VIRMP^® Info

Definitions

Internship
An internship should prepare a veterinarian for high-quality service in practice or for advanced specialty training. It is primarily an educational program for the intern rather than a service benefit to the hospital.

Direct Support and Direct Supervision
The supervising veterinarian is in the building and available to the intern.

Patient Rounds
An in-depth discussion about the mechanisms of disease and a thorough review of case management plans for each patient being managed by the intern and by the service. Typically occur on a daily or twice daily basis.

Teaching Rounds
Journal clubs, seminars, lectures, morbidity/mortality rounds, clinicopathologic conference, etc. Typically occur on a weekly basis.

Internship Orientation Manual
An orientation manual might include a summary of hospital policies, protocols and procedures, performance expectations and minimum post-program competencies as determined by the program director.

First Opinion (Primary Care)
First opinion (primary care) refers to patients that are presented to the veterinarian without referral. These patients have not been seen by another veterinarian for the presenting problem or service. A referral-only specialty hospital typically does not see first opinion (primary care) patients. Patients seen by an emergency service for the first time for the presenting problem are considered first opinion (primary care) patients. By way of example, if an internship program in a referral-only specialty hospital with an associated primary emergency service includes the equivalent of 50% time on service with specialists in the specialty hospital and 50% time on service in the emergency service, the percentage of time the intern is assigned to first opinion (primary care) clinics is 50%. In this context, the term "primary care" should not be confused with the situation in which an intern is allowed to be the primary doctor on a referred case with direct supervision by a specialist.

Program Caseload Reporting

Report each caseload figure as a whole number, never a range. Details the structured fields cannot capture such as species mix, seasonal variation, or alternate program structure should be included in the Additional Details about Caseload section (see the examples below).

The Average Daily caseload numbers are based on the number of workdays per year. If the yearly caseload is seen 5 days per week, divide by 260. If the yearly caseload is seen 7 days per week, such as emergency services/ECC, divide by 365. Round each to the nearest whole number.

Rotating Internship Caseload Reporting

Annual Hospital Caseload: Number of patients presented to the hospital annually. Include only the patients presented to the hospital(s) (small animal, large animal, equine, all) to which the intern will be assigned. Support services (radiology, anesthesia, and similar) serve every population and are counted at the hospital level regardless of the intern's species focus.
Average Daily Number of Outpatients: Number of outpatients seen by the hospital(s) to which the intern will be assigned, divided by the number of workdays.
Average Daily Number of Inpatients: Number of inpatients seen by the hospital(s) to which the intern will be assigned, divided by the number of days the hospital is responsible for care. Most hospitals have inpatients 24/7 therefore divide the inpatient caseload by 365 days.
Average Daily Number of Surgical Procedures Performed: Number of surgical procedures performed in the hospital(s) to which the intern will be assigned, divided by the number of workdays.
Average Daily Number of Patients Presented to the Emergency Service: Number of emergencies seen by the hospital(s) to which the intern will be assigned, divided by the number of days per week emergencies are received (typically 365 days).

Specialty Internship Caseload Reporting

Annual Hospital Caseload: Number of patients presented to the hospital annually. Include only the patients presented to the hospital(s) (small animal, large animal, equine, all) to which the intern will be assigned. Support services (radiology, anesthesia, and similar) serve every population and are counted at the hospital level regardless of the intern's species focus.
Average Daily Number of Outpatients: Number of outpatients seen by the specialty service to which the intern will be assigned, divided by the number of days the service is responsible for care.
Average Daily Number of Inpatients: Number of inpatients seen by the specialty service to which the intern will be assigned, divided by the number of days the service is responsible for care. Most services have inpatients 24/7 therefore divide the inpatient caseload by 365 days.
Average Daily Number of Surgical Procedures Performed: Number of surgical procedures performed by the specialty service to which the intern will be assigned, divided by the number of days the service performs surgical procedures.
Average Daily Number of Patients Presented to the Emergency Service: Number of emergencies seen by emergency service(s) to which the intern will be assigned, divided by the number of days the service receives emergency patients (typically 365 days).

Residency Caseload Reporting

Annual Hospital Caseload: Number of patients presented to the hospital annually. If the residency is small animal, include the caseload for the small animal hospital; if it is large animal, include the caseload for the large animal hospital; and if the program is large and small animal, include the caseload for both. Support services (radiology, anesthesia and similar) are counted at the hospital level across all populations.
Average Daily Number of Emergency Accessions: Number of emergencies seen by the hospital(s) to which the resident will be assigned, divided by the number of days the hospital receives emergency patients.
Annual Service Caseload: Number of patients presented to the service to which the resident will be assigned. Include the number of transfers to that service, if applicable.
Average Daily Number of Outpatients: Number of outpatients seen by the service to which the resident will be assigned, divided by the number of days the service is responsible for care.
Average Daily Number of Inpatients: Number of inpatients hospitalized by the service to which the resident will be assigned, divided by the number of days the service is responsible for care. Most services have inpatients 24/7 and would divide the inpatient caseload by 365 days.
Average Daily Number of Surgical Procedures Performed: Number of surgical procedures performed by the service to which the resident will be assigned, divided by the number of days the service performs surgical procedures.
Average Daily Number of Special Procedures Performed: Number of special procedures performed by the service(s) to which the resident will be assigned, divided by the number of days the service performs special procedures. 'Special Procedures' includes non-surgical procedures such as endoscopy, cystoscopy, and interventional radiology procedures.

Caseload Example

The program is a cardiology residency. The numbers are for the cardiology service. In this example, the small animal hospital sees 25,000 patients per year and the specialty service (cardiology) sees patients 5 days/week = 260 days/year.

Annual Hospital Caseload: 25,000
Average Daily Number of Emergency Accessions: (1,820 emergencies / 260 days) = 7
Annual Service Caseload: 3,930
Average Daily Number of Outpatients: (3,509 outpatients / 260 days) = 13
Average Daily Number of Inpatients: (421 inpatients / 365 days) = 1.1, rounded down to nearest whole number = 1
Average Daily Number of Surgical Procedures Performed: (0 surgeries / 260 days) = 0
Average Daily Number of Special Procedures Performed: (390 procedures / 260 days) = 1.5, rounded to the nearest whole number = 2

Additional Details about Caseload Examples

These are illustrative examples of the kind of narrative the “Additional Details” field is for; they are composites, not figures from any specific program.

A food-animal internship with a seasonal, mixed-species caseload might write:

Our caseload is roughly one-third cattle (mostly beef, some dairy), one-third small ruminants (goats and sheep), with the balance split between camelids and swine. Cases span medical, surgical, urgent, and critical presentations plus some primary care. The mix is strongly seasonal; daily numbers run well above the annual average during our busy seasons and considerably lower in the off-season.

A diagnostic imaging residency reporting caseload by modality might write:

Approximate annual studies by modality: radiography/fluoroscopy ~10,000, ultrasound ~2,000, CT ~2,000, MRI ~500, and nuclear medicine ~100, plus an additional teleradiology service reading roughly 3,000 studies per year.

An emergency and critical care residency describing daily flow might write:

The Emergency service averages roughly 30-40 cases per day, of which about one-quarter are admitted and transferred to other services. The Critical Care service (ICU) typically manages 6-10 patients at a time, and volume runs higher on weekends and overnight.

A comparative theriogenology residency might write: