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Medical Internship

The beginnings

 

Way back in the 90’s, I wondered how I could create a training system for my staff that would allow them to be the most helpful for our growing client base than any other veterinary clinic. I had experienced how other practices answered their phones and handled questions and it was just not good enough. I wanted my staff to be knowledgeable, confident and helpful.

 

But, where to start?

I began by collecting information that I wanted my staff to know. It was very basic and I started by using information that I had purchased to give to my clients as client education. It was written in every day language and easy for everyone to understand. I started with the basics: “Is pyometra similar to pyoderma?” “Does my cat straining to use the litter box need a laxative or is something else going on?” You get the idea. Soon I began collecting and writing all sorts of information and our training materials grew.  As the amount of information, so did our business and the size of our staff and I was faced with another challenge: How to keep track of everyone’s training. We had a licensed tech that wasn’t happy in her position and was looking for something more. I told her that I needed to have a full time training director and she jumped at the chance. We devised a method to track everyone’s skills. At the time, the current training method that was being promoted by the so-called “Management Gurus” did not work in real life. They were promoting that everyone close their clinics to have staff training meetings for a few hours every week. What they didn’t realize is that closing the clinic was non-productive but even more important, did not address the facts that there are always going to be too many people with too varied of skill sets. In other words, we might have a person with 10 years of experience and another who had 10 days… what do we teach that is applicable to both? Group training made no sense. It had to be individualized training. We developed a simple but never before used method to track every staff member’s knowledge base. My goal was to have everyone constantly training and constantly becoming more knowledgeable. I imagined every single person on my staff being better trained than any other practices’ employees.

 

Our training materials became known as modules and we developed modules for everything. We had such a comprehensive program that our practices offered to buy it from us! We had modules for changing light bulbs to Hyperadrenocorticism... and we had perfected the technique to tracking individualized training.

We eventually had the good fortune to re-hire a receptionist that had gone on to college and received a degree in teaching. She was a college-educated teacher but she preferred teaching our staff members than working in a school. Now we had the ultimate training director and the ultimate training program.

 

 

 

Early DVM mentoring

 

We’ve always been extremely selective to hire as good of people as we could find and do our best to create a drama-free work culture. Everyone who works at Animal Care Centers (ACC) is a good person and very willing to help each other. Let’s face it, the more we know, the better we can perform our jobs. When everyone is knowledgeable and willing to work together, it is not uncommon to hear one staff member to say to another, “Do you need any help with anything?” While this might not seem like a big deal, it is a very big deal! While our training director oversees the training of everyone, everyone participates in teaching and sharing experience.

Our doctors are not paid on percentage of production – yet are among the highest paid in our profession. One of the benefits of not paying on production is that our doctors are not financially incentivized to not help a colleague – so they help mentor and their pay reflects that mentoring is a vital part of their daily job – but in truth, they love to teach. It was a natural outgrowth of our staff-training program.

 

Since we already had the structure in place to track skills, it was a natural extension to move toward mentoring new grads. We began to research and identify the most commonly encountered cases that General Practitioners  (GPs) would encounter. Unlike traditional intern programs, we wanted to mentor our doctors on cases that they would need to become proficient in – not cases that needed to be referred to specialists. Traditional mentoring programs at traditional internships involve shadowing specialists as they treat cases that were referred –which isn’t much benefit for the GP. We feel that a recent grad needs to become proficient at hyperthyroidism in cats and luxated patellas in small dogs – not watch as a boarded surgeon performs a TPLO.

 

 

 

DVM Medical Mentoring matures

 

Our collection of modules for the GP continues to grow and includes virtually 90% of what a GP should see. We also have the advantage of having other GPs to work alongside to bounce off a case or a differential diagnosis. They are there to help you read radiographs and interpret blood work if you need it. One time a recent grad  said to us that she “just wanted to hear Dr Wendy’s spiel” on a somewhat involved internal medicine case. As a result of that, we now have videos of our senior doctors talking to the camera as they would to a client. This allows you to hear “their spiel” without tipping the client off to your lack of experience.

 

 

 

The addition of exam room virtual mentoring

 

While many schools now have “simulation rooms” or do a little role-playing with an actor pretending to be a difficult client, we take it to a new level. All of our exam rooms are equipped with cameras and microphones so that we can provide instant feedback to our newer doctors and staff members. We have a coach with over 35 years experience teaching vet med and customer service ready to tell you what a great job you did as well as how to improve the next time. Again, this eliminates the awkward situation where a client would lose trust in you by having a senior doctor in the exam room with you. We have a virtual coach that has done it all and seen it all – and yet is the most patient and positive coach that I’ve ever met.

 

 

 

Surgery mentoring

 

We have an arrangement with a local SPCA that provides them no cost spay and neutering – which they love. The benefit to you is these cases allow our recent grads the opportunity to become proficient in soft tissue surgery and techniques. Once the new grad is confident and competent in their surgical skills, we move on to more complex surgeries. You are never left alone unless you want to be. We believe in the “watch one, “help with one,” “do one with supervision,” and  “go solo” method of teaching surgery. There is no better way to learn surgery than to be taught correctly and then have practice, practice, practice. At ACC, our caseload is higher than The Ohio State University of Vet Med, (not even counting the spays and neuters from the SPCA,) so the opportunity for practice in abundant.

 

 

 

Organized goal setting

 

Since we’ve mentored so many recent grads, we have a very good idea of how fast you can progress. We have goals that are very achievable in our system, yet unimaginable in other internships or associates. Your growth is limited by your abilities – not due to lack of caseload or lack of mentoring. We’ve had new grads successfully performing pyometras within a month and others performing 3 GI foreign boy removals within a week, long before her first year was finished. With our caseload, we perform lots of ACL repairs – and use different techniques depending on the case. We plan on mentoring you to proficiency in solo ACL repair during your first year. There is no need to refer these cases as a general practitioner when you can provide the same results for a fraction of the cost – and your clients will be impressed and grateful. We know where you should be in 30 days, 90 days, 6 months and 1 year, and we have the experience to prove it.

 

 

 

Quality mentoring

 

Our doctors love to teach and it shows. With our large staff, you will be given the opportunity to learn different styles from multiple experienced GPs including a boarded ABVP Diplomate. To augment your mentoring, you will have an optional opportunity to spend enough time with a Boarded Ophthalmologist to learn more ophthalmology than you did in your school’s entire clinical rotation. If you are fortunate to be asked to stay on after your internship, you will be a competent and experienced GP after only one year and be able to command a substantially increased salary either from us or in your next position.

 

Dr. Jay performing an ACL after 10 months with us.
Dr. Alyssa performing an amputation after 10 months with us.

Still Need More Information?

Read more about our mentoring programs and talk to our staff. Talk to those that have gone before you. They will tell you that (like a lot of things we do) this is the real thing and that we are years ahead of everyone else. Better yet, schedule a visit and see for yourself!

“The few weeks of mentorship I have received already has prepared me more for my first year out than an entire year of clinical rotations in veterinary school.”

 

“The environment that Animal Care Centers has managed to achieve is unmatched. A fear free zone where a first year graduate is able to communicate with senior clinicians as equals. They respect all opinions and offer advice and skilled help whenever requested.”

 

 

“The training provided through Animal Care Centers is specifically catered to match each individual veterinarian. If a new graduate needs more training or hands on experience, ACC provides the opportunities.”

FAQ's

  • Could you briefly explain a day-to-day schedule of a typical intern and how that progresses, especially in terms of how the mentorship program fits into all of it?  How exactly are we provided mentorship? 

 

The day to day schedule when you are new is structured around training. Of course this changes as you gain confidence and experience and have spent time with our doctors and staff. When a new doctor starts with us they spend approximately 2 days with Samantha, our training director, to perform your orientation, collect all necessary paperwork including tax forms, go over the handbook, and begin getting you comfortable with our hospital software.

 

After this process you will spend a full week shadowing our doctors. We assign you to a doctor each day so you have clear direction. We will expose you to surgeries during that time as well. After a few days we may have you see boarders with one of our doctors coaching and giving general advice.You will receive as much time from our doctors as you need and ask questions and get to know the staff.

 

When the first week is over you will begin to see routine appointments.You will receive ongoing mentorship throughout the day. You will meet with a senior doctor for a one on one training session weekly.  After each session your Employee Progress Report is updated.(The "Employee Progress Report" is a very structured training program that is broken down into 12 months sections of training - Just as an FYI, we have some doctors doing ACLs, Foreign body surgery, and many other challenging surgeries by the end of their 1st year. Not only can they do them, but they are good at them.)  

 

Depending on what materials are covered, the senior doctor will clear you to see certain types of cases when you are comfortable. Your personalized Employee Progress Report is filled out at least weekly; there is an “Exposed” section, a “With help” section, and an “Independent section”.  For instance, if your mentor has gone over how to handle an ear infection case and the senior doctor feels you can see a case independently, your Employee Progress Report is updated to "I" and you are cleared to see those cases independently. We keep a running list of what the new doctors have been cleared to see so the front desk knows how to schedule them.  

 

We work closely with you in surgery as well. Surgery training is tracked in a very similar manner and is updated weekly to the Surgery Employee Progress Report. You will observe routine surgeries, scrub in with our mentor, and then perform routine surgeries with your mentor. Once your mentor feels you can perform that surgery independently your Surgery Employee Progress Report will be updated and you'll be clear to perform these surgeries independently. With the amount of doctors we always have on staff a senior doctor is always available if you need help. We won't ever leave you alone. We work closely with the SPCA and have pets come in weekly to be spayed and neutered so can give our interns and externs alot of surgical exposure. 

 

  • How long am I assigned to a senior doctor?

 

We will look at the schedule for the day and see what the doctors have scheduled both from a surgical and appointment standpoint, and guide the training accordingly. You may have 2 or 3 doctors you are involved with in any given day. There are no concrete rules for this.  This program is very good at identifying what you need and tailoring the training to help you become successful.

 

Once you start seeing appointments you would usually see appointments in the morning, surgery in the afternoon, you get an hour lunch and then back to appointments. As you can see your mentorship and progress are part of our culture and are practiced daily.

 

  • Also, what is the caseload like?

 

This will differ as when you do your rotation to each clinic. You may spend 6 months at one of our busier clinics and 3 months at the other 2. All of our senior doctors are excellent teachers and you will receive great experience and mentorship at all of our clinics. Newer doctors are scheduled 30 minute appointments and after 6 months usually can see 20 minute appointments if they are ready. You will be single booked during appointment time. As a new doctor you could be booked a full day but that is not usually the case. If we have surgeries we want you to observe or be involved in, you will be marked out for those surgeries. This happens quite a bit. Between the 3 clinics you will get to see and be involved and learn many different surgeries.

 

  • I noticed that the description of the internship says that vacation is available. Is there a set amount of time we generally receive?​​

You receive 1 week vacation after 6 months of employment.

  • What differentiates this internship from others that are available?

​The first thing that needs to be realized is that we were the first in the country to have a legitimate, organized, and structured general practice internship. For that reason, we have experience. The next thing would be to understand what happens in other practices or universities that offer experience or positions for the new grad.

  • 1. We only focus on general practice GP. Other institutions or practices may see specialty cases. It makes no sense to rotate through various specialty rotations if these cases are NOT cases that you will encounter in GP. The cases you see in those internships are almost always cases that GPs refer - thus defeating the purpose of gaining experience in "routine" cases that should not be referred. For example, in a referral practice, you will not see routine vomiting, diarrhea, itching, ear infections, UTIs, URIs, lameness, etc. These are the cases that a GP needs to master. It does you little good to watch a surgeon perform a TPLO if you don't know how to work up a lameness first.

  • 2. We provide hands on experience. You can perform your own surgeries until you are competent enough to teach others. You have your own personal case load and are not shadowing another doctor. This is also important because it will never be obvious to the client that you are still learning - even though learning should never stop. If you are seen shadowing another doctor and see the client again later by yourself, the client will know you are new and not have confidence in you.

  • 3. We provide excellent mentoring and immediate feedback from people with years of experience. Our staff has made our program what it is today because they enjoy teaching and take the time to do so. Unlike other practices that pay their associates on production, ours are not. This way, taking time to mentor you does not take anything away from their salary.

  • 4. We have a huge caseload. Unlike some universities that expose you to 4 cases per day, you can personally experience as many as 20 cases per day - but no more than you can competently handle. The more cases you learn to handle properly, the faster you become competent and gain confidence.

  • 5. We have multiple locations and multiple personalities and styles. If, for example, you've never observed a foreign body removal, and one of the other locations has one, we will usually be able to move your schedule so that you can be there. Our locations are only 15-20 minutes apart so this is logistically simple.

  • 6. The organization and structure of our program is what keeps you moving in the right direction. Once you've seen that foreign body removal surgery for example, you're then ready to assist a senior surgeon in performing one. The next obvious step is to perform one on your own - with an experienced doctor available to pitch in if you need help. Our structured program allows us to know where you are in your development and what you need to learn next.

  • 7. The learning environment at our clinics is not intimidating. Maybe you've experienced "GP bashing" or "specialist arrogance" intimidation at school. At our practices, its all about teaching and learning - not about proving to you how smart we are. We let our track record speak for itself

  • 8. In most practices, mentoring is done when the practice owner finds the time. If you are hired to work in a busy practice, there will be many times that the senior doctors are just too busy to teach. In our program, mentoring is not a sideline or "when we get around to it" kind of situation. We focus on mentoring our interns every day. We also have 1 on 1 conferences to discuss your progress and your needs. Mentoring is embedded into our every day. It’s an integral part of what we do.

  • 9. The experience and knowledge that you will gain in just 1 year surpasses every other opportunity that we are aware of. From a soft tissue surgical standpoint alone, imagine becoming competent in cystotomies, enterotomies, pyometras, mastectomies, and tumor removals You will get the chance to perform almost all of these surgeries including ACL repair taught by competent and experienced mentors. Your outpatient and internal medicine experience will be just as broad.

  • 10. At the completion of your mentorship, assuming you were coachable enough to progress as you should, we will write you a strong letter of recommendation that will go a very long way toward your next position. Talk to previous and current interns to see just how much you can learn in a year. By participating in our internship, you will be extremely qualified to further your career no matter which direction you choose to go. You might even get an offer to join us as a senior doctor and mentor others!

  • What is the dress code?

Scrubs or business casual.

  • What should I bring with me?

Your stethoscope and any paperwork that you have been given by your school for us.  Most paperwork is sent to us electronically. 

  • Do you have recommendation for housing?

1. Extended Stay America (right next to our Blue Ash Office) #513-985-9992
2. Extended Stay America (near our Fairfield Office) #513-860-5733
3. InTown Suites Fairfield (short term apartments) #513-942-8005