Overseas Adventures

You might have noticed a lack of posts in May and June, and attributed it to the fact that I tend not to post for large periods of time. That actually wasn't the case, and in my defense, I never forget to post, I just get too busy or too tired. This time, I was overseas doing some externships at clinics in the northeastern US.

The first clinic I was at is a small animal general practice, so you'd think it would be pretty similar to my other weeks at local small animal practices. It wasn't.

I don't know how common this is in the states since I haven't been to as many practices there, but this place was doing high-end medicine. They don't just have digital xrays and ultrasound, they have chemotherapy, phsyical therapy (including a water treadmill), nutrition specialists, behaviour experts, endoscopy, and more. They do complex surgeries, not quite up to the level of a referral surgery service, but do perform many procedures that other practices would refer. The vets there are all extremely knowledgable. The practice also places a lot of emphasis on client communication and building client relationships, so they had lots of tips to share with me in the "soft skills" department as well. They even called up the Humane Society and had them send over a bunch of speys and neuters for me and my classmate! Our university doesn't even do that.

The other clinic I visited was a specialist clinic. They had multiple internal medicine specialists and boarded surgeons, as well as a regular oncologist, cardiologist, and a few other bits and bobs. That was a step away from the world of general practice, and delving into "What life is like as a specialist." I decided I probably don't want to be a specialist, but they do see some seriously cool stuff. The most memorable was a pair of 20-something-year-old Capuchin monkies that are trained to help blind people (and they do a LOT of neat things for them). It was interesting seeing the different personality types in the different specialties, and to go more in depth in the cases.

It's hard to form a post for a six week period. I did so many things its hard to remember them all, let alone pick some to write about. It was a mix of busy days and sightseeing. I reinforced a ton of my pharmacology and medicine, and got to do quite a few routine surgeries. One thing I noticed (I'm not sure if this is a regional difference, or just luck of the draw with cases), was the large number of pets on the same anti-anxiety meds as people, like Prozac and Xanax. There are different diseases and disease prevalences there, which was an interesting challenge. New Zealand doesn't have rabies, heartworms, ticks, or tick-borne diseases, which are all important in the US and part of standard medicine (eg annual vaccinations and testing). Also, the drugs they have are different, which is tough to remember sometimes.

The best thing about getting away and doing some externships was regaining joy and enthusiasm for veterinary medicine. Hospitals are run very differently to private practices, especially university hospitals. At school, we students are used as free labour for a lot of menial tasks that take away from our time and energy to focus on the medicine itself, things like doing redundant paperwork for the computer system or nursing care for all of our patients (which would be fine if I were at vet nursing school). The clinicians are so used to students, we're just "another one" to them, and they probably get tired of the same mistakes over and over. We have skills books that they need to sign, and we have to chase them down the halls on Friday afternoons before they'll finally, grudgingly give up a signature.

At a private clinic that doesn't see many students, they cared a lot more about my individual learning. They had the approach of, "What can we get you to do? What skills do you need signed off? Let's see if we can organise something for you." My spare time consisted of reading and discussing cases, instead of picking up poop and ice-packing surgical wounds. The biggest difference was that the vets treated me and my classmate like colleagues, rather than students. They asked our opinions on things and never talked down to us. It was a positive, collaborative atmosphere, and the things I did were a lot closer to "real" veterinary medicine than my rosters at uni. It was a great boost halfway through the year, because I'd been beginning to doubt my interest or commitment to the profession. Now I believe that's simply due to the warped perspective we get from spending all our time in a teaching hospital.

I feel like I'm not giving my trip decent justice, boiling down six weeks into those two paragraphs! I suppose most of the interesting stuff was case-related, which would involve getting more technical than the blog is intended to be, so I'll leave it at that.