Hi there; Birdie here!
I've finished my first full 4-week block, my equine rotation. Even though it's a whole block, it's kind of split into two half blocks. There's two surgery services and a medicine service, and the students on the rotation switch services after the first two weeks. My rotation had 11 students, and there's only one medicine service, so some of us didn't get to do medicine. I think one of the surgery services pretty much kept the same students the whole block. I did a surgery service first and medicine second.
The surgery service was really busy when I was on it. We had a few chronic cases that stayed from the first few days on block until we switched services (some even all through the block). We learned a lot about bandage changes and the GameReady, which ices and compresses a leg to bring down swelling. I got to scrub in on a laparoscopic orchiectomy on a cryptorchid stallion who turned out to be monorchid, which was really interesting. One night we stayed until 11:30 at night to recover a horse from a second colic surgery and then lavage his abdomen. We also had a bunch of lameness exams, which I really enjoyed and felt like I learned a lot from. I'm not very confident about watching for lameness, so it was run when I got it right. For one of my cases, I got to do a nerve block and then successfully saw the lameness switch to the other leg when the block worked.
On surgery service, everyone can go in to watch the surgery (any students can go in and watch, really, as long as they wear caps and masks) and the student on the case scrubs in to the surgery and then writes the surgery report afterward. They were more lenient about paperwork in equine than small animal. We still had to write SOAPs every day, discharge summaries, and surgery reports, but it wasn't nearly as stringent as our junior surgery lab reports. Also they didn't look at our paperwork immediately. Like, I know I missed a lot and probably got some things wrong in the report for my cryptorchid, but I never heard anything about it.
For emergencies throughout the block, each of us on the block took 4 shifts as primary on call and 4 shifts as secondary. Some people got called in every time they were on call. I got called in only a couple of times. Once, we had two colics come in at once, and I was helping to do the workups on both of them until the secondary student got there. Another time, there were almost 3 emergencies, but none of them actually ended up coming in.
The medicine service was really slow this block, but I still got a couple of cases when I was on for the second half of the block. It seems like most of what we did was foals with diarrhea, and colics. A lot of colics from emergencies got transferred to medicine (my emergency colic ended up transferring to medicine the same day I did, so I just kept that case). Both of my colics had gastric ulcers, which we diagnosed on gastroscopy. We did a bunch of gastroscopies and a couple guttural pouches, but didn't diagnose any laryngeal paralysis, unlike my previous equine hospital experience. Medicine was much bigger on rounding than surgery. This was partially because it was so slow, so we had topic rounds on endocrine diseases or fluid calculations. But it was also just because they wanted to talk about and plan what we were doing a lot more and keep everyone on the same page. If they actually kept us informed, that would have been great. Unfortunately most days we just sat around with no clear idea what was going on--and then at 4:30 they wanted us to round instead of going home.
I got to practice a bunch of skills on this rotation, too. I put in jugular catheters several times. For one of my foal cases, I helped put in a long over the wire catheter. I had some trouble with that one--it's hard to keep the long pieces sterile, especially when you don't really know what you're doing. I did an ultrasound on that foal, too. We looked for broken ribs (ultrasound is a better diagnostic than x-rays in foals--it's more sensitive, and you can see which side it's on and also the effect on surrounding soft tissues) and scanned the umbilical cord. I'm still proud of how good the images I got were--one of the house officers said my pictures were "textbook"! One particularly slow day, we got out some of the teaching horses to practice procedures. I did an over the wire catheter myself since I'd messed up the first time and wanted to do better. I still broke sterility, but apparently I did an impressive job of suturing it in with a little smooth backhand action.
One of the toughest things about this rotation was that we didn't really have any days off unless we happened to not have any cases over the weekend (which may have happened once). We were responsible not only for the 7am treatments but also 7pm treatments. We still got to leave before 7 most days (we could usually start evening treatments around 5), but on weekends that meant we had to come back in. Combine that with 7am treatments which (1) mean we never have a chance to sleep in and catch up on sleep and (2) sometimes went until 11:30 am to finish all the rechecks, bandage changes, etc., and it means no days off. It was tough, but not nearly as bad as I was expecting. I guess staying at school for about 12 hours doesn't feel as bad as it sounds. Especially when you're actually doing stuff and learning.
The clinicians were great teachers on this rotation, and I learned a lot. Some of the house officers were a lot better about teaching us than others were. Overall, it was a tough rotation, and I was glad for it to be over. But it wasn't as bad as I expected. I learned a lot, and some things were even pretty fun!
Despite how much time it took up, I still managed to make a riding lesson every week. In fact, the first weekend I even got to ride in a schooling show! I was on Baby, and I got to do the medal class for the first time. I love the medal class, it was so much fun! The medal class is a more complicated course with lots of rollbacks. Those tough, tight turns are my favorite. I did my course early in the order, but I didn't untack when I was done because I wanted to ride into the ring for the ribbons. And it's a good thing I didn't, because they called 6 of us (including me) back into the ring to "test the riders" with a short portion of the course ending in a halt. My horse didn't want to get going again--she thought she was done! I thought I might get marked down for how much I had to fight her to get her going again. But I put it out of my mind (they're testing the riders, not the horses, I told myself) and did a great job over the jumps. And then I ended up winning the medal class! I was totally not expecting it, but it was a great bonus to how much fun it was.
Now I'm starting (small animal) surgery rotation, so that'll be my next post. It's not a break at all--there's no way I can make riding lessons this block. But if I get through it, it's summer! In clinics, we don't really get summer off; it just worked out that between family vacation, the Live Oak Bank summer program, and when an externship happened to fall I'm about to spend 3 months away from school. At least, if I get through surgery first!
Saturday, May 14, 2016
Wednesday, April 27, 2016
Back to the Classroom
Hi there; Birdie here!
I know, I'm pretty late with this post. I'm writing about the block that finished two and a half weeks ago; I'm on Equine now, which is super busy...but that's a whole different story.
Last block I was in 5010s--those are our classroom electives (the class number for every single one of them is 5010, so we say that to distinguish it from actual rotation electives). Because of who I am as a person, I was in every single class for this particular two-week block: "Advanced Business Management", ultrasound, dentistry, and feline. That's enough credits in one half block that I got an extra half block of vacation, plus one more credit than I actually need because I just want to learn everything. ANYWAY.
I'm putting "Advanced Business Management" in quotations because there didn't seem to be anything particularly advanced about it. We had a core business class in the fall, and this hardly seemed to build on anything. The first couple of days were leadership/communication type things, and we also did some stuff on financial planning/planning for retirement, practice software, making a business plan, etc. Every single one of them was a lecture, which I feel was not the best use of that class. It's an elective, so it's smaller than the whole third year class. You could totally do more experiential learning, small group activities--at least discussion! But instead it was two hours of class every day for two weeks. I don't regret taking it, but I'm not sure how much I actually learned from it, and I really think the class could have been done better.
Ultrasound was mostly lecture, but we also had a lab each week. We learned about theory, about different types of artifacts, and about normal/abnormal by organ/system. Then in lab we got to try finding the structures. I feel like I did a fair job doing a basic exam (though no, I didn't find any adrenals this time). We also got to practice doing fine needle aspirates and biopsy sampling guided by the ultrasound. I enjoyed this class, especially on lab days. Hopefully it helps me be a step ahead when I do the ultrasound rotation a year from now! And in general--ultrasound is something I'm really interested in, and something I'm trying to use as a selling point when I look for jobs.
Dentistry was just two days, but it was all day. The first day we were in lecture. Some of it was review from what we got in Medicine (or possibly another course, but I think it was Medicine), but it wasn't just a re-hash and they sometimes asked questions, like expecting us to remember. There were also two clinicians teaching it together, which was more entertaining and I think more informative, since they could fill in each others' gaps and bring in their own experiences. The main message of their class was "Even if you aren't a specialist, you can do a lot yourself" (meanwhile, my business class had a lecture on why you should specialize and how it's unethical to advertise yourself as a dentist if you aren't boarded). So then the next day we proved it in lab. It wasn't really all day, just all morning. We learned to pull canine teeth and cheek teeth (I also made sure to ask about incisors), and we learned about nerve blocks and fixing broken jaws and correcting malalignment of the canines. Mostly, it takes high speed dental equipment. I'm really glad I got to practice that, and they were super helpful in answering our questions and making sure we did things right.
The feline elective was basically exactly the same as the one I did second year--each of us brought in a case and we discussed our problems, differentials, and treatment plan. There were a dozen or so of us in the class, so not all of us actually presented (I didn't, for one). It was a pretty good class, and I definitely learned from it. Particularly since I don't have my medicine rotation before NAVLE, it's nice to have some case-based learning about feline diseases.
Despite having a relatively easy block with electives, I still haven't looked up all the topics I'd meant to study for oncology and emergency rotations. And now I'm even more behind with equine because of how long the days are--but again, that's another story. You'll have to wait a week or so for that one (at least--I just happened to get out unusually early today). ;)
I know, I'm pretty late with this post. I'm writing about the block that finished two and a half weeks ago; I'm on Equine now, which is super busy...but that's a whole different story.
Last block I was in 5010s--those are our classroom electives (the class number for every single one of them is 5010, so we say that to distinguish it from actual rotation electives). Because of who I am as a person, I was in every single class for this particular two-week block: "Advanced Business Management", ultrasound, dentistry, and feline. That's enough credits in one half block that I got an extra half block of vacation, plus one more credit than I actually need because I just want to learn everything. ANYWAY.
I'm putting "Advanced Business Management" in quotations because there didn't seem to be anything particularly advanced about it. We had a core business class in the fall, and this hardly seemed to build on anything. The first couple of days were leadership/communication type things, and we also did some stuff on financial planning/planning for retirement, practice software, making a business plan, etc. Every single one of them was a lecture, which I feel was not the best use of that class. It's an elective, so it's smaller than the whole third year class. You could totally do more experiential learning, small group activities--at least discussion! But instead it was two hours of class every day for two weeks. I don't regret taking it, but I'm not sure how much I actually learned from it, and I really think the class could have been done better.
Ultrasound was mostly lecture, but we also had a lab each week. We learned about theory, about different types of artifacts, and about normal/abnormal by organ/system. Then in lab we got to try finding the structures. I feel like I did a fair job doing a basic exam (though no, I didn't find any adrenals this time). We also got to practice doing fine needle aspirates and biopsy sampling guided by the ultrasound. I enjoyed this class, especially on lab days. Hopefully it helps me be a step ahead when I do the ultrasound rotation a year from now! And in general--ultrasound is something I'm really interested in, and something I'm trying to use as a selling point when I look for jobs.
Dentistry was just two days, but it was all day. The first day we were in lecture. Some of it was review from what we got in Medicine (or possibly another course, but I think it was Medicine), but it wasn't just a re-hash and they sometimes asked questions, like expecting us to remember. There were also two clinicians teaching it together, which was more entertaining and I think more informative, since they could fill in each others' gaps and bring in their own experiences. The main message of their class was "Even if you aren't a specialist, you can do a lot yourself" (meanwhile, my business class had a lecture on why you should specialize and how it's unethical to advertise yourself as a dentist if you aren't boarded). So then the next day we proved it in lab. It wasn't really all day, just all morning. We learned to pull canine teeth and cheek teeth (I also made sure to ask about incisors), and we learned about nerve blocks and fixing broken jaws and correcting malalignment of the canines. Mostly, it takes high speed dental equipment. I'm really glad I got to practice that, and they were super helpful in answering our questions and making sure we did things right.
The feline elective was basically exactly the same as the one I did second year--each of us brought in a case and we discussed our problems, differentials, and treatment plan. There were a dozen or so of us in the class, so not all of us actually presented (I didn't, for one). It was a pretty good class, and I definitely learned from it. Particularly since I don't have my medicine rotation before NAVLE, it's nice to have some case-based learning about feline diseases.
Despite having a relatively easy block with electives, I still haven't looked up all the topics I'd meant to study for oncology and emergency rotations. And now I'm even more behind with equine because of how long the days are--but again, that's another story. You'll have to wait a week or so for that one (at least--I just happened to get out unusually early today). ;)
Wednesday, March 30, 2016
Emergency!
Hi there; Birdie here!
So the thing I forgot about having my emergency rotation the last couple of weeks is that it meant I was on emergency over Easter weekend. I mean, when I got the schedule I knew Friday was a holiday, but I was not prepared for Saturday...but that's getting ahead of myself.
Emergency works like most other rotations: when a student gets called for a case, we go up and get the history. Then we bring the animal back, do our physical, let the clinician do a quick physical, and figure out what we're doing next. Unlike oncology and other rotations, there is never any idea what the case will be the day before, obviously. Also unlike other rotations (except possibly medicine), we get critical patients that get taken back to ICU by one student while another student takes the history. And of course, on emergency we definitely don't get weekends off. But we do have two days off each week, which are possibly better than weekends off on other rotations because you actually don't need to come in, even to take care of a patient in the hospital or to take transfers. Also, most days don't start work until 4:30pm, so that meant I had days to do things. I definitely used one of those days to go to the library. Our rotation was big enough that one student was on days during the week. Then on weekends, roughly half of us were on days (8am-5:30pm) and the other half on nights (4:30pm to midnight). The end times were largely theoretical; even once we stopped taking cases, we still had to write up discharge summaries, which could take hours. There are no rounds in emergency, either. The caseload is majorly variable; some days we had basically nothing and some days the only reason I had time to eat was because someone brought food into the treatment room and I could snack while working on paperwork for my cases.
I never personally dealt with the really critical cases. We had two dogs hit by cars during my shifts, and for both of them I ended up getting the case that came in right before that, so I had to sit with that patient and try to do my physical alone while everyone else worked to stabilize the critical patient. I did have a possible GDV that I sent back to ICU (it turned out to be barely bloated) and a snakebite case that I sent back in case it needed immediate stabilization--both of which I was the history-taker for, and neither of which needed much in the way of stabilization anyway.
I really do love working with the clients. I'd always thought I would miss that if I decide to specialize, but now that I've actually done it it's not just a theoretical liking. We had one patient, a cat, hospitalized for the entire Easter weekend, where I made friends with the owner. I happened to be on days that entire weekend as well as the one who admitted the cat, so I stayed involved in that case. One day I stayed late so that the owner could visit. She told me that I really helped calm her and made a good impression of our hospital (she'd never been here before), so that makes me feel good about myself. At least I can actually do the client communication part of my job, and someone thinks I'm good at it.
Other parts, I'm not as good at. It was really only my second rotation at school, but I still felt overwhelmed by how much I didn't know, especially when it was really busy. One day I forgot to update my discharge at the end of the day, which was "inappropriate"--and got called as such. When we did a neuro exam, the clinician explicitly did not ask which nerves each reflex tests--but I barely remembered what reflexes I was supposed to test, anyway. I also got snapped at for not knowing what to do when I cleaned Isolation (even after explicitly asking for help because I didn't know what I was doing--and when I later got told that it isn't even my job, anyway). And that's not even mentioning all the diagnoses I didn't get and drugs I didn't have dosages for. I'm recording this in the hopes of progress--I'm not competent yet, but I will be. I'm still learning.
Saturday was the craziest of all. There was one other day I was on cases for almost as much time, but only on the day before Easter did I personally have four different cases (okay, technically two of them were the same suspected toxicity, from the same owner) and my two classmates on with me have at least three each. And that's not even mentioning how many phone calls we kept fielding--everything from "my dog ate chocolate" to a scratch on an eye to the snakebite case that immediately came in. Luckily, some of the Medicine people stayed after taking transfers to help us with the huge influx of cases (it was a medicine student who did the physical on my snakebite dog). Other than anyone who stayed out of the goodness of their hearts, we only had two clinicians and three students. We were all running around like crazy dealing with something like a dozen cases all coming in at once, plus running more diagnostics on hospitalized patients. In the end, we got through it--but it was hugely stressful, with a lot happening all at once and me feeling like I had no clue how to help. And after the next shift started (that was a day shift, so the night students took over), we still had to write discharges. One of my classmates didn't leave his "day" shift until 9pm because he had to keep taking the phone calls no one else was available foor. That was definitely a defining moment for my decision that I do NOT want to do emergency work for my job.
I've kept up with my horseback riding, more or less. Off days on mergency gave me time to do that. Last week we did something really fun--a catch rider lesson. After warming up and riding a course of jumps once, we switched horses and rode it on each of the other four horses in the lesson. We stayed late (theoretically because no one had to go to school the next day, on Good Friday--I had to be at work at 8am, but I just rolled with it anyway) but it was totally worth it. I hope I get to play that game again. This week, the indoor arena had really hard footing since the tractor to drag it was broken, so we couldn't do much jumping. Instead, I got to learn a little about turns on the forehand and turns on the hind. Unfortunately, the horse I was on (Baby) is not very good at those turns. It was especially hard from a halt; she didn't want to move again! We did a fair approximation, though. I'd like to try again sometime. My instructor told me to remind her and I'll be able to try again on a horse who's better trained to it.
I'm so glad I'm done with emergency. I'm back in the classroom now for two weeks of electives--but that's a topic for another blog. After that I've got two rotations I've heard are tough (equine and surgery)--I'll try to record those as well, but at this point I have no idea what kind of time I'll have so I'm guessing none. Once I get through those, though, it'll be summer and I'll be away from school for three months on a combination of vacation and externships (slash "special topics," which is what school is calling the Live Oak Bank externship since it's not at a private practice). That's what I'm looking forward to most right now, and about as far into the future as I can think at this point.
Two rotations down...over a dozen to go.
So the thing I forgot about having my emergency rotation the last couple of weeks is that it meant I was on emergency over Easter weekend. I mean, when I got the schedule I knew Friday was a holiday, but I was not prepared for Saturday...but that's getting ahead of myself.
Emergency works like most other rotations: when a student gets called for a case, we go up and get the history. Then we bring the animal back, do our physical, let the clinician do a quick physical, and figure out what we're doing next. Unlike oncology and other rotations, there is never any idea what the case will be the day before, obviously. Also unlike other rotations (except possibly medicine), we get critical patients that get taken back to ICU by one student while another student takes the history. And of course, on emergency we definitely don't get weekends off. But we do have two days off each week, which are possibly better than weekends off on other rotations because you actually don't need to come in, even to take care of a patient in the hospital or to take transfers. Also, most days don't start work until 4:30pm, so that meant I had days to do things. I definitely used one of those days to go to the library. Our rotation was big enough that one student was on days during the week. Then on weekends, roughly half of us were on days (8am-5:30pm) and the other half on nights (4:30pm to midnight). The end times were largely theoretical; even once we stopped taking cases, we still had to write up discharge summaries, which could take hours. There are no rounds in emergency, either. The caseload is majorly variable; some days we had basically nothing and some days the only reason I had time to eat was because someone brought food into the treatment room and I could snack while working on paperwork for my cases.
I never personally dealt with the really critical cases. We had two dogs hit by cars during my shifts, and for both of them I ended up getting the case that came in right before that, so I had to sit with that patient and try to do my physical alone while everyone else worked to stabilize the critical patient. I did have a possible GDV that I sent back to ICU (it turned out to be barely bloated) and a snakebite case that I sent back in case it needed immediate stabilization--both of which I was the history-taker for, and neither of which needed much in the way of stabilization anyway.
I really do love working with the clients. I'd always thought I would miss that if I decide to specialize, but now that I've actually done it it's not just a theoretical liking. We had one patient, a cat, hospitalized for the entire Easter weekend, where I made friends with the owner. I happened to be on days that entire weekend as well as the one who admitted the cat, so I stayed involved in that case. One day I stayed late so that the owner could visit. She told me that I really helped calm her and made a good impression of our hospital (she'd never been here before), so that makes me feel good about myself. At least I can actually do the client communication part of my job, and someone thinks I'm good at it.
Other parts, I'm not as good at. It was really only my second rotation at school, but I still felt overwhelmed by how much I didn't know, especially when it was really busy. One day I forgot to update my discharge at the end of the day, which was "inappropriate"--and got called as such. When we did a neuro exam, the clinician explicitly did not ask which nerves each reflex tests--but I barely remembered what reflexes I was supposed to test, anyway. I also got snapped at for not knowing what to do when I cleaned Isolation (even after explicitly asking for help because I didn't know what I was doing--and when I later got told that it isn't even my job, anyway). And that's not even mentioning all the diagnoses I didn't get and drugs I didn't have dosages for. I'm recording this in the hopes of progress--I'm not competent yet, but I will be. I'm still learning.
Saturday was the craziest of all. There was one other day I was on cases for almost as much time, but only on the day before Easter did I personally have four different cases (okay, technically two of them were the same suspected toxicity, from the same owner) and my two classmates on with me have at least three each. And that's not even mentioning how many phone calls we kept fielding--everything from "my dog ate chocolate" to a scratch on an eye to the snakebite case that immediately came in. Luckily, some of the Medicine people stayed after taking transfers to help us with the huge influx of cases (it was a medicine student who did the physical on my snakebite dog). Other than anyone who stayed out of the goodness of their hearts, we only had two clinicians and three students. We were all running around like crazy dealing with something like a dozen cases all coming in at once, plus running more diagnostics on hospitalized patients. In the end, we got through it--but it was hugely stressful, with a lot happening all at once and me feeling like I had no clue how to help. And after the next shift started (that was a day shift, so the night students took over), we still had to write discharges. One of my classmates didn't leave his "day" shift until 9pm because he had to keep taking the phone calls no one else was available foor. That was definitely a defining moment for my decision that I do NOT want to do emergency work for my job.
I've kept up with my horseback riding, more or less. Off days on mergency gave me time to do that. Last week we did something really fun--a catch rider lesson. After warming up and riding a course of jumps once, we switched horses and rode it on each of the other four horses in the lesson. We stayed late (theoretically because no one had to go to school the next day, on Good Friday--I had to be at work at 8am, but I just rolled with it anyway) but it was totally worth it. I hope I get to play that game again. This week, the indoor arena had really hard footing since the tractor to drag it was broken, so we couldn't do much jumping. Instead, I got to learn a little about turns on the forehand and turns on the hind. Unfortunately, the horse I was on (Baby) is not very good at those turns. It was especially hard from a halt; she didn't want to move again! We did a fair approximation, though. I'd like to try again sometime. My instructor told me to remind her and I'll be able to try again on a horse who's better trained to it.
I'm so glad I'm done with emergency. I'm back in the classroom now for two weeks of electives--but that's a topic for another blog. After that I've got two rotations I've heard are tough (equine and surgery)--I'll try to record those as well, but at this point I have no idea what kind of time I'll have so I'm guessing none. Once I get through those, though, it'll be summer and I'll be away from school for three months on a combination of vacation and externships (slash "special topics," which is what school is calling the Live Oak Bank externship since it's not at a private practice). That's what I'm looking forward to most right now, and about as far into the future as I can think at this point.
Two rotations down...over a dozen to go.
Tuesday, March 22, 2016
When the Second Thing You Do on Clinics is...Vacation
Hi there; Birdie here!
I'm a little behind on blogging, since I'm now on my third rotation and just blogging about my second. I'll hopefully get a post up about this rotation later this week, but for now I'm going to write about my second two week block--vacation.
After my awesome oncology block, I had two weeks off--and no, I didn't use it to get a head start on VetPrep. I did a lot of reading, played some video games (especially with my little brother), but the reason I had this block as vacation is so I could travel. On March 5, I left for "Fabulous" Las Vegas. I was attending to recieve a leadership award, and part of the award was travel to the conference, including a stay at the Excalibur hotel. When I was scheduling my rotations (and, honestly, until about a week before the conference) I didn't know how much of the conference I needed to attend as an award recipient (it turned out to only be the first couple of days), and the whole 5-day conference was more than we're allowed to miss for any rotation.
Western Veterinary Conference is huge! When we first got access to the program, there were easily three speakers I was interested in at almost any time. Having gone to SAVMA symposium, though, I was used to that. What I wasn't expecting was the sheer size of it: three floors of the Mandalay Bay convention center, and an exhibit hall that just. kept. going. What first struck me when I walked in to the convention center (after far too long of wandering around and winding up at the shipping docks instead of the actual entrance, but that's another story...Google Maps does not know how to walk around Vegas) was that every advertisement on any wall or display was some veterinary product. That was when I knew that for 5 days, we veterinarians owned this place.
The exhibit hall was much bigger and fancier than at SAVMA--I guess when you're marketing to the people who can buy it on a large scale Right Now, you can pull out all the stops. There were a lot of companies offering surgical lights or kennels or other items distinctly for those in practice, but the same sorts of booths as at SAVMA were there too--just bigger. At least two different booths had espresso you could order (Hill's also had not-coffee; the hot chocolate with hazelnut was amazing and I wish I'd found it before the last day), and the "Gard Yard" (for NexGard) had a bucking flea you could ride, as well as T-shirts screen printed just for you in one of four designs. Some of the places saved their free backpacks or pillow pets for veterinarians, or even for those who made purchasing decisions for the practice. But I still wound up with a whole backpack (won in a plinko game from NutraMax) filled entirely with swag, including three free textbooks--one on nutrition, one on derm, and one differential guide. The huge hall was best traversed with another student, at least at first, when it felt like no one would want to talk to me since I'm still in school. But overall, it was definitely a great and memorable part of the conference.
Of course, the conference was way more than checking out new products and getting free swag in the exhibit hall. Being part of the small group of award winners who did so many things together, I got to know students at different vet schools and see some friends from other things I've gone to like VLE or the Fly-in. Several of us joiners who go around applying for things wind up attending a lot of the same things together. On Sunday night, we had a dinner meet-and-greet, and then several of us attended the Brian Regan show free at the conference. I've seen Brian Regan before, and some of his bits I could probably quote by heart, but he had some new stuff too and I enjoyed it. Plus, now the friends who went with me understand why I intentionally say "take luck" or refer to more than one box as "boxen." The next morning, after breakfast and introductions (in the form of introducing partners we'd been paired with the night before), we took a bus to the Oquendo Center, the hands on learning center WVC built. That place is awesome--we saw an ultrasound lab in progress, a rabbit anesthesia class with cadavers and live rabbits to intubate, the large animal area, and a surgery suite with rows of tables for vets to practice fracture repairs or other surgeries. They don't really offer anything for students (although there is a program for vet techs), but they do have a sort of introductory surgery basics class that I might be interested in taking when I start out. It's supposed to be an intensive weekend or so where you can get really comfortable and confident in surgery; I'm not sure how much surgery experience I'm going to get in clinics, but I'll definitely keep it in mind. On Tuesday, awards were presented at yet another breakfast and we took pictures--including one with the VLE 2014 alums who had won the award for our respective schools--there were a good number of us! Besides these award-recipient things, I also went to several lectures (maybe a dozen overall) on everything from service dogs to parvovirus to FLUTD to practice ownership.
Meeting people was one of the best parts of the conference. I got to hang out with friends from VLE and make new friends from other schools who recieved the same award. Some of us got drinks together and even went to the aquarium (rather small, but pretty cool--especially the "monsters of the deep" exhibit with preserved, dissected specimens from an eel to a penguin) on one of the last days. At a DVM students reception (which was kind of sparsely attended, though I found a good group to hang out with), I met a student from Australia who had come over with her dad, who is a veterinarian. I also networked with people in the exhibit hall. A leader at the company who made some of the equipment my summer research used has ties to Wisconsin and is helping me look for places to find an externship in the area.
I also attended the Lead with Your Strengths workshop with a Gallup strengths coach. It cost a bit extra (and will cost more when I get around to unlocking my full results...not thrilled about that) but I'm really glad I went. At first, it did not meet my expectations at all. When I took the quiz, I was expecting the one I had taken last year at authentichappiness.org, but this one was completely different. Instead of agreeing or disagreeing with positive statements, the test makes you choose between two statements that, often, aren't actually opposed at all. I got very annoyed with it, to be honest. It also has a time limit, theoreticaly, of 20 seconds per question...but I never hit that; I guess I read too fast. There were only 4 of us in the workshop, including me and Betsy Charles--I had really expected more. I learned a lot from it, but I struggled hard against it at the beginning. Part of it was because it didn't match my expectations at all, and part was because the "strengths" were not well defined (my "top 3" seem like facets of one thing, to me) and unlike at least two of the other three participants I never read the book or heard of these concepts before. It's an interesting concept, and I'd like to learn more about it. I'll have to actually read the book sometime. But I do feel like I got something out of our conversations, even if I still have a lot more to learn about this complicated system.
And the conference wasn't all I did in Vegas, either. I saw four different shows, besides Brian Regan. Le Reve (which I cannot pronounce right, the Canadian students assured me, but neither did the announcer at the show, so that's ok) at the Wynn was fantastic. It's similar to Cirque de Soleil but not the same company, and it takes place in a huge water stage. Different solid parts of the stage come up at different times, from the tree rising up for performers to dive off of to the multi-tiered fountain for the finale. There were acrobats, too, dropping in from high in the ceiling on silks or rings or swings. I'm so glad I got to see it. Apparently they change the show every six months, according to the hostess at dinner. You can't even see everything in one show just by seeing it once! For the rest, my dad joined me, meeting a friend of his in Vegas. He did the zipline downtown (I did not, becuase after making me leave and come back with a string for my glasses that didn't seem very secure anyway, they didn't have anywhere for me to leave my things--I don't know why they don't have lockers, they could make money off of that), though not the one where you go flat on your stomach. We had planned to do that one, but the time conflicted with our show, so we gave the tickets to a couple (who were just married...again! according to their T-shirts) as they went in to buy tickets. We saw two comedy magicians (Mac King and Adam London) and the musical Rock of Ages (which is a bit awkward to see with your dad, considering the major stripper subplot--not that you would know that from anything on their advertisements). I did my best to enjoy it anyway, and it was very well done, but...awkward. Although dinner that night, the buffet at the Rio, was easily the best meal of the trip.
So there you have it--definitely worth a post in itself, I'd say. Next time, I'll tell you about what it's like to work emergency for two weeks.
I'm a little behind on blogging, since I'm now on my third rotation and just blogging about my second. I'll hopefully get a post up about this rotation later this week, but for now I'm going to write about my second two week block--vacation.
After my awesome oncology block, I had two weeks off--and no, I didn't use it to get a head start on VetPrep. I did a lot of reading, played some video games (especially with my little brother), but the reason I had this block as vacation is so I could travel. On March 5, I left for "Fabulous" Las Vegas. I was attending to recieve a leadership award, and part of the award was travel to the conference, including a stay at the Excalibur hotel. When I was scheduling my rotations (and, honestly, until about a week before the conference) I didn't know how much of the conference I needed to attend as an award recipient (it turned out to only be the first couple of days), and the whole 5-day conference was more than we're allowed to miss for any rotation.
Western Veterinary Conference is huge! When we first got access to the program, there were easily three speakers I was interested in at almost any time. Having gone to SAVMA symposium, though, I was used to that. What I wasn't expecting was the sheer size of it: three floors of the Mandalay Bay convention center, and an exhibit hall that just. kept. going. What first struck me when I walked in to the convention center (after far too long of wandering around and winding up at the shipping docks instead of the actual entrance, but that's another story...Google Maps does not know how to walk around Vegas) was that every advertisement on any wall or display was some veterinary product. That was when I knew that for 5 days, we veterinarians owned this place.
The exhibit hall was much bigger and fancier than at SAVMA--I guess when you're marketing to the people who can buy it on a large scale Right Now, you can pull out all the stops. There were a lot of companies offering surgical lights or kennels or other items distinctly for those in practice, but the same sorts of booths as at SAVMA were there too--just bigger. At least two different booths had espresso you could order (Hill's also had not-coffee; the hot chocolate with hazelnut was amazing and I wish I'd found it before the last day), and the "Gard Yard" (for NexGard) had a bucking flea you could ride, as well as T-shirts screen printed just for you in one of four designs. Some of the places saved their free backpacks or pillow pets for veterinarians, or even for those who made purchasing decisions for the practice. But I still wound up with a whole backpack (won in a plinko game from NutraMax) filled entirely with swag, including three free textbooks--one on nutrition, one on derm, and one differential guide. The huge hall was best traversed with another student, at least at first, when it felt like no one would want to talk to me since I'm still in school. But overall, it was definitely a great and memorable part of the conference.
Of course, the conference was way more than checking out new products and getting free swag in the exhibit hall. Being part of the small group of award winners who did so many things together, I got to know students at different vet schools and see some friends from other things I've gone to like VLE or the Fly-in. Several of us joiners who go around applying for things wind up attending a lot of the same things together. On Sunday night, we had a dinner meet-and-greet, and then several of us attended the Brian Regan show free at the conference. I've seen Brian Regan before, and some of his bits I could probably quote by heart, but he had some new stuff too and I enjoyed it. Plus, now the friends who went with me understand why I intentionally say "take luck" or refer to more than one box as "boxen." The next morning, after breakfast and introductions (in the form of introducing partners we'd been paired with the night before), we took a bus to the Oquendo Center, the hands on learning center WVC built. That place is awesome--we saw an ultrasound lab in progress, a rabbit anesthesia class with cadavers and live rabbits to intubate, the large animal area, and a surgery suite with rows of tables for vets to practice fracture repairs or other surgeries. They don't really offer anything for students (although there is a program for vet techs), but they do have a sort of introductory surgery basics class that I might be interested in taking when I start out. It's supposed to be an intensive weekend or so where you can get really comfortable and confident in surgery; I'm not sure how much surgery experience I'm going to get in clinics, but I'll definitely keep it in mind. On Tuesday, awards were presented at yet another breakfast and we took pictures--including one with the VLE 2014 alums who had won the award for our respective schools--there were a good number of us! Besides these award-recipient things, I also went to several lectures (maybe a dozen overall) on everything from service dogs to parvovirus to FLUTD to practice ownership.
Meeting people was one of the best parts of the conference. I got to hang out with friends from VLE and make new friends from other schools who recieved the same award. Some of us got drinks together and even went to the aquarium (rather small, but pretty cool--especially the "monsters of the deep" exhibit with preserved, dissected specimens from an eel to a penguin) on one of the last days. At a DVM students reception (which was kind of sparsely attended, though I found a good group to hang out with), I met a student from Australia who had come over with her dad, who is a veterinarian. I also networked with people in the exhibit hall. A leader at the company who made some of the equipment my summer research used has ties to Wisconsin and is helping me look for places to find an externship in the area.
I also attended the Lead with Your Strengths workshop with a Gallup strengths coach. It cost a bit extra (and will cost more when I get around to unlocking my full results...not thrilled about that) but I'm really glad I went. At first, it did not meet my expectations at all. When I took the quiz, I was expecting the one I had taken last year at authentichappiness.org, but this one was completely different. Instead of agreeing or disagreeing with positive statements, the test makes you choose between two statements that, often, aren't actually opposed at all. I got very annoyed with it, to be honest. It also has a time limit, theoreticaly, of 20 seconds per question...but I never hit that; I guess I read too fast. There were only 4 of us in the workshop, including me and Betsy Charles--I had really expected more. I learned a lot from it, but I struggled hard against it at the beginning. Part of it was because it didn't match my expectations at all, and part was because the "strengths" were not well defined (my "top 3" seem like facets of one thing, to me) and unlike at least two of the other three participants I never read the book or heard of these concepts before. It's an interesting concept, and I'd like to learn more about it. I'll have to actually read the book sometime. But I do feel like I got something out of our conversations, even if I still have a lot more to learn about this complicated system.
And the conference wasn't all I did in Vegas, either. I saw four different shows, besides Brian Regan. Le Reve (which I cannot pronounce right, the Canadian students assured me, but neither did the announcer at the show, so that's ok) at the Wynn was fantastic. It's similar to Cirque de Soleil but not the same company, and it takes place in a huge water stage. Different solid parts of the stage come up at different times, from the tree rising up for performers to dive off of to the multi-tiered fountain for the finale. There were acrobats, too, dropping in from high in the ceiling on silks or rings or swings. I'm so glad I got to see it. Apparently they change the show every six months, according to the hostess at dinner. You can't even see everything in one show just by seeing it once! For the rest, my dad joined me, meeting a friend of his in Vegas. He did the zipline downtown (I did not, becuase after making me leave and come back with a string for my glasses that didn't seem very secure anyway, they didn't have anywhere for me to leave my things--I don't know why they don't have lockers, they could make money off of that), though not the one where you go flat on your stomach. We had planned to do that one, but the time conflicted with our show, so we gave the tickets to a couple (who were just married...again! according to their T-shirts) as they went in to buy tickets. We saw two comedy magicians (Mac King and Adam London) and the musical Rock of Ages (which is a bit awkward to see with your dad, considering the major stripper subplot--not that you would know that from anything on their advertisements). I did my best to enjoy it anyway, and it was very well done, but...awkward. Although dinner that night, the buffet at the Rio, was easily the best meal of the trip.
So there you have it--definitely worth a post in itself, I'd say. Next time, I'll tell you about what it's like to work emergency for two weeks.
Saturday, February 20, 2016
White Coats and New Beginnings--Clinics!
Hi there; Birdie here!
I haven't blogged since third year started, but I'm hoping to get back into it because now I have really interesting things to talk about--I started clinics this Monday! LSU starts clinics in spring of third year (and I'm still not sure whether I should be introducing myself as a fourth year student now that I'm Phase II). For about a month, we took 3 classes (population, ethics/jurisprudence, and infectious disease). No final grades back yet (except for ethics, which was practically a participation grade--just a few online quizzes and analysis of two cases), which is kind of annoying, but I don't doubt I passed so it's fine. We had our white coat ceremony on Feb 5th, and then we had a week off (which I spent half in the Bahamas and half visiting family in Houston and 0% studying like I'd planned to). So far I'm still not sure that I actually know how to do anything, but I seem to have retained some stuff from classes and I'm learning more all the time. Clinics are pretty awesome, and so much better than being in the classroom.
My first block is oncology for two weeks--for those of you who aren't sure, that means cancer. Whenever I tell anyone that's what I'm on first, the inevitable reaction is how it must be sad and depressing. And there has been that component--yesterday was a tough one, with a cardiac hemangiosarcoma that was euthanized. The owners were so sweet about it; they thanked me for my part in working with him, even though I really don't feel like I deserved it given how I didn't actually do much for him. And I'm not entirely sure my case Monday might not be another euthanasia. But my case yesterday was the only one all week we couldn't do anything for. Learning about cancer is really interesting, and we have really cool options for treatment. The clinicians are wonderful. Our usual oncologist isn't on clinics this block, but we have a locum from Auburn and some interns/residents. The third year resident is taking most of the cases, and she's great to work with.
We never get grilled in case rounds about details of the diseases or treatments we're working with (although I expect that will be different on other rotations, especially medicine), but the clinicians are really good about pulling you in on a doctor level. They ask about what do you want to do next on this case, or what do you think of this bloodwork finding or this clinical sign, or does this plan make sense to you based on what you know about this disease. The part that most surprised me--and makes me feel most like a real doctor when I get it right--is when they ask about medications. A couple of my patients have needed to be sedated for ultrasound, and I was expected to come up with a protocol. And when our patients have non-cancer problems (a corneal abrasion, neck pain), we're asked to come up with medications for those too. They're really chill about it, though--I'm never afraid to try and come up with something, or to say when I don't know. It helps that everyone knows it's our first block (4 of the 5 students on oncology this block are 2017ers); I'm learning, I don't have to know 100% of everything right now. My next block might be a little harder in that regard, but hopefully I do learn enough to keep up with it.
The way this rotation works is that we start each morning with case rounds, introducing everyone to our patients for the day. Then we go for topic rounds, which is kind of a lecture but mostly a conversation about whatever topic is selected for that day--radiation or chemo safety or a specific tumor type or whatever. That takes about an hour, and then we start seeing our cases. If they aren't already here, the students are the ones who go out and greet them and take a history before bringing the pet back to our area. We do a physical exam (although I should be better at making sure I get a good PE--it's hard sometimes with a painful dog who growls when you touch him, or the patient in ICU that I'm scared to mess with), and so does the clinician on the case. We as students do a lot of filling out paperwork (request forms for everything--a lot of bloodwork and imaging, whatever drugs we need, etc.) and calling clients, and we go in the exam room whenever the clinician goes to talk to the clients. We also have to write up discharge summaries for our cases. I actually wrote my first one yesterday (not the hemangiosarcoma, my other case--one of our oncology patients who presented on emergency, and turned out to have hepatic lipidosis) since throughout the week I've been too busy with my other cases and then it needs to be quickly written when the owner is coming, so the clinician takes it. I usually have at least two cases, although on Tuesday neither of my cases showed up, some days some people have had three or four cases, and sometimes I pick up another case that wasn't expected but shows up later in the day (like that hepatic lipidosis cat).
Some highlights from this rotation so far: I felt lymph nodes on a dog with lymphoma--you can definitely feel them when they're that big! I've watched a couple of ultrasounds and looked at a CT scan. And one day, a classmate and I had a little competition. The only thing we knew about the case coming in was that it had a mass on its leg. We competed for the best diagnostic plan, earning points throughout the day for things like picking the correct top differential diagnosis, noticing a swollen lymph node, knowing the right medication to give. In the end, I won (I think by only one point--it was close), with the prize being the loser buying the winner a latte. That was such a fun day--and our clinician even said that we were practically doctors handling the case ourselves! Those are the best moments, when you feel like a real doctor. Clinics are pretty awesome.
Today was open house, and for the first time, I didn't work it at all. Since we started clinics, we're no longer in charge of (or really even in) any clubs, so I didn't have to--and after working all day the past two years, I'm happy not to have to. We were offered extra credit in Infectious Disease for working (and that's why it's annoying not to have our grades back yet), but it was worth it not to have to come in. Hopefully I don't miss that extra credit when grades do come out! I also bought my NAVLE prep materials today. I wasn't planning to start until maybe May...but the sales don't come around again until the end of May, and I'd wanted to start at the beginning of the month. So I may or may not get some use out of it in the meantime. I chose to buy VetPrep over Zuku. I like the company for Zuku better: their questions-of-the-day have little cartoons at the bottom, they seem more personable and very willing to help students, and they were the only ones who came to talk to our class. But they place a big focus on visual learning, and my first instinct when I see a picture on a textbook-type page is to ignore it and just be glad it's not as much to read. Plus some older posts (which, Zuku is newer and has been adding more and more every year, so they may not be totally accurate) seemed to suggest that VetPrep was better, at least a few years ago. My best friend bought Zuku, though (which is absolutely right for her, she's such a visual learner), so if I made the wrong decision I expect I'll know about it. I don't think it really matters that much, though, which service you use; people pass with both of them.
I haven't blogged since third year started, but I'm hoping to get back into it because now I have really interesting things to talk about--I started clinics this Monday! LSU starts clinics in spring of third year (and I'm still not sure whether I should be introducing myself as a fourth year student now that I'm Phase II). For about a month, we took 3 classes (population, ethics/jurisprudence, and infectious disease). No final grades back yet (except for ethics, which was practically a participation grade--just a few online quizzes and analysis of two cases), which is kind of annoying, but I don't doubt I passed so it's fine. We had our white coat ceremony on Feb 5th, and then we had a week off (which I spent half in the Bahamas and half visiting family in Houston and 0% studying like I'd planned to). So far I'm still not sure that I actually know how to do anything, but I seem to have retained some stuff from classes and I'm learning more all the time. Clinics are pretty awesome, and so much better than being in the classroom.
My first block is oncology for two weeks--for those of you who aren't sure, that means cancer. Whenever I tell anyone that's what I'm on first, the inevitable reaction is how it must be sad and depressing. And there has been that component--yesterday was a tough one, with a cardiac hemangiosarcoma that was euthanized. The owners were so sweet about it; they thanked me for my part in working with him, even though I really don't feel like I deserved it given how I didn't actually do much for him. And I'm not entirely sure my case Monday might not be another euthanasia. But my case yesterday was the only one all week we couldn't do anything for. Learning about cancer is really interesting, and we have really cool options for treatment. The clinicians are wonderful. Our usual oncologist isn't on clinics this block, but we have a locum from Auburn and some interns/residents. The third year resident is taking most of the cases, and she's great to work with.
We never get grilled in case rounds about details of the diseases or treatments we're working with (although I expect that will be different on other rotations, especially medicine), but the clinicians are really good about pulling you in on a doctor level. They ask about what do you want to do next on this case, or what do you think of this bloodwork finding or this clinical sign, or does this plan make sense to you based on what you know about this disease. The part that most surprised me--and makes me feel most like a real doctor when I get it right--is when they ask about medications. A couple of my patients have needed to be sedated for ultrasound, and I was expected to come up with a protocol. And when our patients have non-cancer problems (a corneal abrasion, neck pain), we're asked to come up with medications for those too. They're really chill about it, though--I'm never afraid to try and come up with something, or to say when I don't know. It helps that everyone knows it's our first block (4 of the 5 students on oncology this block are 2017ers); I'm learning, I don't have to know 100% of everything right now. My next block might be a little harder in that regard, but hopefully I do learn enough to keep up with it.
The way this rotation works is that we start each morning with case rounds, introducing everyone to our patients for the day. Then we go for topic rounds, which is kind of a lecture but mostly a conversation about whatever topic is selected for that day--radiation or chemo safety or a specific tumor type or whatever. That takes about an hour, and then we start seeing our cases. If they aren't already here, the students are the ones who go out and greet them and take a history before bringing the pet back to our area. We do a physical exam (although I should be better at making sure I get a good PE--it's hard sometimes with a painful dog who growls when you touch him, or the patient in ICU that I'm scared to mess with), and so does the clinician on the case. We as students do a lot of filling out paperwork (request forms for everything--a lot of bloodwork and imaging, whatever drugs we need, etc.) and calling clients, and we go in the exam room whenever the clinician goes to talk to the clients. We also have to write up discharge summaries for our cases. I actually wrote my first one yesterday (not the hemangiosarcoma, my other case--one of our oncology patients who presented on emergency, and turned out to have hepatic lipidosis) since throughout the week I've been too busy with my other cases and then it needs to be quickly written when the owner is coming, so the clinician takes it. I usually have at least two cases, although on Tuesday neither of my cases showed up, some days some people have had three or four cases, and sometimes I pick up another case that wasn't expected but shows up later in the day (like that hepatic lipidosis cat).
Some highlights from this rotation so far: I felt lymph nodes on a dog with lymphoma--you can definitely feel them when they're that big! I've watched a couple of ultrasounds and looked at a CT scan. And one day, a classmate and I had a little competition. The only thing we knew about the case coming in was that it had a mass on its leg. We competed for the best diagnostic plan, earning points throughout the day for things like picking the correct top differential diagnosis, noticing a swollen lymph node, knowing the right medication to give. In the end, I won (I think by only one point--it was close), with the prize being the loser buying the winner a latte. That was such a fun day--and our clinician even said that we were practically doctors handling the case ourselves! Those are the best moments, when you feel like a real doctor. Clinics are pretty awesome.
Today was open house, and for the first time, I didn't work it at all. Since we started clinics, we're no longer in charge of (or really even in) any clubs, so I didn't have to--and after working all day the past two years, I'm happy not to have to. We were offered extra credit in Infectious Disease for working (and that's why it's annoying not to have our grades back yet), but it was worth it not to have to come in. Hopefully I don't miss that extra credit when grades do come out! I also bought my NAVLE prep materials today. I wasn't planning to start until maybe May...but the sales don't come around again until the end of May, and I'd wanted to start at the beginning of the month. So I may or may not get some use out of it in the meantime. I chose to buy VetPrep over Zuku. I like the company for Zuku better: their questions-of-the-day have little cartoons at the bottom, they seem more personable and very willing to help students, and they were the only ones who came to talk to our class. But they place a big focus on visual learning, and my first instinct when I see a picture on a textbook-type page is to ignore it and just be glad it's not as much to read. Plus some older posts (which, Zuku is newer and has been adding more and more every year, so they may not be totally accurate) seemed to suggest that VetPrep was better, at least a few years ago. My best friend bought Zuku, though (which is absolutely right for her, she's such a visual learner), so if I made the wrong decision I expect I'll know about it. I don't think it really matters that much, though, which service you use; people pass with both of them.
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