/topic oncology rounds.
- Orthopedic Surgery: Interns will work under the supervision of the orthopedic surgeon on clinical duty. Interns will be responsible for independently seeing clients for both new and recheck appointments. They are expected to scrub-in on their own primary cases and reserve the right to scrub-in on additional orthopedic cases. Learning how to run a surgery room table and prepping the patient for surgery is of paramount importance during this rotation. Interns will be given student teaching opportunities in relation to treatment orders, discharges, medications, bandage changes, speaking to clients at discharge, and calling RDVMs on new or complex cases.
- Soft Tissue Surgery: During this rotation, interns will be given primary case responsibility. Interns will participate in receiving soft tissue referral appointments, determining and performing the diagnostic work up, making an operative plan, performing postoperative care and performing client communication. The interns will be given intra-operative responsibilities as appropriate. Interns will attend daily case and topic rounds.
Veterinary interns are selected competitively through the Veterinary Internship and Residency Matching Program (VIRMP) of the American Association of Veterinary Clinicians (AAVC). Each applicant to our program, including applicants born or educated outside the US, must be eligible to obtain a valid regular license to practice veterinary medicine in Texas. This will require:
- graduation from an AVMA-approved College of Veterinary Medicine OR completion of the PAVE or ECFVG certificate,
- a passing score on the NAVLE, and
- a passing score on the Texas State Board examination.
Foreign applicants should note that the Department of Small Animal Clinical Sciences will not sponsor applicants for H-1B or E-3 non-immigrant employee categories. For further information to determine their eligibility, foreign applicants should directly contact the TAMU Office of Immigration Services for Faculty and Scholars (http://isfs.tamu.edu).
Criteria for ranking and selection of intern candidates include academic performance in veterinary school, evaluations from at least three individuals who assess each candidate’s academic record, clinical aptitude and interpersonal skills, and the candidate’s statement of professional goals. The ranked individuals are submitted to the VIRMP and based on candidate program ranking and the program candidate ranking, a selection is made.
Regular, formal feedback from the clinic is an essential part of training within the internship program. Interns also benefit from the mentorship of faculty members outside that which occurs directly on clinic duty, and from coaching towards completion of an Academic Project during the internship year.
- Each intern will be assigned a faculty member from among the Intern Training Committee (ITC) prior to arrival.
- Upon arrival, with the help of the ITC mentor, each intern will select an additional discipline-specific faculty mentor within 30 days of the beginning of the internship. A primary duty of the discipline-specific mentor will be to help the intern achieve completion of an academic project during the internship year (see “Intern Academic Project” SOP).
- The intern should actively seek the mentors’ advice about hospital interactions, confusion or concerns about the internship program, VIRMP or career advice, or any other subjects not directly related to clinical case management.
Faculty on all services complete Intern Evaluations for each intern on each rotation and these are regularly shared with the interns and their mentors. Evaluation Meetings will be scheduled twice per year, attended by each intern, both mentors, and other members of the ITC as available. The goal of these meetings is to review the Evaluations, to provide guidance, and to welcome the intern’s feedback on the internship. Interns continue in the program dependent upon continuous satisfactory performance. Exit interviews are held at the end of each year with the goal of using outgoing interns’ suggestions to continually improve the internship program.
Intern Academic Project and Presentation:
All rotating interns will complete an academic project during the course of the internship. For those interns pursuing general practice, this will provide exposure to the scientific method and will develop skills of critical literature review. For those interns pursuing specialty training, a project underway early in the year will enhance residency applications by demonstrating academic skills; a project that builds momentum later in the year can be completed early in the residency, well in advance of the publication submission deadline for credentialing. Projects may include, but are not limited to, retrospective studies, case reports or case series,. JAVMA “What’s your Diagnosis?” or similar features, invited brief case-based or topical reviews (e.g., Clinician’s Brief), invited narrative reviews co-authored with a faculty member (e.g., Veterinary Clinics of North America). Each intern will present a seminar in the spring House Officer seminar series based on the academic project. With this focus in mind, the intern should prepare a first draft of a manuscript based on the project by the time of the seminar, so that feedback from the seminar can be used to improve the manuscript and it can be submitted prior to completion of the internship year.
Interns may be assigned to assist in various clinical and laboratory courses as deemed necessary by the Department Head. Under no circumstances shall an intern have sole responsibility for, have the major teaching responsibility in, or direct, any required or elective course. The intern will actively participate in the educational instruction and professional development of the senior veterinary students.
The intern program supports a strong didactic education with weekly house officer topic rounds presented by faculty or residents as well as monthly imaging rounds to hone radiographic interpretation skills. In addition, interns are invited to participate in journal clubs, ECG rounds, and various service rounds. Our program emphasizes the problem-based approach and helps interns to learn to identify patient problems, make rational lists of differential diagnoses, project logical diagnostic plans, and base treatment upon pathophysiologic mechanisms. Every case seen by the overnight ER intern is discussed with a group of clinicians the following morning and direct feedback is provided.
Completetion of the Internship:
Satisfactory completion of a veterinary internship is documented by a certificate that recognizes the successful participation of the individual in the internship program.
- The intern must complete all clinical rotations, scheduled emergency duties, medical records, and discharge letters.
- The intern must demonstrate competency in medical and surgical skills judged appropriate for an intern’s level of professional development.
- The intern must attend seminars, rounds, and scheduled meetings (including journal clubs) specific to the service the intern is currently assigned to and specific to the Department of Small Animal Clinical Sciences.
- Each intern must present one seminar in the House Officer Seminar Series which is based upon the intern’s Academic Project.
- The intern must provide a written evaluation of the internship program to the Internship Training Committee upon completion of the program.