Still Bitter About This

Subjective evaluations can be a blessing or a curse. If you're personable and a good student, it's easy to win clinicians over, except for the staunch few who have very high standards--sometimes impossibly high. My feedback throughout final year was a rollercoaster of anxiety as I waited to find out how I did on each roster. The way it worked was that after the roster was over, a clinician or a committee would grade each student and post it to an online system. Your grades were generally 1-5 in a series of categories, including knowledge, professional conduct, and practical skills, accompanied by a comments box.

For the most part, my grades aren't worth talking about. I did well in some, average in others. I worked hard and sometimes it paid off and sometimes it didn't. But a year later, there's still one evaluation that I remember keenly. And it's not so much because I did poorly, but rather that concept that so often makes barbs stick in your memory: injustice.

You see, this was a clinic I had chosen to go visit, for an elective week. It was a small animal clinic right in town. I'd spent a week shadowing them in third year, and at the end of it, they'd welcomed me to come back in final year. So I did. I probably shouldn't have.

Firstly, it's not the greatest clinic. The facility was dark, cramped, and dreary, and the medical practices were... average. Anaesthetic monitoring was subpar, in-patient cages were lined only with newspaper, there were practically no in-house lab options. But hey, this is the point of clinical rotations: see what's done well and what isn't done well. The issues arose, I think, because I was bored out of my freaking mind.

Even though this clinic has a student almost every week of the year, they don't seem well adjusted to having students. There was literally nothing for me to do, ever, and there was also no place for me to sit or stand that wasn't in the way. I can understand that some clinics aren't comfortable allowing students to participate in procedures (even though every other place I spent time with was happy for a final year student to get as hands-on as possible), and I can understand that they don't exist with the aim of mentoring me and making my life better. But, really, when there's a slow schedule, and all I've been doing is standing next to a wall for hours, you can't expect me to not try to make better use of my time. Thing is, in fifth year, we had an absolutely obscene number of assignments, and if I wasn't learning anything, I honestly couldn't afford to stand around.

One really annoying thing was that they had no internet. Not just no wireless, there was no internet on the computers at all, except for the practice owner's office. If you wanted to look up a drug or a disease, forget it. This added to the whole "dark ages" feel of the place. Fortunately, I had a few things I could work on without internet, so during slow periods when there were no consults or surgeries, I opened a separate window on one of the computers and got to work. No one ever said anything to me, but in my evaluation after the fact, they wrote that at one point, I started working when the billing on that computer hadn't been finished. Mind you, I only sat down when there was no one around and nothing going on. Did anyone ever ask me to move, or to use the computer briefly? No. But they got irritated enough by my presence to complain and have it put down in my evaluation.

The other comment that really stands out in my memory is that apparently I was asking questions at inappropriate times. They said it was good of me to show enthusiasm, but I really needed to be more appropriate about when and where I asked questions. I've wondered and wondered, and I still have no idea what triggered that comment. I do always ask questions, and I asked plenty there, because--like I mentioned--I had nothing else to do and no one was engaging me in anything. So I'd chat with the surgeons during surgery, and I'd ask case-related questions between consults. Where was the transgression? Did they feel I was holding them up between consults? Again, no one ever said anything to me.

What really makes getting a bad grade on that rotation hurt is how polite they were to my face. They welcomed me to come back to their clinic, knowing who I was and what I was like, and they let me wander around trying to find things to do to keep busy without comment. They said kind things to me and wished me well, and then graded me lower than almost any other rotation of final year.

It doesn't matter in the slightest, because I got an A in clinics, good references, and a good job. I know that particular clinic is a miserable work environment with poor medical practices, and having students around must have been too much extra stress for them. But you know what? I'm still bitter about those comments.

The Nightmare That Was Boards

After the harrowing experience that was final finals, I had the pleasure of sitting the licensing exam. NAVLE, it's called: the North American Veterinary Licensing Exam. As if three weeks of written and oral exams weren't enough, I had to study for another two weeks, make the six hour drive to Auckland, and then take the most difficult and frustrating test of my life. Unfortunately, the reason it was so awful had a lot more to do with the climate control than the material.

I took the test in December, which means hot, humid, muggy weather in Auckland. We stayed in a cheapish-but-central hotel, in a room the size of a closet, with no fan, no air conditioning, and no internet. The only thing to do in that room was lay on the bed with all the windows open and try not to stick to everything, because outside was just as muggy and breeze-less as inside. There was a tiny tv with six channels, and then me with my stack of notes that I'd read over a hundred times in the past month.

Okay, so miserable hotel, whatever. I've traveled, I can deal. But what really got me was the testing centre. I'm surprised I made it out alive.

The instructions were to show up half an hour early, so we could get all registered and set up. The elevators were weird and broken, so I had to go to the floor below and take the stairs up, then wander around to find a registry desk--which was dark and empty. One by one several of my classmates arrived, and we all stood around awkwardly, waiting for someone to show up. There was a dark, empty, locked room labeled as the testing centre, and literally no other soul in sight. The half hour elapsed, and then another.

Eventually someone did show up, and then we were taken into another room, sat down, and told to wait some more. One by one, we were called up to give ID, get scanned for cell phones or devices, and handed official scratch paper for notes. The actual testing chamber was a row of eight computers divided into cubicles, each with a set of ancient, uncomfortable, noise-blocking headphones. And no climate control.

In the crisp wee hours of the morning, all went well. I worked my way through the old-fashioned UI and got to test-taking. It's a multiple choice exam with six modules of 60 or so questions. They are timed so you have an hour for each module, but no specific timing on individual questions. There were a whole lot of details to this process, but it's all a blur in my memory--which is wont to happen when you take a seven hour exam in a room like an oven. I realise my math doesn't add up right... I think the extra time comes from the hour or so of allotted break time. You can take your breaks whenever and however you want, between modules. So like, if you start a module, you're stuck until you finish it, but if you want a 10 minute break after each one, you can, or you can power through half and take a long lunch, etc etc.

As time wore on, with eight people in this cramped, sound-proofed room (read: oven), my physical and mental state deteriorated. Even though I took as many breaks as I could, as soon as I got back in the room, I started getting lightheaded and having a hard time concentrating. I was so sure I would faint. I had to start taking breaks specifically to go to the bathroom and lay wet toilet paper over my forehead and neck. Oh yeah, the bathrooms were on another level, had a security code on them, and no paper towels. And the cold water was lukewarm.

The material on the test was irritating, too. I knew going into it that there would be a certain percent of questions where I had no clue, had never heard of the disease/diagnostic test before, and would have to guess at random. I didn't expect all the other annoying questions. For instance, at least 50% of the small animal questions were on cat respiratory disease. There was supposed to be a large section of pig questions, and only a rare deer question, but instead, there were no pig questions and lots of deer questions (guess what I studied). And the most annoying of all were the questions that asked what step would you take next, and then list 5 tests or procedures that are absolutely appropriate for that clinical situation, and I had to try and hazard which really-important-helpful-thing they wanted me to do arbitrarily first.

I was the first one out of there. I've always been a fast test-taker, but after a point I was just like, "I need to get out of here before I pass out." I believe I started at 9am and finished at 3:30pm, so 6.5 hours total. On my evaluation form, I wrote angry comments about the climate control. My husband traveled with me, and I found out he, too, had laid around dying of heat and humidity, with the original intention of exploring the city.

We went out to eat at the rotating restaurant on top of Auckland's Sky Tower, and he'd put the reservation under my name as "Dr" and we had wine and lamb and dessert. Then we went to the ice bar and stayed there a good long while.

Funny Quotes From Boards Practice Questions And Lectures

Toxic plants have a tendency to show up inside animals’ stomachs and therefore, toxic plants also have a tendency to show up on veterinary board exams.

The contents of the cecum are dry and cheesy (much like board review study material)

Ok, admittedly this is a tough question, but we do not want to make them too easy.

"Ok ladies and gents, it is time to beat to DEATH the cranial. cruciate. ligament. rupture. All right this lecture might go a little longer than others, but it's going to be worth it, it's going to be glorious."*
 
"So at this point you're probably on the verge of tears, and you no longer want to ever think about neurology again, and you're probably considering a career as a baker."

Suture material can be very exciting if you let it be.

"In this PowerLecture we are going to KILL patellar luxations." 

Remember: with hypothyroidism dogs become fat, lazy, heat seeking missiles of skin disease.
 
"Okay everyone, let's conquer pelvic fractures once and for all." 

UV light is not thought to play a significant role in development of these tumors as they tend to occur in the area where the sun does not shine.

Sorry, it's a human health question, but it is a potential biochemical warfare agent and the public expects veterinarians like you to know this.  

Of note, all Clostridia are categorized as gram positive organisms with the exception of Clostridium piliforme, which is gram negative (yes, Microbiology is confusing). 

Cryptococcus is also not a contagious disease (do NOT confuse this with cryptosporidium, which is very contagious and zoonotic as several of my colleagues can attest to profusely). 

This is the perfect random question. The fun fact to remember is that Cornish rex, British short hair, and Devon rex cats are predisposed to having Type B blood type. 

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*In  case you are wondering, the ones I put quotations around are verbal quotes from recorded lectures, while the others are copy-pasted from the answer pages of multiple choice questions.

To All The Unsung Blog Posts - Part 1

I had many interesting ideas for posts that never got written. Here's a slew of the most interesting snippets that never made it to the light.

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- At a small animal clinic, during one exam there was this very cute little kid who was really into learning about everything that was going on. The vet had a kiddie stethoscope to give him, and he spent the rest of the exam listening to everything--the dog, his parents, himself, the table. The first time he put it on, he put it in his ears backwards, and after being corrected, was very concerned about getting it right every time after that. He kept interrupting to ask "Is it on right?" before listening to another inanimate object.

- One of my classmates fostered a paralysed dachshund that came through the hospital. The dog had a little mini wheelchair, and hung out with us in the student lounge. She was very friendly and would wheel around and get stuck on things.

- While on emergency rotation, a dog came in critically ill. I spent several hours with the team, participating in a small part of monitoring while they performed lots of dramatic procedures. At one point, I got sent to run down the hall to the lab, to see if we had results back on clotting times. They weren't back, and in the 5 minutes I was gone, the dog died.

- We toured a deer farm and a pig farm, which were really cool, but don't make for interesting stories. Though one of the techniques at the pig farm to tell if the feed mixer is doing a good job, is to drop in a bunch of sprinkles and look at their distribution in the final product.

- To prepare us for dealing with clients, we had to break into groups with an actor assigned to each group. We had several scenarios, and had to practice things like delivering bad news or dealing with an angry client. Some of the actors were apparently quite difficult! All of this was recorded so we could study it later. My group was a bunch of pansies and nobody would volunteer, so I ended up going twice.

- On our public health roster, we took tours of several meatworks--beef, lamb, and poultry facilities. While much of my class hated this, I actually found it fascinating. Everything was so clean and orderly. Plus we got to walk through the chiller, where the stripped carcasses hang on slow conveyor belts like we were in a horror movie.

- I'm not sure I ever talked about our naked calendar, one of the fundraisers for Halfway Day. I'm not sure what I did with the photos from my group, but you can check out the current Barely There calendar website for general photos, and maybe even support the current third years! Updated every year by the new class.

I Finished Vet School Today

At 3:30pm, I walked out of my final exam of vet school, and left the small animal hospital for the last time (because I handed in my access card immediately afterwards)!

Here's what I said on facebook:

 THAT'S IT LAST EXAM VET SCHOOL DONE.

Vet school has become such a state of being it's hard to imagine actually being finished. No more lectures, treatments, missing lunch and dinner at the small animal hospital, falling asleep in rounds, running back and forth between radiology/surgery/ICU, getting cold and wet in a paddock, trying to make sense of the insides of a cow, pretending to know something about horses, hesitantly checking ESS feedback, endless hours at the large animal teaching unit, dressing up for all the costume parties, writing presentations practically every week, ten thousand assignments, walking 3-legged dogs in circles, yelling at Cornerstone while trying to do paperwork, struggling to get red book signatures, cluelessly palpating muddy sheep, oral exams, and a hundred other things.

I can actually sleep and have meals and hobbies for a change. No more sitting around studying every night, or feeling guilty about not studying every night (for a few days at least...) Phew, I can't believe it's actually over!

Now that I have time, I promise to update the blog and fill you in on exams and rosters and everything exciting that's been happening. I may sneakily add posts into the "past" so they fit chronologically. I have so many notes and experiences to catalogue!

It's been a full MONTH of studying for me, and it's not over yet. I still have to hardcore study for the next two weeks, then drive to Auckland for the seven hour computer based North American Licensing Exam. But then at long last I can breathe a sigh of relief, visit the South Island, and fly home and see my dogs and family!

And, let's not forget the most important part:

After five years, I am now a veterinarian.

Psychological Effects of the Small Animal Hospital

Hand touches faucet when washing hands - Crap, have to start over!

Barking dogs - What noise?

Strange ticking noise following me around all day - Oh right, I wear a watch now.

7:30am start - Wow, what a nice sleep-in.

End of the day - How many spots of dog drool got on my pants today? I don't have enough black pants if I can't wear this one again tomorrow.

Any repetetive motion such as grating cheese - Started counting by accident

Can't remember how to give directions - Go to the uh... the more distal part of the road...

Cell phone or tablet vibrates - I'm getting paged!

Dinner time - I have lettuce in the fridge. I guess I'll have lettuce for dinner. (Credit to my friend for that one).

Weekend - I have all this extra time today. Don't I have hobbies for days like this? I can't remember what they are.

Eating finger food - I washed my hands a thousand times today so no need to worry about contracting something.

Unusual animal comes into hospital - I want a pet parrot.

Introducing someone - Amber is a 23 year old female entire vet student with a history of lethargy and exercise intolerance.

Faced with life problem such as computer dying - Time to form a problem list and differential diagnoses.

This Is What We're Reduced To

"Is there anything in your sandwich besides cheese?"
"Oh, no."
"So it's a slice of cheese and bread?"
"I was too tired to go shopping, so I just used what I had left."

-The small animal hospital strikes again.

Phew, He's Breathing / Classic Vet Student Moment

A very sick little blue penguin was brought to the hospital. It wasn't doing well, so it went straight into what's basically the ICU "tank" in the wildlife ward, a clear incubator/oxygen cage thingy.

When I came back from lunch, the poor guy looked awfully still. I watched him for a moment, then had a mini panic attack when I couldn't see him breathing.

Deeply concerned, I peered into the tank and watched him for a good minute. Uh oh, did he stop breathing? Do we need to start CPR? Then, much to my relief, I thought I saw some chest movement. Phew! He's breathing.

The clinician came out of the ward a moment later and said, "The little blue penguin died while you were at lunch, by the way."

Second Years Move In Slow Motion

This week I'm at one of the local practices in town. I think it's Easter break for people who have normal semesters (I had the option to have time off, but needed to schedule a week here). Apparently, as part of the new curriculum, the fledgling vet students start doing some clinic practical work in second year, where the school makes arrangements for them to spend two weeks with a private practice somewhere.

Instead of spending time with the vets, they actually shadow the vet nurses, learning things like IV catheters, bandages, monitoring and recovery from anaesthesia, and just what clinics are like and where things are. I think it's a fantastic idea. However, I'm totally not envious of them, because while I get to stand in on consults and surgery, they have to putter around the back, cleaning.

Interestingly, the second years are super slow. I know students are always slow, but it's fascinating to watch their brains go. For instance, they get asked to draw up a drug. It's one of the first times in their lives they've ever done that. What would take me somewhere between 10-30 seconds, and would take a vet nurse like 2-5 seconds, for them takes 2-3 minutes. I'll see one with a bottle, syringe, and needle one minute, turn away, and when I turn back the needle's made it onto the syringe and she's putting it in the bottle. Go do something else again, and when I look back, the drug is about 1/3 drawn up. Then 2/3. Then finally finished! Now... where does the bottle go?

Since they have so little clinical experience, they don't have the hang of where to look for things, or even what sort of cupboards and drawers there usually are. For me, I need to waste time poking around for the needles & syringe drawer on the Monday at a new clinic, but then I know where to go. For them, it's a mission to find anything, every single time.

They also stand around doe-eyed and lost-looking occasionally. The most fun part is that they'll look to me with questions, which makes me feel all knowledgeable and stuff. Unfortunately, since I've never been at this clinic before, I have no idea how things are done, either.

Snooze You Loose

Student: *Half falling asleep on desk* *Big yawn*

Prof: Warm afternoon on a sunny day, eh?

Student: Sorry! Post-prandial coma.

Prof: I fell asleep during my own tutorial once. A student was answering a question, and it must have been the soporific effect of her voice or something, put me right to sleep.

It's Actually A Walk-In Freezer

The air conditioning for the computer lab in the hospital is a source of some contention. The occasional person gets too hot and turns it on, and that transforms the room into an arctic survival training scenario. Even if you turn it back off, it inevitably gets turned back on again when you aren't looking.

One of the biggest culprits for the arctic warfare is a Canadian student. Someone printed out a Canadian flag and posted it above the rheostat, with text that reads: Welcome to Canada, where the temperature is always sub-optimal.

It Matches Her Coat

Today I turned someone's dog orange.

Fortunately, it was a classmate, not a client, and it was during an ophthalmology practical lab. Which, by the way, no one told us we had until the ophthalmologist actually walked through the door into the hospital and we're like, "Uhhh, I guess we do have a prac this afternoon." It was finally confirmed that it was supposed to take place at 1pm (confirmed at 1pm), and as we all rush to arrive--including a number of students off on lunch--we suddenly realised we also had no idea where the prac was. Also it was very inconveniently timed and I had to miss my only consult for the day, rendering my day rather useless.

Anyway, back to the point--orangeness. Amongst other things, we were given a bunch of fluorescein dye to put in the dogs' eyes. It sticks to ulcers, glows under UV light, and just drains out through the tear ducts and into the nose. Usually you squirt it into the eye with a syringe or dropper or something, but for some reason we had a bazillion little strips with dye-coated tips. I used one of those. Why not?

There were only three dogs. One had some eye pathology so was constantly surrounded by a cloud of students and had lights shined into both eyes for pretty much the entire duration of the lab. One was teeny tiny and at that moment also being examined by others. So I selected the remaining dog, my classmate's, considering people were just sitting by her, talking. I should mention that this dog has white fur.

I went ahead and stuck the strip in like normal, but the dog squinted her eye shut around it really tightly, to the point that the eyelid rolled inward. After about 10 seconds, it became clear that orange was seeping out around her eye. I removed the strip and she opened the eye. She suddenly had a giant spot all around her eye, bright orange. It seemed to be an inordinately large spot considering the procedure, and it was contrasted nicely by the sheer whiteness of the fur around it.

To be fair, I did get the fluorescein into her eye. I don't think she has an ulcer.

(To add insult to injury, no one was paying much attention to the fluorescein strips, and I'm pretty sure some of my classmates thought something had gone horribly wrong with the syringe/dropper method.)

Said in Surgery Rounds

Surgeon: What's a "cherry eye"?
Me: The gland of the third eyelid is prolapsed.
Surgeon: No. What's the gland called?
Students: Nictitating gland?
Surgeon: Yes. And what's wrong with it?
...
Surgeon: It's PROLAPSED


Surgeon: What's a type I open fracture mean? What does the fracture do?
Student: Do?
Surgeon: Where does the bone go?
Student: Uh...?
Surgeon: From the inside to the outside!
Student: How else would the bone go?!


Surgeon: What's the third type of plate?
Students: It makes a bridge.
Surgeon: Yes but what's it called?
Students: A... bridge plate?
*Surgeon starts drawing*
Surgeon: Picture Notre Dam. These things off to the side that support it.
*Draws big arches*
Students: Arches? Scaffold?
*Surgeon writes B _ _ _ _ _ _ _*
Students: Bridge! Bulwark! A! E! O!
*Head shaking*
Students: U!
*Writes B U _ _ _ _ S S*
Students: Buttress!


Surgeon: What type of screws would you use?
Student: Small ones.

You Didn't Need To Use These, Right?

In a skillful display of coordination and foresight, someone decided that the best time to change over all the computers in the hospital would be starting in the morning on a Wednesday, in the middle of the Small Animal Hospital Core roster.

During the late morning, someone from reception comes in to tell us it's scheduled for that day, and if it's okay for them to tell IT to come and do it now. Everyone shrugs and nods, thinking we'd have a bit of time to finish up what we were doing and disperse. However, there must have been some sort of time-space distortion because the computer guy showed up literally a minute later. I'm pretty sure computer guys as a rule never show up one minute after they are asked to come down.

We got kicked out. During the day, I wandered back to see how it was going. First, everything was logged out as  the guy got to them one computer at a time. The next time, all the screens were black and covered in white text, updating or something. Then, they were all frozen at the login, with the keyboard and mouse not working (every computer was like this). Finally, we could log in and get to a desktop, but there was no internet browser or hospital database.

We use the computer constantly. We need the hospital database to look up patient histories, type in updates and reports, make up prescriptions, and a thousand other things. There are a total of five groups of four people (you do one of five different things each week with your roster group), and now only six computers in the hospital that are for student use, plus two more if the nurses aren't busy.

It just so happens that it was a slow day for my roster, which means the only thing to do is work on assignments. On the computer.

Fortunately, there are other computer labs around. There's the computer lab in equine, and when we went down there all the computers were gone. There's the anatomy museum upstairs, which is locked with a key code. The undergrad office gave me the wrong code, plus the thing is finicky about how you type it in, so getting in turned into something of an ordeal. When we finally made it through the door, we were faced with the same black screen and white text as the hospital computer lab! Finally we went to the Farm Services building next door, where the computer lab smelled like cow poo.

Just Another Day in Class

This week, we have a block of lectures. It's a full day of back-to-back lectures and very tiring.

A person in the front row today pulled out a chopping board, a knife, a tomato, and a wheel of cheese. She quite casually got to slicing and making up crackers. In the middle of lecture.

Another interesting thing that happened was a catered lunch. Goodness it was delicious. Coincidentally, we received our "fifth year packs" today, which mainly include paperwork, but we also got our stamps. Yes, our stamps!

Your Name
BVSc

People were pretty enthused about this. As in, stamped blank pages, stamped each other, stamped the free food. Everyone had stamps on their hands and arms. I'm not kidding about stamping the food: I found an apple slice with someone's name stamped on it.

Retrospection on Fledgling Doctor Me

In second year, we had a class called Mechanisms of Disease.

I have only just now, after reviewing this post, noticed I actually made a post on that class before. I just forgot to delete it from my notes so I wrote another one, but what I talked about there was totally different anyway.

It was explained as a way of getting our feet wet with clinical thinking. Even though we had no knowledge of diseases, pathology, or treatment, we were given weekly cases, a lab relevant to the case, and sort of guided through it. It didn't work super well, because every case was presented by a different clinician--some were really helpful, others had completely forgotten what it is like to know absolutely nothing about medicine.

We were divided up into groups, and every group was assigned one case. You didn't have any knowledge of what it would be about until the week of, and then you put together a presentation on the diagnosis for the Friday. They were big groups so this totally sucked. Some people had ten thousand words on their slides, some people repeated what other people said, the formatting was completely crazy on the powerpoints, and there was no coherence to what anyone was trying to say. Then of course when it is your turn, it is absolutely impossible to get 10-ish people to do their research and pool it together into a reasonable form by the end of the week. In our case, the professor in charge of us did a really unhelpful intro lecture, and to guide us in our presentation he told each person to pick what most interested us about the topic and talk about that. That is a good idea, but it results in a less-than-comprehensive discussion of the disease or diagnostic process, and a lot of inane details. Overall, I think the student presentations deserved an A for effort but were useless for learning.

In retrospect, we learned way more in that class than I thought we did at the time, and it was mostly because of the labs. That class was basically mini-medicine class. For instance, that class was the first time we ever read an ECG or looked at a urine dipstick. Now, in fourth year, our level of learning is that we would be expected to diagnose and work up the same sort of cases all by ourselves from start to finish--so it's interesting to think back and compare my mindset. We were so clueless back then!

I remember the first case reasonably well. It was a dog with hair loss, pot belly, and drinking and urinating excessively. The professor asked us what disease this was most likely to be and I had no clue. There was the one person who timidly asked, "Cushing's?" and the rest of us are wondering what Cushing's even is. If someone asked our class that now, it would be too easy. It's like the free points question.

More importantly, back then we especially had no clue on what to do to figure anything out. So I didn't know the specific disease name, but I also got stuck there. What do you even do? I guess bloods--doctors always take bloods for stuff. For the longest time, "bloods" was such a vague, I-know-we-should-do-this-but-not-why answer (then... enter the mysterious world of clin path).

Throughout third year, we had a class called Clinical Studies, and it was the next step up. We didn't have cases or anything like that, but it was essentially almost-medicine class. That's where we started learning things like how to do a physical exam. They hammered in clinical thinking techniques. Along with pathology, we were getting an idea of what diseases are out there, but I'd say we were still completely useless at medicine in general. What is the first thing you do? Take a history! Perfect. Problem is, there's no "Take A History" button, you have to actually think of the questions that you want answers to. Similar to "take bloods", the "take a history" response is more of a reflex than anything else.

Now we kind of sort of know medicine. The process to get from there to here was something like putting thousands of pages into a blender, opening up your brain, and pouring it in. It is coming out of our ears and we have a lot more to go!

Vet School Requires Costumes

Naturally, to keep ourselves from going insane, vet students like to party. Some more than others, but in general we get so little opportunity to let loose that the events we do have are a little ridiculous.

I don't know what it's like for other people, but we have an enormous amount of costume parties. The Happy Hours always have a theme, and some people go really all-out in the costumes. I mentioned the mentor-mentee happy hour already, where everyone comes in pairs as famous duos. Usually, they have a broader theme.

There are the classics like...
- Cowboys and Indians
- Ninjas and Pirates
- Traffic Lights

I guess normal people know this, but apparently for the traffic light one (I don't recall if that's what it's called), you don't actually dress up as traffic lights. You wear green if you're single, orange if you're "it's complicated," and red if you're in a relationship.

There are the fun but not unusual ones like...
- Black Light
- Around the World
- Harry Potter vs Lord of the Rings
- Jungle Fever

Then there are the silly ones like...
- Dream Job if I Wasn't a Vet

Where everyone wore their overalls or their lab coats and came up with something to fit. I guess most of us are a "mechanic" at heart.

Mentor-Mentee - My Turn!

Last year, as third years, it was our turn to be mentors to the incoming first years. I was pretty keen--my mentor was absolutely useless and never talked to me after the original mentor-mentee happy hour. I was going to hang out and be friends with a first year, and tell them all about vet school, and give them lots of notes and tips and resources.

I was Rudolph and my mentee was Santa.

Here's me. I did have a red nose, but I had long since given up trying to keep it on. My favourite part of this costume is not shown - I made a super cute fluffy deer tail out of ribbon and sewed it on the back. The necklace of bells and the antlers each took a really long time, even though I don't look like I spent any time on it.

I found my mentee and bought her a drink, as is the custom. I talked to her a bit, but she seemed like she would rather be left to talk to her friends so I did. I talked to heaps of the first years while I was there, which was really fun. It was their first week and they had no idea what they were getting into, and so many of them were shy.

I realised that we, as third years, knew everyone in our class. We could look at any person and know instantly if they were first or third year. The first years, on the other hand, hardly even knew each other. I think that's why they tended to cluster in little friend groups--they only knew a handful of familiar faces, and didn't know who else was in their class! After all, that's what it was like for us when we were first years.

Since then, my mentee contacted me a few times, and we are facebook friends. I gave her some files on a flash drive, in a very secretive exchange of moving the flash drive around between our mailboxes. We seem like pretty different people, though, so we never hung out.

What, you aren't a qualified surgeon?

In third year, we had a class called Clinical Studies, which was a hodgepodge of stuff that's important as a real-world vet, like how to do clinical exams, anaesthesia, and imaging. A large section of the course was dedicated to "introductory" surgery, like the basic principles of tissue handling. That was the aim, but the surgeons live in their own little surgery universe, and in order to pass the exam, you basically had to be a surgeon already.

Our class had to come together in a collaborative effort to answer the questions from past exams, even with all of our books and notes at hand. We made a massive google document full of every colour imaginable, with highlighted answers and multi-coloured discussions and arguments about which one was correct. Lots of spots have something in red or caps, asking "Can someone explain this??" Here's the top of the page when you open it:

I would just like to say good work everyone on all the question answering I think we can all say these questions are worded terribly and information is very inconsistent but GOOD LUCK FOR TOMORROW :) This will not be a very pleasant experience ...i resent this test and the people that prepared it

Here are a few examples of our attempts to answer the questions in the study guide (SG):

18. C because it SHOULDN’T be designed to enhance traffic flow through clean areas? (agreed) (p70 of SG confirms this)

19. A apparently can someone explain this? :)

Disinfectants are used to sanitize surfaces / Antiseptics are used to cleanse wounds / Autoclaves are used to sterilize instruments. Hope this helps

20. B

21. C (Isn’t this B...? The image is the same as the one in the lec slides) Yep pretty sure its B

22. C

23. C

24. G/D (lettering is not ideal on this question!) not sure bout this either, thoughts peeps. I agree theres a table on page 1062 of fossum that says it is.

                               

FROM FOSSUM - Allogeneic cancellous bone grafts provide limited mechanical support and are osteoconductive, but not osteoinductive because the matrix is mineralized.  Therefore, answer is NOT G/D. where is this? because according to the table cancellous allografts are osteoinductive..

Thus is the answer E????????    I thought none of the grafts were good at osteogenesis. If the graft was rendered inert it would have no more protein therefore cannot be osteogenic unless a protein source was added

yeah i think its E (the last option...E2).. the questions is asking for which one is true..

But it gets worse.

j)  An advancement flap in the shape of a U is created, in order to not compromise its vascularity, the ratio of the length to the width should not be greater than:

                                   

i)  1to1.        ??       

ii)  1.5 to 1.               

iii)  2to1.        ??       

iv)  3to1.               

v)  4to1                        

ok so been trying to find this one... and found a few recent articles/studies saying that ratio isn’t even a factor …. “Therefore, the traditional concept of a width-to-length ratio does not dictate flap survival, rather perfusion pressure does.”    

anyways it carries on to say “ Classically, advancement flaps have a length-to-width ratio of 1:1 or 2:1” WHICH STILL DOESN’T HELP US!

The questions are ridiculously pedantic. Look at these. Seriously, the fuck?? WHY WOULD ANYONE KNOW THIS? Let alone in introductory surgery in third year, when you've barely even begun learning anything past anatomy, genetics, and microbiology.

When using Chlorhexidine solution (stock strength = 4%) to lavage a wound what is the maximum concentration that should be used?

                           

(a)  1 part in 10 of saline.                            

(b)  1 part in 20 of saline. p.27 has lavage concentration should be .05 = 1/20)??   

(c)  1 part in 30 of saline                            

(d)  1 part in 40 of saline.     Fossum says 1:40                       

(e)  1 part in 50 of saline. ← I thought it was 1ml to 80ml but....

       

you want to get Chlorhexidine down to 0.05% soln thus need to dilute it down 20 times

e.g. 10ml chlorhexidine diluted by 200ml saline = 0.05%

10/200 = 0.05%  actually idk    (I agree with B since that’s what the SG says.. eg 1/20=0.05)

You have to remember you are starting with a 4% solution......  So, you can’t just do 1/20.....  Besides 1/20 gives 5% not 0.05%

there was a something on the internet that had it as 1 part in 40 but I can’t find the link anymore..some textbook on google books...

ughhh me gad!

2. The maximum level of bacterial contamination required for successful wound closure in surgical wounds is generally considered to be:

a. 104 / g of tissue

b. 105 / g of tissue

c. 107 / g of tissue

d. 109 / g of tissue

Plus there's the questions like this one, about fistulas. We never talked about fistulas. Not once. I had no idea what a fistula was before I saw this question, let alone had any clue how to answer something about surgical management of one. Plus you'll notice this question goes from cow teats to foaling injuries. You may be beginning to see why vet school is so stressful.

18. Which of the following is a correct statement about a fistula?

(a) When closing a teat fistula in a cow the most important layer to make leak

proof is the mucosa.

(b) When closing a teat fistula in a cow the most important layer to make leak

proof is the skin.

(c) When closing a teat fistula in a cow preserving the epithelial tract will

accelerate healing. ← maybe this one but i really have no idea

(d) When repairing a foaling injury that has resulted in a rectovaginal fistula in

a mare a complete closure of the vaginal mucosa is more important than

the rectal mucosa. i know rectovaginal tears are not usually closed right away to allow for swelling to go down, but I think the vaginal mucosa is the most important thing to worry about (to reduce further infection from the rectum)...

(e) In time most fistulas will close as wound contraction is completed. 

Our whole document was 28 pages long. It was full of misery and stress and colour. Here's the best part, however:

Five minutes before the exam was about to start, as we were sitting at our computers ready to open the program, one of the high-up vet school coordinators appears. He only tends to appear to yell at us, so I immediately knew something was wrong.

It turns out that the surgeon had put the test online ahead of time over the weekend, because he was going to a concert or something. A few people in the class noticed it and accessed it. For some reason, the school decided to wait until that moment in time to let us know about the security breach and change the test. They had to throw out the multiple-choice test and throw something together for us. We would meet in a lecture room in half an hour, and would be taking a written test instead.

People cried.

Halfway Day

After years of anticipation and fundraising, halfway day finally arrived. It takes place near the beginning of second semester, third year, and marks the exact halfway point of our degree.

In preparation, the third years host all the annual vet events (Mr. Vet, the Slave Auction, the Naked Calendar, the Vet vs Ag students debate, and numerous bake sales and other small fund raisers). The other classes always support the third years, in return for getting supported when their time comes.

I'm pretty sure what we did is basically what happens every year: bus trip to Taupo, fancy dinner, and three options for activities during the day. Those options are skydiving, river rafting, or chillaxing (groups went to the hot springs, or fishing on the lake). Skydiving was crazy popular, as you'd expect, however on account of the expense, if you wanted to do that you had to pay a bit extra. I decided not to go skydiving, because you get your one jump and you're done. I chose the rafting, and it was amazing.

We got the day off of class (it was a Friday), and got up at the crack of dawn. After the two or three hour bus ride, with half of us asleep and the other half getting a head start on drinking, we were dropped off at the rafting facility. There was a large amount of chaos as we ate our packed lunches, changed into swimsuits, and queued up for our gear. That was kind of fun: we wove through this little area with staff at every station, rapidly sizing us up and stuffing something in our arms. Then there was the awkward squeezing into wetsuits and buckling up the jacket correctly, and redoing it all when you realise you put something on in the wrong order. Or when, ten minutes later, you suddenly have to pee.

Once we were all geared up, and had taken a sufficient assortment of photos of each other, it was time to grab the rafts and get going. The vans took us about ten minutes away to the river, we teamed up, got ourselves into the water, and then we were off.

The river guide said there were fifty rapids. I was expecting a wild ride, splashing around corners and what have you, but in reality it was actually quite relaxing. Well, I guess it was pretty exciting when we got stuck, and had to rock back and forth pretty vigorously to get ourselves un-stuck. And there was also a lot of passing and getting passed by other rafts, which always involved more than a little bit of splashing with paddles. 

But like I was saying, apart from a few speedy turns and the larger rapids, I would mainly describe it as serene. We had an absolutely perfect day, not a cloud in the sky, warm and sunny. The river cut through cliffs covered in ferns, so most of the time we were surrounded in lush greenery. Halfway through, all the rafts stopped, and they served us hot chocolate and marshmallow fish. Quiet, still, bright, green, ah it was beautiful.

Adding to the relaxed feel, our river guide had a very calm, pleasant voice:

"Okay forward paddle team, forward paddle. That's it team. Okay guys back paddle now. Back paddle."

After the last rapid, they stationed a photographer and shouted at us to pose. I'm in the back right, in front of the river guide. 

On top of everything, when they brought us back, they gave us complementary sausages, beer, and a few other munchies. Everyone was showered and relaxed, and overall the whole experience took up most of day, so personally I think it was the best value choice.

The rest of the evening, we hung out at our hostel, watched some of the Olympics, and got ready for our formal dinner. After night fall, we walked down to the lake, where three boats waited for us. Since there are about a hundred of us, and the boats were not really that big, we kind of crammed ourselves in there, but it was still pretty romantic. The line for the teeny tiny bar, however, must have taken up half the boat. Once we were in the middle of the lake, the town of Taupo nothing but lights on the shore, the boats lined up so we could move between them. Depending on what meal we had ordered (I believe the options were beef dish, chicken dish, and vegetarian dish), we found tables on our designated boats, and dined.

I had the vegetarian meal, and it was awesome. Most of the others weren't actually vegetarians (only 2 or 3), but just thought it would be the best meal, and I'm pretty sure they were right. We had lasagna, along with numerous sides, including scalloped potatoes (one of my favourites), and fresh, soft rolls. We were also the smallest boat, with the fewest diners, so it was reasonably quiet and intimate.

After we finished the meals, our class rep and a few others gave speeches, and they awarded silly prizes ("cutest couple" for instance, and recounting embarrassing moments). The rest of the night was music and dancing, standing out on the deck watching the lake, and sitting at the tables chatting. A vet faculty member is always voted to come on halfway day, and ours was really into it, totally dancing with us and joking around with everyone.

Once the boats got back, most people hit the town. Or more correctly, most people hit the hostel to get themselves ready, and then hit the town, which is a slight detail my friend and I did not realise. We followed some classmates to a nice bar, did some dancing, and noticed that there was a surprising lack of vet students around. So we got bored and left, and just hung out back at the hostel with a small number of people.

Overall it was a great experience, and every bit as fun as expected. The only downside is that we've been looking forward to it for so long, and now it's over. We're faced with long years of classes and studying, as many in front of us as behind, but harder than the first half. I guess the next thing to look forward to is... graduation!