The new postgrads
For a growing number of students across the health professions, life after graduation leads back to universities for the pursuit of advanced training. This month, The POST gives you an inside look at what some of these residencies and fellowships are like.
By Allyson Fox
Since he was a little kid, Robert Armentano, D.V.M., wanted to be a veterinarian. A dog owner himself — he has a fluffy Australian shepherd-mix named Hannah — he also knows animals are as much a part of most families as their human companions and believes their medical care should reflect that.
This belief led Armentano to pursue a residency specializing in internal medicine after he graduated from veterinary school. Now the chief resident at the UF College of Veterinary Medicine’s Small Animal Hospital, he spends his days seeing patients in the clinic, conducting research, attending conferences and publishing papers. The three-year residency has provided him an opportunity to not only fine-tune his skills, but also to provide the highest standard of care for furry loved ones.
Unlike physicians who practice on human patients and complete three to seven years of residency training following graduation, veterinarians, dentists, pharmacists and other health professionals are not required to seek additional training after they graduate. But the pursuit of advanced training — either through residencies or postdoctoral fellowships — is a choice more students are making in order to be competitive in the job market and provide the best possible care to patients.
In the College of Dentistry, for instance, the number of students seeking advanced education has increased steadily over the years.
“The background that (students) get in dental school is so broad that a lot of students are not comfortable practicing without more intense education,” says Timothy Wheeler, D.M.D., Ph.D., senior associate dean and director of the School of Advanced Dental Sciences and chair of orthodontics in the College of Dentistry.
With another graduation upon us, a not-so-great economy and changes in patient care, specialized degrees are becoming increasingly common across each of the health fields. This month, The POST takes a look at some of the residents and fellows who are in these programs at UF and the new graduates who are following in their footsteps.
College of Veterinary Medicine
For Armentano, it’s all about working with the animals from diagnosis to treatment.
He believes doing a residency is important to keep up with ever-changing advances in
“Coming into a residency, you have to love it,” Armentano says. “You have to be dedicated and want to pursue it.”
Armentano loves being in the clinic with animals, but other veterinary residencies have a stronger focus on laboratory work. The College of Veterinary Medicine has 14 postgraduate programs, with residents coming from across the country to fill these slots, though only about 15 percent of the college’s graduates choose to go this route, usually because they want to pursue a more advanced specialty, such as internal medicine or oncology.
After Bill Craft, D.V.M., and Serena Craft, D.V.M., graduated from veterinary school, they went into practice. However, after six years, they realized they were each most passionate about specific areas of veterinary medicine; Serena was fascinated by diagnosis, and Bill was interested in pathology.
As a husband-and-wife team, they decided to return to school and specialize in anatomical pathology, the diagnosis of disease based on evidence found through methods such as microscopic examination and necropsy, the animal form of an autopsy.
With two young boys to take care of at home, the Crafts say the work schedule for anatomical pathology is more family friendly, despite having an average 12-hour workday (sometimes it can reach 20).
Although their hands are full now, taking this path will ultimately give them flexible work hours as opposed to having to work weekends and holidays in emergency medicine.
As part of the residency, the Crafts work on two services: surgical pathology and necropsy. They receive and analyze biopsy samples from referring veterinarians and write reports on what they find when they are working in surgical pathology.
“One of the reasons we wanted to come back is because we missed the academic environment,” Bill says. “You can never know everything. You’re always learning throughout your whole career.”
The work schedule is hectic, but the residency is worth it, the couple says.
“There’s not a day that I wake up that I’m not happy to come in even though it’s tough,” Serena says.
College of Dentistry
After owning and operating a private dental practice for eight years, a desire to learn more brought Richard Donatelli, D.M.D., M.S, back to UF to pursue a specialty degree in orthodontics.
“After doing the same kind of dentistry, it got repetitive, so I knew I wanted to do more,” says Donatelli, now an assistant professor in the College of Dentistry.
Donatelli is not alone is his desire to continue his education. About half of dental school graduates pursue advanced education programs, Wheeler says.
In Florida, general dentistry practitioners can do everything a specialist can do, but they are also held to the same standard as a specialist. Donatelli knew if he wanted to practice orthodontics to the proper standard of care, he would have to specialize.
“I really enjoyed orthodontics,” Donatelli says. “I enjoyed working with adolescents and kids.”
The College of Dentistry offers 10 different postgraduate programs, including orthodontics, prosthodontics, pediatric dentistry and advanced education in general dentistry. The programs vary in length, and some graduate with a certificate and specialty degree.
The days were long, but Donatelli’s three years as a resident flew by, he says. Often his days started at 7 a.m. and ended at 6 p.m. or 7 p.m.
Typically, residents see patients for three hours in the morning and in the afternoon, take classes in the morning and attend conferences, conduct research and earn a master’s degree at the same time, Donatelli says.
“I never regret doing it, and it was an extremely positive experience,” Donatelli says. “My advice (to incoming dental students) is to make sure that they experience all aspects of dentistry, then decide what you want to do. If you enjoy it, you will be really good at it.”
Residents are not limited to one specialty. If you have a passion for multiple specialties, you can create your own program. This is the path Vaughn Holland, D.M.D., decided to take. Holland’s residency includes specialties in prosthodontics and orthodontics.
Holland wanted to pursue two specialties because he wanted to have more control over his patients’ progression through treatment. The two specialties are intertwined, Holland says. Many times prosthodontic patients have weakened, damaged teeth that would benefit from repositioning before restoration.
“By double-specializing it gives me the ability to really give patients the best treatment option available,” he said.
Unlike Donatelli, Holland took two years off before dental school but decided to go straight into a specialty program after he graduated.
“In my opinion, it’s about being able to provide a higher level of care,” Holland says. “Everything I do, I want it to be perfect.”
Pursuing a residency is very time-consuming, Holland says. There are times he wants to go home and spend time with his child, but he has to work.
“You sacrifice now in order to do better later,” he says.
After he finishes his residency he wants to move to Jacksonville to practice with his dad and uncle. He would like to work with kids who lack certain teeth from birth, which happens in a small percentage of the population.
“A great benefit to specializing, is that you have to know everything about certain things, but you also get to rely on other people to help you out with areas that you really don’t feel as comfortable with,” Holland says. “For me, that is surgery. So I plan to practice with a good oral surgeon or a good periodontist, hopefully in the same practice.”
College of Pharmacy
About one-quarter of pharmacy students go into residency, says Michael McKenzie, Ph.D., senior associate dean for professional affairs in the College of Pharmacy. Although the number of students who pursue residency programs has stayed level at about 25 percent, the competition has increased in recent years.
Brian McCullough, Pharm.D, a second-year resident, decided to go into residency after he completed pharmacy school.
Although residency is not required to practice, it is more beneficial now because of the competitiveness of the job market, McCullough says.
McCullough specializes in infectious disease, which includes monitoring antibiotic use in the hospital, predicting antibiotic resistance and doing research projects.
So far, his residency has been a more intense learning process than pharmacy school, he says. The biggest challenge is the time commitment; He works between 50 and 70 hours a week.
However, McCullough believes the benefits outweigh the challenges. Pharmacists who complete residencies have a better chance at moving up to administration, earning more clinical recognition and receiving more professional training.
“It was well worth it,” says McCullough, whose residency will end this year. “You can’t match the training you get with a residency. Invest yourself fully in the process, dive deep into the information and make sure to have fun.”
As McCullough finishes up his residency, a new class will be coming in.
Janet Arrazcaeta, Pharm.D., a student at the University of North Carolina, Chapel Hill, will pursue her residency at UF starting in the fall.
“The care of patients is becoming more and more complicated,” Arrazcaeta says. “It’s an opportunity to learn more and push yourself to become a better pharmacist.”
If you want a clinical position, you need more training, Arrazcaeta adds.
Arrazcaeta is intrigued by the treatment aspect of medicine and wants to specialize in hematology, oncology or solid organ transplant. She ultimately hopes to work in a hospital, interacting with patients. But she’s moving forward with an open mind.
“You never know where you’re going to end up,” Arrazcaeta says. “It’s important to be open to a variety of different experiences.”
College of Public Health and Health Professions
Opportunities for physical therapy graduates are much more extensive today than they were just 20 years ago, says Milap Sandhu, P.T., Ph.D., a postdoctoral associate in the College of Public Health and Health Professions. With increased focus on evidence-based practice and translation of findings from basic science to clinical practice, a growing number of physical therapists are pursuing doctoral degrees.
In decades past, a Ph.D. was sufficient to qualify for a tenure-track faculty position. However, as the academic job market has become more competitive and the degree of technical expertise required to conduct high-level research has increased, Ph.D. graduates now require postdoctoral training to prepare for a career in academic research. Now, a postdoctoral fellowship is considered a stepping-stone and a prerequisite for a tenure-track faculty position in most research universities, Sandhu says.
The College of Public Health and Health Professions has postdoctoral programs that focus on research in several different areas — physical therapy, occupational therapy, clinical and health psychology, and environment and global health.
Sandhu is one of the fellows in the college. He received his physical therapy degree in India before completing a rehabilitation science doctoral program at UF. He has worked in clinics but his real passion is basic science research.
His work is focused on improving breathing after spinal cord injury. He is investigating novel strategies to repair connections between the brain and the muscles in hopes of developing therapies for individuals with spinal cord injury.
“Postdoctoral fellowship is an ideal time to broaden your skill set, expand professional networks and facilitate your research agenda,” Sandhu says. “You assume more responsibility in the lab, and you get a taste of what a faculty position would be like.”
After completing his fellowship, he hopes to become a research faculty member at a university.
“My advice to people considering a postdoctoral fellowship is to pick a research topic you’re most enthusiastic about,” Sandhu says. “Your best work will be done when you are passionate about your research.”