What I Wish I Learned In Veterinary School

Veterinary school is an interesting institution.  Veterinary colleges are tasked with teaching veterinary students the foundations of animal nutrition, physiology, infectious disease, pathology, epidemiology, parasitology, medicine and surgery.  In the first 2 years of veterinary school, this is primarily done in the classroom.  The second 2 years are spent in the teaching hospital rotating through the various specialty departments in clinical training called clinical rotations.

Sound good, right?  Yes and no.  The kinds of cases that we encounter in the teaching hospital are cases that we indeed benefit from experiencing, working through them with seasoned specialty clinicians, participating in rounds, etc.  However, most of the cases we see are referrals from general veterinarians making much of what we see beyond the diagnostic, facility, equipment, or specialty expertise scope of general practice.  It is important to recognize these diseases, injuries or conditions?  Yes.  Is it important to be able to stabilize these types of cases in preparation to refer them out to the appropriate facility?  Yes.  Will we realistically be managing these types of cases in general practice?  Mostly no.

Below is brief list some of the most common conditions I encounter in veterinary practice as a general veterinarian (the ones with a * are EXTREMELY common):

• Upper respiratory infection*
• Urinary tract infections*
• Bladder crystals and stones
• Gastrointestinal foreign body ingestion obstructions
• Diarrhea*
• Vomiting*
• Ear infections*
• Pancreatitis*
• Skin allergies*** (triple star for this one as this is THE most common)
• Arthritis*
• Back injuries*

Of course I see a broader scope of cases than this and over the years have increased my body of experience and post doctoral training where I am managing more diverse and complex cases, but during my veterinary school clinical training, I saw very little of these more common and mundane types of cases.  Case in point, one would think that dermatology rotation would have been invaluable to clinical practice with the amount of skin allergies I have to treat on a daily basis.  One would be quite wrong.  While I did manage some allergy cases with my supervising board certified veterinary dermatologist, I saw more exotic autoimmune disease cases like pemphigus vulgaris and vogt karogi harada like syndrome.  In 16 years of practice, I have seen one case of the former and none of the latter.  On the other hand, I lost count of my skin allergy cases in my first week of practice, ringworm and ear infections in my first month!

To make matters worse, with little guidance from anyone to advise me otherwise, in the 6 weeks of off block that the veterinary college (I did my clinical training at University of Illinois) allows clinical students to work in outside accredited veterinary hospitals and practices (called externships), rather than gain practical “real world” experience in general practices, I went for the prestige and resume padding choices of high end referral hospitals: Animal Medical Center in NYC, Oradell Animal Hospital in NJ for rotations in orthopedic and soft tissue surgery, and medical oncology.

What I should have done in hindsight was find a few high quality general practices and gained valuable experience to better prepare me to hit the ground running right after graduation.  Instead, I found myself taking in one of my first cases, an ear hematoma, and having to ask my boss how I fix it.  An ear hematoma results from a dog flapping and scratching its itchy ears (usually because of allergy) and the skin of the ear flap separates off the underling cartilage and fills with fluid.  I see at least one of these per week, yet never experience one in veterinary school except in a textbook.

To be sure, I now see a number of veterinary colleges implementing “community practice” departments and rotations where veterinary clinical students work along side general veterinarians to manage more routine and common general practice cases from yearly well visits with parasite screening and vaccines to kennel cough.  Still, my understanding is that the cases in these rotations remain rather limited since most people are not thinking about taking their pet to a university teaching hospital for general veteirnary care and yearly well visits,

The remedy?  (pay attention aspiring and current veterinary students!) The students that intend to enter the work force immediately upon graduation as a general veterinarian is best served using off block rotations to work high quality (I would suggest practices accredited by the American Animal Hospital Association) to gain practical experience to augment their veterinary education.

A perfect example is soon to be Dr. Amanda Johnston, a young lady who worked in my veterinary practice as a technician for a few years as she finished her prerequisite pre-veterinary undergraduate courses to apply to veterinary school.  She attended Ross University School of Veterinary Medicine and is currently finishing up her clinical training at Texas A & M College of Veterinary Medicine teaching hospital.  For her off block, she chose to work as a veterinarian trainee in my American Animal Hospital Association accredited practice seeing real world medical and surgery cases.  Not only did she gain valuable general practice experience, she got as job out of it, as we hired her and she is set to start shortly after her graduation.  Double bonus!

My veterinary podcast co-host, Dr. Karen Louis, and I did an episode on this where we delve even further into what we wished we learned in veterinary school and what was utterly useless.  It turned out to be a very funny therapeutic venting session for both of us.  Take a listen if you get a chance.

Dr. Roger Welton is a practicing veterinarian and highly regarded media personality through a number of topics and platforms.  In addition to being passionate about integrative veterinary medicine for which he is a nationally renowned expert, Dr. Welton was also an accomplished college lacrosse player and remains to this day very involved in the sport.  He is president of Maybeck Animal Hospital , runs the successful veterinary/animal health  blogs Web-DVM and Dr. Roger’s Holistic Veterinary Care, and fulfills his passion for lacrosse through his lacrosse and sport blog, The Creator’s Game.