On Being a Veterinarian: Book 3: Practicing Small Animal Medicine

On Being a Veterinarian

Book 3:

Practicing Small Animal Medicine

April Kung, DVM

Content disclaimer: Any incidents recounted in this series that are based on true occurrences have had select details altered to protect confidentiality. Suggestions made are based on the author’s personal experience and research. Author claims no professional training or education in financial or legal matters, psychiatry, psychology, human nutrition, exercise physiology, or medical education. Please consult a certified or licensed expert in these areas for professional help. Any advice on veterinary medical practice provided by the author is intended for application by licensed veterinarians capable of using their own medical judgment. Do not attempt to use any medical advice provided by the author without a medical degree. In no event should the author be responsible or liable, directly or indirectly, for any damage or loss caused or alleged to be caused by, or in connection with, the use of or reliance on any such information provided by the author. Health-related topics, legal and financial information provided by the author should not be substituted for professional medical, legal and financial advice. It is your responsibility to research the accuracy, completeness and usefulness of all opinions and other information provided by the author. The author assumes no responsibility or liability for any consequence resulting, directly or indirectly, for any action or inaction taken based on or made in reliance on the information provided.

Published by Happy Animal Productions

First Edition January 2018

ISBN-13: 978-1-948356-04-6 

Copyright © 2018 by April Kung. All Rights Reserved.

No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, or by any information storage and retrieval system without the prior written permission of the author, except in the case of brief quotations embodied in critical reviews and certain other non-commercial uses permitted by copyright law.

This book is dedicated to my father.

Dad, I wish you could have made it to Flagstaff.

Table of Contents

Preface

Before You Become a Doctor

When You Become a Doctor

The Honest Imposter?

The Slow Turtle

The Beautiful Mirage

16 Things I Learned the Hard Way

What Kind of Veterinarian Should You Be?

How to Decide Where (and Where NOT) to Practice

What Employers Want From You

Logistical Advice

You Are Amazing

Index

Preface

Before reading this or any of the other books in this series, please download and read the free Book Series Introduction from my website. It explains the aim and scope of the On Being a Veterinarian Series, including who the series is for, and perhaps more importantly, who it’s not for. Additional help and advice for future veterinarians is available on my website at www.realize.vet

One of my favorite medical satire websites is GomerBlog. A couple years ago it featured an article entitled, Optimistic, Bright-Eyed Med Students Eager to Transform into Jaded, Burned-Out Physicians. The article describes the moment when medical students, bursting with altruism and full of dreams break out of their optimistic cocoons […] and morph into creatures of unbridled pessimism and apathy. In the article, a psychiatrist asserts that this jadedness is a sign of a truly mature physician. An internal medicine residency program director adds that when this transformation takes place, That’s when I know I can call you my colleague.(10)

Humorous as this article is, there is truth in it. I began my veterinary career bright-eyed and optimistic. During my first six months of mentorship at the ER where I was hired after vet school, everything was exciting and fun. However, I detected mild irritation in some of my more experienced colleagues. My enthusiasm seemed to irk them. This was a barrier between us and it prevented any sense of camaraderie. A year later however, after my optimism had been stripped away by the realities of practice, by transition shock, I felt more accepted by the other doctors. They began to treat me as a colleague.

Later in my career, the tables were turned. I was the experienced veterinarian when a new graduate was hired by my hospital. The light of a thousand suns shined from her happy eyes. Her enthusiasm irked me. As the months passed though, the light in her eyes gradually dimmed. Gone was the naïve optimism. Reality had set in. Now we were truly colleagues. I wish I could have done better for her. I wish I could have been a better mentor. But she was just so enthusiastic... And I was just so jaded.

It isn’t that experienced doctors wish ill on the idealistic newcomers to this field. We don’t derive secret satisfaction from seeing that enthusiasm die. It’s simply that the exuberant new graduate is still living in a land of mirages, where perfect medicine is practiced, where we solve every medical mystery and nothing bad ever happens. She hasn't yet been disillusioned of her illusions, and until she has, we don’t exist in the same dimension, we don’t speak the same language and we have little in common. Perhaps also, we jaded practitioners are irritated by the bright-eyed optimism of the new graduate because we are still grieving the loss of our own naive optimism.

I'd like to eradicate the dichotomy between the enthusiastic new graduate and the jaded, seasoned practitioner. The transition from the former to the latter currently involves falling from a great height as the unrealistic expectations of the new graduate are pulled from beneath his feet. The injuries sustained from this fall can cause permanent damage, and that sense of enthusiasm for veterinary medicine can be lost forever.

The early sections of the book were written with the hope of helping you enter the field with greater sobriety. You may not fall at all, and so you may never descend into jaded apathy. Perhaps instead, you'll find the happy medium between realism and enthusiasm that we all seek. What I really hope is that when you become the seasoned practitioner, you'll meet nothing but sober yet realistically enthusiastic new graduates, and you'll immediately feel you can call them colleagues.

Later in the book, I provide practical tips for helping you become an astute and effective practitioner, without paying the emotional toll of learning everything the hard way. These discussions unveil some of the common underlying day to day challenges of clinical practice. Unlike human medicine, where the standards and protocols are more clear cut, veterinary medicine is still a bit like the old wild west. If you ask ten different veterinarians for an opinion on how to practice medicine, you may get ten different answers. Bear this in mind as you read, and ask other veterinarians for their opinions on the topics covered in this book. The more perspectives you get, the greater the breadth of options you'll have to choose from when it comes time for you to decide how you want to practice veterinary medicine - and it is for you to decide. Never forget that.

The last sections of the book offer information to help you decide where to begin your career, and additional options to consider as you gain more experience. Perhaps most importantly, I give you the foresight to know how to choose a good employer. I provide a list of the top skills employers want in new graduate veterinarians so you can proactively work on these skills as a veterinary student, and I suggest other things you can do to make yourself a good investment for your employer. Also included is some logistical information I wish I'd had as a new graduate.

Before You Become a Doctor

Sit somewhere quiet where you won't be disturbed or distracted. Close your eyes, and spend at least ten minutes imagining in vivid detail exactly what you want your life as a small animal veterinarian to look like. Where do you live? What does your house look like? Do you have a yard? A garden? What kind of people do you work with? What kind of hospital do you work at? What's your boss like? What are your fellow doctors like? What kind of relationship do you have with them? What's your personality as a doctor? How do you feel every day while you're at work?

What does your personal life look like? What kind of things do you do to take care of your body and mind? What kinds of hobbies do you have? Where do you go for vacations? What do you do on those vacations? Is there someone wonderful sharing your life? What is he or she like? What kinds of friends do you have? Do you have kids? Pets? How much time do you get to spend with the important people and animals in your life? What kinds of emotions are you experiencing day to day in this future ideal life of yours? Joy? Fulfillment? Optimism?

After you've got a crystal clear vision in your mind about your future as a veterinary doctor, cement it in your brain by re-envisioning it on a regular basis. Do it while you're having your morning coffee or tea. The reason I want you to hold onto this vision is so that you can use it as a compass. If, after you become a veterinarian, you find yourself living a life that doesn't resemble what you envisioned for yourself, remember your original vision and use it to navigate out of the life you don't want and into the life you do. While our futures rarely (if ever) turn out to be exactly what we envision - and the practice of medicine especially likes to confound our perfect plans - if we are clear in advance about what we want the flavor and the spirit of our future lives to be, we are far more likely to find ourselves living an approximation of that vision. But, if we don't have a clear vision in advance, it's all too easy to end up tolerating the kind of life we shouldn't. In my opinion, too many veterinarians are tolerating what they shouldn't. That is not the future I want for you.

When You Become a Doctor

There are two things I want you to do either before or immediately after you begin practicing. First, seek out other newly graduated veterinarians in your area. Run an ad on Craigslist, in the local paper, in your state or city veterinary medical association newsletter. Start a group. Meet on a regular basis. Meet for drinks, or coffee, or pie, or meet virtually via a group call on Skype. Share with each other your experiences and perceptions as new vets. Compare notes about the different hospitals where you all work. Talk about difficult cases you’ve seen or issues you’re facing. This can accelerate learning for all of you, as well as providing the critical, empathetic social support all of you will need, and that you can’t really get from people who don’t walk in your shoes. Take care to prevent these meetings from becoming opportunities merely to complain. You should all feel that you can talk about negative things that have happened, but the goal should be combating feelings of isolation and helping each other deal with the negatives in a constructive way.

The second thing I want you to do is to find a psychiatrist. Yes, even if you feel perfectly fine. As a new veterinarian, the time to start seeing a good psychiatrist is before you need one. You may need to see several before you find one you click with. Tell them you’re a recent graduate of veterinary school, you’ve heard the first several years of practice can be tough and you want to be proactive about your own mental health. See how they respond. When you find one who gets it, see them on a regular basis - at least monthly, and at least for the first year, but preferably for your first five years in practice.

Why a psychiatrist? Because when you begin practicing, in addition to your support group of other new grads, I want you to have a therapist who knows what it’s like to practice medicine. Psychiatrists are MDs. Their friends are MDs. They know firsthand how difficult medical practice can be, especially when you’re just starting out. The other reason I recommend seeing a psychiatrist is because they can prescribe medications for depression and anxiety. You may never need these medications, but if you do, it's nice not to have to schedule more appointments with someone else. You're going to be busy. Every hour of free time is precious.

The Honest Imposter?

You are a doctor. You have the education, the degree and your state license. It’s day one of your first job. You’re all decked out in a brand new white coat and there’s a stethoscope around your neck. Your coat pockets contain