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Sample Residency Submission Form

View Internship Form

Thank you for your interest in the VIRMP. Starting with the 2024 VIRMP, the VIRMP launched a new form to gather important information from programs. This form is made available to you as an example of what will be requested. This form is subject to change each year.

General Information

Max 100 words
Youtube and Vimeo URLs are supported
Enter each satellite work site, if any

Employment

Numeric Amounts Only
Numeric Amounts Only
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e.g. 5 miles / 10 minutes
Include time & distance
Numeric Amounts Only
check all that apply
check all that apply
If available

Benefits

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Medical Benefits

Leave

Whole Numbers Only
Whole Numbers Only
Whole Numbers Only
Whole Numbers Only
Whole Numbers Only

Other Benefits

Hospital Caseload

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 Additional Details about Caseload 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.

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) typically serve all hospitals so the combined caseload (all hospitals) should be counted.
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.

Specialty Service Supporting this Program

Number of patients presented to the service to which the resident will be assigned. Include the number of transfers to that service, if applicable.
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.
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.
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.
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.
Use this space for anything the numbers above do not capture: species mix, seasonal variation, or alternate program structure. See the definitions page for illustrative examples.

Personnel

Direct Support - Personnel in direct support of the service to which the resident is assigned.
Full-Time Part-Time
Consultant		 Full-Time Part-Time
Consultant		 Full-Time Part-Time
Consultant
ABVP ABVT ACLAM
ACPV ACT ACVAA
ACVB ACVCP ACVD
ACVECC ACVIM/CARD ACVIM/INTMED
ACVIM/LA ACVIM/NEUR ACVIM/NUTRITION
ACVIM/ONC ACVM ACVNU
ACVO ACVP ACVPM
ACVR ACVR/ONC ACVS
ACVSMR ACZM AVDC

Work Schedule

Choose the unit that best matches how your program plans each assignment — no unit is preferred. Enter 0 for anything your program doesn't schedule; a zero needs no unit.

Including patient care, on-call, night float, research, conferences, etc
Excluding on-call

Clinical Experience and Responsibilities

Didactic Training

Educational Benefits

Facility

Available on-site

Outcomes

%

Interviews

Scheduled interview dates, if available

Other Program Requirements

All programs receive the standard VIRMP Application Packet that consists of:

  • Special Disciplinary Interest
  • Current Position
  • Publications, research or other pertinent experience
  • Post-DVM Training Programs Completed
  • North American Veterinary Licensing Examination® Status
  • Career Interest
  • Work Authorization
  • CV
  • Personal Statement
    Prompt: Please provide a personal statement discussing your expectations of an internship program and your future professional goals. In addition, we encourage you to describe your anticipated contributions to your matched institution. These may include life experiences, background, past activities or unique personal characteristics that would contribute to the program in meaningful ways.
  • Veterinary College Transcripts (DVM & Post-DVM)
  • References
    Applicants must submit a minimum of 3 references with a maximum of 4 references.
    Guidance: We recommend professors, instructors and others who have had close professional contact with you and are aware of your veterinary knowledge and performance in veterinary college.
If undergraduate transcripts are only required if the applicant is matched, you should select 'No' and state transcript requirements in the 'Other Program Requirements' box below.

Additional Information