Residency guide

• Residency training aims to provide a 3-4 year programme of in-depth training into a specialist subject, commonly with the aim of achieving the requirements for board-certification to a specialist college (e.g. those within the European Board of Veterinary Specialists).
• Most University-based residency programmes include additional qualifications (e.g. a Masters degree).
• Residents work within veterinary hospitals, either as an employee of the business (i.e. assistant or resident in a veterinary practice) or as a registered postgraduate student (i.e. at a University clinic). This is an important distinction as it may affect the benefits offered (see below).
• It is important to ensure that the proposed residency programme is accredited by the relevant European (or American) College of specialisation. This is important as otherwise it may not be recognised, and you won’t be eligible to sit the Board examinations. It also provides certain assurances of the facilities available for the training.

• A residency is the start of a route to specialisation. Therefore you need to be sure that this is the route for you. Specialism is often thought to be the ‘pinnacle’ of the profession although this can restrict what you do subsequently which can lead to disappointment in the job (e.g. a surgeon not getting enough surgery). In contrast, there is also considerable (and comparable) value in achieving a high level in general practice (and currently being addressed by the RCVS).
• When considering a residency, focus on the area in which you wish to specialise. While the most popular are those that are client-facing (such as surgery, sports medicine, internal medicine, etc), there are many others which encompass equine care, such as anaesthesia and analgesia, diagnostic imaging, pathology, animal welfare ethics and law, behavioural medicine, reproduction, pharmacology and toxicology, dentistry, ophthalmology, dermatology, neurology, etc., although these are not solely equine specific.
• The nature of the training is important and careful assessment of the balance between training and service provision is needed. Those residency training programmes, especially in the client facing disciplines, are often hard work, with long hours, and for little financial reward. However, there is both a value and a self-investment components of residency training. Residency training leading to specialist status will often lead to increase in earning potential, although this is highly discipline dependent. Residencies have their own intrinsic value that represent the balance between teaching, supervision, research and service provision. This value comes from daily one-to-one training and from access to facilities and caseload that the supervisor/centre is able to attract but is offset by the pay/reward structures, as well as need for service provision, especially when delivered outside of normal working hours.

• The structure and variety of rotations: This will reflect in the skills acquired (see below).
• Rota: BEVA agrees that long hours, with resulting high exposure to clinical cases, are an important part of a residency. However, residents also need to be provided with sufficient time off to rest and carry out independent learning.
• Provision of training: Both training in the workplace and external CPD are considered important aspects of the residency (see below under ‘Benefits’).
• Research: Most residency programmes require you to undertake at least one research project, have the work accepted for publication and present at a conference. This requires time allocated to the project as well as supervision and guidance, sometimes including input from a statistician.

The requirements of the residency programme will be set out by the college with which the residency is registered, and available on publicly available on the college’s website. It is important that you are familiar with the outlines of the requirements, as these will vary between boards but often fall into:

• Supervised clinical work within your specialist subject (or subdivisions) for a specific number of weeks/months.
• External rotations in allied fields.
• Research involving one or more research projects and publication.
• Statistical/research skills training.
• Study time for examinations, regular attendance at journal clubs and case rounds.

• The residency programme will require you to have at least one supervisor within your specialist subject area.
• You will also require a research supervisor.
• Often it is best to be able to work with several specialists within your subject area, for diversity of training.
• It is generally considered advisable to be in a training programme/institution with at least two specialists in your chosen field – this means that if either supervisor leaves, or is absent for any reason, your residency training can continue.

Each resident should have access to adequate workspace, including use of a desk, photocopier and networked computer.

Before applying for a residency programme, it is worth speaking to the residents who have trained before you, both in your specialist subject and other subjects. Useful questions include:

• Did you feel you had/have adequate supervision?
• Have you and your predecessors found it possible to meet the requirements set by your supervising board?
• Was the case load sufficient to fill your case log?
• Did you have enough time to undertake your research project?
• Have you/ your predecessors passed your board examinations?
• What are people who studied here doing after their residencies?

• Salary/stipend: This will vary depending on whether the resident is an employee (when salaries tend to be higher), in a charity-funded residency programme or registered as a post-graduate student and receive a tax-free stipend (currently ~£22,000/annum in most Universities). Salaries should be considered in the light of other benefits offered by their employer (see below).
• Vacation: BEVA supports the legal requirement that workers who work a 5-day week must receive at least 28 days’ paid annual leave per year, including bank holidays (i.e. 20 days plus bank holidays or days off in lieu).
• Sickness and maternity pay/Private health care/Pension schemes: These are likely to vary between programmes and will be heavily influenced by whether you are a student or employee. As a student you would not be able to pay into a pension and there is usually more limited (or no) benefits related to sickness. It is worth understanding the details of these aspects before applying to a particular programme.
• Postgraduate qualification: Some residencies will be linked to an additional post-graduate qualification other than board-certification, such as a Masters programme, but this will usually only be at Universities. This is likely to provide additional training in areas such as research skills and teaching, which are useful attributes, and often reflects a more structured residency training programme.
• Benefits in kind: Some residencies provide accommodation, and occasionally other benefits such as a car. It is worth being clear about these details before accepting a position.

• Notice/probationary periods: Some jobs provide a probationary period after which either party can decide whether to continue employment. This would hopefully not be necessary, but should the residency not work out as expected, a reasonable notice period would be advantageous (usually between 1-3 months). If there is a problem with your residency programme, although not ideal it may be possible to transfer your outstanding training to a different institution.

• Income protection: This is unlikely to be provided by the employer but should be seriously considered as it is relatively cheap and provides some financial security if you can’t work for any reason.

Do your research:

• Read up about the requirements for the board certification in your chosen speciality.
• Are there sub-speciality areas that you find particularly interesting? If so, are you applying to programmes which are working/researching in this area?
• What would you want to do afterwards? Are there jobs available in this area? What would the salary be like? Are there out of hours commitments?

Attributes likely to benefit your application:

• There are likely to be prerequisites specified by the board requirements and these are publicly available.
• At least 1-2 years’ experience in general practice or an internship.
• Some previous experience of research +/- publication, this can be something such as submission of an abstract for a conference/publication of a case report etc.
• Demonstrating interest in your chosen speciality area, for example further work in this area/CPD focus, starting a certificate in your chosen area.

• As a member of the Royal College of Veterinary Surgeons (MRCVS), you have the opportunity to live and work in many different countries.
• The ability to learn from a range of world-renowned specialists.
• Acquire specialist knowledge and skills which may not be available in your own country of residence.
• Exposure to a different/more diverse/higher caseload.

Below is a list of considerations when you are thinking of applying to a residency abroad:

• Can you speak the language, or will the primary language of the country/vet school be English?
• Does the residency programme meet the requirements for sitting the board certifying (diploma) exam you have chosen (e.g. board exam for ACVS Vs ECVS)?
• Does the ‘board certification’ (e.g. DipECEIM, DipACVS) that you will ultimately end up with get the recognition that you expect it to have?
• How long is the programme? Most will be 3 years in duration so make sure you are happy to spend that period of time abroad.
• Can you meet the visa requirements for that country and what are the cost implications to you (some programmes will ask you to pay these fees)?
• Ask about caseload. Does this meet your expectations?
• Does the programme have the appropriately qualified and experienced staff to be able to provide you with the education that you need?
• Look at the entry/application requirements that the programme wants you to meet.
  • Some residency programmes abroad will have wanted you to have completed an internship in the same country
• Do you want to live in that country?

• When considering whether or not to apply for a residency programme based in a foreign country, it is important to consider whether you want to be abroad for a protracted period.
• Residencies are often intense, and it is not always as easy to take longer holiday breaks to travel home.
• Being ‘on your own’ away from family and friends requires consideration.
• You need to be sure that this is something that you want to undertake before you start the process of applying.
• Having said all that, the opportunity to develop and experience life in a different country is hugely rewarding!

We would recommend investigating the position carefully.

• Can you speak with the Faculty?
• Can you travel there to interview?
• Can you contact incumbent residents to ask them what the programme is like and what life is like there?
• It is important to try and make a full assessment of the place and the programme before you travel to make sure that a) you want to do it, b) you want to do it there, and c) it is going to as rewarding as you hope it will be.

A residency can take a Standard or Alternate form:

• A standard veterinary surgery residency programme (SVSRP) is a postgraduate training programme that has been pre-approved by the EBVS recognised College.

• An alternate veterinary surgery training programme (AVSTP) is a postgraduate training programme that has been tailor-made and approved for an individual.

• Largely used in countries where it is difficult to find a ECVS Diplomate (which is necessary for a pre-registered standard programme).

• However, standard programmes can be in practice and shared between different centres.

• Both have a minimum duration of 3 years and a maximum time limit of 6-7 years.

• Standard and alternate residency programmes have identical requirements for resident activities and documentation, as well as for supervision by an EBVS Diplomat. 

• The resident must spend the equivalent of at least 60% of 3 years working in a surgical practice, under the direct supervision of a Diplomate of the College (ECVS Book of Procedures).

• Candidates hoping to establish a alternate veterinary surgery training programme (AVSTP) should be aware that this is often a much harder route to successful membership of the College than a standard veterinary surgery residency programme (SVSRP).

• ECVSMR and ECVIM have a direct parallel process with no ECVS type restrictions. However, they are often harder and the alternate track residents do less well in exams (this may be because they are less well-supported).

"3.2.4. The alternative residency-training programme:
Residents who are unable to work full-time are entitled to opt for less than full time training (LTFT) programmes (EC Directive 2005/36/EC). However, these programmes must incorporate all the training, conference attendance, professional presentation, publication and case log requirements for certification by ECEIM. Alternative programmes are individualised so a resident is required to liaise closely with the Education and Credentials Committee throughout the programme. It should be recognised that the alternative route is not considered to be ideal but may be used by individuals who are combining residency training with graduate degree studies or by individuals who spend some of their time working in a clinic or practice in which there is no suitably qualified supervisor. 
An alternative residency-training programme must be preceded by a rotating internship or equivalent and must be comparable to a standard residency-training programme in duration, supervision, quality and case type and number. The alternative residency-training programme (93 weeks of direct supervised training and 13 weeks in related disciplines as in a standard residency-training programme) must be completed within six years.  The resident must accumulate the required weeks of direct supervised training in blocks of no less than three weeks at a time and 13 weeks of training in related disciplines in blocks of two to four weeks at a time. All cases included in the case log must have been seen in direct conjunction with an ECEIM Diplomate with the case log containing signatures for verification. The direct supervisor of an alternative residency-training programme must be an active ECEIM Diplomate. Training in related disciplines can be supervised by other Board-certified individuals."

No equine European college has a modular route although they are being considered by some colleges.