Veterinary school: It’s the best of times, it’s the worst of times. My friends and I used to describe veterinary school in one statement: “This too shall pass...kind of like a kidney stone.” Don’t get me wrong. The veterinary education I received from the University of Missouri was top notch. The volume of information I learned was huge, and after a tough week of finals, I would often feel like I had a lobotomy. After a few years of practice, veterinarians tend to forget a lot of the things we don’t use, however, we can sometimes surprise ourselves like when we just happen to describe the Krebs Cycle during a conversation. Or when our colleagues are discussing a cat scratch fever, someone blurts out, “Bartonella henselae!” However, after seven years of schooling and a doctoral degree, there are simply some things I (and many of my colleagues) didn’t learn in veterinary school: 1.) How to stand up for yourself- Luckily, I learned how to do this before veterinary school after years of “experience,” however, if you haven’t learned how to stick up for yourself by veterinary school, you’re certainly not going to learn it there. In fact, speaking your mind or standing up for yourself in veterinary school is generally frowned upon. As a student, being agreeable and sometimes downright submissive was encouraged. In a lot of ways, there really is a good reason for that. Students are at the bottom of the vet school hierarchy, for good reason. As a student, you really don’t know a lot, especially compared to faculty members with lots of initials behind their names and years of experience. Even though I do try to avoid conflict when necessary, I’m a pretty outspoken, stubborn person. Keeping my mouth shut is not one of my many talents, especially if someone is being disrespectful or arrogant. However, my need to be agreeable and obedient had almost become habit by the time I graduated. Most new graduates realize quickly that in the real life of private practice, many of those qualities that were reinforced in veterinary school will get you nowhere. While it’s important to be patient and professional with colleagues and clients, there are many times when it becomes necessary to stand up for yourself, and stand up for your license. Do no harm, but take no crap either. Whether it’s a client that wants a prescription drug without seeing the pet, a breeder that wants a half dose of vaccine because it’s “too much” for their chihuahuas, or a coworker that’s case dodging, don’t hesitate to stand your ground. It’s a tough transition from student to practitioner. The world is also a tough place, so toughen up, Buttercup. 2. How to solve a $1000 problem on a $50 budget- When you’re in veterinary school, your clinical rotations often take place in a teaching hospital with state-of-the-art diagnostic equipment, including MRI, CT scanner, fluoroscopy, echocardiography, advanced laboratory tests, and more. Most clients taking their dog, cat, horse, or cow to a referral center are prepared to spend thousands of dollars. As students, we’re trained to listen to symptoms and history, come up with a differential list (possible diagnoses), diagnostics to rule out those differentials, and a treatment plan. This is how we’re trained to treat animals and give standard-of-care medicine. During clinical rotations, most clients (but not all) consent to advanced testing to find an answer. After graduation, an owner may bring you a sick cat. You do some labs and imaging and find the cat is diabetic, hyperthyroid, and has heart disease. You discuss all treatment options to find that the client is on a fixed income. They’re not ready to let go of Fluffy. They want you to try something, to treat them. You may think, “This is not part of the plan! This is not how I was trained!” The fact is, many of your clients may be on limited incomes. They love their pets, but they need to feed their families. However frustrating, in these situations, you learn to improvise and do your best, all while trying your hardest to maintain realistic expectations from the client. Can you actually solve a $1000 problem on a $50 budget? No, you can’t, but like Macgyver, sometimes you can work with the resources you have to get yourself out of a tricky situation and give your clients more time with their pet. 3. How to handle stress in a healthy way- The transition from college to veterinary school can be difficult. Instead of having finals week twice a year as you do in undergrad, picture that hell every three weeks, and the material is twice as difficult. Don’t get me wrong. I worked hard in college. I studied hard and was rewarded with A’s in pretty much every class I took, except Gen Chem I. Darn you, stoichiometry! Not to brag, but I went from being one of the best students at my moderately sized college to just an average Joe. My first week of tests in veterinary school showed a common trend: B’s. B’s?! Really?! Getting B’s really bothered me for about the first week of class, but I let it go. I took school seriously and was willing to work, but I also was aware of what it took to make straight A’s in veterinary school (locking yourself in the library and studying 24/7). Did veterinary school dominate my life, and at times, did I go days without showering or sleeping? Yes. But most of the time, I made time for things that were important to me, which was time with my husband and exercising. However, healthy life-balance habits were not generally encouraged. After squeezing in a run during a one-hour class break, I would get strange looks from professors and fellow classmates while rushing into class in my spandex covered in sweat. Actually, those strange looks may have just been grimaces from my smell or the sweat I just flicked on someone. Feel like you should eat healthier? Nah, get a pizza and a soda from The Zou (our cafeteria) instead. Sitting in class eight hours/day and then going home and studying has its challenges, and the sedentary lifestyle was somewhat of an adjustment. I’d still run most days, but did my 45 minutes of cardio really make up for sitting on my bum for the other 23 hours of the day? So how did we cope? Well, we ate lots of unhealthy food, drank LOTS of coffee, stared at our computer screens in coffee shops, eavesdropped on other people in the coffee shop when that got too boring, ate more food to reward ourselves, and then laughed with our study pals when all of the previous things listed made us delirious. And yes, I’m not going to lie, there were veterinary school parties, another coping method for many of us. Some of the students (usually the ones that had spent the previous three weeks in the library), would go gangbusters at these parties. It was an entertaining and somewhat disturbing thing to watch. There’s a reason why compassion fatigue, depression, alcoholism, and even suicide is common in our profession. Our careers are stressful and many professionals haven’t established healthy habits to handle that stress. We put so much into our jobs that we forget to take care of ourselves, and if you haven’t established healthy stress-handling habits before veterinary school, you’re certainly not going to learn it there. My advice is to exercise, eat well, don’t drink to excess, get plenty of sleep, and get a hobby outside of veterinary practice for God’s sake. That may seem impossible in this profession, but if you make time to prioritize your health, you’ll be a better person and a better professional because of it. 4. How to back a trailer- Despite going into mixed animal practice and working with farm animals on a daily basis, I was not raised on a farm. I lacked many of the skills a seven-year-old farm kid would have. Weeks before graduation, I came to the realization that my job would entail backing the clinic’s portable chute, which is what we use when we go to farms to work animals. Sure, I could have Omer, one of my technicians, back it for me, but how would that look? Farmers may already think less of me as a young, inexperienced female veterinarian. I didn’t need to add fuel to the fire, so the first several weeks of practice, my husband graciously volunteered to train me on backing the chute during the weekends. On a Sunday afternoon, I would pick up the portable chute with my vet truck, drive it to the local fairgrounds, and practice backing it over, and over, and over again. My husband called this marriage counseling. He would guide me, and often times throw his hands in the air saying, “What are you doing?!” I would respond with, “I don’t know! I’m never going to get this!” There may have been a little swearing from both sides as well. Well, eventually I did get it. Did I have to have Omer back the chute for me on occasion when I failed to do it myself? Yes, a few times, but it always feels good when a farmer gives you a look of surprise and delight when you line the chute up perfectly on the first try. 5. How to have difficult conversations with clients- One of the great benefits of veterinary school is that for the most part, you are shielded from delivering terrible news to clients. Students do interact with clients quite regularly, but for the tough stuff, the “big guns,” like faculty or residents, were brought in. This is partly for liability reasons (and the fact that most students in the middle of their clinicals aren’t prepared for this). Many recent graduates may walk into work and find the patient they have hospitalized for days, hoping for a cure, has lost their battle with their disease. Your hands clam up and you get a knot in your throat, not only at the thought of losing your patient, which is bad enough, but now you have to deliver the news to Mrs. Smith yourself. This is new territory, and it’s hard to say how the client will react. With more and more experience with these conversations (not that you want to have them often), you learn what helps and what doesn’t. You learn how to read your clients and express empathy more effectively. You also learn to remain calm, professional, and understanding when you talk to a client whose immediate reaction is anger. This profession is not for the weak of heart. 6. How to supervise staff, especially those who are older with many more years of experience in the field- This can be a touchy situation. It can be hard for the staff at a clinic to adjust to a brand new veterinarian, especially if they feel they outrank you with experience. Luckily, the staff at my current practice has been very accepting, but this is not always the case for every new graduate. Veterinarians may be faced with staff questioning their methods (especially if they’re different from previous veterinarians). Conflict can also arise when staff don’t appreciate taking orders from the newbie vet. As always, communication is so important in these situations. Assuming you’re dealing with a reasonable person (not always the case), simply explaining and educating the staff as to why you do things a certain way goes a long way. Most people will be understanding if you approach it this way. However, sometimes it’s not that simple. If you can’t resolve the conflict on your own, you may need to get the practice owner and practice manager on your side. However, some are not so lucky. The interpersonal skills of some practice owners and managers can leave something to be desired at times, which can lead to even more conflict. We’re not trained to deal with this in school. Sure, you may get on a clinical rotation with certain blockmates that don’t pull their weight or you just simply don’t get along with them. In most of those cases, you bite your tongue and buckle down for six weeks until the block changes. That’s not possible once you enter private practice. You have to learn to work with the people in your practice, and pray that the practice you’re going into has excellent/reasonable staff. However, even with great staff, not a single practice is free of conflict and every practitioner will have to learn these skills. You may have to change jobs if the situation is dire enough, but in most cases, you’ll need to learn to adapt to your surroundings and work with people to make positive change if possible. 7. How to make changes or improvements without rocking the boat too much too soon- The number of changes or improvements you’ll want to make can vary largely depending on what practice you join. After graduating veterinary school, you’re on cloud nine and ready to save the world. You have the most up-to-date knowledge of medicine, which is why many people hire new graduates. That and you’ll work like a dog for cheap. Some practice owners may be more receptive to change than others. I was fortunate to go into a situation where even as an associate, I was able to make MOST of the changes I wanted and practice medicine the way I wanted to practice. In some practices, there may be some changes you’ll want to make right away, especially if certain practices are not in line with standard-of-care. Remember, most practice owners hire you because they want your input. However, you have to tread carefully. Make a list of changes you want to make and prioritize those changes. You’re probably not going to be able to make ALL the changes you want all at once. You need to approach these conversations respectfully, but be clear about your needs. Don’t lead by insulting the practice owner or saying their methods aren’t appropriate. Even if this is true, you’re not going to get anywhere with that approach. It also helps if you’ve done your research and provide reasons why those changes are necessary. You also have to remember that a veterinary practice is a business. If you’re asking a practice owner to make a $50,000 upgrade, you need to provide evidence that there is a need for that equipment upgrade, and that the practice can make enough money off of that upgrade to pay it off in a reasonable amount of time. If you’re wanting to add a new service, you need to show that there is a demand for that service and that you will market it effectively. In most cases, things are not going to be handed to you. Pick your battles and suggest changes a little bit at a time. Unless there are dire changes that need to be made right away, I suggest practicing for at least a month or two before you suggest any improvements. This will allow you to get a feel for the practice owner and how progressive they are, but also how well the current methods they’re using actually work. You may be surprised how well certain things work, and you’ll learn new methods along the way. Remember, you have the most up-to-date knowledge, but you can learn a lot from the experience of your practice owner and colleagues, even if some of their methods differ from what you’re taught in school. Keep an open mind, but if something is important to you, let yourself be heard.
Needless to say, your first few years after graduation are going to be very enlightening (sometimes in a good way, sometimes in a bad way). If you get anything out of this blog post, it’s this: Your education doesn’t end when you graduate veterinary school. In many cases, that’s when your true education begins. I’m far from having it all figured out, but I’ve certainly come a long way in four years.
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Jessica Stroupe, DVM
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August 2017
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