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Khelmar
Oct 12, 2003

Things fix me.
Here's the thread for all of us to bitch about our classmates, schools, other veterinarians, or whatever.

If you've got questions about what it's like to be a vet, how to get into vet school, internships, residencies, going on to grad school, or other topics, this is also the place!

A brief overview of veterinary school:

1. Stress like a rodent on meth to get grades good enough to get accepted into veterinary school (2-4 years)

2. Stress like a rodent on meth and crack to get through the pre-clinical phase (while drinking like a fish) (2-3 years)

3. Skip sleep to write more damned SOAPs on clinics (1.5-2 years)

4. Graduate! (2 hours)

5.

6. Profit (I'm still working out how long it takes to get to this step)

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Khelmar
Oct 12, 2003

Things fix me.

Carebear posted:

Can we make this a veterinary nursing thread as well? I've love to talk to people about tips with stuff like catheters, laboratory procedures, etc... or talk about sad / interesting cases. Or if that's too broad, that's okay. I'd still love to hear vet stories.


Yeah, vet techs / nurses are welcome to participate as well!

Braki posted:

I just went back into the archives and found one of Khelmar's old threads about pathology back when he was studying for path boards. Khelmar, would you ever be willing to do that again? I remember it being so fun and cool, and now that I kind of have an idea of what I'm looking at, I see those pictures in a totally new light.

Sure, I'll work on one this weekend.

One of my favorite vet student stories was when I was a resident. A student had forgotten to check a dead foal for a cleft palate, so I said I'd hold the mouth open while she checked. While her arm was inside the mouth, I pretended to close the jaws and went "GRR!", which made her scream a lot. :)

Our students about a year ago had a small animal surgeon on the rotation, to fulfill a requirement for his boards. They turned to him and said, "Hey, we forgot to get gall bladder on this horse. Could you go get it for us?" The poor guy spent 20 minutes looking before the students busted out laughing. I was so proud. :)

A few months ago, I had a student submit a mass on the labia for histopathology. The history included such gems as "This horse is lightly ridden every day. She gets a 1/2 flake of sweet clover hay twice daily, and is on Cosequin to prevent arthritis." I'm sorry, what part of "labial mass" makes you think I need to know this crap?? How about telling me how long the mass has been there instead??

Then, there's veterinarians. Getting a history form with a biopsy with "N/A" under species is always awesome. One vet who sent their biopsies to the place I did my residency always put "Please give diagnosis and prognosis" under the history section. Oh, really, that's why you're sending this? Other people put down "Please biopsy." You really don't want me to do that, since you've already sent me a chunk of tissue!

Khelmar
Oct 12, 2003

Things fix me.
Radiologist: A radiology report should be like a skirt. Long enough to cover everything, short enough to keep it interesting.

(This didn't go over well.)

Cardiologist: "What are those, reservoir-tipped condom gloves? You need to go down half a size smaller."

Same surgery:

"Do you masturbate with your thumbs? Get those out of there and pull the suture with your fingers!"

We were always amazed that he never had a sexual harassment suit against him.

Khelmar
Oct 12, 2003

Things fix me.
"Starter topics" for conversation:

1. How many tries did it take you to get in?

2. What weight did your school place on different components of the application?

3. Did you interview? What were the questions like?

4. What do you like LEAST about vet school?

5. What do you wish you would have known before starting?

6. If you could start over with undergrad, what would you do differently?

Khelmar
Oct 12, 2003

Things fix me.

Travic posted:

Professor: "The only way to fail this rotation is to miss a lesion or stab me with a necropsy knife."

"You'll notice this fluid/tissue looks like cottage cheese/tomato soup/pudding/etc."

I tell students that the most important thing on the rotation is to not make me do paperwork. Stabbing yourself makes me do paperwork. If you stab me, I stab back.

I also tell students, "I don't start hose fights. I finish them."

The second phrase there was NOT uttered by a pathologist; we hate food terms. :)

When I was in school, there was no automatic logout, so we used to get e-mails from random people saying they were selling their books to drop out and become monks.

Khelmar
Oct 12, 2003

Things fix me.

Rixatrix posted:

Why? I remember food came up a lot in dissections and autopsies back in uni.

They're imprecise - "grapefruit-sized" doesn't tell you how big the grapefruit is. Also, if all you can do is compare things to food, it suggests you have a limited vocabulary.

Some terms, like "nutmeg liver" or "caseous discharge" are so entrenched that they're still used.

It's better to say "30mL of viscous, pink fluid" rather than "tomato soup like".

Khelmar
Oct 12, 2003

Things fix me.

YourCreation posted:

So Khelmar since you're a rockstar Pathologist now (and since you stood me up for a Gainesville tour hehe), perhaps you could share with us students some study strategies for learning Histology/Pathology. It would be greatly appreciated!

I'll start with histology, since it's easier to explain.

1. Look at the slides.
2. Look at the slides.
3. Look at the slides.

What you need to do for histology is associate structure (what you see under the microscope) with function (what the organ does). Histology seems stupid and pointless until you realize that the structure of these organs is directly related to function.

So, when you look at a lymph node, it seems stupid to learn that the incoming lymphatics go into the subcapsular sinus and filter through the node to end up at the medulla, until you realize that if you're looking for metastatic cancer, you need to look in the subcapsular sinuses since that's where the cancer will go first.

What you REALLY need to do is have a mental picture of what each organ looks like, which starts with having a knowledge of what each kind of cell looks like.

For example, "There's a blood vessel and a tube made up of epithelial cells, with distinct cell borders. Those are surrounded by eosinophilic cells forming cords radiating towards another blood vessel." Well, that pretty much has to be liver - you just need to be able to recognize bile ductules, and you've got portal vs. central sorted out.

Khelmar
Oct 12, 2003

Things fix me.
MSU had an intramural inner tube water polo team for students and one for faculty - that was a lot of fun.

Khelmar
Oct 12, 2003

Things fix me.
Cryptosporidium is called the "food animal weight loss plan", since it seems like someone gets it every rotation.

Khelmar
Oct 12, 2003

Things fix me.
I've had vets put down "N/A" under "species" on a biopsy form. I've had students forget to tell me a dog was blind, then wonder why I didn't look at the eyes under the microscope. One of my favorites is watching people try to justify using the term "lymphoma".

Khelmar
Oct 12, 2003

Things fix me.

Chaco posted:

Khelmar, can we get some clear guidelines about what is and is not allowed in the way of offering medical-type explanations and suggestions? don't also get banned.

Sorry, I was out of contact when that all went down. That said, I was kind of bugged by the presentation - "it's this... or it could be this... or this.." in three separate posts is not a great way of going about this.

I'm also going to have a discussion with other mods and admins about it, since I have yet to come up with a policy that's all-inclusive and easy to verbalize. Right now, it's kind of a feel thing - some things just feel wrong, but that doesn't give you folks a good meterstick to go by.

For now, until I get a better policy hammered out, don't discuss individual bloodwork results, and tell people to get a second opinion if they're concerned. If you have ideas for how to come up with a policy that prevents people from turning this into a vet replacement, but still allows for interesting case discussion, let me know!

Khelmar
Oct 12, 2003

Things fix me.

Solis posted:


Otherwise, I don't even know which schools or places I should be looking at for this stuff. Can anyone give me some advice?

What do you want to do? It's easier to tell you where to look if we know the kind of thing you want to do. For example, if you want to hate yourself, UC Davis is a good place to go. :) (I hate California)

If you want zoo / wildlife medicine, Florida is a great place. If you want oncology, Colorado is great.

Khelmar
Oct 12, 2003

Things fix me.

Chaco posted:

What, you don't even like our Path department? Heck, I like our Path department, and our necropsy floor is pretty sweet. I would not recommend coming out here for a rotation cutting up dead things, though, unless you're into that kind of thing.

I know a lot of your path department, and I like them. I just loathe California in general and Davis in particular. :) Your path floor is new and amazing. No one in the drat state can drive worth a drat.

If you want to do ER, Penn is an obvious choice (yes, yes, Pennwes, we know). If you want something exotic, you might talk to Matt Beal at MSU about doing an ER / interventional radiology rotation.

UCD is a good choice for anesthesia. I don't think they do interns, so if you're thinking you might go for an anesthesia residency, doing an externship there might be a good choice.

Khelmar
Oct 12, 2003

Things fix me.

Solis posted:

Thanks Khelmar! I'll probably start calling/surfing around after my last exam Friday.

My wife also says that Cornell and Penn are good for anesthesia. However, if you want to do anything "touristy" while down here (and, let's face it, that's what externships are for!), Penn is not a good choice. :)

As much as I loathe California, at least Davis is only 4 hours from Yosemite, which is amazing.

To all the other vet students: anyone have any cool externships lined up? I went to Edinburgh in Scotland while I was in vet school, which was amazing. Also, Plum Island is an incredible place, so check if your school is part of the Smith-Kilborne program. The FADL course was the best CE I've ever done, and I wish I could go back every year. My wife really enjoyed doing an externship to UF's wildlife program and Minnesota's raptor program.

Khelmar
Oct 12, 2003

Things fix me.
That brings up an interesting topic - how do you think vets SHOULD be educated? Should we focus more on problem solving, and less on memorizing facts? Would you rather have a more vague question that makes you think, or something that is concrete?

While many people say they want the former, my experiences with teaching have told me that students would rather barf out facts. :)

Khelmar
Oct 12, 2003

Things fix me.

Braki posted:

"Nevertheless, from time to time you’ll have dead space in your life no matter what (insert snide remark about Pathology here)."

"Iatrogenic [fractures]: the type of fractures surgeons blame on Anesthesia...or on owners letting their dogs run around too much after surgery."

This is definitely a surgeon. My wife and I say that one of the things that brings us together in our marriage is how much surgeons irritate us. :)

And let me say, from the standpoint of your teachers - it's MUCH easier to just give a multiple choice test. For a review course of small animal path, I taught liver. On the test, I gave a question with a cat with a big liver and big kidneys on abdominal palpation, elevated liver enzymes, a mild leukocytosis, azotemia, and isothenuria. My questions were things like "What are your differentials? What's most likely? Why? How would you confirm that?"

There were several people who didn't even mention the kidneys. Other people didn't realize 1.012 is isothenuric in a cat. These things scare me.

Khelmar
Oct 12, 2003

Things fix me.
The problem with PBL is that it takes a LOT of time and effort, and the research suggests that pure PBL doesn't do a better job producing doctors than non-PBL. Personally, I favor a blend - there are facts you need to know, and you can cover way more of them without PBL, but PBL helps students to see how it fits together into a picture that's useful.

Western basically throws you into a case - you learn anatomy, etc. through a case-based format. Some students like it, some hate it.

WSU did two awesome PBL sessions in one semester; they would bring in people from the community as clients, and students would have to talk to them about what they want to do and why. It really makes you think about not just the case, but how to deal with owner concerns, money problems, etc. as well as communicating with them.

However, I'm convinced we need to do a better job in examining applicants to vet school to determine their ability to integrate information into a whole picture.

Khelmar
Oct 12, 2003

Things fix me.

Enelrahc posted:

"Sooooooo you're doing the nasal swab so that you can identify which antibiotics you will use on the virus, right?"

:suicide:

quote:

surgery is fun

This is an enormous lie. :)

quote:

I 100% agree with you, but don't know how you'd go about measuring something like this.

I guess my thought on this is that you have the person explain something they've done in the past, which obviously requires an examination of their packet. Most of what we do as doctors can be broken down into:

1. Gathering data
2. Synthesis of data into a gestalt
3. Determining a course of action
4. Educating people about the course of action

Whether you're a private practitioner, an academic, or working for the CDC, you're doing those 4 steps. I think teaching someone about something you've done is a good way to show that you can do those things - explaining the WHY behind the WHAT you do is a good way to show you were paying attention.

This brings up an interesting (to me) subject - what do you think vet school interviews should be like? Has anyone done that "speed interviewing" thing that seems popular now? Any opinions? Should we have interviews at all?

Back in the dark ages, when I interviewed, we had a timed essay on a subject we got when we arrived. Then we had an hour long interview, and then a tour of the school. I thought it was good overall, although my interviewers asked a lot of knowledge and not many thought questions.

Khelmar
Oct 12, 2003

Things fix me.
You're not crazy, it's the dog formulation, it's just that Hartz doesn't mark the packages that well so people freak out.

Khelmar
Oct 12, 2003

Things fix me.

Topoisomerase posted:

It's an elective for us too. I figured my vet school experience was not complete without this time honored tradition.

Every vet should have to do this, if only to have more respect for people who don't suck at it. :)

After a while, I could just barely get to the point where I could figure out what was the uterus. Still, helps keep the arms warm in winter.

Worst lab? Learning how to "collect" dog semen. Those were, however, the happiest beagles on the planet - it was disturbing how they started wagging as soon as they got into the room the lab was in.

Khelmar
Oct 12, 2003

Things fix me.
Being intubated was the first time my dog could actually breathe.

Khelmar
Oct 12, 2003

Things fix me.
I'm on call now. Still, on call path isn't usually too bad except weekends. :)

Khelmar
Oct 12, 2003

Things fix me.

HelloSailorSign posted:

So what generally is a path emergency?

What I can come up with:
- herd health situations (try to save the others!)
- some infectious disease processes where people/other animals have been bitten (figure it out to know the treatment!)

Yeah, also (IMO) neonatal diarrhea - I want the GIT out as fast as possible before it rots too much.

quote:

Also, what is the greatest number of different cancers you've found in an animal, and what was the animal and what were the cancers?

Good question - I don't remember right off. I can say I've seen slides of "collision tumors", where you get two different masses (usually a carcinoma and a sarcoma) that invade the same tissue. They like to put these on boards. :)

Khelmar
Oct 12, 2003

Things fix me.

Solis posted:

a congenital traumatic diaphragmatic hernia

The puppy was hit by a car in utero?

Khelmar
Oct 12, 2003

Things fix me.

Topoisomerase posted:

I'm screwed aren't I?

If you haven't figured THAT out by now, you haven't been paying attention...

Khelmar
Oct 12, 2003

Things fix me.

HelloSailorSign posted:

Oh hey, has anyone gotten anything weird from clients as gifts? One client gave me one of those Watchtower-esque religious pamphlets as a gift because I did good.

I got a kid's Snoopy backpack.

Khelmar
Oct 12, 2003

Things fix me.
Congrats! You guys have jobs yet? :)

Khelmar
Oct 12, 2003

Things fix me.
The semester ends and you all disappear? WTF?

Khelmar
Oct 12, 2003

Things fix me.
Here's my thoughts:

Trained assistant: I expect them to be able to hold animals and not get me or them bitten.

Eventually, I expect them to draw blood, give pills, give IM, SQ, and IV injections, take temp, pulse, and respiratory rate, work the computers, answer phones, and clean kennels and equipment.

LVT: I expect all the above, plus ability to monitor anesthesia and warn me of varying trends or areas of concern, ability to train assistants, knowledge of sterile procedure (to help in surgery if needed), and analysis of stocking / ordering. I also expect knowledge of controlled substance laws, since they'll probably be doing the inventories for DEA.

However, I worked at a practice that wanted the doctors to diagnose, prescribe, and do surgery (since those are the things you must be a DVM to do), and techs to do everything else. It's skewed my perspective (in a good way).

Khelmar
Oct 12, 2003

Things fix me.

YourCreation posted:

Ugh yes. I must have about 300 pockets on my scrub pants. Where else will I fit my bandage scissors, suture scissors, pen light, permanent marker, three pens, highlighter, and hemostats?

You can tell where someone is on clinics by how much stuff they carry. Faculty don't carry a thing. :)

Khelmar
Oct 12, 2003

Things fix me.

Topoisomerase posted:

anyway what does a pathologist need to carry around? a butcher's knife and some paraffin wax?

One of the professors at WSU had a list, including a holster for your knife, knife, sharp scissors, shears, etc. For Halloween one year, one of the students dressed up as the "ideal pathologist" based on his description.

When I'm on the floor, I have scrubs, an apron, a bluetooth speaker, and my iPhone. The students are doing the cutting, so I don't need much. :)

Khelmar
Oct 12, 2003

Things fix me.

Asstro Van posted:

I've been meaning to ask you something, Khelmar. Our pathologist said that around 3% of the samples that they get sent don't even have the patient's species listed. Do you get a lot of poorly labeled things sent to you?

A better question is, "Do you ever get anything that's not poorly labeled?"

I don't understand it, but people cannot write a history to save their damned lives. There's nothing like doing a necropsy and having the clinician ask, "Did you find out why they were blind?"

No, probably because you never mentioned that.

"Acute death" as the sum total of my history is awesome, too.

If you want to anger a pathologist, ask them about histories.

Khelmar
Oct 12, 2003

Things fix me.
There was one practitioner who submitted every history as "Please give diagnosis and prognosis", and that was all she'd tell me. Another said "Please biopsy".

I especially love seeing "N/A" under species. Yeah, the species is NEVER applicable as to what's wrong with the animal.

And yes, we occasionally have consults with each other trying to decipher WTF someone is telling us on our history forms.

How hard is this to figure out? Don't copy and paste everything out of the computer system, don't write nothing, just pretend you're transferring the animal to me for further treatment and tell me why it came in, what you found, what you did, and what the response to that was, as well as pertinent medical history. It's not rocket science.

Khelmar
Oct 12, 2003

Things fix me.
Looks like it has amitraz, which, while damned effective, can have some nasty side effects. Probably a lower dose of amitraz than what we used to use, but may still suffer from some of the same issues.

Khelmar
Oct 12, 2003

Things fix me.

Enelrahc posted:

I've been doing zuku with a 4th year on this externship and I don't mind them. I do need to learn more about chickens though. Stupid chickens.

Merek's, ILT, Fowl cholera, AI, Newcastle's disease, you're done with chickens.

Khelmar
Oct 12, 2003

Things fix me.
Rules of junior surgery:

1. EAT BEFOREHAND.

2. If you feel hot, tell someone. You are about to pass out. It's better to do so when someone is ready to catch you.

3. See #1

Khelmar
Oct 12, 2003

Things fix me.

I Love You! posted:

UC Davis
Ross University
Michigan State University
University of Minnesota
University of Pennsylvania
Cornell University

UC Davis is in California, and should be all I need to say about how bad it is. :)

Ross University is an interesting place. It's basically in a third-world country, and so there's a fairly high crime rate on the island and people from the US are somewhat targeted for that. It's also expensive.

That said, the only mission there is teaching, and they focus heavily on that. They also have some great folks working down there, and pretty decent infrastructure. Unfortunately, they also have a fairly high attrition rate, because they're taking in people who weren't admitted to "standard" US schools. Finally, they've become accredited, so there's no taking the ECFVG to practice.

MSU is great. Great people, great facilities, and I might be biased because that's where I went. :)

Khelmar
Oct 12, 2003

Things fix me.

HelloSailorSign posted:

I loved going to Davis. Khelmar, why do you hate California?

First, no one in the state can drive a car. I wanted to murder every single person on the highway, continuously, the whole time I was there. It takes forever to get anywhere, because of all the idiots.

California is super expensive to live in, and it's hotter than hell and humid. The only good thing about California is Yosemite. :)

Khelmar
Oct 12, 2003

Things fix me.

sat. posted:

Oh my god I just looked at MSU for the first time and found their Unit for Lab Animal Medicine and am in love. Is it only for residents though? I don't see anything about it in the 3rd/4th year of the vet school curriculum. :(

We took a tour through there, but you can usually arrange stuff even if it's not the "normal" curriculum.

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Khelmar
Oct 12, 2003

Things fix me.

Topoisomerase posted:

I'm pretty sure that the current place you live is better described by these statements than Davis is. ;)

The drivers in Florida are better, it is less hot but more humid here.

Seriously, WSU had the most beautiful climate - 90˚ during the day, but 10% humidity. At night it would drop to 50-60˚ so you could sleep. There was snow in the winter, it was great.

I'll stop the derail, but I seriously cannot understand how anyone can stand living in California.

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