Discussion

An internship is a fixed-term training position for white collar and professional workers in which the trainee exchanges his/her services in return for on the job experience. The position may be paid, though usually at a level lower than expected for similar work in a permanent position (i.e. a remunerary stipend) or unpaid. In the UK, such placements are most commonly encountered within the fields of medicine, law, architecture, engineering and business and are typically held by recent graduates keen to develop their skills.

Until 2005, all newly qualified doctors within the UK were required to complete, to a satisfactory standard, one year as a pre-registration house officer before they were allowed to become fully registered with the General Medical Council. The house officer or houseman would normally concentrate on general medicine for half of this period, during which time they were commonly referred to as the house physician. For the remaining 6 months, the young doctor would typically become the most junior member of the general surgical team, and as the house surgeon, would become the first port of call for concerned nursing staff, however antisocial the hour. Progression to the hallowed 2 year position of senior house officer (SHO) was normally then followed by specialist training in the disciplines of medicine, surgery or general practice.

In the 1980s, most UK university veterinary clinical departments employed one or several house surgeons who, as young, keen veterinary graduates worked alongside nurses, lecturers and professors as part of the in house clinical team. Their involvement in diagnostic work, treatment and in-patient care was invaluable to the smooth running of the hospital and they contributed to undergraduate training by acting as an interface between the young students and the sometimes intimidating senior academic staff. At the same time, it allowed these young vets to develop their clinical skills, to determine whether they indeed wished to pursue a particular specialisation and to create a network of contacts which would prove useful for their future career development, whether this be in academia, research or private practice.

At this time, most of the UK university house surgeon positions were filled by word of mouth and/or advertised in The Veterinary Record. In North America, a relatively sophisticated (postal) system was already in place, whereby large and small animal internships were listed in a large tome which UK undergraduates could access. Prospective candidates were invited to apply via a placement system, not dissimilar to the old UCCA and today's UCAS system for sixth form students wishing to study at university.

At around this time, most equine veterinary work in private practice was carried out on an ambulatory basis. However, a small number of private practices had, for some years, been developing their in-patient facilities to the extent that they now resembled small hospitals, with patients admitted for diagnostic tests or for surgical or medical treatment. This produced an increasing workload, well-suited to the employment of energetic young graduates, keen to advance their skills within an intensive training environment, under the supervision of experienced private practitioners. These internship positions, (the term house surgeon gradually falling out of favour), were thus no longer the sole domain of the academic institutions.
Over the past 15 years, the extraordinary growth of the UK equine industry has led to the establishment of almost 20 private equine hospitals or clinics, whose in patient caseload requires a 24/7 in house vet/nurse team, ideally suited to the employment of young graduate trainees, who work under the supervision of senior clinicians. Typically, 2 or 3 interns work for a fixed term of 12-18 months, overlapping by approximately 6 months in the interests of continuity. Interns normally take primary responsibility for the day to day (and overnight!) care of in patients, working closely with and complementing the nursing team and liasing with senior clinicians with whom case responsibility ultimately remains. They may be involved with diagnostic work including imaging, perform general anaesthesia and act as surgical assistants. Interns will often rotate between these different clinical areas on a weekly basis.

The results of a survey of employers and past and present interns will be presented. However, preliminary discussions reveal that the prospective candidate must possess excellent communication and team skills and be armed with the physical, mental and emotional robustness to function effectively and cheerfully in the face of chronic sleep deprivation and on a relatively low wage. Although hard work, these training positions offer the young intern a unique opportunity to become totally immersed in the equine veterinary world for a fixed term, providing a valuable springboard for progression to a more senior role. For the majority, the experience is enormously rewarding and enjoyable and is regarded as a tremendous privilege, which is reflected by the huge competition for each and every UK internship position. This presentation will consider those factors which may just give one the competitive edge!