Practice Managment

How to Reduce Burnout, Increase Retention Among Equine Interns

By Landon Gray

Incorporating nine dimensions of wellness into equine veterinary internship programs may lead to reduced burnout and increased retention rates, according to a presentation given at 2023 AAEP annual convention, held in San Diego.

Jonathan A. Yardley, DVM, NBC-HWC, an associate clinical professor at The Ohio State University College of Veterinary Medicine, discussed how workplace burnout is affecting equine care, such as increasing the risk for medical errors and staff shortages.

“We know young veterinarians overall have more serious psychological distress,” said Dr. Yardley, who is also a health and wellness coach, citing a 2022 wellbeing study by Merck Animal Health. “And the more burnout we have the more medical errors.”

He cited another study of nurses who care for human patients that were burnt out, patients receiving urinary catheters, were more likely to get a urinary tract infection from a nurse experiencing burn out than one who was not. “This is very translatable to what we do every day,” he explained.

He alluded to the elephant in the room—only 5.8% of all graduating veterinary students go into equine practices. Twenty-two percent of fourth year veterinary students go directly into private practice; 78% pursue an equine internship. However, 50% of these recent graduates will leave equine practice.

“We have 70% of [new graduates] going into an internship, how can we keep them in equine practice and really stimulate their wanting to be here with us?” Dr. Yardley asked rhetorically. “Burnout is huge. [Occupational Safety and Health Administration] is now studying burnout like a workplace issue, and burnout is defined by having a workplace issue—so it’s not the individual.”

The Ohio State University, the College of Veterinary Medicine, which has had a rotating internship program since the 1970s, which includes areas such as equine field service, equine surgery, equine medicine, equine overnight emergency and critical care, according to Dr. Yardley. Each intern serves for two weeks on each service and are responsible for patient care, on-call duties and client communication.

“The interns week seek an internship after graduation from vet school to gain more experience and confidence,” he told Modern Equine Vet.

The goal of any veterinary internship program is to transition recent graduates into competent clinical veterinarians—and to not burn them out, Dr. Yardley emphasized.

To assure that does not happen, they have placed an emphasis on wellness, he explained. Yardley explained that by incorporating the 9 dimensions of wellness, as defined by the university, burnout can be addressed and mitigated.

9 Dimensions of Wellness
1. Physical wellness
2. Financial wellness
3. Intellectual wellness
4. Creative wellness
5. Environmental wellness
6. Emotional wellness
7. Career wellnes
8. Social wellness
9. Spiritual wellness

After completing the program, interns were given exit interviews to help improve the process. Based on these interviews, Dr. Yardley reported that 100% of the interns continued in veterinary medicine, with 82% continuing in equine practice. Twelve percent of interns took a position with small animal general practice, and 6% took a mixed animal medicine general practice job.

Dr. Yardley noted that the cohort was too small to do an in-depth burnout analysis.

“We just must change the culture. We think that by focusing on the most vulnerable population, our trainees, we’re optimistic that we can change the culture overall,” Dr. Yardley concluded. “If the culture does not change, [a] strategic plan will be eaten for lunch—you must change the culture. So therefore, we must lead by example.”

Merck study link: https://www.merck-animal-health.com/about-us/featured-stories/veterinarians-wellbeing/#:~:text=According%20to%20the%20study%2C%20veterinarians,the%20most%20frequently%20reported%20conditions.