Clinics! Permalink | 4 Comments

Leap ahead five months to present day vet school. But first, a bit of a retrospective. Second semester, third year, was like one of those dreams you wake up from and wish you didn’t. Gone were the seemingly endless nights of studying in hopes of keeping up with at least some of the coursework. Gone were the weeks with back-to-back-to-back tests that one could not possibly adequately study for. Gone was the finals week with 8 finals in 7 days. In its place were courses that were pass-fail instead of graded A-F. Classes that consisted mostly of labs and either didn’t have any tests at all, or had open-book tests. And clinical cases – actual, real cases that were relevant to what we will face in the real world – were the basis of most of the classes. After two and a half years of mental torture, we were, at last, reaping our reward. And, of course, in a bit of irony, second semester, third year is also the shortest semester in the curriculum.

The second week in April at last brought the highly anticipated white coat ceremony. This ceremony marks the passage from classroom-based learning to the clinical rotations. Friends and family abound on this weekend, and I was fortunate enough to have my wife, mother, sister and brother-in-law, and brother and sister-in-law join me for the ceremony. The weather was perfect and we all looked “dashing” in our crisp white lab coats. Sadly, this was our last time we would all be assembled together as a class until graduation, but time, and obligations, march on.

Two weeks later I was fortunate enough to be invited to the annual College of Veterinary Medicine awards night. I was one of three people in my class to receive a scholarship from Pfizer Animal Medicine, and was the proud, and humbled, recipient of a scholarship voted on by my fellow classmates for being “caring, compassionate, and an all around nice person.” Who says nice guys finish last?

After a week of “introduction to rotations,” we plowed ahead into our 13-month stint of 2-week clinical rotations. My first rotation was Small Animal Medicine (SAM), arguably the most demanding and angst-inspiring rotation there is. Of course, fear of the unknown is typically far worse than the reality of the situation, and so it was with SAM. The instructors – one of the faculty, along with two residents and an intern – were very nice and strived to help us learn the ropes. That’s not to say, however, that it was not challenging. Quite to the contrary, it was two weeks of high anxiety coupled with an intense feeling of inadequacy. Time and time again I found myself struggling to extract from the depths of my mind even the most minor details of what I had been taught over the previous three years.

One of the most difficult things I had to deal with on SAM was the sudden level of responsibility that was placed upon us. Up to this point, we had to actively seek out opportunities to get even the most minute level of “real world” interaction with clients or patients. Most everything we encountered in our labs and coursework were “simulated” patients and clients – good practice, but in the back of our minds we know it wasn’t the real thing. Now, suddenly, we not only had the opportunity to interact with real clients and patients, but we were expected to take the lead in doing so.
This is best illustrated by looking at a typical day in SAM. The day officially starts out at 8 a.m. with the selection of cases. However, if you have a case from the day before that is still in the hospital, you are required to complete all paperwork and treatments for that patient before 8 a.m. When 8 a.m. rolls around, the cases for the day are officially presented on the white board, and you barter/argue/steal the case you are most interested in from the rest of your classmates. On more than one occasion, I was left without my first choice, or even second choice, because after three years of being taught to cooperate rather than compete, I was not mentally prepared to do battle with my classmates. I guess this harkens back to my “nice guy” award.

From 8 until 9, you have time to so any research you can on your case. This might include faxed information from the referring veterinarian, looking up possible causes of a particular disease in any of the various reference books you have available, and/or searching the internet. At 9 o’clock, you have rounds where everyone discusses either a particular case, or a particular disease or syndrome. On most days the topic of rounds was made known the day beforehand so that you could spend most of your evening researching the topic.

At 10 o’clock, appointments began. Since you, the student, are in charge of the case, you go out to the lobby of the small animal hospital and greet the client and patient. You then take them to an exam room and take a detailed history of the problem (all the while typing the answers on the computer) and then give the patient a toe-to-tail physical. All this is supposed to be done in 15-20 minutes, but I am the first to admit that I rarely, if ever, met that time goal.

Once the history and physical are complete, you leave the exam room and take a few minutes (usually very few) to come up with a problem list, a list of differential diagnoses (diseases that might fit the problems being seen), and a plan (what further diagnostics to run, what medications to provide, etc.). You then seek out the doctor assigned to the case and present the information. You then accompany the doctor back to the exam room, where he/she goes over most of what you already went over with the client/patient and then offers a diagnosis.

Once the doctor presents the plan and the client approves, it is the student’s responsibility to schedule any diagnostic tests, order any drugs from the pharmacy, and sign up and place the animal in wards if it is going to stay for any length of time. The student also has to draw blood if necessary, collect urine or feces if necessary, or perform any of a myriad of other procedures that might have been ordered. You then follow your patient throughout the appointment – be it down to ultrasound, or to radiology, or endoscopy, or whatever. At the end of the day, you are responsible for writing the discharge, which indicates everything that was found in the history, physical, diagnostic tests, etc. And, of course, if the animal has to stay overnight, you are responsible for creating a treatment sheet (which outlines what needs to be done over the course of the next 24 hours) and for coming in the next morning and doing the morning treatments and updating the paperwork to account for anything that occurred over night. All of this needs to be done with each of your patients, and typically we had 2-3 patients each per day. Suffice it to say the days were long and the sleep was inadequate. Plus, you had to work at least one day per weekend, and both days if you had a patient in the hospital. I got one day off in 14. It was exciting and frustrating at the same time, and while the experience was invaluable, at the end of the two weeks I was ready to move on to the next rotation.

My next rotation was Equine Ambulatory. The university maintains a mobile equine practice based in the western suburbs, about 30 miles west of Minneapolis. For two weeks, me and another student accompanied the two veterinarians that work at the practice on all of their farm appointments.

The difference in stress level between Equine Ambulatory and SAM was night and day. The appointments for Equine Ambulatory were mostly for yearling vaccinations and/or dental work. The ambiance was relaxed, and the veterinarians were equally as relaxed. We were still in charge of doing all the paperwork, but it was less complex than the SAM paperwork, and we often had time during the day to work on it. Most days we even had time for lunch, unlike in SAM. And, best of all, we got to see daylight. It was enough to make me seriously consider a career solely in large animal medicine.

My next rotation was Equine Lameness and Podiatry. This was held at the Equine Center on campus, which is a wonderful facility that was just built in 2007. The study of and diagnosis of equine lameness is a surprisingly complex task, and by no means can it be learned in two weeks, but our two instructors gave us the basic tools we need to get us started. About half the time was spent in the classroom, and the other half was spent looking at lameness cases – carefully palpating horses to check for signs of pain, watching them walk and trot, taking radiographs (x-rays) and ultrasound, giving them nerve blocks to try to localize the location of the lameness. It was fascinating and fun – and, again, a great argument for considering a career in large animal medicine.

My next rotation is “labs,” which is a departure from the hands-on rotations I’ve had so far. It will be primarily classroom based, with a bit of looking in the microscope thrown in for good measure. It’s all about analyzing blood work and urine in an effort to try to understand what might be going on inside an animal’s body.

After that, I am blessed with two whole weeks of vacation! Somehow I think I may need it.

Just 3 more months of life as I know it Permalink | 2 Comments

I managed to survive the test week from hell - 8 tests in seven days. In retrospect I can’t say I survived it particularly well - the 4 hour clinical correlate test for small animal gastroenterology, for example, was a classic exercise in pain. It was so challenging that when the instructor encouraged us to take a bathroom break two hours into the test, almost nobody moved for fear that the few minutes “wasted” to go the bathroom could mean not completing the test on time.

Other than the onerous testing at the end, I thought the semester was rather interesting and relatively stress-free. I spent a lot of time palpating cows and horses, which many non-veterinary people might consider disgusting, but which was actually quite useful and interesting. “Palpating,” in these instances, meant sticking my arm up their rectums and feeling for the reproductive tract in an attempt to find the ovaries and figure out if the cow/horse was pregnant. They say you don’t really get good at this until you do about 1000 cows or horses. Overall, I probably did about 35 cows and 15 horses. So, no, I’m not good at it. We also used ultrasound, via the same route, to “inspect” the reproductive tracts. Unlike the ultrasound images of human babies where you can pretty easily make out the images of little limbs, heads, and bodies, ultrasound images of cow and horse uteruses and ovaries are quite non-descript. It, too, is an acquired art. I guess I will have to keep practicing.

If I could sum up the semester in one word, that word would have to be “reproduction.” No, I didn’t produce any offspring personally. Rather, I was immersed in a seemingly endless run of reproduction classes. There was small animal reproduction, equine reproduction, small ruminant reproduction, and large animal reproduction. That’s a lot of naughty bits to learn about. The highlight had to be the lab in which we collected semen from a stallion. If you’ve never been witness to such a thing, let’s just say it is a highly energized and potentially dangerous affair (pun intended). We also collected semen from a goat, which was a decidedly less dangerous affair, but only less dangerous based on animal size, not animal intent.

The semester started off with a trip to Lexington, Kentucky to learn about opportunities in equine practice, and ended with a trip to Las Vegas in December to attend the American Association of Equine Practitioners conference. I can say without reservation that I prefer Lexington to Las Vegas.

During the semester, we also said goodbye to our long-term foster dog, Morgan, who found a great new home with a little girl that loves the heck out of him. We then fostered Gretal, a slight, young, German Shepherd who found a great new home after only three weeks with us. And currently we have Bernie, a most awesome 1 year old Saint Bernard who we’ve found a great home for in just a matter of a week and a half.

From the very beginning of my vet school career, I’ve talked about the fact that everyone says it goes by extremely quickly. I can certainly add my voice to that chorus. We start back to class next week and as a third year, our spring semester lasts a mere 3 months. Come April 12, we begin our year-long clinical rotations. I’ve come to know the 89 other people in our class pretty well over the course of the past two and a half years, and it’s difficult to fathom that in a mere three months, we’ll all essentially be going our separate ways. As much as I’m looking forward to moving away from lectures and towards actually applying what we’ve been learning, there is a certain sadness that comes with knowing that the camaraderie that we have all shared over the past few years will soon end.  And of course, vet school being vet school, there will be no time to relish these next three months. But I will try - I will certianly try.

The final push Permalink | 4 Comments

As I sit here on a Monday night studying (i.e. cramming) for a small animal infectious diseases test, I am lamenting the fact that I can’t really enjoy the build-up to Christmas. Between now and next Tuesday, a period of a little more than a week, I have eight finals, a quiz, and an assignment to complete. There will be a celebratory eggnog next Tuesday afternoon, for sure. It is during times like these that I issue the warning to all in earshot (or eyeshot, as the case may be) - if I ever serve as your vet, you’d better never, ever, ever, ever complain about vet fees in my presence - or I will double your fee and make you take eight finals in seven days!

Top of the heap Permalink | 25 Comments

First of all, yet another apology for not updating this blog very often. I’m really busy with school, blah, blah, blah…you get the picture. I’ll try to update more often, but no promises.

And yes, vet school is back in full force. I thought the days of solid lectures from 8 a.m. to 5 p.m. ended with second year, but, sadly, that’s not the case. It seems that my schedule this year is packed even more solid than last year. But part of that is my fault. We had a wider choice of electives this semester, which, being electives, we were of course pefectly free to pass up. But I just couldn’t pass on them. They all either seemed really interesting, or were applicable to my “track” which is “mixed animal” (meaning large (horses, cows, camelids, sheep, goats, etc.) and small (dogs, cats, house pets) animals. And so, while lots of other people didn’t have to come in until 10 a.m. on Monday mornings, for example, I had to be there at 8 to participate in the equine reproductive elective.

Not all classes run a full semester in vet school, so even though we are just over two months into the semester, I have already completed five courses. There is still plenty more to go, of course, but there is a certain satisfaction knowing that you’ve already “knocked off” a few things. The downside is that typically when one course ends, a new one begins.

So other than the long days, how does third year compare with the first two years of vet school? First off, it is kind of surreal in that it’s hard to believe that we’ve come so far in only two years. Seeing the freshmen start out and remembering what that was like seems like decades ago. And it’s also interesting to think that in two short years we’ve gone from the wide-eyed, clueless people who walked through the doors to the somewhat sophisticated, seasoned vet school students we all are now. And although it’s true that we still  have a year to go after this, we are pretty much at the top of the heap right now as far as our vet school academic carreer goes. That’s because as fourth years we scatter off into clinical rotations and externships and we won’t really be together as a class anymore. So this is it - the pinnacle of our classroom learning as vets in the making.

Third year classes range from very interesting to run-of-the-mill dull. Last week we had our gastrointestinal surgical labs which involved various GI surgeries on dogs. I love surgery, but I hate anesthesia which, of course, goes hand-in-hand with surgery. I had to patiently plod through two hours of anesthesia before I could get to do a surgery, but I guess I’m finding that the more you do anesthesia, the less nerve-racking it becomes.

I’ve also had plenty of both bovine and equine palpation labs, so my arms have spent considerable time inside of rectums this semester. Of the two I find I’m much more comfortable and capable with horse palpations which is probably fortunate because I’d much rather work with horses than cows.

And just to make sure we keep our eyes on the prize, they made us plan out our entire fourth year by the end of this September. We had to submit all of our rotation and externship requests by that date and once the computer and a few select humans have their way with them, I should know exactly what I’ll be doing and where until May, 2011. Although we have to have our externship dates blocked off, we don’t really need to figure out what and where those externships are going to be - at least for a little while. So far I have two externships definitively set up. I will be spending two weeks at  Rood and Riddle equine hospital in Lexington, Kentucky in October next year. In March of 2011, I’ll be spending two weeks with a vet in Oregon going on farm calls to alpaca and llama farms. That leaves two externships unfilled, but I should know about them soon - if all goes well, of course.

But for now I have to study for an oncology final… sigh.

The Summer that Was Permalink | 31 Comments

I thought that having a relatively “easy” summer would mean that I would be updating this blog more frequently. Not so, as it turns out. When the weather is nice, it’s just too hard to sit down in front of a computer and type. But school is fast approaching so I thought I’d better make up for lost time while I had the chance.

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Reflections from 1/2 a vet Permalink | 128 Comments

I am officially half way through this journey and thought it might be a good time to reflect on where I’ve been, where I’m going, and what I think it all means.

At this point, it is difficult to separate school from life in general, because school has become my life. This is not necessarily a bad thing, just an observation. While I am certainly currently enjoying the respite from having to study every night and most weekends, I think that vet school, in general, has been very good for me. I have a hard time staying focused on things for any length of time, and vet school does that for me. By the time I graduate, becoming a vet will have been a 7-year commitment to education. I do not feel the time could have been better spent. Sure, I could have been making money rather than going into debt, but in the end  we all know that real accomplishment is not achieved without sacrifice and hard work. And I have certainly had my share of both. (more…)

Of Giraffes, Horses, and Spanish speaking countries Permalink | 110 Comments

Year 2 of vet school is just about history. All of our finals are over - the only thing remaining is this week’s “Integrative Medicine” elective where we explore classic oriental medicine therapies like acupuncture and herb therapy and learn to diminish our stress through yoga and QiGong. A rather relaxing end to a rather demanding semester. (more…)

Surgery! Permalink | 291 Comments

Sophomore surgery lab started out with a bit of a surprise when we discovered that the humane society did not have enough dogs in need of spaying to supply all of the surgery groups. So instead of performing a dog spay, I would be performing a cat spay. I was a bit disappointed at first in that I had done a cat spay a few months before and was looking forward to doing a dog spay. But in the end, it doesn’t really make that much of a difference - same procedure, just with smaller “parts.”

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Sophomore Surgery Permalink | 162 Comments

First things first. The answer to the radiology question in my last post is “A”. Several people got it correct and I am currently negotiating to get them into vet school. I take the radiology final this Tuesday - a three-hour computer-based test that gives you instant feedback when you are done. Please send good karma.

We have about six more weeks left in the semester and, as always, they’ve packed as much fun as possible into that time. In addition to the radiology final, we have a two-part clincal pathology final, with the first part on Monday and the second part on Friday. The next week we are faced with three more tests. The fun never ends! (more…)

This semester’s controversy Permalink | 386 Comments

Vet school can go up against the best high school or junior high in terms of drama. I’ll make a blatant sexist statement and blame the high drama quotient on the fact that 80 percent of the students are female. Or maybe it’s the fact that most of the students are in their early 20s and don’t have enough life experiences to weed out the real crises from the temporary ones. Whatever the reason, the drama offers a bit of amusement in our otherwise mundane, lecture-filled days. It’s like we have our own reality TV show, only it’s real and not on TV.

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