Last week's rotation was oncology.
The oncology patient I saw with a senior student on Tuesday morning with a senior student was strongly suspected to have lymphangiosarcoma.
Lymphangiosarcoma is a super-rare malignant cancer derived from the endothelial cells that line the lymphatic vessels. The lymphatic system drains excess fluid from the tissues all around the body and helps that fluid get back into the blood vessel circulation where it belongs.
Of the 5 or so veterinary oncologists on the rotation with us students last week, only 1 of them had ever seen another case of lymphangiosarcoma -- and there are only 16 cases of it documented in the veterinary literature.
The patient, "Sunny," was a sweet, medium-sized, portly 6-year-old mutt. She came in from her owners' backyard a few weeks ago with what looked like an abrasion on her hind leg -- which was unusual, because it spanned most of the inner surface of the leg -- a strange place to have gotten a large abrasion without any other obvious trauma.
Over the next few days, the suspected abrasion developed a lot of bruising around it and appeared to spread -- not only on the inner surface of the leg, but up into the inguinal and caudal abdominal tissue as well.
Even though Sunny's regular vet put her on antibiotics for possible infection, her leg just continued to get worse. After a few more days, the vet decided Sunny had a bad case of vasculitis and referred her to the vet school.
Sunny presented to the VTH's Dermatology service a week before she ended up at Oncology. The clinicians in Derm that week agreed that Sunny probably had a very bad case of vasculitis and cellulitis that would just take awhile to resolve. But, they pointed out to Sunny's owners that they couldn't rule out a cancerous process just by the way things looked.
So the dermatologists offered Sunny's owners a biopsy to definitively diagnose the condition that was causing horrible swelling and oozing all up and down her hind leg. Fortunately, Sunny's mom and dad agreed to the procedure, because the biopsy results (taken from 4 different locations on Sunny's leg and inguinal region) showed "angiosarcoma."
"Angiosarcoma is a semi-broad term that can encompass 2 different types of cancer: (1) Hemangiosarcoma, a cancer of the cells that line the blood vessels, or (2) lymphangiosarcoma, cancer of the cells lining the lymphatic vessels. Because both types of vessels are lined by endothelial cells, it can sometimes be difficult to differentiate their origin when you look at a cancerous tissue sample microscopically.
Hemangiosarcoma (HSA) is much more common than lymphangiosarcoma. Actually, HSA is one of the more common types of cancer seen in dogs. However, HSA is usually found in the organs -- the spleen, liver, and heart. It less commonly appears in a skin or subcutaneous form, like what Sunny might have.
But after consulting with all of the experienced oncologists, and reviewing what little information is available in case reports and textbooks pertaining to lymphangiosarcoma, it was felt that that was more likely to be the cancer that poor Sunny was facing.
So what to do for Sunny? Unfortunately, not cure her illness. Her disease had an extremely rapid onset and progression of her disease (over just a couple weeks' time). The inability to differentiate neoplastic lymphatic vessel cells from neoplastic blood vessel cells on her biopsies indicated that the cancer was probably a very progressive form. If it weren't so aggressive, or had been treated within a couple days of appearing, perhaps Sunny could have been treated by amputating her affected leg and hoping the cancer hadn't spread locally or metastasized. But with biopsy samples confirming the spread of disease past her leg and onto her abdomen, amputation couldn't cure her.
This was a really sad case. Sunny's owners were not only faced with a dog who had at best 6 months to live even with the best medical treatment, but also had financial concerns about how they would be able to afford her treatment. Not including the money spent at their referring vet and in Dermatology for her workup and biopsy, they faced a $120 consult fee with Oncology, plus around $170 for thoracic radiographs to check for metastasis to the lungs and $300 for abdominal ultrasound to look for abdominal organ involvement.
One of the toughest things Sunny's mom and dad had to handle was the fact that, from a hygienic point of view, Sunny's quality of life wasn't great. Her affected leg was very swollen and constantly oozed a copious amount of reddish fluid -- to the point that Sunny's mom would apply compresses to her leg multiple times a day and drain out maybe a half cup of fluid, but the leg would fill back up again with the same amount of fluid within 10-15 minutes.
Because of her messy leg, poor Sunny was restricted to certain parts of the house -- the dining room with hard floors, a carpeted section of the house where her owners had laid down plastic sheeting, and the patio and backyard. Sunny wasn't happy being away from her owners, and they weren't happy being apart from her, and not being able to have her sleep in bed with them.
One of the sort of neat treatments that Sunny's owners opted to try with her was some palliative radiation treatment. Radiation therapy can be used in one of two ways: (1) with "curative intent," or (2) to make the animal more comfortable. Radiation can reduce pain and inflammation and also sometimes dries up the irradiated tissue, which the oncologists hoped would help with the constant oozing and dripping from Sunny's leg.
Other than that, there wasn't a whole lot that even my university's renowned animal oncology department could offer Sunny and her family. She was enrolled in a clinical trial for a new chemotherapy drug that she's scheduled to start this week, but nobody was too optimistic about that.
Sunny's case was tough to handle emotionally, but provided some good insight into the type of cases that the oncologists see every day -- or at least every week. They kept telling me that "not all cases are this sad!" but it sure seemed like I just got luck of the draw with the bad ones all week.
My case on Monday was an older miniature Schnauzer who came in because her owners were worried about 7 skin masses. We aspirated 6 of the masses which turned out to be lipomas (benign fatty tumors). The 7th came back as a nerve sheath tumor. However, on physical exam, the oncology resident detected some liver and spleen enlargement during her abdominal palpation. Little Schnauzer headed over to radiology for an ultrasound, and went to emergency surgery just a couple hours later to have her huge, cancerous spleen removed -- later diagnosed as a hemangiosarcoma. It was sort of funny (in a morbid way) that this little dog presented for skin masses, one of which turned out to be bad, but the thing that would have killed her (the splenic tumor) was something the owners and referring vet had no idea about.
My Wednesday case was a sweet little 13 year old terrier mix -- tan in color but shaped and sized like a largish Jack Russell. He showed up at his regular vet about 5 months previously for a mass on his hip. He went on antibiotics and the mass went away; he stopped antibiotics and after a few weeks the mass came back; he had more antibiotics and the mass shrunk but didn't disappear this time. Finally his rDVM did a fine needle aspirate to look at some of the cells from the mass microscopically. As the owner put it, "Dr. RDVM said he had no idea what the cells were and he said that meant we should go to the teaching hospital." Sadly, by the time the little terrier presented to us, he had multiple other masses and enlarged prostatic lymph nodes indicating that his disease had already spread beyond the point of much treatment. He's probably also headed for some palliative radiation, mostly to shrink his sublumbar lymph nodes enough to let him defecate comfortably for as long as possible. At the time I left the case, his mass was suspected to be histiocytic in origin.
After 3 depressing cases (hey, some dogs come in with a leg tumor, get it amputated, and they're all better!), I opted to spend all of Thursday morning hanging out with the radiation technicians in the radiation therapy department. I got to meet some cool patients who were having either intensity-modulated-radiation-therapy (usually treated 5 days a week for 3 or 4 weeks) or stereotactic-radiation-therapy (treated 3 days in a row, then that's it). I got to see the difference between the palliative therapy and the 'curative-intent' treatments. And I got to meet the dog with the huge skull tumor between his eyes who is affectionately referred to by the oncology staff as "our unicorn"!
Monday, February 21, 2011
Tuesday, February 15, 2011
All hail the end of Practice Management!
At long (LONG) last, Practice Management has reached its conclusion! Our last morning of lectures was last Friday.
I admit that I learned a couple useful things during our 80 hours of lectures and presentations. However, I'll add that just about every single morning made me feel even more strongly that I never want to own or manage a practice. Their theory on getting us all to be practice owners seems to be:
1. Tell them how far they are in debt and how terribly their meager little lives will be affected by the enormous loan payments that will be heaped upon them at graduation.
2. Show them fancy charts displaying how much more money you can make as a practice owner rather than just an associate veterinarian.
3. Gloss over most of the negative aspects of actually having to own and manage a business. Let's instead focus on things like where on your display shelves in your lobby is the best place to put your most popular items for sale!
I'll say that the most positive aspect of the course, at least for me, was the fact that all of the instructors and the course coordinator seem very receptive to feedback. We're told that Practice Management is the course in the curriculum that changes more rapidly than any other course, based mainly on student input about what they want to learn less or more of.
However, my feeling is that Practice Management should be offered as a 2-week elective course in the Junior Practicum -- i.e. would be blended into the same curriculum as our morning clinical rotations. One of the four weeks of this year's version of the course was a series of mandatory accreditation lectures by the state vets, that is required to get a state license to practice veterinary medicine. So everyone could take that during the first week of the semester, then they could trim the remaining 3 weeks of "actual" practice management topics to a more reasonable 2 weeks, and then stop forcing everyone to take it. After all, I don't want to be an equine vet or a food animal practitioner, and I'm not forced to take elective courses this semester on those topics if I don't want to. Why should it be any different if I just want to be an associate vet rather than a practice owner?
In any case, what's done is done, and I'm looking forward to the opportunity to participate in a focus group to give additional feedback about the course. For now, though I'm on Oncology!
(Yes, that's right: An actual clinical rotation where I am working with clinicians, residents, interns, senior students, real live patients, and real live clients! A rotation where I'm actually learning applicable things and getting to practice some hands-on skills! What a novel idea!)
Oncology is, however, a little depressing, what with the whole "oncology-means-the-study-of-cancer" thing. I've seen a couple neat patients already this week, and I'm sure some of them will be appearing in subsequent blog posts.
But I just can't tell you how great it is to be back on my feet and applying what I've spent 2.5 years sitting in lecture halls absorbing from a didactic standpoint. Hooray for clinics!
I admit that I learned a couple useful things during our 80 hours of lectures and presentations. However, I'll add that just about every single morning made me feel even more strongly that I never want to own or manage a practice. Their theory on getting us all to be practice owners seems to be:
1. Tell them how far they are in debt and how terribly their meager little lives will be affected by the enormous loan payments that will be heaped upon them at graduation.
2. Show them fancy charts displaying how much more money you can make as a practice owner rather than just an associate veterinarian.
3. Gloss over most of the negative aspects of actually having to own and manage a business. Let's instead focus on things like where on your display shelves in your lobby is the best place to put your most popular items for sale!
I'll say that the most positive aspect of the course, at least for me, was the fact that all of the instructors and the course coordinator seem very receptive to feedback. We're told that Practice Management is the course in the curriculum that changes more rapidly than any other course, based mainly on student input about what they want to learn less or more of.
However, my feeling is that Practice Management should be offered as a 2-week elective course in the Junior Practicum -- i.e. would be blended into the same curriculum as our morning clinical rotations. One of the four weeks of this year's version of the course was a series of mandatory accreditation lectures by the state vets, that is required to get a state license to practice veterinary medicine. So everyone could take that during the first week of the semester, then they could trim the remaining 3 weeks of "actual" practice management topics to a more reasonable 2 weeks, and then stop forcing everyone to take it. After all, I don't want to be an equine vet or a food animal practitioner, and I'm not forced to take elective courses this semester on those topics if I don't want to. Why should it be any different if I just want to be an associate vet rather than a practice owner?
In any case, what's done is done, and I'm looking forward to the opportunity to participate in a focus group to give additional feedback about the course. For now, though I'm on Oncology!
(Yes, that's right: An actual clinical rotation where I am working with clinicians, residents, interns, senior students, real live patients, and real live clients! A rotation where I'm actually learning applicable things and getting to practice some hands-on skills! What a novel idea!)
Oncology is, however, a little depressing, what with the whole "oncology-means-the-study-of-cancer" thing. I've seen a couple neat patients already this week, and I'm sure some of them will be appearing in subsequent blog posts.
But I just can't tell you how great it is to be back on my feet and applying what I've spent 2.5 years sitting in lecture halls absorbing from a didactic standpoint. Hooray for clinics!
Tuesday, February 1, 2011
Classes and life continue
This is only my second blog post of the semester because this semester has contained just barely enough information and activity to be worthy of a full two blog posts in two weeks.
Sigh.
Don't get me wrong -- my classes have improved over the last week or so. Practice Management is, at time, positively tolerable to attend. We've had better speakers recently, with more animation and enthusiasm, lectures that could actually qualify as organized, and several specific topics that are relevant even to the 75% of the students in my class who don't want to own or manage a practice someday.
I'm enjoying applied animal behavior. We had our 3rd day of lectures today. I respect the instructor and her ideas about dog (and cat) training. She keeps lectures light and entertaining by interspersing a fair number of YouTube videos (all related to the lecture material yet still almost invariably amusing) in between her PowerPoint slides. Unfortunately, I was so involved with the school's behavior club (for which she is the faculty advisor) last year, that I've basically already heard these lectures from her before.
Small Animal Medicine & Surgery is progressing decently. I really enjoyed the dentistry section we started with, which was followed by about a week of meandering, hilarious-yet-disorganized presentations by a gastroenterology faculty member who hasn't lectured to us much before. We've now moved on to liver disease taught by one of our best professors, which is a subject for which I could definitely use some review.
I've not yet managed to convince myself to sit through any of the equine or food animal medicine lectures that I thought I might attend in my free time. (I know, I can tell you're surprised.) I haven't had the opportunity to go to any of the small mammal disease lectures, which I guess means it's a good thing I dropped my enrollment from that class.
I've had plenty of non-class things on my mind. I trained 5 new tour guides the week before the semester started, and 2 more last Monday. It's been quite an 'experience' getting them all up to speed, and primarily helping them jump through all of the university's hoops required for official employment (which include a formal application, background check, sexual harassment training, sharps policy form, and meeting with the personnel director -- and that's in addition to my 2-hour tour guide orientation followed by several practice tours and shadowing experienced guides). However, I'm thankful that 7 of my original 10 recruits have stuck with it to this point. The added new guides are really taking some of the stress off of my experienced guides who were overworked last semester.
In addition to routine coordination of tours (including scheduling regular guides and scrambling to find replacements when I get last minute emails announcing "I have the flu" or "My dog's in CCU so I can't make it this afternoon"), I'm trying to arrange two more special extended tours for the university's pre-vet club, which will take place in March. These tours have big groups (20-30 students) requiring 2 guides, last longer than usual (1.5-1.75 hours), and include special exhibits (ophthalmology, anesthesia, junior surgery models, and necropsy presentation), all of which I have to coordinate.
Outside of school, we have handbells. Oh, handbells. We do 3-4 concerts plus an open dress rehearsal at the end of every season, which in the spring means May. Unfortunately, we don't actually know any of our concert dates yet, which is unusual and, especially for me, problematic. You see, by the time our spring bell concerts roll around, I'll most likely be a senior vet student for most if not all of the performances. Sure, I'll be on Community Practice which doesn't require weekend attendance at school, but any weeknight evening concerts (2 of which we have tentatively scheduled) may pose a serious conflict. Here's hoping we can figure that all out soon.
Then there's the house. For those who don't know me personally, the hubby and I are in the process of selling our condo. Why? Because it's currently about a 35-minute drive in morning and evening traffic from home to the VTH. Aside from the fact that I'll be on call a lot during senior year, which has a mandatory arrival time of 20 minutes from the time they call you in (which I could potentially make from our current location if all the stoplights, weather, and traffic were on my side, and if it was the middle of the night), I fear for my sanity if I were to try to commute 35 minutes each way for much (or any) of my senior year.
So the basic steps to selling the house are done. We have a realtor recommended by several of my classmates. We have had the house interior measured to create a basic floorplan. A professional home stager was consulted and I did my best to follow her recommendations. Photographs were done last week. During the entire month of January, we have been fairly consumed with deep house cleaning, organizing, packing, and moving anything not immediately needed over to our newly rented storage unit.
And.... drum roll.... as of yesterday afternoon we have a 'for sale' sign out front, a lockbox on the door, and an MLS listing on the web. Now to just wait for those oh-so-lucky buyers who want to make us a terrific offer based on the extremely excellent nature of our condo. Well, that is if the cats haven't just dropped a huge load in the litter box anytime within the 4 hours or so prior to a showing...
There's also that little matter of taxes. We've gotten almost all of our required tax documents -- except for a W2 that's gone missing, a tax form for CLH's health savings account that we can't find, a form from the mortgage company that hasn't been sent yet, and the fact that due to changes in billing practices, my school tuition tax statement will have 1 semester of tuition for 2010 and 3 for 2011...
Throw in a few potlucks to bake for and attend, and you can imagine why I'm glad that this semester doesn't seem to be too intense as far as coursework goes. I'm sure things will pick up once we get back into junior practicum, but for now it's a good thing that I have extra hours in my day to devote to the house and everything else going on.
Sigh.
Don't get me wrong -- my classes have improved over the last week or so. Practice Management is, at time, positively tolerable to attend. We've had better speakers recently, with more animation and enthusiasm, lectures that could actually qualify as organized, and several specific topics that are relevant even to the 75% of the students in my class who don't want to own or manage a practice someday.
I'm enjoying applied animal behavior. We had our 3rd day of lectures today. I respect the instructor and her ideas about dog (and cat) training. She keeps lectures light and entertaining by interspersing a fair number of YouTube videos (all related to the lecture material yet still almost invariably amusing) in between her PowerPoint slides. Unfortunately, I was so involved with the school's behavior club (for which she is the faculty advisor) last year, that I've basically already heard these lectures from her before.
Small Animal Medicine & Surgery is progressing decently. I really enjoyed the dentistry section we started with, which was followed by about a week of meandering, hilarious-yet-disorganized presentations by a gastroenterology faculty member who hasn't lectured to us much before. We've now moved on to liver disease taught by one of our best professors, which is a subject for which I could definitely use some review.
I've not yet managed to convince myself to sit through any of the equine or food animal medicine lectures that I thought I might attend in my free time. (I know, I can tell you're surprised.) I haven't had the opportunity to go to any of the small mammal disease lectures, which I guess means it's a good thing I dropped my enrollment from that class.
I've had plenty of non-class things on my mind. I trained 5 new tour guides the week before the semester started, and 2 more last Monday. It's been quite an 'experience' getting them all up to speed, and primarily helping them jump through all of the university's hoops required for official employment (which include a formal application, background check, sexual harassment training, sharps policy form, and meeting with the personnel director -- and that's in addition to my 2-hour tour guide orientation followed by several practice tours and shadowing experienced guides). However, I'm thankful that 7 of my original 10 recruits have stuck with it to this point. The added new guides are really taking some of the stress off of my experienced guides who were overworked last semester.
In addition to routine coordination of tours (including scheduling regular guides and scrambling to find replacements when I get last minute emails announcing "I have the flu" or "My dog's in CCU so I can't make it this afternoon"), I'm trying to arrange two more special extended tours for the university's pre-vet club, which will take place in March. These tours have big groups (20-30 students) requiring 2 guides, last longer than usual (1.5-1.75 hours), and include special exhibits (ophthalmology, anesthesia, junior surgery models, and necropsy presentation), all of which I have to coordinate.
Outside of school, we have handbells. Oh, handbells. We do 3-4 concerts plus an open dress rehearsal at the end of every season, which in the spring means May. Unfortunately, we don't actually know any of our concert dates yet, which is unusual and, especially for me, problematic. You see, by the time our spring bell concerts roll around, I'll most likely be a senior vet student for most if not all of the performances. Sure, I'll be on Community Practice which doesn't require weekend attendance at school, but any weeknight evening concerts (2 of which we have tentatively scheduled) may pose a serious conflict. Here's hoping we can figure that all out soon.
Then there's the house. For those who don't know me personally, the hubby and I are in the process of selling our condo. Why? Because it's currently about a 35-minute drive in morning and evening traffic from home to the VTH. Aside from the fact that I'll be on call a lot during senior year, which has a mandatory arrival time of 20 minutes from the time they call you in (which I could potentially make from our current location if all the stoplights, weather, and traffic were on my side, and if it was the middle of the night), I fear for my sanity if I were to try to commute 35 minutes each way for much (or any) of my senior year.
So the basic steps to selling the house are done. We have a realtor recommended by several of my classmates. We have had the house interior measured to create a basic floorplan. A professional home stager was consulted and I did my best to follow her recommendations. Photographs were done last week. During the entire month of January, we have been fairly consumed with deep house cleaning, organizing, packing, and moving anything not immediately needed over to our newly rented storage unit.
And.... drum roll.... as of yesterday afternoon we have a 'for sale' sign out front, a lockbox on the door, and an MLS listing on the web. Now to just wait for those oh-so-lucky buyers who want to make us a terrific offer based on the extremely excellent nature of our condo. Well, that is if the cats haven't just dropped a huge load in the litter box anytime within the 4 hours or so prior to a showing...
There's also that little matter of taxes. We've gotten almost all of our required tax documents -- except for a W2 that's gone missing, a tax form for CLH's health savings account that we can't find, a form from the mortgage company that hasn't been sent yet, and the fact that due to changes in billing practices, my school tuition tax statement will have 1 semester of tuition for 2010 and 3 for 2011...
Throw in a few potlucks to bake for and attend, and you can imagine why I'm glad that this semester doesn't seem to be too intense as far as coursework goes. I'm sure things will pick up once we get back into junior practicum, but for now it's a good thing that I have extra hours in my day to devote to the house and everything else going on.
Wednesday, January 19, 2011
Acupuncture: your input, please
I'm trying to decide whether or not to enroll in the elective acupuncture course that is offered to senior vet students next spring.
Disclaimer: I don't have to actually sign up for the course until a solid 6-9 months from now, so it's not like I have to make this decision this week. However, if I opt out of acupuncture, I'll need to choose another elective, and the longer I wait on that, the more limited my options will be.
Here are the basic details:
The course meets for 3 weeks. The first 2 weeks occur back-to-back and are mostly didactic. The third week is a month or two later, and covers clinical application (i.e. hands-on practice) of acupuncture with small animals.
The first two weeks would count as one of my two electives I'm allowed for senior year. The third week would take place during one of my two-week vacation blocks, basically on my own vacation time.
At the end of the course, you get a certificate of completion. I'm not exactly sure how veterinary acupuncture works, but I don't believe that, as a DVM, you have to have been certified in order to legally perform acupuncture.
All of that is well and good, until you get to the cost of the course: about $4,700 if I register by October (and yes, that is already including a discount for students).
On the one hand, I tell myself that having this experience and certification with acupuncture may be the selling point that gives me an edge over other new grads competing for a limited number of jobs -- that is, if those employers value acupuncture and want to add it or build it up in their practice. On the flip side, though, there are probably plenty of practices out there that don't care much about acupuncture or don't believe it is really useful.
You can learn acupuncture on your own as a DVM, and/or attend continuing education to develop your technique. So it's not like vet school is the only opportunity I'd have to learn it. However, as a working DVM, it would be much more difficult to get enough time off to attend this sort of intensive 3-week, 120-hour course. Add in the fact that I'd probably be facing travel expenses since this type of thing is not offered everywhere in the country, as well as the fact that I'd lose the vet student discount, and the cost could go up.
I keep thinking that $4,700 is a LOT of money to invest in this course given that (a) I don't if it will be something I really enjoy doing, (b) I can't guarantee it will make any difference with potential employers, and (c) it will take up my second of two elective spots, as well as a week of my vacation (which isn't a big deal). However, I can easily put in perspective that I'm already paying about $50,000 in tuition and fees for my senior year, so as long as I'm taking out tons of student loans, why not borrow another $4,700 for something that may pay off when I'm a new grad?
I'd be interested in your thoughts, if you'll post them in the comments section below. I have repeatedly flip-flopped back and forth over the last few months about whether I want to take the course or not, so I guess it's a good thing I have a few more months to decide.
Disclaimer: I don't have to actually sign up for the course until a solid 6-9 months from now, so it's not like I have to make this decision this week. However, if I opt out of acupuncture, I'll need to choose another elective, and the longer I wait on that, the more limited my options will be.
Here are the basic details:
The course meets for 3 weeks. The first 2 weeks occur back-to-back and are mostly didactic. The third week is a month or two later, and covers clinical application (i.e. hands-on practice) of acupuncture with small animals.
The first two weeks would count as one of my two electives I'm allowed for senior year. The third week would take place during one of my two-week vacation blocks, basically on my own vacation time.
At the end of the course, you get a certificate of completion. I'm not exactly sure how veterinary acupuncture works, but I don't believe that, as a DVM, you have to have been certified in order to legally perform acupuncture.
All of that is well and good, until you get to the cost of the course: about $4,700 if I register by October (and yes, that is already including a discount for students).
On the one hand, I tell myself that having this experience and certification with acupuncture may be the selling point that gives me an edge over other new grads competing for a limited number of jobs -- that is, if those employers value acupuncture and want to add it or build it up in their practice. On the flip side, though, there are probably plenty of practices out there that don't care much about acupuncture or don't believe it is really useful.
You can learn acupuncture on your own as a DVM, and/or attend continuing education to develop your technique. So it's not like vet school is the only opportunity I'd have to learn it. However, as a working DVM, it would be much more difficult to get enough time off to attend this sort of intensive 3-week, 120-hour course. Add in the fact that I'd probably be facing travel expenses since this type of thing is not offered everywhere in the country, as well as the fact that I'd lose the vet student discount, and the cost could go up.
I keep thinking that $4,700 is a LOT of money to invest in this course given that (a) I don't if it will be something I really enjoy doing, (b) I can't guarantee it will make any difference with potential employers, and (c) it will take up my second of two elective spots, as well as a week of my vacation (which isn't a big deal). However, I can easily put in perspective that I'm already paying about $50,000 in tuition and fees for my senior year, so as long as I'm taking out tons of student loans, why not borrow another $4,700 for something that may pay off when I'm a new grad?
I'd be interested in your thoughts, if you'll post them in the comments section below. I have repeatedly flip-flopped back and forth over the last few months about whether I want to take the course or not, so I guess it's a good thing I have a few more months to decide.
New record
Classes started yesterday.
I came prepared with a positive attitude, a sense of optimism. I swear, I really did.
It took about 5 minutes of "VM712: Practice Management" to kill any shreds of enthusiasm I brought with me. Pretty sure that is a brand-spanking-new record for the amount of time required to generate this level of cynicism at the beginning of a new semester.
Before we get into the course material, let's just talk some logistics. Last fall was spent half on clinics/rotations, half in classes. Except for a few select rotations (like Emerging & Exotic Diseases), I've basically been on my feet all morning thus far this year, interacting with senior students, interns, residents, clinicians, clients, and patients. Or if not in the clinic, then at least in a lab like parasitology or clin path -- at least doing something, rather than getting talked at.
Fast forward to the first 4 weeks of this semester, and you might be able to imagine why I'm less than thrilled to be spending 4 hours every morning learning about why I want to own and manage my own veterinary practice (which I rather emphatically don't).
Additionally, we have a weird course schedule this semester. It's really the first and only semester in which the large and small animal trackers are enrolled in vastly different courses. Last fall, aside from some electives, we were basically all still in the same Clinical Sciences classes together.
Now, though, the large animal trackers are taking "Bovine Herd Medicine" and "Equine Medicine & Surgery," while the small animal trackers are taking "Small Animal Medicine & Surgery" (1 & 2).
Since we have a large number of "general" or "mixed" trackers in our class, and they need to be able to take any combination of the above courses that they want, all of the classes have to be offered at times that don't conflict with each other. So aside from Practice Management or junior rotations till noon every day, I'm in class only from 2-4 on Mondays, 1-5 Tuesdays, 2-4 Wednesdays, 3-4 Thursdays, and 2-4 Fridays. Definitely an odd schedule, with all of those extended lunch breaks in the middle of the day.
So there's that: not only have I wasted 8 hours of my week so far on fairly useless Practice Management topics, but yesterday was one heck of a long day being in class till 5, and I'm sitting here today watching the 7200 seconds of my lunch break tick by incredibly slowly.
Think I've complained enough already? Fear not; the venting shall continue.
Let's talk about some of the "course material" we've covered so far in Practice Management. About half of our lecture time on Day 1 was spent hearing the "motivational" life stories of some of our speakers, including such facts relevant to Practice Management as where they went to vet school, their favorite species to practice on, innumerable details about their nuclear and extended families, pictures of their hiking trips to Mount Everest, and how their rich relatives died and they inherited enough money to pay off their vet school loans within a couple years after graduation.
Today, Day 2, included more motivational quotes than I've honestly ever heard in the span of 4 hours' time, or probably in a single month. Add the time spent on cheery cliches to the recitation of all of those helpful quotations, and we had about 30 minutes left to actually cover Practice Management material.
And the small amount of information we did discuss was very basic financial and management advice that I've already covered in my elective business courses during vet school, and even that was mostly stuff that I had figured out on my own through common sense long before entering vet school.
We also took personality tests today and discussed the results. Never mind that we took exactly the same personality tests during our freshman orientation for vet school 2.5 years ago, and it was a waste of time then too. Gee, I'm more introverted than extroverted, more of a thinker than a feeler. Thanks for the earth-shattering news.
I'm telling myself it will get better (and I really hope it will; after all, I don't see that it can get much worse). However, it's difficult not to keep in mind that we have 56 hours of this left.
On a brighter note, I'm fairly excited about our once-a-week Applied Animal Behavior course, the first session of which was held yesterday. Yes, it's the dreaded class that will keep me at school until 5 pm on Tuesdays, but I find behavior topics really interesting, and overall it seems that vets receive an inadequate education about animal behavior during vet school. Most of the DVMs I've met offer clients behavior and training tips that the DVMs learned working as technicians or trainers before vet school, or that they've learned through CE and self-education after graduation.
Also, I have had some previous experience with the instructor for this behavior course, and I really like her and respect her ideas. She is not a DVM (although it is possible to become a board-certified veterinary behaviorist after vet school), but rather has a PhD in animal behavior. She does a great job of using science-based research to back up her recommended methods and suggestions, and cuts out a lot of the touchy-feely stuff.
My other course this semester is Small Animal Medicine & Surgery. We're in part one through March, and will cover review topics in dentistry and oral surgery, GI disease, respiratory medicine, respiratory and soft tissue surgery, cardiology, oncology, and ophthalmology. We've started with dentistry lectures, given by a clinician who is not especially popular but whom I really like. He's only been at this university for about 3 years and has become a progressively better lecturer every time we have him as an instructor.
See? I can end positively! And things will be way better in 3.5 weeks when Practice Management is over.
I came prepared with a positive attitude, a sense of optimism. I swear, I really did.
It took about 5 minutes of "VM712: Practice Management" to kill any shreds of enthusiasm I brought with me. Pretty sure that is a brand-spanking-new record for the amount of time required to generate this level of cynicism at the beginning of a new semester.
Before we get into the course material, let's just talk some logistics. Last fall was spent half on clinics/rotations, half in classes. Except for a few select rotations (like Emerging & Exotic Diseases), I've basically been on my feet all morning thus far this year, interacting with senior students, interns, residents, clinicians, clients, and patients. Or if not in the clinic, then at least in a lab like parasitology or clin path -- at least doing something, rather than getting talked at.
Fast forward to the first 4 weeks of this semester, and you might be able to imagine why I'm less than thrilled to be spending 4 hours every morning learning about why I want to own and manage my own veterinary practice (which I rather emphatically don't).
Additionally, we have a weird course schedule this semester. It's really the first and only semester in which the large and small animal trackers are enrolled in vastly different courses. Last fall, aside from some electives, we were basically all still in the same Clinical Sciences classes together.
Now, though, the large animal trackers are taking "Bovine Herd Medicine" and "Equine Medicine & Surgery," while the small animal trackers are taking "Small Animal Medicine & Surgery" (1 & 2).
Since we have a large number of "general" or "mixed" trackers in our class, and they need to be able to take any combination of the above courses that they want, all of the classes have to be offered at times that don't conflict with each other. So aside from Practice Management or junior rotations till noon every day, I'm in class only from 2-4 on Mondays, 1-5 Tuesdays, 2-4 Wednesdays, 3-4 Thursdays, and 2-4 Fridays. Definitely an odd schedule, with all of those extended lunch breaks in the middle of the day.
So there's that: not only have I wasted 8 hours of my week so far on fairly useless Practice Management topics, but yesterday was one heck of a long day being in class till 5, and I'm sitting here today watching the 7200 seconds of my lunch break tick by incredibly slowly.
Think I've complained enough already? Fear not; the venting shall continue.
Let's talk about some of the "course material" we've covered so far in Practice Management. About half of our lecture time on Day 1 was spent hearing the "motivational" life stories of some of our speakers, including such facts relevant to Practice Management as where they went to vet school, their favorite species to practice on, innumerable details about their nuclear and extended families, pictures of their hiking trips to Mount Everest, and how their rich relatives died and they inherited enough money to pay off their vet school loans within a couple years after graduation.
Today, Day 2, included more motivational quotes than I've honestly ever heard in the span of 4 hours' time, or probably in a single month. Add the time spent on cheery cliches to the recitation of all of those helpful quotations, and we had about 30 minutes left to actually cover Practice Management material.
And the small amount of information we did discuss was very basic financial and management advice that I've already covered in my elective business courses during vet school, and even that was mostly stuff that I had figured out on my own through common sense long before entering vet school.
We also took personality tests today and discussed the results. Never mind that we took exactly the same personality tests during our freshman orientation for vet school 2.5 years ago, and it was a waste of time then too. Gee, I'm more introverted than extroverted, more of a thinker than a feeler. Thanks for the earth-shattering news.
I'm telling myself it will get better (and I really hope it will; after all, I don't see that it can get much worse). However, it's difficult not to keep in mind that we have 56 hours of this left.
On a brighter note, I'm fairly excited about our once-a-week Applied Animal Behavior course, the first session of which was held yesterday. Yes, it's the dreaded class that will keep me at school until 5 pm on Tuesdays, but I find behavior topics really interesting, and overall it seems that vets receive an inadequate education about animal behavior during vet school. Most of the DVMs I've met offer clients behavior and training tips that the DVMs learned working as technicians or trainers before vet school, or that they've learned through CE and self-education after graduation.
Also, I have had some previous experience with the instructor for this behavior course, and I really like her and respect her ideas. She is not a DVM (although it is possible to become a board-certified veterinary behaviorist after vet school), but rather has a PhD in animal behavior. She does a great job of using science-based research to back up her recommended methods and suggestions, and cuts out a lot of the touchy-feely stuff.
My other course this semester is Small Animal Medicine & Surgery. We're in part one through March, and will cover review topics in dentistry and oral surgery, GI disease, respiratory medicine, respiratory and soft tissue surgery, cardiology, oncology, and ophthalmology. We've started with dentistry lectures, given by a clinician who is not especially popular but whom I really like. He's only been at this university for about 3 years and has become a progressively better lecturer every time we have him as an instructor.
See? I can end positively! And things will be way better in 3.5 weeks when Practice Management is over.
Wednesday, January 12, 2011
Senior schedule!
I know my blog posting has dwindled over winter break, but hey, it's break! No vet school = not much vet school info to blog about.
To make up for it, I bring you the long-awaited (well, since October), just-published Senior Year Schedule!
Reminder: My junior year ends May 10, with senior orientation on May 11, and senior year starting on May 12. That means I'll be a senior in exactly 4 months! Yikes!
Here's an overview of my senior schedule, by weeks:
----------------------------
May 12, and weeks of May 16/23/30 and Jne 6: Community Practice (spay/neuter, dentistry, and non-referred, non-emergency appointments)
Weeks of June 13/20: small animal internal medicine
Weeks of June 27/July 4: neurology
Weeks of July 11/18: dermatology
Weeks of July 25/Aug 1: small animal orthopedic surgery
Weeks of Aug 8/15: vacation
Weeks of Aug 22/29: critical care/emergency (overnights/triage)
Weeks of Sept 5/12: oncology
Weeks of Sept 19/26: postmortem diagnosis (aka necropsy aka ugh)
Weeks of Oct 3/10: critical care/emergency (days)
Weeks of Oct 17/24: cardiology
Weeks of Oct 31/Nov 7/14/21: anesthesia
Weeks of Nov 28/Dec 5/12: diagnostic imaging
Weeks of Dec 19/26: one of these will be a vacation week; the other will be more diagnostic imaging
Weeks of Jan 2/9 (2012): vacation (this is awesome: if I have the week of Dec 26 as my vacation week, I'll get 3 weeks off in a row)
Weeks of Jan 16/23: small animal soft tissue surgery
Weeks of Jan 30/Feb 6: elective acupuncture course (debating whether I am actually going to enroll in this $4800 elective course...)
Weeks of Feb 13/20: small animal internal medicine
Weeks of Feb 27/Mar 5: more vacation
Weeks of Mar 12/19: ophthalmology
Weeks of Mar 26/Apr 2: Harrison Memorial Hospital (a huge small animal clinic in the metro area where we get to see appointments and practice spay/neuter)
Weeks of Apr 9/16: more vacation!
Weeks of Apr 23/30/May 7: small animal urgent care (a 5-11 pm, possibly extending to 8 am shift)
Then graduation, whoo hoo!
--------------------------
Items to note:
**I have four 2-week blocks of vacation, only 1 of which occurs in the first 6 months of senior year. Gulp.
**I really can't decide if I want to take the acupuncture course. It would take up my second of two elective spots, as well as requiring a week of my vacation time in the spring. Plus it costs a ton of money.
**My only elective (other than acupuncture) is the Harrison Memorial Hospital elective. I wish I had gotten the shelter medicine elective too!
**My 4 core weeks of emergency/critical care are divided up! Hallelujah for not having 4 weeks of CCU in a row!
**I definitely don't need to spend any more time volunteering in Community Practice as a junior, since I'll be starting out my senior year with 4.5 weeks of CP in a row.
**Not excited about having Anesthesia during the week of Thanksgiving... I'm a bit alarmed that that means I won't get much of a holiday.
**On the other hand, diagnostic imaging is pretty low stress, so even though I'll have to have that either the week of Christmas or the week of New Year's, I'm hopeful that will still allow me some extra time off.
**Hooray for 6 weeks of vacation in the 4 months prior to graduation!
To make up for it, I bring you the long-awaited (well, since October), just-published Senior Year Schedule!
Reminder: My junior year ends May 10, with senior orientation on May 11, and senior year starting on May 12. That means I'll be a senior in exactly 4 months! Yikes!
Here's an overview of my senior schedule, by weeks:
----------------------------
May 12, and weeks of May 16/23/30 and Jne 6: Community Practice (spay/neuter, dentistry, and non-referred, non-emergency appointments)
Weeks of June 13/20: small animal internal medicine
Weeks of June 27/July 4: neurology
Weeks of July 11/18: dermatology
Weeks of July 25/Aug 1: small animal orthopedic surgery
Weeks of Aug 8/15: vacation
Weeks of Aug 22/29: critical care/emergency (overnights/triage)
Weeks of Sept 5/12: oncology
Weeks of Sept 19/26: postmortem diagnosis (aka necropsy aka ugh)
Weeks of Oct 3/10: critical care/emergency (days)
Weeks of Oct 17/24: cardiology
Weeks of Oct 31/Nov 7/14/21: anesthesia
Weeks of Nov 28/Dec 5/12: diagnostic imaging
Weeks of Dec 19/26: one of these will be a vacation week; the other will be more diagnostic imaging
Weeks of Jan 2/9 (2012): vacation (this is awesome: if I have the week of Dec 26 as my vacation week, I'll get 3 weeks off in a row)
Weeks of Jan 16/23: small animal soft tissue surgery
Weeks of Jan 30/Feb 6: elective acupuncture course (debating whether I am actually going to enroll in this $4800 elective course...)
Weeks of Feb 13/20: small animal internal medicine
Weeks of Feb 27/Mar 5: more vacation
Weeks of Mar 12/19: ophthalmology
Weeks of Mar 26/Apr 2: Harrison Memorial Hospital (a huge small animal clinic in the metro area where we get to see appointments and practice spay/neuter)
Weeks of Apr 9/16: more vacation!
Weeks of Apr 23/30/May 7: small animal urgent care (a 5-11 pm, possibly extending to 8 am shift)
Then graduation, whoo hoo!
--------------------------
Items to note:
**I have four 2-week blocks of vacation, only 1 of which occurs in the first 6 months of senior year. Gulp.
**I really can't decide if I want to take the acupuncture course. It would take up my second of two elective spots, as well as requiring a week of my vacation time in the spring. Plus it costs a ton of money.
**My only elective (other than acupuncture) is the Harrison Memorial Hospital elective. I wish I had gotten the shelter medicine elective too!
**My 4 core weeks of emergency/critical care are divided up! Hallelujah for not having 4 weeks of CCU in a row!
**I definitely don't need to spend any more time volunteering in Community Practice as a junior, since I'll be starting out my senior year with 4.5 weeks of CP in a row.
**Not excited about having Anesthesia during the week of Thanksgiving... I'm a bit alarmed that that means I won't get much of a holiday.
**On the other hand, diagnostic imaging is pretty low stress, so even though I'll have to have that either the week of Christmas or the week of New Year's, I'm hopeful that will still allow me some extra time off.
**Hooray for 6 weeks of vacation in the 4 months prior to graduation!
Monday, January 3, 2011
What's the grossest thing you saw today?
I'll go first:
Very alive, very mobile tapeworms crawling out of a dog's anus.
Very alive, very mobile tapeworms crawling out of a dog's anus.
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