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Who Gets to Specialise? The Hidden Inequities of Veterinary Residencies

Introduction: The Shiny Surface, the Cracked Foundation

Residencies carry prestige. They’re marketed as the pinnacle of veterinary training — a pathway to mastery, influence, and impact. But beneath the glossy surface lies a truth the profession rarely says aloud: residencies are one of the most inequitable structures in veterinary medicine.

They filter by class, gender, geography, disability, and circumstance. They ask impossible sacrifices of some while smoothing the path for others. And by pretending this is meritocracy, we silently erase the very talent our profession cannot afford to lose.

Financial Filters: Who Can Afford to Specialise?

The first inequity is the most obvious: money.

• Low stipends, high costs: Residency stipends are often less than half what a GP vet could earn. Over three or more years, that gap compounds into tens of thousands lost.

• Up-front expenses: Membership exams, conference travel, relocation costs — often with little to no institutional support.

• Opportunity cost: While peers are buying houses, paying off loans, or starting families, residents are delaying financial security. With housing and education costs soaring, we risk seeing specialist training increasingly becoming a privilege reserved for the socioeconomically advantaged.

Who can afford this? Usually those with family wealth, supportive partners, or savings from privileged early career opportunities. Who gets locked out? First-generation graduates, working-class vets, single parents, and anyone without a safety net.

Gendered Impact: The Motherhood Penalty Amplified

Residencies coincide with prime child-bearing years. For women and gender-diverse vets, this creates impossible choices.

• Rigid structures: Few residencies allow part-time work, job-sharing, or flexible leave.

• Pregnancy and parenting penalties: Taking time out often means losing a place, with little chance to re-enter.

• Cultural bias: Female residents with caregiving responsibilities are too often seen as “less committed,” while male colleagues may be applauded for minimal caregiving.

The result? Women are over-represented in vet schools but under-represented in specialist leadership. Residencies entrench the glass ceiling.

Disability and Neurodivergence: The Invisible Exclusion

Residencies are built around assumptions of endless stamina, perfect health, and 24/7 availability.

• Physical barriers: Long hours without accommodations for fatigue, pain, or mobility.

• Cognitive barriers: Rigid structures that punish neurodivergent working styles.

• Disclosure risk: Fear that revealing disability will mark residents as “unfit” in competitive programs.

This means disabled and neurodivergent vets rarely make it through — not because of lack of skill, but because residencies refuse to adapt.

Geographic and Class Divide

Residencies cluster in universities and referral hospitals in major cities.

• Rural students: Expected to relocate, often at their own expense, away from community and support systems.

• International graduates: Face additional visa hurdles, relocation barriers, and financial exploitation.

• Class filter: Those with parents to subsidise rent in Sydney or Melbourne can move. Those without quietly opt out.

Residencies reproduce privilege geographically as well as socially.

The Hidden Curriculum of Suffering

Residencies transmit their own unspoken lessons — and inequity is baked into them.

• “If you can’t work 80 hours, you’re not cut out for this.”

• “If you can’t afford it, you didn’t want it badly enough.”

• “If you take leave, you’ve failed.”

This hidden curriculum doesn’t measure skill. It measures who can endure unpaid labour, unstable income, and unsafe hours without breaking. That’s not merit. That’s exclusion masquerading as excellence.

Attrition We Don’t Count

How many talented vets never apply for residencies because they know they can’t afford it? How many parents, disabled vets, or rural grads quietly self-exclude before even trying?

Their attrition is invisible. We don’t call it “loss of talent.” We call it “personal choice.” But every one of those choices is shaped by structures that make belonging impossible.

And even among those who do get in, many leave mid-program, citing burnout, financial strain, or family pressure. Again, we write it off as “not a good fit,” instead of naming the inequities baked into the system.

Perhaps one of the most telling contradictions is this: residencies demand full-time sacrifice, insisting that only those who can give everything are worthy. Yet once they qualify, many specialists themselves choose to work part-time (and thrive). The very flexibility denied to residents becomes the norm in specialist practice. Which begs the question: if part-time work is compatible with excellence after qualification, why is it treated as incompatible during training?

Who Benefits From the Current Model?

Residencies as they exist serve particular interests:

• Institutions gain a source of highly skilled, low-paid labour to staff hospitals.

• Privileged applicants climb faster, entrenching existing inequalities in leadership.

• The myth of meritocracy is preserved: the idea that only the “toughest” survive, when really, the wealthiest and most supported do.

The losers? Students, vets, and communities who never see themselves represented in specialist medicine.

Lessons From Human Medicine: We’re Not Alone in This

Veterinary medicine is not the only profession grappling with inequitable training pathways. Human medicine has been confronting many of the same cracks in its residency model:

• Financial barriers: In the U.S., medical residents have long advocated for stipends that match living costs. Loan forgiveness, childcare subsidies, and housing allowances are increasingly discussed as essential reforms — recognition that financial exclusion isn’t a sign of “lack of commitment,” it’s a structural problem.

• Gender and caregiving: Medicine has well-documented data on the “motherhood penalty.” Women and gender-diverse doctors report stigma around pregnancy, inflexible leave, and derailed careers. In response, some programs now offer flexible training tracks, job-sharing, and formal re-entry pathways — small but important signals that parenthood and specialisation can coexist.

• Disability and neurodivergence: Doctors with disabilities highlight many of the same barriers veterinarians face: rigid schedules, fear of disclosure, and limited accommodations. Groups like the Coalition for Disability Access in Health Science and Medical Education are pressing institutions to dismantle ableist structures and embed accessibility from the outset.

• Geographic inequities: To address shortages and broaden opportunity, medicine has invested in distributed residency programs — placing residents in regional centres, community hospitals, or telehealth-linked networks. Veterinary medicine could do the same, breaking the metro monopoly and training specialists where communities actually live.

• The hidden curriculum: Human medicine names it openly: the belief that long hours and self-sacrifice equal competence. After studies linked this to burnout and patient harm, reforms like the U.S. ACGME duty-hour limits and the UK’s European Working Time Directive were introduced. They are imperfect, but they show that cultural change is possible.

Why This Matters for Us

When we look at medicine, we see both a mirror and a roadmap. Their inequities remind us that residencies everywhere are not neutral pipelines of talent — they are filters shaped by privilege. But their reforms remind us that change is not only possible, it’s already happening.

Veterinary residencies could learn from these shifts: fair stipends, flexible structures, distributed models, and built-in accessibility. We don’t need to wait until attrition reaches crisis levels. We can choose to lead now.

Preparing Specialists for the World We Actually Live In

Residencies don’t have to be inequitable. They could prepare specialists who reflect the workforce we need, not just the workforce that can afford it.

That means:

• Fair compensation: Stipends that reflect professional contribution, not “trainee” exploitation.

• Flexible pathways: Part-time residencies, job-shares, and re-entry programs after leave.

• Geographic diversity: Regional residencies, telehealth case involvement, distributed training models.

• Accessibility: Built-in accommodations for disability, neurodivergence, and caregiving responsibilities.

• Transparent selection: Clear, merit-based criteria, not opaque networks and insider sponsorship.

My Reflection: Who Gets to Belong?

Residencies are not just about training. They are about signalling who gets to belong at the highest levels of the profession. And right now, that signal is exclusionary.

When I look at residencies, I don’t just see specialists in training. I see the profession deciding — consciously or not — that only certain bodies, certain bank accounts, and certain family structures are welcome. That’s not equity. That’s gatekeeping.

There’s a tendency to say residencies are built on meritocracy. But meritocracy without equity is not meritocracy - it’s an illusion. It’s just privilege with branding.

The reality is stark. Where veterinary medicine is one of the least diverse professions, specialist practice is even less diverse than GP practice.

Conclusion: A Residency Reckoning

Residencies are supposed to be pathways to excellence. Too often, they are pathways that filter by privilege and punish difference.

We cannot keep defending prestige while ignoring inequity. Not when the workforce is already shrinking. Not when communities need specialists who reflect their realities. Not when the next generation is watching and deciding if they belong.

Residencies need a reckoning. Because until we face their inequities, the pinnacle of our profession will remain a pyramid built on exclusion.