Internal Medicine Residency

  The small animal internal medicine residency program at Texas A&M University creates an opportunity for our residents to develop a broad background in internal medicine, while gaining exposure to a wide variety of other specialties in clinical medicine. The goals of our 3-year residency program are to provide each resident with the skills to achieve board certification in the specialty of small animal internal medicine of the ACVIM, and to be competitive for career opportunities in the academic or private sectors after finishing their programs.

There are 7 small animal internal medicine diplomates in direct support of our residency program: Drs. John August, Audrey Cook, George Lees, Kathy Scott, Jöerg Steiner, Mike Willard and Deb Zoran. Our internists have a wide variety of clinical expertise and experience. We have two medicine services, one of which is dedicated to feline medicine. Texas A&M University also is the home of the Gastrointestinal Laboratory (GI Lab, directed by Dr. Jöerg Steiner. The GI Lab provides opportunities not only for clinical research in the areas of canine and feline gastrointestinal, pancreatic and liver disease, but also for significant basic research and graduate training programs.

In addition to the seven members of the Internal Medicine section, Drs. Claudia Barton and Kenita Rogers are both double boarded in internal medicine and oncology. 

Here at Texas A&M, we have 3 cardiologists, 3 oncologists, 2 neurologists, 2 criticalists, 1 radiation-oncologist, and 2 dermatologists in direct support of the program. As part of the 3-year training program, each resident will also spend time with our 5 radiologists and ultrasonographers and with our clinical pathologists to gain important interpretation skills in imaging and laboratory medicine.

Didactic training for the residents includes weekly  reading rounds, journal club,  and specialty rounds in cardiology, oncology, and pathology. The residents are also required to present 3 seminars over their 3-year training program, which is not only valuable in development of their presentation skills, but also provides specific feedback on their projects. General house officer rounds are also held on a weekly basis. Morbiidity and mortality rounds and imaging rounds take place every month.

We are very proud of our residency program and our recent graduates, who have been extremely successful in completing the board examination (all of our residents, except one, have passed the certifying examination in the past 10 years).

Objectives of the Residency Program in Internal Medicine

Medicine residents hold appointments as Veterinary Resident Instructors. Residents are expected to provide patient care and teaching assistance in the clinical programs of the College of Veterinary Medicine and Biomedical Sciences. Faculty will make extensive efforts to provide an outstanding program, but the ultimate responsibility for value gained from the program lies with the resident.

The training objectives for residents in internal medicine are as follows:

• Provide the resident with the opportunity to become proficient in advanced diagnostic and therapeutic methods in small animal internal medicine.
• Permit the resident to satisfy the requirements for board certification set forth by the American College of Veterinary Internal Medicine (ACVIM).
• Prepare the resident to express clinical ideas and concepts to other members of the veterinary profession in a concise, professional manner (e.g., seminars, lectures).
• Prepare the resident to flourish in the practice of small animal internal medicine in the private sector or the academic setting, or to pursue further advanced training.

Individual Resident Advisor

By October 1st of the 1st year, the resident shall choose a small animal medicine faculty member to be his/her Residency Advisor, and shall register him/herself with the ACVIM -- specialty of IM. The resident's choice of an advisor must be acceptable to the Chief of Medicine and the Medicine Residency Committee.

• Ensure that the resident is aware of all requirements of the residency program and options that are available. The resident is expected to consult with his/her prospective advisor(s) within 30 days after the start of the program to begin developing his/her individual schedule.
• Supervise completion of scheduled requirements according to guidelines established by the Medicine Residency Committee.
• Suggest reading material to aid in preparation for the general and/or certifying board examinations.
• Communicate appropriate feedback to the resident regarding his/her continued progress in the program. Although encouraged at other times as well, feedback to the resident will be provided each time the Medicine Residency Committee conducts its evaluations twice yearly. On these occasions, the resident's advisor also will inform the Medicine Residency Committee about the resident's progress.

Notify the resident of his/her assigned clinical teaching responsibilities (i.e., laboratory instruction, didactic lectures, etc.).

Graduate Program

A Master's degree program to run concurrently with the residency is optional; residents wishing to pursue a PhD program are strongly advised to consider a consecutive type of program (e.g., PhD followed by a residency or vice versa). A resident who wishes to pursue a degree should discuss available options with the Program Director for the medicine residency (Dr. Audrey Cook). Specific requirements of the graduate degree program are described in greater detail in the Texas A&M University Graduate Catalog.

Internal Medicine Residency Program

• Completion of a 3-year advanced clinical training program subject to formal evaluation, under supervision of board-certified individuals (internal medicine, cardiology, oncology, neurology, anesthesiology, radiology, behavior, dermatology, emergency medicine and critical care) designed to educate the resident in the art and science of internal medicine.
• Preparation of the resident to qualify for examination and certification by the ACVIM. The resident is required to register with the Secretary-Treasurer of the ACVIM at the beginning of his/her training program (see ACVIM General Information Guide (GIG). The ACVIM website is http://www.acvim.org/   .
• Completion of a resident project is required. A written report on the project or publication is also desirable. The resident is required to submit an abstract for consideration at a national or international meeting (e.g., ACVIM, ECVIM, BSAVA, WSAVA) during the course of his/her program.
• In-depth training in patient evaluation, performance of diagnostic procedures, use of therapeutic techniques, and overall medical management of serious illnesses will be combined with experience in developing client relationships, fee structure, instrumentation, radiographic interpretation, and clinical laboratory evaluation.
• Participation in didactic and laboratory instruction of students in the professional curriculum is another component of residency training. The resident may be required or elect to help with laboratories in certain courses.
• Participation in teaching of clinical medicine and patient management in the professional student program. This affords teaching experience as well as further professional development. This may include daily student rounds and to help in the clinical instruction of third and fourth year veterinary students with patient care and client communication.
• All residents will be required to present an oral seminar to the faculty once yearly. This may be based on the resident's project or another topic of clinical interest.
• Residents may elect to take the ACVIM general examination either a) after 2 years of his/her residency program, or b) with the certifying examination after 3 years of the residency. If option (a) is chosen, application to take the general exam is due by October 1 of the 2nd year. Application to take the general and certifying exams or certifying exam alone (if the general exam has already been passed) is due by October 1 of the 3rd year. Consult the ACVIM website for specific details needed to apply.
• Formal evaluation by the Section of Medicine will be done at least twice yearly each year of the 3-year program. The evaluation process will be conducted by the Medicine Residency Committee.

The academic rank of the resident will be Veterinary Resident Instructor.

• Salaries are determined annually by the Head of the Department. They are standard for all residents in the Department of Veterinary Small Animal Clinical Sciences, and currently salaries increase with each year of service.
• Residents may participate in the University's medical-surgical insurance program.
• All courtesies, such as athletic ticket purchases, use of university facilities, etc., are the same as for other faculty.

A certificate of completion of the residency program will be presented to the resident upon successful completion of the 3-year medicine residency. A certificate will not be given for partial completion of a 3-year program or if the resident fails to meet the requirement for submssion of an abstract. ACVIM bylaws require institutional certification of completion of the candidate's residency before an ACVIM diploma is granted.

• The clinical service assignments and educational programs are established to meet, and in most cases exceed, the minimum requirements for residency training programs in the specialty of Internal Medicine as outlined in the ACVIM GIG. (Refer to descriptions of individual years below). Consult the Chielf of Medicine for questions about scheduling.
• Residents are required to participate in the provision of emergency services by the Small Animal Clinic which may include providing backup to interns on emergency cases and taking medicine transfers. Residents will be required to take case transfers on weekends to facilitate patient care of medicine referrals. In most cases this duty will occur when the resident is on an IM rotation. The schedule will be assigned by the Head Resident using a rotating schedule. 1st-year residents will be generally required to take more transfers than 2nd-years, etc. However, variations in assignments may occur if necessary to facilitate the function of the Veterinary Teaching Hospital.
• Participation in the departmental faculty-intern-resident rounds is required. The seminar programs consists of a variety of scheduled professional development activities (clinicopathologic conferences, seminars and group discussions) arranged by the Head Resident in conjunction with a Faculty Coordinator. In general, activities will be scheduled weekly.
• Residents are expected to present 3 seminars over the course of the 3-year program in the departmental Intern-Resident Seminar Series. Details of the requirements can be obtained from the Chair of the Residency Committee.
• Residents will occasionally be expected to assist in didactic and laboratory instruction of students in the professional curriculum. They shall not head or have major teaching responsibilities for any course, elective, or didactic.
• Participation in phone consultations with veterinarians/clients will be required. Responsibility will increase as the program progresses.
• Holiday duty assignments will be determined by the Chief of Medicine and the Head Resident.
• Vacation or other time off should be scheduled during non-internal medicine blocks, unless it cannot be avoided. Requests for off time must be approved in writing by the service chief, the resident's advisor, and signed off by the Chief of Medicine. A time off must be recorded and documented on Leave Traq System.
• Funding for travel to meetings (either to take the board exam or present research) is the responsibility of the resident. In some cases, travel funds can be obtained for residents presenting research abstracts. But, it will be the responsibility of the resident to use their incentive funds wisely for payment of their travel expenses. No departmental funds will be used to pay for residents travelling to take their board exams.

Service Rotation and Educational Program

The clinic schedule is based on a 48 week academic year; 4 weeks each year are counted as Holiday time, and cover Christmas, New Year and Spring Break. House officers are required to work at least 2 of these 4 weeks every year, on a rotating schedule.

First-Year Resident in Internal Medicine

• 44 weeks of clinic duty and 4 weeks of elective/study/research time
• Registration of the resident and their advisor with the ACVIM Specialty of Small Animal Internal Medicine MUST be done by October 1st of the 1st year.
• A research project should be identified during the first year. Some funding is available for house officer studies, and an application for funding may be submitted in the first year.
• Faculty-intern-resident Seminar Program Participation
  • The Head Resident and Faculty Coordinator for this program will schedule and assign responsibility for activities within this program. No more than 2 major presentations will be required of an individual during the 1st year.
  • Participation in the departmental seminar program is required. In addition, attending seminars and conferences held by other units of the college (e.g., radiology, necropsy, pathology, clinical pathology, physiology, etc.) is encouraged.
• Service Rounds - Daily rounds of assigned clinical service are required, but the degree of participation will vary with the service and will by determined by the senior clinician.
• The first-year resident(s) will be assigned to clinical duty during the ACVIM Forum.

• Clinical duty assignments: 40 weeks on and 8 weeks off or 36 weeks on and 12 weeks off (if resident is able to justify need for time off to complete their project or an out-rotation). The off clinic time will be scheduled to meet the needs of the resident and the department by the best available compromise.
• The 2nd-year resident is generally expected to apply to take the ACVIM general examination following 2 years of his/her residency program, and must submit their application to the ACVIM office by October 1 of the 2nd year.
• Participation in Intern-Resident seminars, clinical rounds, teaching assignments, and emergency duty is required and will continue as described in other portions of this document.

• Clinical duty assignments: 32 weeks on and 16 weeks off; the off blocks to be scheduled to meet the needs of the resident and the department by the best available compromise and based on the needs of resident to complete their project or paper. The resident may be placed in charge of a clinical service and student group (under guidance of a senior clinician) for up to 4 weeks (with mutual agreement of the resident, his/her advisor, and the Medicine Residency Committee).
• Application to take the ACVIM certifying examination (or general and certifying examination together) is due by October 1 of the 3rd year.
• Participation in Intern-Resident seminars, clinical rounds, teaching assignments, and emergency duty will continue as described in other portions of this document.
• Acceptance of the resident's program (which includes a signed resident certificate), submission of the credentials packet (which includes one referred publication) and successful completion of both the general and certificate exams is required before ACVIM diplomate status can be obtained.