How to Become a Veterinary Internal Medicine Specialist

By Ruth Cawston MA VetMB CertAVP(SAM) MRCVS

Becoming a vet opens doors to a whole variety of career options – both clinical and non-clinical. If you are pursuing clinical career options, and enjoy the medical aspects of a veterinarian’s job, then you may have considered training to become a veterinary internal medicine specialist. Completing an approved program can widen your career opportunities, opening the door to teaching or research roles as well as high-level clinical practice.

If you’re interested in learning more about available Internal Medicine jobs, why not register with The Vet Service and explore your options? If you are not yet a specialist, we provide a range of options, including graduate vet jobs.

So, how do you become a specialist in internal medicine?

Who certifies veterinary internal medicine specialists?

The two main internationally recognised colleges that accredit veterinary internal medicine specialists for companion animal species are:

Many countries (including the UK) will require you to be certified by one of these two colleges before you are allowed to call yourself a veterinary internal medicine specialist.

Routes to Specialisation

There are a few different ways that vets can become specialists. Most will follow the standard route of rotating internship followed by residency, but there are some other ways routes, too.


Rotating internships are a standard feature of almost all veterinary specialist centres. They offer not only a chance to spend time working in your chosen discipline, but also allow you to gain experience in the other major disciplines (surgery, imaging, neurology, ophthalmology, and so on) which gives you a deeper understanding of how these different areas can work together.

Specialised internships in internal medicine are also available at a few centres and offer a more in-depth exploration of the discipline. However, these are not the same as a rotating internship and are often completed after a rotating internship has already been done.

Internships are not an absolute requirement to start a veterinary internal medicine residency. Both the European and American colleges do allow a period in general practice to be considered as an alternative, at the discretion of the residency program director. However, most specialists will complete an internship before starting their residency.


The main route to becoming a veterinary internal medicine specialist is to complete a residency in the discipline. A residency is a training position at a large multidisciplinary veterinary centre, and both the European and American colleges use these to train the majority of the specialists.

Residencies are generally quite intense, requiring long hours of clinic work (including on-call) as well as studying / Veterinary CPD. The salaries on offer are often lower than for equivalent levels of experience in general practice, though this improves significantly after becoming a specialist.

The major benefit of a residency is that it allows you to advance your knowledge and skills in a well-equipped and supportive environment, with highly trained clinicians, nurses and support staff to assist you. You will also be involved in cutting-edge medical research and will get involved in educating both students and other vets as part of your training.

A residency usually lasts for three years, though the ECVIM-CA currently allows them to last for a maximum of six years, whereas for the ACVIM it is five years.  Many residents will stay on at their training centre for a time after to continue working whilst they complete their final exams.

Alternative Routes

Both the European and American colleges also offer another route to specialist status – variously called the Alternative Route (ECVIM-CA) or Non-Traditional Route (ACVIM). This route has similar requirements to the traditional residency route but is usually less structured, and done over a longer period of time.

The ACVIM discourages this route for the study of Small Animal Internal Medicine. The ECVIM-CA states that it “…will only be considered in exceptional cases and if not possible to undertake a conventional residency.”

Part-Time or Flexible Training

It is theoretically possible for training centres to offer part-time residencies, but in practice, this is seldom done. This can make it challenging for those who have caring responsibilities, or who are disabled or have long-term health issues, to complete a residency program.


In addition to completing a residency, vets must also pass various exams before they can be recognised as specialists. Some of these exams can be taken before completing the residency, but some must be done afterwards. These are generally written exams, but also include submission of case logs, case studies, proof of published research, and other pre-prepared work as well.

Both colleges set time limits within which they must achieve specialist status once they begin their residency. For the ECVIM-CA, it is within eight years from completion of the residency; for the ACVIM, it is eight years from starting the residency – so within five years after completion, under normal circumstances.

Alternatives To Specialisation

There are alternative routes available for vets who wish to deepen their knowledge of internal medicine without becoming a specialist. Various certificates and diplomas are available and are usually studied alongside working in general practice.

In the UK, completion of a recognised qualification can lead to achieving Advanced Practitioner status in Small Animal Medicine. Advanced Practitioners often work in larger first-opinion clinics, taking internal or even external referrals from other vets for more complex cases which may not need specialist input. They may also see advanced cases for which referral to a specialist is not financially viable. If you are interested in working in the UK why don’t you check out our UK vet jobs?

Studying for a certificate is usually done alongside working in general practice. This usually requires three to four hours each week for study and assignments, so can be quite intense, but may be easier if you are working a four-day week. The final examination is a viva (oral examination) which can feel intimidating, and you will usually need to take some time off to study beforehand.

Completing a certificate also allows you to maintain your income, unlike a residency where salaries (or stipends) are often lower. Many practices are supportive of vets wishing to undertake certificates and may cover some or all the cost of these courses. However, salaries for Advanced Practitioners are usually lower than for specialists.


Becoming a specialist in Internal Medicine is challenging, but can be very rewarding in the long run. Most specialists will complete an internship and then a residency, but there are some other routes available. If you are contemplating applying for an internship or residency, consider reaching out to your local specialist centre to see if you can spend some time there to get a feel of what it might be like.

If working globally is something you’re interested in we have a diverse range of roles available worldwide: Vet Jobs in The USAVet Jobs in AustraliaVet Jobs in New ZealandVet Jobs in Canada and further international vet jobs

Get in touch with The Vet Service today to see how we can help with your vet career. We have lots of opportunities available! Register Today!