Small Animal Medicine and Surgery Internship

Objectives | Prerequisites | Employment and Benefits | Advisors and Mentoring | Clinical Service Responsibilities | Emergency Duty | Teaching Responsibilities | Educational Opportunities | Evaluations | Appendices

Objectives

The internship program is designed to provide successful candidates with a broad but intensive learning experience in various areas of small animal medicine and surgery. The program is designed to prepare individuals for residency training programs, but graduates seeking advanced training and experience prior to beginning practice will also benefit. Interns should expect to advance their technical skills, clinical decision-making, ability to critically evaluate the scientific literature, and clinical teaching abilities.

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Prerequisites

  • DVM degree from AVMA-recognized institution or equivalent is required.
  • The Ohio Revised Code requires all veterinarians within the College to hold a current Ohio license to practice veterinary medicine. A limited license is sufficient for all professional activities carried on within the College. Holding a limited license restricts you to engage in the practice of veterinary medicine only to the extent necessary to fulfill your employment obligations.  Conditions of employment are contingent based upon your eligibility to obtain and maintain the minimal state requirement of a limited license. If at any time you lose eligibility to be licensed your employment with the university will be at risk.
  • Foreign applicants will only be considered if they hold a current green card or other visa with work authorization by the time the match begins.  The Ohio State University Department of Veterinary Clinical Sciences cannot provide work or study visas to internship applicants.
  • Foreign applicants must also meet the Graduate School Admissions requirements for the Test of English as a Foreign Language (TOEFL) (currently 550 for the paper-based TOEFL, 213 for the computer-based test, and 79 for the internet-based test). Applicants must have completed at least 6 weeks of instruction at an AVMA accredited institution and have at least 2 letters of recommendation from that experience.
    • Candidates who have completed the Educational Commission for Foreign Veterinary Graduates (ECFVG) training do not need to fulfill these language and recommendation requirements.

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Employment and Benefits

  • The salary of the 2014/2015 class will be $27,390. Interns are classified as Clinical Instructors/Staff for payroll purposes.
  • Health insurance will be provided by through the University. This includes full medical/dental/vision insurance. Plan information will be presented during orientation and the intern will be required to choose a plan type. While health insurance through the University is not required, some form of health insurance must be obtained (i.e., through parents or spouse).
  • Leave Policy: This policy only addresses leaves of absence that are provided and administered by the Department of Veterinary Clinical Sciences. Leave provided by the Department of Veterinary Clinical Sciences is a privilege and not an entitlement.  Clinical service needs (patient management, client care, referring veterinarian service, professional student education), the performance of the individual requesting leave and, for professional leave, the educational value of the meeting will be considered. All leave must be pre-approved by the Intern Program Director and, except emergent leave, taken when it has the least impact on clinical service. If leave is taken on while on clinical service with primary case responsibility, it is the responsibility of the person requesting the leave to identify and arrange coverage by an appropriate replacement clinician (other intern, instructor or faculty clinician not on service at that time) so that there is no negative impact on patient management, client care and clinical education responsibilities and duties provided by the service. Furthermore, it is expected that the leave will be requested as far in advance as possible, but no later than 30 days prior to the first day of leave requested. See Appendix 1 for the Scheduled Leave of Absence Form for Interns.
    • Ten days of vacation are allowed during the internship year. Five working days are expected to be taken as assigned over the Christmas holidays, plus 5 working days at the intern’s discretion. Vacation time must be arranged at least 30 days in advance, and is expected to be taken when the intern has been assigned to an elective rotation.
    • Professional days for interviewing or conference attendance are allowed. Current policy allows for up to (5) days of professional leave. Professional leave time may not be taken for vacation.
    • Vacation and professional leave must be arranged in advance with the Intern Program Director, Intern Program Scheduler and the Service Chief of the rotation affected by the leave.
    • Vacation time and professional leave forms must be signed by the Service Chief of the rotation, the Intern Program Director as well as the Department Chair.
    • The process for requesting leave is as follows:
      • A Request for Leave form is obtained from the Intern Program director, who will log the interns name and time requested off in a spreadsheet.
      • The Intern Program Director will contact the Intern Program Scheduler to verify the time off and any need for a trade.
      • If initially approved, the Intern Program Director will hand the Request for Leave form to the interns, who will approach the Service Chief of the Rotation and inquire as to the feasibility of taking said day off.  The Service Chief is under no obligation to allow the time off if doing so will impact clinical service or patient care.
      • If the Service Chief allows the leave, they will sign off on the Request for Leave form.
      • The intern will bring the leave slip back to the Intern Program Director, who will sign the form and take the form to the Department Chair for signature.
      • The time off will be logged into the departmental leave spreadsheet and a pdf of the Request for Leave will be emailed to the Intern Program Director, Intern Program Scheduler, the Service Chief of the rotation and the intern.
      • If the Intern Program Director does not receive the Request for Leave form from the intern with 2 weeks of the request, the intern will be contacted to see if the time off was still going to be requested.
    • It is the responsibility of the intern to ensure proper procedures are followed prior to any leave and that they limit leave days to within the designated allowable amounts.  Failing to submit the proper paperwork (Request for Leave form) and limiting leave to the allowable amounts is in violation of intern policy and my result in probation and/or dismissal from the program.

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Advisors and Mentoring

  • Advisor:  The Intern Program Director will serve as the clinical advisor for all interns unless otherwise designated. The advisor is responsible for coordinating the orientation and addressing significant problems with intern performance.
  • Mentors: Interns will be assigned a faculty member from the internship committee. The mentor is responsible for advising the intern regarding career plans or other professional development activities.  The mentor will also be responsible for performance evaluation. This faculty mentor may also be designated as the clinical advisor if agreed upon by the intern, faculty mentor and Intern Program Director.
  • Interns: Interns are responsible for notifying and working with the Intern Program Director regarding scheduling requests, seeking and incorporating performance feedback into daily activities, meeting deadlines as agreed upon with the mentor and seeking counsel and support when needed.

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Clinical Service Responsibilities

  • Primary duties during the program include diagnosis, treatment and care of patients; timely communication to client and referring veterinarian; instruction and supervision of senior veterinary students; and timely and thorough maintenance of patient medical records. Case management will be under the guidance of the senior members of the clinical service team.
  • Interns will rotate through the following services. The times are approximate and subject to change.
    • Daytime Emergency – 6-8 weeks
    • Evening Emergency – 6-8 weeks
    • Overnight Emergency – 6-8 weeks
    • Total Emergency – 18-22 weeks
    • Internal Medicine – 6-8 weeks
    • Soft Tissue Surgery – 2 - 4 weeks
    • Orthopedic Surgery -  2 - 4 weeks
    • Electives – 10-12 weeks
    • Anesthesia – 2 weeks
    • Radiology - 2 weeks
  • The intern is expected to have primary case responsibility for the Emergency, Internal Medicine, and Community Practice rotations, and will have primary case responsibility while on other services at the discretion of the Service Head.
  • Interns are expected to provide medical care at a level expected in an academic tertiary care facility. If expectations are not met, the intern may be placed on probation. If satisfactory improvements are not made, the intern on probation may be dismissed.

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Emergency Duty

  • All interns will participate in emergency receiving. This includes rotation through daytime, evening and overnight emergency rotations (also includes weekends and holidays).
  • Emergency service will include primary receiving of cases during evening and weekend periods. The intern must stay in the hospital for the duration of their shift.
  • Interns on overnight emergency duty do not have clinical duties the following day. While sleeping is allowed if all cases have been received and are stable, the intern must be available at all times to respond to emergencies.
  • Back-up system: While on weekday emergency duty, interns will have an Emergency and Critical Care faculty or resident present in the hospital until 8 or 10PM, and a formal back-up call system for residents and faculty in all specialties. The intern is expected to utilize this back-up system when appropriate, especially during the first few months of internship.

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Teaching Responsibilities

  • Clinical teaching: While formal teaching is not required, all interns are expected to participate in clinical teaching, including case discussions with the primary student(s) or group discussion.
  • Rounds: Interns are expected to attend rounds as designated by the Service Chief. Interns typically will not be required to present at rounds, but may be asked to do so at the discretion of the individual service unit.
  • Seminars: Interns will present ONE case conference in Clinical Pathology Conference (CPC) and ONE case in Intern Morbidity and Mortality (M&M) rounds.

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Educational Opportunities

  • The Communication Skills Training course is required upon arrival and video review sessions will be conducted throughout the rest of the year.
  • Intern Lecture Series: Attendance is required. This lecture series will cover pathophysiology and management of common medical problems.
  • Attendance is required at monthly Intern M&M rounds. Attendance at CPC is required when interns are rotating in ACVIM designated specialty rotations, and emergency/critical care rotations.
  • Journal clubs are offered by most services. Attendance at a journal club in the intern’s area of interest is strongly encouraged.
  • External (off-site) rotations are generally not allowed, but may be considered if arranged in advance with the Intern Program Director. The time off will need to come out of professional or personal leave time and the time off conform to the clinic schedule.

Evaluations

  • Formal performance reviews are given at 1, 4 and 8 months of the program.
  • Online evaluations are required to be provided by each service at the end of each rotation.

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Appendicies

Appendix 1:  Scheduled Leave of Absence Form for Interns

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Appendix 2:   Intern Performance Evaluation

Introduction

  1. The goal of the Intern Performance Evaluation is to ensure that our intern colleagues make successful progress during the course of their intern year. The evaluations provide the constructive feedback and reinforcement of desired skills and attitudes that motivate interns to continued excellence. Moreover, if problems of performance arise they can be addressed and attempts made to resolve them in a timely manner.
  2. Interns must adhere to The Ohio State University “Code of student conduct” (section 3335-23), the Ohio Veterinary Practice Act, and other applicable Department, College, University, State, and Federal rules and regulations.
  3. Informal guidance – Interns should receive informal feedback on their performance from faculty members as part of their interaction on a daily basis.
  4. Service performance review – Interns will be evaluated by attending clinicians through the One45 system. The attending clinician will receive an email notification indicating a task to complete in the One45 system. The intern to be evaluated will be included in the attending clinicians “to- dos”. Once the attending clinician has clicked on the intern’s name, a list of performance evaluations will be listed, along with an area to list any additional comments in regards to the intern’s performance.

Evaluations

  1. Attending clinicians on service with an intern will receive an email from the distributor of the One45 system indicating the specific intern to be evaluated.
    1. The performance evaluation includes the following categories
      1. Clinical abilities: Efficient during clinics, able to handle emergencies, able to solve problems (diagnostic ability), attentive to changes in patient condition, provides good patient care in wards, manages ICU cases properly, conducts special procedures competently, demonstrates appropriate technical skills, uses consultations with other specialists effectively.
      2. Knowledge: Understands basic science of specialty, familiar with and understands relevant literature, demonstrates growth in knowledge base, can critically evaluate newly reported information.
      3. Interpersonal and communication skills/Professional conduct: Communicate effectively with faculty/students/technicians/receptionists/staff, interacts collegially with other services/faculty/staff/colleagues/RDVMs, demonstrates enthusiasm, demonstrates willingness to work, accepts responsibility, accepts constructive criticism, demonstrates judgment, maturity and professionalism, supports a “team effort”, and participates in consultations.
      4. Teaching ability: Demonstrates teaching ability during clinics, rounds, workups and special procedures, shares knowledge with other residents/faculty, supervises ward students effectively (including treatments and orders), fulfillment of assigned student teaching requirements in laboratories, lectures and seminars.
      5. Patient care: Demonstrates compassion towards patient, appropriately handles patient when performing diagnostic tests and procedures, attentive to changes in patient condition, provides good patient care in wards and ICU.
  2. Interns are evaluated on the extent to which they meet the performance expectations of the service according to the following scale;

5 = Well above – intern’s performance continuously exceeds minimum expectations

4 = Above – intern’s performance always meets and frequently exceeds minimum expectations

3 = Meets – intern’s performance always meets minimum standards expectations

2 = Below – intern’s performance is below minimum expectations

1 = Well below – intern’s performance is well below minimum expectations

NA = Not applicable

In addition, there will be a section for overall comments - to indicate any areas positive performance/recognition or specific areas for improvement

  1. Formal meeting with the intern attended by the Service Head and/or mentor/advisor and/or Intern Director should be performed at minimum of 1- , 4-, and 8-months to review the Intern Performance Evaluations and student SEIs.
    1. Low performance SEIs will be flagged and sent to the Chair of PPEC, Section Head, Intern Program Director, and Advisor/Mentor for review. These should be handled if needed when they arise via a separate meeting with the intern.

Guidelines for Probation

  1. Examples of reasons for placing an intern on probation, or dismissal from the program include, but are not limited to:
    1. Failure to provide the expected standard of care
      1. One45 faculty evaluations are to be provided to the Intern Program Director and Chair of the PPEC by the attending clinician, Section Head or mentor/advisor.  If the intern has an average Overall Rating score of less than 3, or three or more individual scores of less than 3, the intern is at risk of being placed on probation as described below.
    2. Uncollegial behavior. Collegiality, mutual support, and respect for others are strongly held values in the College of Veterinary Medicine. We support diverse beliefs and the free exchange of ideas and expect that faculty, residents, staff, and students promote these values and apply them in a professional manner in all academic endeavors.
    3. Behavior that reflects badly on the veterinary profession, The Ohio State University, the College and/or colleagues.
    4. Neglect of duty, including, but not limited to;
      1. Attendance and participation in ward rounds and compulsory conferences (grand rounds, etc).
      2. Absence from scheduled emergency duty.
      3. Absence from regularly scheduled appointments.
      4. Inadequate client communication.
      5. Failure to complete bills and medical records in the prescribed time frame and fashion.
    5. Negligence, incompetence, and reckless behavior toward people, patients or equipment.
    6. Failure to comply with directives issued by the Department Chair, Hospital Director, Post Professional Education Committee, Intern Program Director, Service Head, or Advisor(s)/Mentors
    7. Failure to comply with Departmental guidelines regarding outside employment.
    8. Academic misconduct.
    9. Abuse of prescription or non-prescription drugs, alcohol, or other substances while on the premises or on-call duty.
    10. Physical or mental limitations that interfere with the resident’s performance that cannot be remedied by reasonable ADA-approved accommodations.
    11. Failure to comply with OSU policies on sexual harassment, consensual relationships or discrimination.
    12. Other deficiencies identified by the performance evaluation that result in unsatisfactory performance.
  2. Procedure for placing an intern on probation:
    1. The decision to place an intern on probation or to continue probation must be made by the Intern Program Coordinator and the Chair of the PPEC or their designees. If these disagree, then the Department Chair will make the final decision to place an intern on probation.
      The intern must be notified in writing of their probationary status, and an evaluation form must be provided.
    2. The intern has seven (7) days to provide a written rebuttal of the evaluation and summary letter if desired. The Intern Performance Evaluation form, summary letter (if provided) and rebuttal (if provided) are to be signed by the intern and Intern Program Director with the original copy being submitted to the office of the Department secretary and copies to be provided to the intern, the evaluator, the Intern Program Director, and the Chair of the Post Professional Education Committee (PPEC). If the intern chooses to NOT provide a letter of rebuttal to the evaluation, they will be placed on immediate probation. If the intern DOES choose to write a letter of rebuttal, then a final decision on probation will be made within seven (7) days of receipt of the letter of rebuttal.
    3. The probationary period will last for 4 weeks. The intern on probation must meet with the Intern Program Director at least weekly during this one-month period. If both the Intern Program Director and the Chair of the PPEC agree that satisfactory improvement has been documented over the course of the month, then the intern will be released from probation.
    4. If the intern does not make satisfactory improvement, the probationary period can either be extended for a maximum of one more month, or the intern can be dismissed.
    5. If the intern does not made satisfactory improvement after 2 months on probation, or if the intern has been through a probationary period twice within a one year period, the intern may be dismissed.
    6. The decision to dismiss an intern must be made by a committee consisting of: the Chair of the PPEC, the Intern Program Director, the Intern Mentor/Advisor, the Hospital Director and the Department Chair.

Guidelines for Dismissal

  1. The following constitute grounds for dismissal from the internship program:
    1. Gross misconduct or unprofessional behavior
    2. Any criteria outlined under reasons for probation
    3. Egregious behavior that reflects poorly upon the University, the veterinary profession, or both
    4. Violations of the Ohio Veterinary Practice Act

Evaluation Time Frame

  1. The intern evaluation must be completed and submitted online in One45 within 2 weeks of receipt in One45.  Once completed, the evaluation will be available in One45 to the Intern Program Director (Dr. Lynette Cole), the ECC Section Head (Dr. Ed Cooper), and the Mentor/Advisor. The intern evaluation will be reviewed/discussed with the intern along with any corresponding student SEIs they have received since starting their internship or since their last evaluation no later than August 31, 2014; November 30, 2014; and March 31, 2015; for the interns 1, 4-, and 9-month evaluation, respectively.  A formal evaluation including the results of the One45 evaluation and student SEIs will be emailed to the Chair of the Post-Professional Education Committee (Dr. Matthew Allen).

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