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Category: Student blogs

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
Two years as a vet student

In November, Glasgow descended on Liverpool as zombies for an alcohol-fuelled weekend of “sport”.

Having endured the wait for results, I can officially say I’ve passed my second year at vet school, and reflect on another crazy twelve months of life as a Glasgow vet student.

A vet is a unique type of student – despite having a crammed uni timetable we all manage to fill our “spare” time with a mountain of other activities. Not only that, but the close-knit circle of vet students at each individual school and the wider community across the schools in the UK and Ireland is something that is particularly characteristic to vet students.

In November, Glasgow descended on Liverpool as zombies for an alcohol-fuelled weekend of “sport”. Shortly after, however, the Glasgow vet sports teams focused their attention on the far more serious matter of “Dick Day”, the sports day against Edinburgh.

January brought my first experience of Association of Veterinary Students’ Congress, which was a great weekend of helpful practicals and talks. Here, the AVS elections opened, in which I was running for the editor position of JAVS (the vet student magazine).

Jordan gets her hands dirty during IVSA SpringBreak.

In March, I jumped on a plane to Germany to undertake foaling EMS at a thoroughbred stud yard, which was incredible and well worth the travel. Along with having an enthusiastic vet and yard manager (who were both keen for me to learn) I was also given the opportunity to return in the summer for yearling preparation.

After a year of meetings, emails and phone calls, the group of friends that had formed the Rodeo Committee finally pulled off a fantastic charity event for the public, despite battling the typical Scottish weather. It was a marathon effort for everyone involved, but worth it to see families having fun on the day, and succeeding in raising £16,000 for our chosen animal charities.

During the Rodeo aftermath, our exams hit, and the entire vet school population turned into library hermits. But after two weeks of red bull, little sleep and aching writing hands, we were free.

Shortly after, I ventured abroad once again, this time to Naples, Italy, as part of an IVSA (International Veterinary Student Association) trip. In addition to the interesting and unusual practicals and lectures, I met a variety of vet students from various countries and learned far more about veterinary in different cultures.

Having competed with the university riding team all year, I then found myself at the BUCS (British University and College Sport) Riding Championships with my teammates.

After three days of dressage and style jumping, our team was placed second in our league – a fantastic result for our club!

It’s been a busy year, and although exam results may suggest it’s now over, my summer has other ideas.

June 30, 2014
IVSA SpringBreak in Naples

Jordan “attempts” pregnancy diagnosis in buffalo

A friend who had attended an International Veterinary Students’ Association trip told me I should definitely attend any of its future events if I had the opportunity. Hence, when an email arrived about the IVSA SpringBreak in Naples, I applied immediately.

In all honesty, by the time I received an email confirming I had a place, I’d forgotten about applying entirely and began to reconsider.

Luckily my “what’s the worst that can happen” and “I have an overdraft if it gets costly” attitude got the better of me, and shortly after my professional exams finished in May, I found myself on a plane to Naples at some ungodly hour of the morning.

After the total of 24 vet students from all over the world (Poland, Taiwan, Israel, Nigeria, Algeria, Grenada, USA, Greece, Ireland and Scotland) had arrived, our Italian hosts held a welcome party in our honour at their university’s veterinary faculty. Despite Naples living up to its dodgy reputation within hours (one of our group got mugged after the party), we were soon thrown headlong into a packed week of vet activities and sightseeing and began to enjoy ourselves.

Over the course of the week, we had a few activities relating to the buffalo that are milked in Italy to produce mozzarella. In addition to sampling fresh mozzarella, we were shown around a buffalo farm and dairy parlour, were able to (attempt to) pregnancy diagnose some buffalo ourselves, dissected pregnant uteri and performed a postmortem on calves.

Standardbreds are a breed of horse best known for their ability to race in harness at a trot or pace instead of under saddle at a gallop – Wikipedia

The racecourse at which we had equine activities held some flat races on turf, but its main use was for harness racing of Standardbred trotters – not a common occurrence at home, but very popular in Italy. We took part in lameness assessment of Standardbreds, were shown the procedure for pre-race documentation checking and doping testing, and watched an endoscopy of a horse with suspected laryngeal problems. We did also, of course, get to watch a few harness races, which were quite the novelty.

An important aspect of the veterinary course in Naples involves the role of the vet at the fish market. For us, this meant waking up at 3am (thankfully supported by beautiful Italian espresso) in order to witness the process from fish arriving from the boats to being sent off to other markets, and the ways in which the vet ensures quality and maintains health and safety standards throughout.

Among all the exciting vet stuff, we managed to squeeze in a little sightseeing, including the breathtaking Cemetery of Fontanelle and the Pompeii ruins, after navigating (and getting in a complete mess with) the Italian public transport system.

After an impressive send off in the form of another party in the veterinary faculty, it was quite sad to say goodbye to some of the friends we’d made in a short space of time and, of course, to our fantastic Italian hosts – however, having being at least two hours late for most activities all week (after all, the Italian way is to not rush), I was relieved to be safely seated on my plane home.

IVSA SpringBreak in Naples: 24 international veterinary students and their Italian hosts

Aside from the experience I gained from the structured activities, I learned even more from the different types of people I encountered and their tales of how veterinary differs in their respective countries, which I think can be even more important than the specific veterinary knowledge acquired.

Sharing experiences with people from different backgrounds and cultures can be truly eye opening, and never ceases to amaze me.

June 16, 2014
Could I have a pet at university?

Missing her cats, Jordan ponders the feasibility of owning a pet while at university.

I’ve always had cats at home, and they often played the role of revision buddy/lap warmer. That was one of the things I missed most when I first went to university.

Pets aren’t allowed in student halls, but now that I live in a flat with other vet students, pet ownership becomes a possibility (landlord permitting).

As a student, I meticulously budget in order to ensure I eat well, am able to enjoy myself and get some travelling in without blowing all of my cash the first week that student loan comes in. But even with this amount of planning, could I find some spare to pay to feed a cat as well as myself? Probably. Could I find the money if something went wrong, if said cat needed lifetime insulin or thyroxine treatment or broke a limb in a road traffic accident? Probably not.

Pet insurance would extinguish the worry surrounding the “what ifs”, and I do know other students with pets that are insured. Even then, premiums that cover long-term conditions come at a fair price, and I wouldn’t want to find myself in a financial position forcing me to cancel insurance and risk my pet requiring costly treatment.

Money is not the only commitment that you make to a pet though. The other major consideration is time – although this is more of a concern with dogs, which require a greater time commitment than cats.

I often feel that owning a dog would be excellent stress relief, but as idillic as dog walking seems, could I commit several hours a day, every day, including around exam time?

Even if I could commit the time while I’m around, I know that I don’t stay permanently in one place. For the majority of the time I’m in Glasgow, but during the holidays I’m at home (Leicestershire), on EMS or travelling. Who would look after the pet then? Since I live with vets, they have similarly busy lifestyles and it would be unfair to expect them to pet-sit while I’m away.

And what would happen when I graduate? I don’t know where I’ll be living, where my first job might take me, or whether it will be feasible to take a pet along for the ride.

An alternative to pet owning is fostering. The Glasgow branch of Cats Protection has recently advertised their fostering service to vet students at Glasgow. The fostering scheme encourages taking on a cat, with bedding, litter and food provided. They will provide all veterinary care and will even take back the cats if you go on holiday.

I think fostering is a great way of caring for cats without a lot of the concerns outlined above, and perhaps the only option I’d consider while at university with regards to pets. As much as I’d love to own a pet in Glasgow, I think it would be unfair on the animal if I could not offer the money and time to give it a great quality if life.

It’s unfortunate that many people do not undertake greater consideration when deciding to own a pet. Perhaps many of the day-to-day ethical issues faced in practice could be avoided if they did.

May 30, 2014
Examining for the real world

A little last minute cramming? Image ©iStockphoto.com/Stock Shop Photography LLC

It’s that dreaded time of year again: end of year professional exams.

Having already completed our OSCEs (practical clinical exams), we now have the written exams to “look forward to”. Stress levels at vet school are sky high at the moment, and while my immediate concern is also the fast approaching exams, I have a more long-term concern playing on my mind: how reflective are the exams of our veterinary knowledge, really?

Some people can do exams and some just can’t handle the pressure. I am definitely the sort of person that can cram for an exam and then forget the majority of what I’ve learned as soon as I walk out of the exam room – I think this stems from riding and having to learn four show jumping courses a day, then immediately erasing the route of the first from memory so as to not mix it up with the next.

Don’t get me wrong, I’m not a complete last minute crammer – I have been working towards these exams for the best part of the last six weeks and hope I won’t forget everything immediately, but I know I can’t remember every detail from first year now. So how am I possibly going to retain everything I will need to know as a practising vet?

I have some small animal clinical EMS lined up this summer, and the staff at the practice are well aware that I’m only just finishing second year, so they won’t be expecting me to have expert knowledge on every drug in their cabinet or be a masterful surgeon. However, if I’m shown an radiograph of a limb, from first year anatomy, I should know what I’m looking at… but will I?

I suppose this reinforces the critical importance of EMS in supplementing our knowledge and allowing us to apply it in a practical situation. I can certainly appreciate the retention value of things I’ve seen or done on placements already – even from before vet school.

My first work experience placement at a vets was with a farm practice when I was 15. I remember being very cold while spending three hours pregnancy diagnosing dairy cows in February. But I also remember the three methods of correcting a left displaced abomasum that I saw that week and the unforgettable diagnostic “ping” heard through the stethoscope.

One of our practical exams last week involved the clinical examination of rumen function in the cow, and required that same diagnostic test. At this level, we were given healthy cows, and many of my friends were unaware of what exactly they were listening for. But I’m certain that even now, six years later, if I heard that ping, I’d know what it was.

Perhaps this just means that personally, I’m a practical learner – but being a vet will be a practical job, and the truth is, you can’t learn everything out of a book… and you can’t test long term retention by sitting a written exam.

The real test of whether I’ve remembered first year knowledge will be when vets start quizzing me in context.

May 16, 2014