Factors associated with veterinarians’ career path choices in the early postgraduate period

Abstract

Veterinarians who graduated between 2000 and 2004, inclusive, were surveyed to determine the factors associated with career path (job) switching in the early postgraduate period. The sampling frame consisted of 348 veterinarians, 285 of whom were contacted and of these, 192 (67.4%) responded to the survey. Only 28.4% of respondents had remained with their initial employer. Three main factors were associated with employee retention: the type of practice/caseload, the workload (hours worked and number of nights on-call), and the level of mentorship and support provided by the practice. Workload and mentorship were also cited as the main reasons for leaving a place of employment. More than a third (38.0%) of respondents reported leaving a position solely because of inadequate mentorship and support. A third (33.7%) of respondents who began their careers in mixed or food animal practice were no longer in these types of practice; the main reasons for leaving were related to workload and mentorship.

Introduction

A previous survey of graduates from the Western College of Veterinary Medicine (WCVM) found that most new graduates only planned on working with their initial employer for a median period of 3 y (1). This expectation appears to be well-founded. Surveys administered to WCVM graduates, 2 y after graduation, showed that only 32.7% to 41.0% of respondents had remained with their initial employer (2–4). Heath (5) reported similar findings from Australia where > 50% of veterinarians had left mixed animal (MA) practice within 5 y of graduation. An American study also found that employee retention and turnover was more of an issue for MA than companion animal (CA) practices (6).

There are 2 aspects to veterinary graduates leaving their initial place of employment. The 1st relates to the loss of food animal (FA) oriented graduates in the early postgraduate period, a situation that is common to Canadian graduates (7). The 2nd is that employers incur significant costs when hiring and training new employees (8); therefore, the loss of any employee, particularly new graduates, has financial implications. In addition to the time and resources devoted to advertising and interviewing prospective new employees, practice owners must also absorb the costs associated with training the new graduate. These costs can be significant due to the potential loss in clinic revenue (opportunity cost) when the clinic is operating less efficiently because resources are being devoted to training the new graduate versus being focused on servicing the practice’s clientele. While dedicating time and resources to new employees may be costly, this extra effort results in a higher employee retention rate (9).

Several studies have examined the issue of retention of veterinarians and the results are invariably the same. The main factors associated with leaving a place of employment are: an improper work-life balance, a heavy workload, poor remuneration, workplace-related stress, and working in a practice that provides inadequate mentorship and support (10–13). Increased workplace stress has also been associated with a lack of support from colleagues and employers, a finding that was particularly true of female employees (14). The primary objective of this study was to assess the importance of mentorship and support in the retention of new graduates.

Materials and methods

Survey instrument

An online survey was administered to veterinarians in western Canada who had graduated between the years 2000–2004, inclusive. The covering letter informed the potential respondents that the objective of the survey was to determine the factors that influenced their decision to remain at, or leave, a place of employment. To avoid introducing biases into the data, no mention was made of the survey’s primary objective, which was to assess the importance of mentorship and support on job-switching in the early (≤ 7 y) postgraduate period.

The survey questionnaire consisted of 30 questions divided into 4 sections. Section A, “Employment history,” consisted of questions about the respondents’ current employment status (full-time, part-time, casual, maternity/paternity leave), number and types of employment positions since graduation, and how their interests in practice type (such as, small animal, food animal, mixed practice) had changed since the time of the preveterinary program. A change in employment included switching employers or becoming a partner/sole owner in the same practice in which they had been employed. The respondents categorized themselves to a particular practice type and no definitions or criteria were provided describing each type of practice. Section B, “Factors influencing career paths in veterinary medicine” consisted of questions about the occupational factors that influenced the respondents’ choice of a career path. Specifically, respondents were asked to rank the following 6 factors as to their relative importance in their decision to remain at a practice, where “1” was “most important” and “6” was “least important:” type of caseload, remuneration (salary and benefits), hours of work and number of nights on-call, geographical location of the practice, number of practitioners in the practice, and the level of mentorship and support provided by the practice. A follow-up question asked them to rank the same factors as to their importance in their decision to leave a practice. For both questions, the final rankings were determined by the cumulative percent of respondents who ranked each factor as either a “1” or “2;” the factor that received the highest combined percentage of the top 2 rankings was the most important factor overall, the factor with the 2nd highest percentage was the 2nd most important factor, and so on for the 4 remaining factors. Respondents who left a food animal related (FAR) (MA or predominantly FA practice) practice were also asked to rank 12 different factors, on a scale of 1 to 5, with respect to how influential each factor was in their decision to leave a FAR practice. As before, each factor was ranked by combining the percentage of respondents who gave each factor either a 1st or 2nd place ranking. Lastly, all the respondents were asked to provide a series of qualitative judgments on factors relating to the respondent’s relationships with their colleagues and employers. Section C, “Mentorship before and after graduation,” included questions about the respondents’ mentors. Specifically, who was their mentor (employer, colleague, nonveterinarian), and how long they had been mentored by this person. Section D, “Background,” sought basic background information such as age, gender, year of graduation, and how long the respondent planned to remain in their present position.

Sampling procedure

The sampling frame was generated from the directories of the 4 western provincial veterinary medical associations. Out-of-province veterinarians were excluded as were social members and veterinarians who were employed as locum tenens. Three-hundred and forty-eight (n = 348) veterinarians met the selection criteria and the breakdown by college of graduation was as follows: WCVM (n = 255), Ontario Veterinary College (n = 28), Atlantic Veterinary College (n = 26), and “Other” (n = 39).

Survey administration and analyses

The survey questionnaire was administered online by a company that specializes in online survey design and administration (Insightrix, Saskatoon, Saskatchewan); the survey can be viewed online in its entirety (15).

In May 2007, each veterinarian in the sample was sent a copy of the survey, a personalized covering letter outlining the objective of the survey, and a self-addressed, postage-paid, return envelope. While veterinarians were encouraged to complete the survey online, they were also given the option to complete and return a paper copy of the survey. The data from the paper returns were then entered into the online database. At the completion of the survey, all the survey data were transferred from the online database to data analysis and statistical software (SPSS, Version 14; Chicago, Illinois, USA; Statistix, Version 8.1; Tallahasee, Florida, USA). Both descriptive and analytical statistics were used to assess the data at a significance level of P < 0.05 (two-tailed). The continuous data were compared using the t-test statistic and the proportional data were compared using the chi-square statistic.

Results

The sample consisted of 348 veterinarians, who resided in the 4 western Provinces: Alberta (n = 159), British Columbia (n = 102), Saskatchewan (n = 51), and Manitoba (n = 36). Following the initial mailing, Canada Post returned 83 letters that had not been delivered. Attempts were made to contact as many of these 83 individuals as possible. Owing to a typographical error in the covering letter, 2 responses were received from the same graduates of the classes of 2005 and 2006, both of which were omitted from the analyses. Ultimately, 285 veterinarians were contacted, and surveys were received from 192 (67.4%) respondents; however, not every respondent answered every question. The breakdown of respondents by year of graduation was as follows: 2000 (n = 39), 2001 (n = 35), 2002 (n = 49), 2003 (n = 33), and 2004 (n = 36).

Employment history

There were 3 times as many female (144) as male (48) respondents and the median age of all respondents was 31 y. Of the 192 respondents, 77.6% (n = 149) were working full-time, 14.6% (n = 28) part-time, 1.6% (n = 3) on a casual basis, and 6.3% (n = 12) were on maternity or paternity leave. The percentage of women versus men working part-time was not different (P = 0.06).

Upon starting their 1st job, 50.2% of respondents reported that they were working “independently” within 2 wk of starting their job, 27.6% indicated that it took until 4 wk, and by 4 mo essentially all were working independently. The time to independent working did not differ by gender (P = 0.84). No criteria were provided as to what constituted working independently and hence each respondent may have had a different definition for this term.

Table 1 is a breakdown of the respondents by year of graduation and the number of different employers since the time of graduation. The definition for changing employers (jobs) included changing employment status within the same practice from being an employee to becoming a partner/sole owner. Eighteen (9.3%) respondents had become partners and another 27 (13.9%) were sole owners. Only 28.4% (n = 40) of these employees had remained with their 1st employer. With respect to those who had > 1 employer (n = 90), the number of months the respondents worked with their 1st employer varied from 2–72 mo, and the mean and median times were 21.0 and 15.0 mo, respectively. There was no difference (P = 0.64) in the median number of months that the male (17.2 mo) and female (15.5 mo) respondents worked for their 1st employer.

Table 1.

Frequency distribution, by year of graduation, showing the number of different employers the respondents had since the time of graduation (n = 138^a)

Number of employers since graduation	Year of graduation
	2000	2001	2002	2003	2004	Totals
1	2	6	10	7	12	37
2	8	8	14	12	7	49
3	8	6	8	2	7	31
4	2	3	4	2	1	12
≥ 5	3	2	3	1	0	9
Total by year	23	25	39	24	27	138

^a There were 192 respondents to the survey but 45 had remained at the same practice since graduation and were now either partners in the practice or sole owners and hence they are not included in the table. Another 9 respondents did not answer this question.

Table 2 shows how the respondents’ veterinary career path aspirations changed from the time of their preveterinary program to time of the survey (“now”). Although 49.0% of respondents began their veterinary education with aspirations of becoming MA practitioners, only 23.7% were currently engaged in MA practice. Conversely, interest in small animal (SA) practice increased by 2-fold over the same time period.

Table 2.

Percentage of respondents interested in each type of veterinary practice from the time of their preveterinary program to the time of the survey (“Now”) (n = 192)

Time	SA	FA	MA	Equine	Other	Unsure
Preveterinary	24.7	15.5	49.0	6.2	3.1	1.5
Graduation	37.6	8.8	44.3	7.2	1.5	0.5
1st year postgraduation	44.3	10.3	35.6	6.2	3.1	0.5
Now	54.1	9.8	23.7	4.1	6.7	1.5

SA = Small animal practice.

FA = Food animal practice.

MA = Mixed animal practice.

Factors that influenced respondents to remain at, or leave, a place of employment

Respondents were asked to rank 6 factors as to their relative importance in influencing their decision to remain at, or leave, a place of employment. The percentages of respondents who ranked a factor as either a “1” or “2” were then combined. Three factors were evenly ranked with respect to why respondents remained at a practice: type of caseload (53.3%); hours of work and number of nights on-call (51.2%); and practice mentorship and support (51.2%). Fewer than 26% of the respondents ranked the remaining 3 factors (level of remuneration, geographical location of the practice, number of practitioners in the practice) as either a 1 or 2. The same 6 factors were ranked as to their influence on making the decision to leave a practice. Only 2 factors stood apart from the rest: hours of work/number of nights on-call (60.9%) and lack of support/mentorship (47.4%). Fewer than 33% of the respondents ranked the remaining 4 factors as either a 1 or 2. There were no differences (P > 0.05) in the rankings when stratified by the type of practice the respondents’ were most interested in at the time of graduation.

Significantly, 38.3% (67/175) of respondents indicated that on at least 1 occasion, poor mentorship and/or lack of support had been the number 1 reason for leaving a place of employment; a greater proportion (P = 0.04) of women (42.5%) than men (24.4%) had left a position solely because of poor mentorship/support.

Table 3 shows the respondents’ level of agreement with 5 qualitative statements regarding their current workplace environment. Most reported that their job was satisfying and challenging, but 57.4% also found their position to be overwhelming at times.

Table 3.

Respondents’ level of agreement, expressed as a percentage, to 5 work place related characteristics that describes their current place of employment, where “1” is the lowest level of agreement and “5” the highest (n = 176^a)

	1	2	3	4	5
Satisfying	1.7	7.4	21.0	47.2	22.7
Gives sense of accomplishment	1.1	4.5	19.3	43.8	31.2
Challenging	0.6	3.4	9.7	46.0	40.3
Dull	60.2	31.2	6.2	1.7	0.6
Overwhelming at times	2.8	11.4	28.4	30.1	27.3

^a 16 respondents did not provide data for this question.

Of the 103 respondents who began their careers in FAR practice, 34 (33.0%) had already moved onto a non-food animal related career. The mean time spent in FAR practice was 31.5 mo, which did not differ by gender (P = 0.80). Table 4 shows the relative ranking of 12 factors with respect to their level of influence when it came to deciding to leave FAR practice. Gender was not associated (P > 0.26) with any of the rankings. The 2 most important determinants for leaving FAR practice were long hours of work and number of nights on-call and lack of support and mentorship.

Table 4.

Relative ranking of the factors that influenced the respondent’s decision to leave a mixed or food animal practice. Rankings were derived from a question that asked the respondents to rank each factor on a scale of 1 to 5, where 1 was “not at all important” and 5 was “very important.” Percentage of respondents represents the percentage of respondents who assigned each factor a score of “4” or “5” (n = 31^a)

Factor associated with leaving a mixed or food animal practice	Percentage of respondents
Hours of work and number of nights on-call	67.7
Lack of support and mentorship	54.9
Level of responsibilities and type of caseload	38.7
Injury or risk of injury	32.3
Left because of family considerations	32.3
Geographical location	29.1
Disillusioned by this type of practice	25.8
Too physically demanding	22.6
Wages and benefits	22.6
Size of city/town where clinic was located	10.9
Just needed a change of pace	12.9
Clientele	6.5

^a This table only includes respondents who began their careers in mixed or food animal practice but had since left these types of practice.

Relationship with employer

Table 5 shows the respondents’ level of agreement or disagreement with 6 statements that characterized their professional relationship with their employers. Approximately 70% disagreed or strongly disagreed with the statement, “Employer is supportive and understanding when a case or procedure goes badly” and 74.4% agreed or strongly agreed with the statement, “Employer makes disparaging comments about new graduates or their education.”

Table 5.

Level of agreement, expressed as a percentage, of the respondents to a series of statements regarding their current employer, where 1 was “strongly agree” and 5 was “strongly disagree” (n = 176)

	1	2	3	4	5
Employer praises good work	14.8	11.9	29.0	27.8	16.5
Employer is tactful when you make a mistake	9.1	8.5	22.2	38.6	21.6
Employer is supportive and understanding when a case goes badly	5.1	5.1	19.3	36.9	33.5
Employer is an excellent role model	6.2	14.2	35.8	27.8	15.9
Employer is annoying and shows little confidence in your abilities	58.5	19.3	15.3	4.5	2.3
Employer makes disparaging comments about new graduates or their education	56.2	18.2	16.5	5.1	4.0

Table 6 shows the extent to which the respondents agreed or disagreed with 14 statements regarding their personal and professional interactions with their supervisor (employer). Most respected their supervisor’s (employer’s) knowledge of the profession and teaching abilities.

Table 6.

Respondents’ level of agreement, expressed as percentage, to statements referring to their personal/professional relationship with their supervisor (employer) (n = 176)

	Strongly disagree	2	3	No opinion	5	6	Strongly agree
My supervisor (or employer) takes a personal interest in my career	10.8	7.4	6.2	20.5	24.2	15.3	15.3
My supervisor has placed me in important assignments	1.1	2.8	5.1	19.3	20.5	22.7	28.4
My supervisor gives me special coaching on the job	11.4	8.0	11.9	14.2	27.3	14.2	13.1
My supervisor helps me coordinate professional goals	15.3	9.7	13.1	24.4	17.0	12.5	8.0
My supervisor has devoted special time and consideration of my career	17.6	10.2	10.8	18.8	22.2	12.5	8.0
I share personal problems with my supervisor	27.3	14.2	8.5	14.2	23.9	10.2	1.7
I socialize with my supervisor after work	25.0	15.9	14.2	12.5	19.9	8.0	4.5
I exchange confidences with my supervisor	22.7	11.9	13.1	7.6	22.7	7.4	4.5
I often go to lunch with my supervisor	27.8	13.6	15.3	14.2	16.5	7.4	5.1
I try to model my behaviour after my supervisor	18.2	9.7	18.2	21.0	19.9	8.5	4.5
I admire my supervisor’s ability to motivate others	18.2	10.2	8.5	27.3	17.0	11.4	7.4
I respect my supervisor’s knowledge of the profession	2.3	5.1	2.8	11.4	15.9	35.8	26.7
I respect my supervisor’s ability to teach others	7.4	5.1	7.4	20.5	23.3	22.7	13.6

Characteristics of mentoring relationships

Approximately 69% (133/192) of respondents reported having had a mentor either before or after graduation, and 83.5% (111/133) had a mentor since graduation. The average age of the respondents at the time they met their 1st mentor was 24.7 y and the average age of their 1st mentor was 40.0 y. In 48.9% of relationships the mentor and mentee were of the same gender. Most (72.2%) of the mentees interacted with their mentor on a daily basis and 18% interacted at least weekly. In 63.5% of cases the mentor was the employer, in 34.8% of cases a colleague, and in 1.7% (n = 2) of cases a nonveterinarian.

One hundred and three (58.5%) of the 176 respondents had an employer or colleague who took a personal interest in their career. Thirty-four percent (60/175) indicated that they were mentoring another veterinarian, with more males (48.8%) than females (29.9%) being mentors (P = 0.04).

Most respondents (59.1%) believed that their veterinary education had not adequately prepared them for practice and 50.3% favored having to complete a mandatory 1-year intern-ship in private practice before becoming fully licensed. This differed by gender (P = 0.045), 54.5% of women versus 36.6% of men supported mandatory internships. Finally, 73.9% of respondents indicated that mentorship should be included in the veterinary curriculum.

Discussion

This study shows that career path switching begins early in the students’ veterinary education and that considerable job switching continues into the postgraduation period. Approximately half of the students entered veterinary college wanting to become MA practitioners but the percentage of people interested in this type of practice declined at every subsequent time-point. Conversely, the level of interest in SA was lowest during the preveterinary program and increased at every time-point thereafter. Andrus et al (16) reported on a shift of students from food animals during their time at veterinary college and attributed this to students being exposed to other facets of the veterinary profession. They also noted that those who switched from a food animal career prior to graduation did so because of concerns of a heavy workload and the belief that they would not be able to fully utilize their medical and surgical skills.

While much has been said and published on the need to alter college admissions policies, the veterinary curricula, and veterinary licensing in order to attract and retain food animal oriented practitioners (17–19), none of these initiatives would address the root cause of the high attrition rate — long hours and too many nights on-call. A possible solution proposed by some is to change the model of delivering veterinary services to allow animal health technicians to perform many of the task-oriented procedures that veterinarians now perform (20,21). Presumably, veterinarians could then divest some of their workload to technicians, a situation that would benefit smaller practices that cannot justify hiring another veterinarian but could make greater use of technicians. Using technicians more extensively would most likely be embraced by marginal practices where there is less competition from surrounding practices.

The 2nd most important factor associated with leaving a place of employment was lack of support and mentorship. Tait (22) noted that mentorship is a very subjective term, having different connotations for mentors and mentees, and with this in mind we avoided providing a definition as to what constitutes mentorship and support. Many of the respondents indicated that their employers were not very tactful or supportive when new graduates mishandled a case. Respondents also reported that their employers lacked confidence in the new graduates and made disparaging comments about graduates and their education. Only 6.2% strongly agreed that their employer was an excellent role model. These findings are similar to another Canadian survey wherein graduates reported an increased level of frustration and stress in practices that offered little to no mentorship (23). Consistent with our findings, this previous study also reported that the most valuable nonmonetary attribute that graduates were looking for in a practice was good mentorship. Other studies have also associated mentoring with career satisfaction and success (24) and noted that the most frequent and effective mentors to veterinarians were the initial employers (25).

Approximately 60% of respondents felt that they were not adequately prepared for practice. Therefore, it is not a surprise that 54.5% of women and 36.6% of men agreed that new graduates should be required to complete a mandatory 1-year internship in private practice before becoming fully licensed. Some caution, however, is required when interpreting these results. We suspect that the respondents are equating a mandatory internship in private practice to the formal internship programs being offered at universities and by larger specialized practices. In both instances, new graduates receive a high level of mentorship and support from their fellow clinicians and have a support network when it comes to handling difficult surgical and medical cases. This must be distinguished from graduates being placed on probation for 1 year but not being mentored or supported at a level that exceeds what is already being offered. In short, limited or graduated licensure is of little value unless practitioners are willing to make fundamental changes in the way they mentor new graduates.

This study confirmed previous reports that the marketplace for new graduates is very fluid, with considerable job switching occurring within the first 2 to 3 years of graduation. Only ~25% of the respondents had remained with their initial employer and 50% of the respondents who had > 1 job worked for their initial employer for < 15 mo (median). The ease with which the graduates were able to switch jobs is indicative of the current job market, where there are lots of opportunities for employment. This is germane because the main reasons the respondents left their place of employment were management related. Therefore, practice owners who pay attention to human resource issues such as training and mentorship will have a competitive advantage when it comes to attracting and retaining employees. While some owners may be successful in attracting new graduates by paying an above average salary or having a clinic equipped with the newest equipment, a key determinant to employee retention over the long term is to provide a supportive working environment that fosters job satisfaction.