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Journal Entry #5

March 9, 2006

OK, I have survived one of the most chaotic weeks (well, tomorrow is still part of the week...but I'm almost there).

     What happened was this: on Monday the 6th, the VIRMP match results were due. It was also the day I began my internal medicine rotation. The match results were due at 1pm and I was a bit jittery waiting until that time. Finally, I went up to the computer cluster and logged in to my VIRMP account page. Well, it was horrible news: I did NOT match to any of the places I had applied to. I applied to 24 places and only 1 was a private practice (a real biggy: Angell in Boston). It just hits you hard to realise that no one wants you! No university, that is. I totally felt like crying, but I was at school and was expected to continue seeing patients that day etc. I don't like to cry in public (who does?!) so I just *felt* like crying for the rest of the day. Only 3 people in my class applied through the match, so I was pretty much alone in the "you didn't match" mindset.

     When you don't match, there is a list of non-matched positions that becomes available to you. There were 145 non-matched small animal rotating internship positions and 50 non-matched small animal emergency/critical care internship positions. I just went through page after page, picking out places that sounded good to me (but in my head, I still just wanted a university internship). I later refined my search and narrowed it down to 5 places that sounded pretty good. The next couple of days, I faxed these practices my application, CV, and two letters of recommendation (I couldn't get hold of my third letter quickly because that writer is in the USA).

     Well - I was lucky!! I got a position at my favourite place of the 5 I had chosen from the non-matched list. I received a phone call last night (totally unexpected) and I spoke with the internship director about the programme. It just sounded SO good, and I am still very excited about it. He said he likes diversity in his interns and tries to get representatives from a variety of schools each year (I checked the list of this year's interns and it's true - everyone from a different school!). What really made me like the place was the internship director's obvious passion about teaching and helping people to become better vets. He was also very passionate about his hospital and excited about upcoming changes/additions to the place. When he offered me the spot, I took it.

     Starting June 26, 2006 I will be an intern at the VCA Sacramento Animal Medical Group in California. It is made up of about 3 hospitals at the moment, but two are merging into one 24000 sq. ft. building later this year (something I get to help with). One hospital, the "central" hospital, is open 24 hours (24/7) and has specialists in dermatology, internal medicine, radiology, oncology (radiation and medical), cardiology, emergency/critical care, and surgery (soft tissue and orthopaedics). It sounds like the majority of surgeons are at the second hospital though (a surgical specialty centre). The third hospital is a general practice and I will spend about 1/6th of my time there (I think it's great that I'll get first opinion exposure). My rotations will be in 3-4 week blocks through the various specialties and I will spend about 30% of my time on emergency duty (still not sure if it's just a separate rotation or if I will be doing it certain days/nights each week). My work days will be at least 12 hours long and 5-6 days per week. I get 5 days of vacation, total (this time is often spent for residency interviews).

     Have a look at the website: http://www.vcasamg.com or http://www.vcapets.com if you're not familiar with VCA. I have worked for a couple years for VCA as a technician and I like the way they treat their employees. I like the way they work, and I like the fact that each hospital is individual (different due to the medical director being different). I have always said I'd be happy to work for VCA again - and look what I just did! I accepted a job with VCA. I'm so happy! Especially since this is an INTERNSHIP and will likely help me get into a residency (my main goal). Other good things: my salary is higher than I had ever expected from an internship, and the cost of living up north (I'm a southern California girl) is cheaper. I was recently in Sacramento to take my state board exam and I really liked it (I drove around a bit, just out of the blue...makes you think that things happen for a reason, huh?).

    BACK to the vet school side of my brain! Well, after I finished my 4 weeks of EMS at a couple of practices to the north and east of Glasgow, I moved back to the vet school small animal hospital. My first rotation was diagnostic imaging. It turned out really great - I loved the challenge of interpreting radiographs. Everyone says "you just sit in a cupboard all day"...and it's true. You sit in a tiny room full of x-ray viewers and wait for x-rays to be taken/developed. Then you grab a case and start reporting your findings. I would usually do 3-4 cases per day (and so would the other two girls in my group). Then, the next morning we would have radiology rounds with the board certified radiologist. We would report our findings and he would tell us where we went wrong (or right). We had 3-4 textbooks in "the cupboard" to help us interpret the radiographs, and we also had a couple of tutorials that week (they helped a lot).
     The second week of small animal rotations was "Special Services I". This included dermatology, ethics, exotics, and behaviour. We spent a Monday and a Friday at a specialty dermatology clinic south of the river (the river Clyde) (away from the vet school). The dermatologist was the nicest man and his appointments lasted 45 minutes to an hour! Plenty of time to learn about the cases. We learned (and/or got practice doing) how to do skin scrapes, tape prep slides, coat brushes, impression smears, and watched intradermal skin testing and skin (punch) biopsies. We had one day off (Tuesday), and Wednesday was exotics. We don't see many exotics at our small animal hospital, but we were lucky and got to castrate two chinchillas! One testicle each (there are 3 students in my group including me, and then there's the board certified exotics clinician who showed us how to do it). That was fun. Thursday, we met for a discussion about the ethics of oncology. Sadly, we found we had zero behaviour cases. So Thursday was mostly a day off. Friday we were back at the dermatology clinic.
     THIS week has been internal medicine. There is supposed to be a student assigned to each case that comes in, and that student has to do the history, physical exam, and help with differential diagnosis and planning. That student also watches and helps with any procedures like radiography and ultrasound, or actually does the procedure (like blood draws). If the patient is hospitalised, the student on the case must examine the animal each morning and evening and present the case during rounds (which are at 8:45am and 4:30pm each day). Each morning after rounds, we also have a tutorial. Monday and Wednesday we had tutorials on echocardiography (it makes much more sense now!). Tuesday's tutorial was computer-based cases. Today's tutorial was about ECGs (how to take them properly and interpret them, including how to calculate the mean electrical axis...we'd had this before, but it's not an easy topic so this tutorial was great help). I think maybe tomorrow we have a tutorial on interpreting blood panels.
     So far this week, I've had these cases: a cat with previously diagnosed hypertrophic obstructive cardiomyopathy, a dog with chronic diarrhoea, a dog with a chronic cough, a cat that was in cardiogenic shock (heart failure), a dog with hyperadrenocorticism and heart disease, and a diabetic dog with ketonuria. It seems like everything I've seen has had radiographs or ultrasound/echo done...and blood work. When the blood results come back, I get to interpret them and discuss them with the clinician. When the patient leaves the hospital, I get to write the discharge notes. Pretty fun stuff!
     Next week is our LAST SMALL ANIMAL ROTATION EVER! Oh my gosh...I can't believe it. It's amazing how this year has flown by! The last rotation for me is oncology. I think I will like it, just as I have enjoyed this week. It's a rotation run together with internal medicine, so we will still have twice daily rounds and will still have discussions on internal medicine cases.
    ...and after that, it's SPRING BREAK! Yahoo. But I will be seeing practice the entire 4 weeks. BUT - I scheduled it so that I will be traveling at the same time. :0) I tell you, if you ever have to do EMS - that's the way to do it. Go somewhere strange to do your EMS. This time, I'm off to Islay for 2 weeks and then to Orkney for the last 2 weeks. These are both islands of Scotland; Islay is off the southwest coast and Orkney is a group of 64ish islands to the very north of Scotland (but still south of Shetland). I'm planning on visiting some whisky distilleries while I'm on both islands. I really like whisky - I don't truly drink it, but I enjoy tasting (sipping!) it. I think I need to learn to drink it - make cocktails with it or something. It's real strong stuff but I like the flavours.

So, in all - I can't believe I have a job for next year. A real job. A place where I am wanted, a place to belong. AND it's in my home state of California, where I have already passed the licensing exam and will be just SO happy. Close to UC Davis, too...in case I want to apply for a residency there when the time comes around.