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What makes a good vet?

Vets aren’t superheroes… or are they?
Original image ©iStock.com/VasjaKoman

As a student on placement, I’m often in awe of the vets I’m working with. The ability to take a history, examine an animal, run through differentials and come up with a diagnosis or action plan within 10 minutes – all while listening to an owner commenting on the weather or traffic – seems superhuman.

This may seem an exaggeration (after all, vets aren’t superheroes), but when considered like that, it is pretty impressive.

While seemingly intangible at the moment, I know the ability to do this with such ease comes with practice – and clearly some presentations are far more complex than that.

However, while I find this impressive, others have a different opinion…

A family friend recently commented on their own vets, claiming they would avoid seeing the partners if possible because – in their opinion – they see an animal for five minutes and see it as a money making exercise, whereas the younger vets spend a bit more time with the clients.

Obviously I can’t comment on the vet/client rapport, which may have a huge influence on this opinion, but I can’t help but think that a younger, newly qualified vet would spend more time during consultations purely due to experience, or lack thereof.

It has become evident recently that the profession has an image problem and we must try to change that for the better. But what do the public consider as a “good vet”? Apparently the opinion differs depending which side of the table you’re on.

This is just one example, but in general, do clients want the vet to spend more time with their animal? They probably do – but, at the same time, they don’t want to be kept waiting and they want to be able to get an appointment. There has to be a balance between the three.

As for cost, I’ve seen some vets charge meticulously, whereas others would try and keep prices as low as possible to please customers. In the clients’ eyes, the cheaper the better. But a vet practice has to function. It’s no good offering neutering for £10 because the practice would be bankrupt within a week.

“The most highly qualified and experienced surgeon in the practice might not be the best at client communication,” claims Jordan.

Surgical skills and experience are perhaps something that the client will never fully appreciate. For a start, the vet seen in the consultation room may not be the same one who performed the operation, particularly if it’s something fairly routine. Also, the most highly qualified and experienced surgeon in the practice might not be the best at client communication.

A vet can have such a diverse set of skills and knowledge that it is difficult to pinpoint which of these defines a “good vet”. Many vets have certain areas of expertise and will be better than others in certain situations, but not all.

The key to time and money is striking the balance between what the client desires and what is realistic.

Communication, however, doesn’t need to be compromised and can be the difference that alters the client’s opinion. For example, the manner in which an examination is conducted and the attitude of the vet during a 10-minute consult could leave the client feeling rushed, whereas a different vet with a different approach could leave the client with a far more positive impression.

Client opinion is important, but at the end of the day, the welfare of the animal in front of you is your priority, whether or not the client values you highly.

While the profession as a whole should take heed of what clients want, the customer is not necessarily always right, and at the end of the day, it is the welfare of the animal in front of you that should be paramount.

January 15, 2015
Helping the hounds of the homeless
Image ©iStock.com/artefy

The homeless come with a certain stigma – particularly those with pets at their side.

Should we be concerned for the welfare of those animals, whose owners cannot afford to feed themselves so surely cannot adequately care for a companion?

Of course we should.

However, instead of claiming these pets should be removed from their owners, Ruby Shorrock (a fourth year vet student at the University of Glasgow) took a different approach.

Being homeless can be extremely isolating and lonely. For some of these people, their dog is their only companion, and can often be the only thing keeping them going. A dog can also provide a connection to home, and so the reluctance to give them up is understandable.

Despite this, many shelters refuse to accommodate dogs and so the help available can become increasingly restricted for homeless dog owners.

In light of this, Ruby founded Trusty Paws, a non-profit organisation that hosts free clinics and provides preventative care for hounds belonging to the homeless. The clinics involve a free health check (a clinical examination performed by veterinary students, supervised by a qualified vet), microchipping, flea and worming treatment and vaccinations. Dog food packages and other supplies such as leads and dog coats are also given out at the clinics.

Trusty Paws: a vaccination clinic for dogs belonging to the homeless, run by fourth year vet students at the University of Glasgow.

There have been three Trusty Paws clinics in Glasgow so far, with several grateful clients being able to benefit from the supplies donated and the services provided by the students. Everyone involved is delighted with how the clinics have been received.

Plans for 2015 include registering as a formal charity and organising public fundraisers. The Trusty Paws team also intends to tackle the problem of local shelters and hostels not allowing dogs.

Trusty Paws relies entirely on donations and sponsorship and the response to requests for both has been exceptional. The concept has really taken off and looks to gain popularity and success in the future.

The work of Trusty Paws is a fantastic way of not only actively ensuring quality care for homeless pets, but also raising awareness within the community to tackle public perception. If these misconceptions can be eliminated, others will be willing to accept that pets are a huge part of the lives of homeless people too and, perhaps, be encouraged to help the situation instead of avoiding eye contact with that person sitting in a doorway on a rainy evening.
- For more information, or to donate, visit the Trusty Paws Facebook page or follow @Trusty_Paws on Twitter.
December 30, 2014
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
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
Neuro-exams can be very helpful

Prolapsed gland of the third eyelid, or cherry eye as it is sometimes known. Image by Joel Mills (CC BY-SA 3.0) via Wikipedia.

A nice six-year-old Labrador with a history of possible trauma, complete forelimb muscle atrophy and proprioceptive deficits was brought to see me.

Radial paralysis was high up on the list of differentials, but the poor chap had not shown any response to conservative management.

I noticed it had mild anisocoria, slight ptosis and third eyelid prolapse, indicating the less obvious Horner’s syndrome. A bell rang in my mind of a case I recalled seeing as a student – it revealed itself to be indicative of a brachial plexus injury/tumour.

Sadly, an MRI scan at Davies Veterinary Specialists confirmed the presence of a tumour.

Very sad.

July 28, 2014