staging.vettimes.com

Author: admin

Hitting the third-year wall

Jordan and her peers, not even halfway through their course, feel they are fighting to keep their heads above water – Image: ©iStockphoto/Anton_Sokolov

Everyone had heard rumours third year at veterinary school was the worst. On coming back to university after a long summer of extra-mural studies and relaxation, we were nervous. Two weeks in, things didn’t seem too bad and we were sceptical.

We were indifferently meandering through the bewildering world of Latin names and impossible-to-spell drugs, resigned to a fate of an increased workload and new subjects, but not overwhelmed just yet. It happened to different people at different times, but, seemingly out of nowhere, the third-year wall hit. And it hit hard.

Whether it was the hours of straining to make sense of indiscernible pinky-purple mess under the microscope, or trying to differentiate one parasite from the next by the subtlest of morphological changes, or even just trying to fathom the hideous amount of Latin that had forced itself into our lives, veterinary school suddenly got the better of most of us.

While drowning under the sheer amount of information to take in, the realisation we’re not even halfway there really seemed to set in this term, making it almost impossible for us to keep our heads above water.

A week of very little sleep, long hours studying and eight exams will mark the halfway point for my year group. The most disturbing part of this revelation is the feeling we’ve been at vet school for a long time (can anyone even remember freshers’ week?), and yet we still have that same length of time left to go.

Several of us have been questioning our aspirations of late – why did I want to be a vet? Why am I putting myself through this? Is it worth it? Is this as hard as it gets? These are just some of the whispers heard around vet school.

Image ©iStockphoto/pick-uppath

It’s often comforting in itself your classmates are feeling as fed up as you are, but you also need to find a way to combat your doubts and climb the wall, or punch right through it. Veterinary students are particularly susceptible to stress and mental health issues – we’ve all heard the statistics, which is why it’s vital to know how and where to access support should you need it.

The student-run welfare system at Glasgow’s veterinary school has boomed this year, with multiple welfare talks and the start up of many new clubs and societies aimed at stress relief, including relaxing yoga classes to help you reboot or a high-energy Muay Thai sessions to help you release all that pent-up stress. Following in the footsteps of Liverpool, Glasgow vet school is also currently developing a peer-support network to provide an ear for those students who need someone to turn to in times of need.

Of course, your own interests can distract you from the stress of vet school, and while it’s tempting to entirely prioritise your studies, it’s really important to ensure they don’t consume your entire life. For me personally, writing, editing and riding keep me afloat.

One lesson I’ve learned this term is you also need to keep on top of your own health. You may have a persisting issue that you keep putting off because you haven’t got time to see a doctor and have too much work to do. But it doesn’t pay off in the end. I allowed back muscle pain to get to the point of me being barely able to walk before shaking some sense into myself and seeing a physio. After a couple of sessions, I felt a million times better and regretted putting it off for so long. Just remember you need to look after your body to keep your mind on top form.

On the upside, by the time our “halfway ball” comes around in February, we’ll be over the hump, and just a little bit closer to graduation. Or in other words – a little bit closer to fulfilling our ambitions or dreams that many of us have had from a very young age. We just need to find a way to hold on to the light at the end of the tunnel, so we don’t run out of steam.

December 17, 2014
D-day

To the victor go the spoils…

It’s that time of year again, when vet students become more competitive than ever and inter-school rivalry (friendly and, for the most part, light-hearted) culminates in the biggest sporting event in the Scottish vet school’s calendar.

The renowned “Dick Day” – the annual event where Glasgow’s vet students take on those from the Royal (Dick) School of Veterinary Studies (AKA Edinburgh) – was held in Glasgow on November 19.

After recovering from the AVS (Association of Veterinary Students) Sports Weekend only ten days previously (where the only part of the body that got much exercise was the liver), Glasgow was pumped and ready to fight harder than ever for victory.

Totalling nine matches, Dick Day hosted more sports than ever before – and we weren’t sure whether the new additions were going to put us at a disadvantage or add to our strength.

After a stressful morning on my part (having organised the riding competition), the hard work paid off and the Glasgow vet riding team were again victorious.

The other scores started coming in fast, and we were drawing with Edinburgh, having lost ultimate frisbee, lacrosse and hockey, yet triumphing in riding, netball and men’s football. Netball in particular was a huge success, with this year’s match being the first time the Glasgow vets have won in years.

Glasgow fought to victory in both the men’s and women’s rugby.

With another victory in women’s football, we only had to win one rugby match to secure the title – and after a tense couple of hours, Glasgow fought to victory and won both men’s and women’s rugby.

Having finished on a score of winning six out of the nine sports, Glasgow claimed the Dick Day cup for the first time in more than 10 years!

Every team had trained harder than ever and thoroughly deserved the success. Spirits were high even before the games began, and every Glasgow vet was thrilled with the result. All those involved in organising the day put in a mammoth effort, which made the victory so much more rewarding.

I think all the students that took part or supported their schools will agree that it’s great to have that sense of community and teamwork within veterinary, even when doing something entirely non-vet related.

December 1, 2014
The view from the other side

Tom.

A recent weekend at home comprised a much-needed rest and time spent with my family – which, of course, includes the animals.

Tom, my moggie farm-born cat (who is far more scared of any potential prey than it would be of him, so doesn’t really live up to his farm origins), has an allergic skin condition that usually gets worse during the winter months. However, his most recent flare-up was worse than usual, so I took him to the practice I undertook EMS with over the summer and found myself on the other side of the consult table – as the client.

Having primarily taken him in for his skin, the vet prescribed a short course of corticosteriods to reduce the itching, as I had anticipated.

However, upon physical examination, it was discovered that Tom had lost weight and had a 3/5 heart murmur.

It wasn’t until the vet said she could possibly feel a thyroid nodule that the penny dropped – at home Tom continuously cries for food and has a constantly “on edge” demeanour (he’s practically scared of his own shadow).

This, along with him being an older cat (14 years old), makes for an almost textbook case of hyperthyroidism – so we decided to monitor his weight over the next couple of months and take T4 blood tests if he continues to show a loss.

I felt a bit guilty for not realising thyroid could be at play. However, Tom has always cried for food, so I’d never noticed a particular increase in that behaviour – nor had I realised he’d lost condition. Hopefully, this is not because I’m a poor excuse for a vet student, but because gradual changes can easily go unnoticed, which underlines the importance of recording figures for parameters such as weight.

It can be easy to become frustrated with clients who don’t notice these sorts of things, or omit information that could be vital but they might consider irrelevant. But, having now experienced this myself while understanding the position of both the vet and the client, I think I’ll be able to sympathise much more in the future.

November 17, 2014
Vet School’s Got Talent

When you apply to vet school, there are certain boxes you have to tick: achieve the right A-Levels (or Advanced Highers), complete a number of weeks of work experience, and pass that dreaded interview.

What nobody tells you, however, is that being a vet student requires a number of other skills that seemingly have nothing to do with the veterinary profession.

Star Baker

After completing a week of EMS at a vet practice, there is the unspoken expectation that you should produce some form of teeth-rotting goodness as a thank you. Your vets would probably appreciate a box of Celebrations, but they’re going to be far more impressed if you turn out to be harbouring secret Mary Berry-esque talents.

Not only that, many clubs and societies use baked goodies to lure in new members, and some vet schools even host an anatomy themed bake off, for which the more exceptional entries often leave us questioning whether their creators are in the right profession.

Salesperson Extraordinaire

Fundraising is a common theme at vet school, whether it’s for a charity event, to reduce the ticket price of halfway ball or for a veterinary society to hold a practical session.

Getting fellow students to part with their hard-earned cash can be more difficult than you’d expect, but persuasion is a great skill to develop, especially when you may find yourself moving on to trying to entice large pharmaceutical companies to sponsor a much bigger event.

Perseverance (or rather bugging people on Facebook and through emails) can really pay off.

Catwalk Designer

Jordan (far left) and the other Glasgow Gnomes prepare for the AVS sports weekend.

Vet students are notorious for their love of fancy dress. Perhaps the results aren’t quite what you’d expect to see on the cover of Vogue, but it is astonishing what we can whip up out of nothing in five minutes flat (or perhaps three hours that may have been better dedicated to studying).

Movie characters, gnomes, circus, thrift shop, “anything but clothes”… There hasn’t been a theme that has baffled us yet.

Rally Driver

We may not all be the next Sébastien Loeb or Lewis Hamilton, but driving is a pretty important skill. Granted, not every vet student holds a licence, but those that do find it a lot easier to get to the numerous EMS placements we have to fulfil during our time at vet school.

Many of us have other attributes from being sporty or musical, to being a fluent multi-linguist or technology whizz. These may stem from trying to boost our personal statements prior to applying for vet school or could just be personality traits.

However, if you don’t enter vet school as a “well-rounded” person, you’ll certainly come out as one.

October 30, 2014
It takes two to tango
Argentinian Tango dance duo German Cornejo and Gisela Galeassi. Image: Fuentes/Fernandez

Before the full force of third year hit, the first week back at vet school started with everyone catching up on tales from their summer holidays.

Before long, it was like we’d never left and the four months of freedom seemed to fade into a distant memory. However, one particular topic of holiday gossip that I have been dwelling on is extramural studies (EMS).

Everyone had undertaken some form of EMS over the summer, whether it was just a week or two, a solid two months, clinical, preclinical, large or small animal – there is a lot of room for variation in our placements, but I was still surprised to hear of how different some of my friends’ experiences had been, despite doing theoretically similar placements.

A number of us had embarked on our first clinical placements, and although we’re all at the same stage of our studies and therefore should be able to get involved during veterinary placements to a similar extent, the truth is somewhat different.

Just among my friends, there were experience levels at both ends of the scale, with some students having been simply told to observe consultations and others being allowed to scrub into surgical procedures.

This wide range of experiences can be attributed to many factors, including:
- the veterinary practice
- how well the vet knows the student (either from previous experience or length of placement)
- how well the staff have judged the student’s knowledge and ability based on stage of the veterinary course
- attitude and competency of the vet
- the individual student’s skills, experience and attitude
I was advised by a final year student last year to undertake the majority of my clinical EMS at one single practice if possible, because by getting to know the vets well (and vice versa), they’ll be able to judge your level of competency better and encourage you to get more involved. I can now begin to appreciate this advice more, having listened to the anecdotes from my friends.

The practical teaching we receive at vet school is just not enough to be able to adequately develop and refine essential clinical skills that will be needed everyday in general veterinary practice. The solution to this is EMS, and we are constantly being told that we, as students, need to take responsibility for our own learning and ensure that we get the most out of EMS by getting involved. And I whole-heartedly agree – we can’t be spoon-fed forever and need to be proactive in gaining the right type of experience.

However, you could be the most enthusiast student in the world and read up on cases every night, and yet still be very limited in what you are allowed to do. While getting the most out of a placement is up to us, it takes two to tango, and we need the vets’ support too in order to enable us to do this.

I know taking on students and teaching or letting them practice techniques can be time-consuming and inconvenient, but we need to gain experience somehow. At some point during their training, all vets would have had to see practice and learn in the same way, so is it not just a way of giving back to the profession?

I can also appreciate that some people are just not natural teachers (after all we’re training to work in a vet clinic, not a school), but a little bit of patience and some advice can go a whole lot further than just ignoring a student.

It may sometimes be inappropriate for a student to be asking questions or trying things out – in the consultation room in front of the client, for example – but these situations can be fine when approached the right way. I was lucky enough to stand in with vets that would always try and get me to see/hear/feel things. If they found something interesting in the consultation room, they’d always explain to the client that I was a student and ask if they minded me having a look. This seems far more reasonable to me than telling a student they are to observe only.

Another approach I experienced myself was the vet taking the animal to the surgery room to take blood samples and allowing me to perform my own clinical examination (having not actually been in the original consultation).

As mentioned previously, there can be many factors involved in getting a “good” clinical placement. It also depends how busy the surgery is – if there are four clients waiting to see the same vet, it’s understandable for the vet to whizz through them without having much time for questions or explanations (whenever this happened to me, the vet apologised for not explaining, even though she really didn’t need to!).

I have to agree there are advantages to going back to a veterinary practice you know. I did work experience for three years before university at the practice I did my EMS at this summer, and definitely felt welcomed as part of the team, which can be difficult at an entirely new practice.

Yes, it is our responsibility to find the balance between getting involved to gain experience and not interfering with consults, but we also need vets to help us a bit too. Undertaking EMS is the only way we will prepare ourselves for the future, and we’re extremely grateful for the vets that encourage and help us every step of the way (partly why most vet students are pretty good at baking). I think it’s just a case of finding the right practice for both you and the vets you’ll be learning from.
October 15, 2014
Ask the editor

Jordan and her fellow stewards “hard at work” at the 2014 BEVA Congress.

As a student steward at the British Equine Veterinary Association (BEVA) Congress, my responsibilities included helping set up the trade exhibition, handing out welcome packs at the registration desk and escorting speakers to the appropriate rooms. However, we were also able to sit in on lectures and act as the legs for the microphone whenever there were any questions.

The congress provided a great opportunity for networking and meeting other students from across both the UK and the world, as well as many veterinary professionals from every corner of the globe.

One of the lectures I sat in on was a Q&A session, “Ask the editor”, about publishing clinical research. A particularly sensitive topic was the process of peer reviewing research papers. The main point of discussion that interested me was the huge variation in quality of reviews depending on the reviewer, especially when veterinary schools were brought in to the argument.

As someone with no experience of research, the general impression I got was that one of the issues with peer reviewing is many reviewers are practising vets who – having done a veterinary degree rather than a research-based degree – are never taught specifically how to write a paper, and therefore aren’t taught how to review one either.

And then came the inevitable “well perhaps that should be introduced to the veterinary curriculum”.

In my opinion, absolutely not. The format of the veterinary degree is primarily geared towards producing vets. The majority of veterinary students will have chosen veterinary school because they wanted to be a vet, not because they wanted to learn how to review scientific papers.

BEVA 2014 was obviously a very sombre event.

Is the veterinary course not intensive and long enough without adding in extra skills that would be of limited use to the everyday clinician with no interest in research?

This also brings me back to the controversy surrounding the opening of new UK veterinary schools. One of the arguments countering the “too many graduates and not enough jobs“ point is a veterinary degree doesn’t necessarily lead to a career as a vet. Some graduates opt for other aspects of the profession, such as research.

I have to disagree – with extramural studies forming such a huge chunk of the course, it is certainly preparing students to be practising vets, not researchers. If you want to end up in research, do a bioveterinary science degree instead. That way, students aiming for a research career would get the scientific background knowledge of veterinary and research experience, without having to undertake hours in a veterinary clinic, learning practical skills they’ll never use.

I understand some students may want to practise as vets and yet still become involved in research. However, I believe masters’ courses are available, or the option of intercalation, which would allow them to gain some research experience.

I strongly believe not only the vast majority of veterinary students would resent a more research-based degree, but also it would produce less-competent clinicians as a result.

Research should be an option, but not a compulsory part of becoming a vet.

September 29, 2014
Only the best will do

“In an ideal world, welfare should always come before cost. The truth is that it often doesn’t” – Image ©iStockphoto.com/SimonJamesLBIPP

All too often the deciding factor in an animal’s veterinary treatment is cost.

It has to be a factor because there is no NHS for pets. But it is unfortunate that, when undertaking the care of an animal, many people underestimate this cost or even seem to give it no consideration at all – although this is a crying shame because, in an ideal world, welfare should always come before cost. The truth is that it often doesn’t.

Countless times on placements I’ve seen owners arrive in an expensive motor, or flash a handbag worth more than my own car, and yet grumble about the cost of treatment for their pet. However, I was pleasantly surprised by the total selflessness of one particular client I had the gratification of meeting recently.

From appearance (and sadly smell) this client evidently doesn’t have much in the way of spare cash, but comes into the practice frequently throughout the year to add what money is around to their account, ensuring they are always in credit.

This client owns numerous cats, every one of which is up to date with vaccinations, worming etc and receives any other veterinary attention as and when required, despite that none of them are insured.

Some people will do everything they can for their pets, whatever their own situation. Image ©iStockphoto.com/DLeonis.

During one consultation, the vet asked what food the cats all eat, to which the client answered “Sheba”.

As one of the premium brands on the market, this came as a surprise, but cemented the notion that this client really does put their animals before themselves and will provide nothing less than the very best for them.

It was so refreshing to meet someone who genuinely prioritises their pets over anything material in their life – and while this client is an extreme example of dedication to animals, there are other clients who will do all they can with the funds they have for their animals.

The unfortunate reality that so very few people have this mentality can often be disheartening and enraging, but it is the clients that really care and genuinely put their animals first that make the less grateful ones bearable.

September 2, 2014
Clinical EMS 101

Vet school doesn’t prepare you for making a complete idiot out of yourself.

At vet school, you learn some basic clinical skills and are taught how to conduct a general clinical examination to prepare you for EMS placements in veterinary surgeries. What they don’t prepare you for is making a complete idiot out of yourself.

Before my first clinical placement I told the vets I would be working with that I had only just finished second year and had no pharmacological knowledge as of yet, non-existent surgical experience and very little understanding of small animal medicine in general.

Luckily, all the vets in the practice were very good at judging the level of my understanding and seemed to find the right balance between patience and pushing me for answers.

Things seemed to be going OK. I’d successfully taken blood samples and started to make sense of abdominal palpation. However, applying clinical skills taught at vet school isn’t necessarily straightforward – cadavers have a distinct lack of weapons in the form of claws and teeth, but I was coping with that reasonably well and taking note of the vets’ advice on particular techniques.

This was until a few days in, when I found myself working with the head vet…

In the same morning, I managed to spray penicillin all over my face while trying to administer an injection, incorrectly insert an endotracheal tube despite being 99% sure it was OK, and cover myself in guinea-pig blood while clipping nails, leaving me to wear the stained tabard for the rest of the day.

To add insult to injury, I later misread the scales and recited the incorrect weight without thinking (it didn’t occur to me that there’s no way a fully grown border collie could weigh 10kg).

Isolated, these incidents might not seem like the end of the world, but when they all happen in the same day in front of the head vet and when one of the clients involved is your neighbour, you do feel like shouting “I am a vet student – honest”, despite feeling like a complete moron.

This was, however, followed by days of mini-triumph, such as inserting an IV catheter correctly for the first time or scaling and polishing a dog’s teeth myself.

The important thing to remember is that you are inexperienced, and you just have to accept there will be days when nothing seems to go your way, get past them and carry on with your head held high – even if it is covered in yellow spots of penicillin.

August 15, 2014
I blame the NHS
Original image ©iStockphoto.com/hidesy

A couple of articles have been brought to my attention this week regarding the public perception of vets versus the reality.

When somebody finds out that you want to be a vet or are studying veterinary medicine, there are a few arduous questions that usually follow:
- “Is it seven years at university for that?”
- “It’s hard to get into isn’t it?”
And, of course:
- “Well, vets earn loads of money don’t they?”
Unfortunately, only one of those three assumptions is true. However, those detached from the veterinary world still uphold the perception that vets are rich and set high prices to rip off the unsuspecting public. What these people don’t understand is that a new veterinary graduate can expect to start on a salary of around £20k while working all living hours of the day, plus being on call.

While each individual job varies, the reality is that we can expect to earn very little considering the length of intense training required and the high levels of stress and responsibility that come with the job.

With experience and promotion to more superior roles – such as becoming a partner in a practice – the salary will increase, but often to less than half the average wage of a GP doctor. In general, vets accept this and are highly dedicated to the health of the animal they work with. If they were after a high salary, they’d be better off in a different career field entirely.

But the public can’t be entirely blamed for their own ignorance – I think a lot of the problem lies with the National Health Service…

“There is no NHS for pets, and I think many people would do well to remember this.”

We are blessed with a “free” health service in the UK, but this means those of us outwith the field of human medicine have very little understanding of how much treatments, operations or drugs cost.

Perhaps if people knew how much these things would cost if they had to fund them privately, they’d have a greater appreciation of both the NHS itself and the veterinary care they pay for for their animals. After all, there is no NHS for pets, and I think many people would do well to remember this.

My American friends tell me that clients in the US do seem to have a more grounded understanding of the cost of healthcare and are able to apply this to veterinary care without quite so much complaining.

It’s also worth noting that the money people spend on their animals’ treatments does not go directly into the pocket of the surgeon, but contributes to the cost of anything required for the procedure, including medication, electricity, needles and syringes, catheters, x-ray plates, bedding, food, anaesthetic, licensing… this list goes on – and somewhere at the bottom of that list sit the wages of the hardworking and dedicated vet, who often only receives a grumbling about the expense in “thanks”.

On a recent EMS placement at a small animal veterinary surgery, I witnessed a lot of this grumbling, and sometimes even full blown arguments about cost. Luckily it’s the few clients that are truly grateful and would do anything for their animals that make it all worth it.

I find it highly offensive and disrespectful when I hear remarks that vets are “only in it for the money” because, if that were true, then we are not as intelligent as our education might suggest.
July 30, 2014
How far is too far?

Noel Fitzpatrick runs one of the most advanced veterinary practices in the UK.

In my interview for Glasgow vet school, I was asked the question “how far is too far?”, and recent episodes of The Supervet on TV had me musing on the topic again, particularly as I had used The Bionic Vet as an example in my answer.

At the time I discussed kidney transplants in cats in the US and, in the UK, the inspiring work and pioneering techniques being carried out at Fitzpatrick Referrals.

Arguably the most famous patient of Noel Fitzpatrick’s is Oscar the cat who, after having both back paws cut off by a combine harvester, had prosthetic legs specially engineered and fitted (see video below). Oscar’s surgery was the first of its kind, and a huge step for orthopaedic veterinary medicine worldwide.

While this type of surgery was a world first in cats, prosthetic limbs are not an alien concept in human medicine – and, at a time when the emphasis on “One Health” becomes stronger every day, why shouldn’t routine or even rare human procedures extend their applications to our domestic species too?

But at what point do we say that medical advances are not ethically suitable for animals? A person may have a reasonable quality of life in a wheelchair, but that doesn’t mean a dog with wheels for back legs would. Such a “cart” would dramatically effect the quality of life of cats like Oscar, but his new legs have given him the freedom to continue to “be a cat”.

Each individual case is different, and the benefits and risks of undertaking a new, advanced technique would have to be weighed up accordingly. I don’t believe the point at which we draw the line on “going too far” is set in stone – every case is unique.

Kidney transplants in humans are life saving, and yet not seen in the UK in cats. A cat with kidney failure would gain a lot from a transplant, providing the risk of rejection was reduced to minimal. The ethical issue here lies with the health and welfare of the donor cat and the fact the donor can’t consent to its healthy organ being taken.

Answering the question “how far is too far?”, Stephen King’s classic 1989 film Pet Sematary is available to buy from www.amazon.co.uk

In the US, donors are often cats from rescue shelters and the recipient cat not only gains a new organ, but also an adopted friend who will come to live with them after the surgery. I think this is an excellent compromise on the consent dilemma – both cats get a second chance at life.

But it is not just the ethical question of whether we should perform such surgeries on our pets, we also have to consider the practical aspects of these procedures (i.e whether we could carry them out if we decided it was ethically acceptable).

There will be a limited number of vets with sufficient surgical experience to attempt such innovations, especially if a certain type of procedure has never been attempted in a particular species yet (such as Oscar’s legs). Financial constraints are also extremely relevant – owners that would love to give their animals the chance to receive such surgery if needed may be limited by the cost that comes with them.

Personally, I think the work of the surgeons at Fitzpatrick Referrals is exceptional and a real inspiration to vets across the country. I would love to see the day that treatment options for our animals routinely match those available in human medicine, and really hope the work of Noel and his team encourages those interested in such developments to continue and further research in order to make it a possibility – within ethical limits, of course.

July 15, 2014