Deficient basic skills coming out of vet school

[JM313]

I have worked at clinics where the vet was the only one who did blood draws and placed catheters and now I work at a clinic where the techs pretty much do it all. The clinic where the vet did it all was very small and 'old school' we only placed catheters on very sick animals , never for surgery and we did not do blood work often. Where I work now the techs are so good at it that the vets almost never do it, while the vets do draw blood sometimes I have yet to see one place a catheter (been there a year). I'm not saying they couldn't but the way the practice works we try to divide up time so that the doctors can dedicate their time doing things only doctors can do, interpreting diagnostics, prescribing medications, exams, calling clients back etc.. etc. Honestly their skills are rusty because by dedicating things like blood draws, catheter placements etc to the technicians the doctors have more time to review each case thoroughly and make the best decisions for that patient and the clinic runs more efficiently. You called these things 'vet skills' and while I agree vets should be able to do them, I would never expect a new grad to do it with confidence and really these are the areas where vet techs get to shine, it's the stuff they are good at, why they get hired and why they are so valuable.

I was also a phlebotomist at a human hospital for a year an a half and most M.D.s are not very good at drawing blood for the same reason some vets aren't, their time is better spent doing things only a doctor can do and other things are why we have nurses and phlebotomists. When a patient would request the doctor to draw blood we would nicely explain that we draw blood 20 times a day and the doctor has most likely not performed a basic blood draw in very long time, of course it depends on doctors employment situation but you get my point.

Veins are a tricky thing, and it takes A LOT of experience before you are confident and even when you are confident and have 20 + years of experience sometimes it just doesn't happen. Honestly if vet schools dedicated the amount of time it takes to become confident in these skills new grads would be seriously lacking in more important areas of medical knowledge. These are skills that can be learned in the field and are best learned through experience and not in a classroom setting, they can also be taught by many many people. When I attend veterinary school this fall and have access to specialists in different fields for 4 years, I hope that a majority of my time is spent learning about the information they can teach that I cannot learn so easily somewhere else.

If these are skills you want to be confident in and feel strongly about then yes you should seek experience outside of/prior to vet school to strengthen these skills, it will be the best way to learn and the best way to get lots of practice.

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[Coquette22]

In addition to the excellent points made by other people, I'd also like to add that in addition to all of the scientific knowledge, there's a ton of "hands on" skills that we have to learn, so things that are more likely to be passed off to techs (blood draws, IV catheters, ET intubation, etc) just don't always get priority. Sure, we learn how to do those things. But we've also done transtracheal washes, bronchoalveolar lavages, intraosseous catheters, bone marrow aspirates, skin scrapings and biopsies, dental scaling/polishing, surgery, abdominocentesis, nerve blocks, urinary catheters, cystocentesis, rectal palpation in large animals.... Not saying techs can't be trained to do some of these things, but that we have a very long list of things we need to get familiar with and there's only so much time during that 4 years in vet school.

 

[twelvetigers]

How about just plain auscultation? Learning how to listen to a heart correctly is hard, and ain't no tech gonna be doing that. So given the choice, I'd rather practice listening with my stethy than drawing blood.

 

[Coquette22]

How about just plain auscultation? Learning how to listen to a heart correctly is hard, and ain't no tech gonna be doing that. So given the choice, I'd rather practice listening with my stethy than drawing blood.

That too, and as dyachei said about the physical exam being a basic skill for vets.

 

[Crystalight33]

So, in my opinion, vet school is just that: school. When you're at school, you learn how to do something, then you go home and practice. Take differential equations as an example, the teacher goes through one or two problems with you in class, then you go home and work through practice problems (in my case, many hundreds of practice problems cause math is not my forte). Vet school is the same: you learn how you are supposed to draw blood (and what vessel you're hitting and what muscle it's draining and what that muscle does and where it attaches on the bones, and why the pressure inside the vessel isn't as high as it should be and what can cause the pressure to be low and what medications you can give to bring the pressure up and what medications may have made it low.....the list goes on and on and on and on and on and on and on and on and on....). Then you go "home" (to volunteer as a student or to your first job post graduation) and "practice" everything you learned in school. Makes you look at the term "private practice" in a new light.

Others have already said that vet school is what you make of it and there are plenty of opportunities outside of class to hone your clinical skills. However, after a really rough week of classes and tests and all you can smell is formaldehyde from anatomy lab and you've got 4 more exams next week that you are freaking out over, I find it really hard to motivate myself to go practice skills that, most likely, my technicians will be performing. That's just me though, and I like to sleep lol.

 

[SV88]

This is a first on me. I have worked with older generation and newer generation vets, both of which wanted vet techs to set the catheters and draw blood samples. The reasoning is not because they wanted the techs doing the "grunt" work (I hardly consider these things grunt work) but because vet techs are generally better at doing those things. I actually had an older generation vet tell me that he wanted me setting the catheter on the HBC dog in shock, because my skills were more proficient than his.

I have never met a vet that expects techs to do all of the work, but I do not see any reason as to why a vet tech should not be plenty capable of setting an IV catheter or drawing the blood sample while the vet is busy maybe doing CPR/figuring out medications and dosages or discussing things with the client (all things that a tech can not do).

I have never worked with a vet who only wanted techs to assist by restraining animals. This includes both older generation and newer generation vets. I am going to hazard a guess that vets you have worked with are maybe out of the norm, to be honest.

I am a 6 year exp tech who came from a practice where we did all the senior workips anesthesia inductions catheters blood most injectable treatments (famotidine etx) and educated the clients. I am now at a practice where all I do is restrain for the vet and monitor anesthesia. Sometimes we get to draw blood. Sometimes we get to do treatments. I hate it. I'm so undervalued and under appreciated and a glorified kennel worker. I work with 4 vets. 2 that graduated before 1990 and two that graduated in the last 5 years. The only one that lets me be a tech is our newest grad - out for a year.

 

[SV88]

I am a 6 year exp tech who came from a practice where we did all the senior workips anesthesia inductions catheters blood most injectable treatments (famotidine etx) and educated the clients. I am now at a practice where all I do is restrain for the vet and monitor anesthesia. Sometimes we get to draw blood. Sometimes we get to do treatments. I hate it. I'm so undervalued and under appreciated and a glorified kennel worker. I work with 4 vets. 2 that graduated before 1990 and two that graduated in the last 5 years. The only one that lets me be a tech is our newest grad - out for a year.

FWIW if I get into school and graduate I will allow my staff to do their jobs. They went to school to be a tech. Let them do it.

 

[BlackDog17]

I feel like the original post is on par with looking at a 10+ year vet tech and saying "What do you mean you can't diagnose that case? Shouldn't you know how to do that by now?"

Everyone has different skill sets, and what you learn in tech school (or from years of tech work) is very different from what you learn in vet school. No matter who you look at - vet, tech, pre-vet, volunteer - every single person is going to have skills that they're awesome at, and skills that they're not so great at. I've met plenty of newly-certified vet techs who couldn't even find the vein, let alone hit it. Does that mean that the tech school they attended was somehow deficient? No, it just means that they probably haven't had much opportunity to practice. So why would it be any different for a new vet, especially considering blood draws are emphasized far less in vet school than they are in tech school? As others have said, you have to make your own opportunities in vet school. Everyone comes into it with different levels of experience. It would be hard to spend an entire semester practicing basic skills like blood draws and catheter placement when half the class has been teching for years and can do it blindfolded while the other half of the class doesn't even know where to begin. Not to mention that I'm sure most of us have no desire to continually stick needles into a teaching animal purely for the sake of practice.

I know that my clinical skills are shaky, so I've been seeking out opportunities for this summer that will give me a chance to improve them. That's my personal choice. Those new grads the OP is criticizing? Maybe they had to work full time to be able to afford vet school, so they didn't have to opportunity to go to wetlabs that would have allowed them to practice those skills. Maybe they had an interest in pathology and spent their summers in the necropsy lab instead of in the clinic. Maybe they have no interest in small animal at all and this job is just a temporary bill-payer until they can move on to a particular specialty. Automatically assuming that they are somehow inadequate is a pretty narrow way of looking at things.

 

[NStarz]

I pretty much agree with what everyone else has said. I volunteer as a tech at a shelter when I go home on breaks sometimes. One of the techs there likes to mock my "tech" skills, and it frustrates me a lot. Like "why haven't you learned this yet?" Because I'm learning how to be a doctor! I have drawn blood maybe a dozen times (not yet in vet school besides going in to hang out in the ER and asking the techs if I could do some blood draws), but I also learned how to place an esophagostomy tube yesterday, how to unblock a tom cat, and how to use an endoscope to remove a foreign body. I can also tell you that when we had a blocked cat come into the shelter, my first concern was "hyperkalemia" when the techs were running around looking for tomcat catheters. Vet school taught me that. I knew what could kill the cat in that second and how to fix it. Am I proficient at unblocking cats? Nope! I've done only one and it was on a cadaver. But you can bet that the techs won't be doing that, nor did they know that hyperkalemia was more of a concern in that second than a possible bladder rupture. I'll do what I am being trained to do and let them be used where they were trained.

Honestly, if I am doing a ton of tech skills at a clinic, I would be getting overpaid. They are paying me to be a doctor, not to place an IV catheter. Though you can bet that when the techs have trouble getting a tough stick, they will turn to me, and I would like to learn and keep up with my skills for that reason. But 99% of the time, they will be better at it than me. But I will be better 99% of the time doing the doctor stuff

 

[Kpowell14]

Im not sure if this point has been made yet or not, but at the fast paced GP I worked at, It was expected that all surgery patients have blood work and IV catheters placed and ready to go before the doctor even hit the door. That way when the doc arrived, they could go over the blood work, do a physical exam and pre med for surgery. It wasnt a matter of the Dr not being proficient... It was a matter of efficiency. By having everything done before the Dr arrived we could get into surgery faster meaning we finished surgery and could move on to the next patient as efficiently as possible. We could do 5-6 surgeries before lunchtime and then have the afternoon for in room appts. If we had to wait for the doctor to get there, we could only see half the amount of patients we normally would.

The same goes for when I worked at the ER/Referral hospital. When a dog would come in- shocky, seizing, or lateral recumbent, even coding for that matter... We were the ones placing catheters, starting fluids, getting blood.. while the Doc was doing a physical and rushing out the door to talk to the owner about what were the next steps of action.

I hope one day when Im a Doc I have technicians with half the skill of the ER techs I worked with.. They were the bomb. A good technician(s) is an asset to any team.

 

[nyanko]

Yeah, actually in the feral and low cost spay/neuter clinics where I've worked the doctors have pretty much been surgerizing machines unless they had to step out to run a code. They were certainly not drawing blood and such - that is not an efficient use of the doctor's skillset in an environment like that.

 

[pinkpuppy9]

I am a volunteer-a-mus, just kinda hanging out waiting to see if I get off a waitlist & into a DVM program. In the myriad of places I volunteer, I've run into several recent PVM graduates who don't know how to do a blood draw, or don't feel comfortable handling animals, or are deficient in some other basic skill I expected to come out of vet school knowing well. The first time I met a new dr. who lacked what I thought were very basic vet skills, I was really surprised. Now I've seen enough new dr.s & quite a few 3rd & 4th year students who do not have the skills I'd expect they would, that I've begun to think you really need to take responsibility to learn hands-on vet skills yourself, outside of the regular curriculum. I wanted to see if others have thoughts on this, or maybe current vet students want to chime in. I highly suspect that some schools have less of an issue w/this than others, but that's purely speculation. Love to hear comments.

A little late here, but I think this is because it is impossible to teach a vet student how to perform a procedure under every single possible scenario. For example, you might NOT see a seizing dog during clinicals. You might NOT have to deal with an aging cat/dog with terrible veins. That's why it's up to you to get yourself out there and try to get this experience. My boss has been practicing for almost 30 years and sometimes (rarely) she can't hit a vein either. There are a whole variety of factors that come into play with a successful blood draw.

I don't mean to be sassy (yes I do), but you sound like one of those pre-vets who thinks they are capable of performing a spay/neuter before vet school just because they've WATCHED it (Everyone knows the kind of person I'm talking about). Nobody wants to work with someone demeaning and judgmental. Perhaps, next time you see someone struggling, offer helpful/friendly tips that allow you to succeed in your clinical skill applications.

 

[LetItSnow]

I don't mean to be sassy (yes I do), but you sound like one of those pre-vets who thinks they are capable of performing a spay/neuter before vet school just because they've WATCHED it (Everyone knows the kind of person I'm talking about). Nobody wants to work with someone demeaning and judgmental. Perhaps, next time you see someone struggling, offer helpful/friendly tips that allow you to succeed in your clinical skill applications.

Hehehe. Truth. They're also the people (maybe not the OP, I dunno, this isn't directed at him/her) who end up in vet school and interrupt every conversation with "Well, at MY clinic we never do that. We always [....]" (I don't actually know what they say at that point because by then I'm totally tuned out.)

 

[dovelover]

Hehehe. Truth. They're also the people (maybe not the OP, I dunno, this isn't directed at him/her) who end up in vet school and interrupt every conversation with "Well, at MY clinic we never do that. We always [....]" (I don't actually know what they say at that point because by then I'm totally tuned out.)

This was pretty much 50% of my class during clinical skills labs last semester. Along with, "This is stupid, I've worked in a clinic for the past 3 summers, I know how to do this, why do I have to be here?" Well, some of don't know how to do this, so be helpful instead of annoying, thanks. And maybe you should try to learn how the school wants you to do it, since that's really what matters for the next 4 years, like it or not. Luckily, as a class, we seem to have grown out of the "I already know everything" phase of early vet school at this point.

 

[wolfpackprevet]

I'm a baby C/O 2018er, and I can tell you that I'm going to try as hard as I can to get that experience over the next four years, but when I got my meager 280 hours at a small animal clinic -- I was working in reception. I couldn't hit a vein on a small animal to save my life. So I'm sure I'll be able to rock some of the students up one side and down the other on large animal handling and such, but I'm gonna need all the help I can get for the small furry ones. There's no way that I'll be nearly as confident after four years as someone who worked in SA clinics their whole life. But that doesn't mean I won't end up in a SA clinic (thanks a lot, job market).

 

[SV88]

This was pretty much 50% of my class during clinical skills labs last semester. Along with, "This is stupid, I've worked in a clinic for the past 3 summers, I know how to do this, why do I have to be here?" Well, some of don't know how to do this, so be helpful instead of annoying, thanks. And maybe you should try to learn how the school wants you to do it, since that's really what matters for the next 4 years, like it or not. Luckily, as a class, we seem to have grown out of the "I already know everything" phase of early vet school at this point.

I've got 6 years unde my belt and I'll be totally honest - sometimes we work with a new vet who beings in a new perspective and it totally changes things. For instance the old vets I work with do lateral cystos. Voila new grad comes in and does them dorsal - and it's like sliced bread!!! Greatest method ever according to one vet. They just learned differently so this new method was great. Even though as vets or techs or vet students we think we know, there's always something new to learn so people should shush and absorb.

 

[StartingoverVet]

Im not sure if this point has been made yet or not, but at the fast paced GP I worked at, It was expected that all surgery patients have blood work and IV catheters placed and ready to go before the doctor even hit the door. That way when the doc arrived, they could go over the blood work, do a physical exam and pre med for surgery. It wasnt a matter of the Dr not being proficient... It was a matter of efficiency. By having everything done before the Dr arrived we could get into surgery faster meaning we finished surgery and could move on to the next patient as efficiently as possible. We could do 5-6 surgeries before lunchtime and then have the afternoon for in room appts. If we had to wait for the doctor to get there, we could only see half the amount of patients we normally would.

The same goes for when I worked at the ER/Referral hospital. When a dog would come in- shocky, seizing, or lateral recumbent, even coding for that matter... We were the ones placing catheters, starting fluids, getting blood.. while the Doc was doing a physical and rushing out the door to talk to the owner about what were the next steps of action.

I hope one day when Im a Doc I have technicians with half the skill of the ER techs I worked with.. They were the bomb. A good technician(s) is an asset to any team.

This would be my point.

These days, a vet has to really do as much value-added work as they can to make a living and make a profitable clinic.
Old-timers might enjoy doing things themselves (or not trust others to do it), but it is a lousy use of time and resources.

Vets go to school to learn diagnostics. Examination and diagnosis (and treatment/surgery to a degree). They have to do as much of that in a day as they can. If they are spending their time poking around drawing blood, they are wasting their time. A tech, who is paid maybe 1/3 the salary should do that while they go see the next client.

Honestly, as a client, I don't give a rat's arse if the vet is the best at blood drawing in the country, but I damn well want him/her to be the best damn diagnostician/examiner I can find. The view that a vet needs to be all-pro at those things is crazy. And some of the old-timers I worked with hadn't drawn blood or given an injection in so long, they would be horrible at it, but yet they were amazing surgeons and an amazing internal medicine guy. And if I was to project myself in the business, I would hope that is what I would aspire to be, and that is how I will judge others (if I am in the judging mood).

 

[lailanni]

In a fast paced, high volume clinic it's a waste of time for a vet to do blood draws or other things a tech can do.

It's called teamwork. Each person does what they do best (filling in where necessary) to get the most efficient, best result possible. If you're making your vet spend time on non-diagnostic things, you're downgrading the efficiency of the entire system.

It's a bit old school to think that the vet is going to do the exam, draw the blood, do a CBC, read ear cytology, etc. Can a vet do those things? Sure. But the whole system is better off if they're attending to the next client instead. More clients served = more clinic income. You need to learn how to delegate tasks that others can do so you can be more effective. Are there places where vets do all the work? Yes. But that's certainly not what they teach for in school. Vet school is to learn how to diagnose. If you're expecting tech skills: look to your techs.

I don't know. Maybe the OP expects the vet to also work reception, kennel and grooming while they're at it? And they can be smug/judgmental when the vet doesn't know how reception likes things filed, or where the grooming tools are kept. It's a similar comparison, really.

While the OP is standing there smirking at the new grad while they struggle with an occasional blood draw, keep in mind the staff notices. Including the new grad. And you can bet when you ask for a LOR they'll smirk right back.

You know what you should be noticing? New grads aren't quite as good at time management. That's the new grad issue. Practice owners or managers don't care if the vet can do the blood draw on the first stick - they want to see the new doctor moving through the surgery and appointment schedule like a veteran. That's where the money is.

Maybe someday the OP will end up at a clinic working on a production salary. See if they want to do all the sample collections themselves then?

 

[BlackDog17]

I don't know. Maybe the OP expects the vet to also work reception, kennel and grooming while they're at it? And they can be smug/judgmental when the vet doesn't know how reception likes things filed, or where the grooming tools are kept. It's a similar comparison, really.

While the OP is standing there smirking at the new grad while they struggle with an occasional blood draw, keep in mind the staff notices. Including the new grad. And you can bet when you ask for a LOR they'll smirk right back.

This. Not to mention that OP wouldn't even have a job in the first place if vets did all the work themselves.

And jobs are scarce in a lot of communities right now. If a vet never wants to have to do their own blood draws and three more people get taken off the unemployment line because of it, I fail to see how that is a bad thing for anyone.

 

[LetItSnow]

Maybe someday the OP will end up at a clinic working on a production salary. See if they want to do all the sample collections themselves then?

The other thing that bugged me is that the OPs view completely ignored the mental process leading up to the draw. The technician gets asked to do a draw and does it. The vet has to think "given this animal and its presentation/history, what can I learn from blood work? Which blood work do I need? Is it the best use of the client's funds? Is the client particularly limited on money? What's my next diagnostic step?" All of that is harder than the blood draw.

I mean, I know that for you vets that have been out in practice a year or two that's all automatic - but it's not for the new grad who has to think it through.

I was putting an NE tube in on Saturday night and that's what got me thinking about it. Normally putting an NE tube in is a quick, easy, no-brainer task. This dog was on his second tube after vomiting the first one up and biting it off and I had heard the first one had been a challenge (for an experienced tech....). I was finding it a challenge, too. Probably just the way the dog's nose was built. Whatever. But had some pre-vet been standing there he would have thought "man... this guy can't even put in an NE tube? It's just insert and push, right?" Never mind that I do it routinely as part of my job. And, if I were the vet ordering it up, never mind that I would have gone through the algorithm in my head: Is supplemental nutrition needed? If so, how much and what kind? NE tube? NG tube? E-Tube? G-Tube? Parenteral?

I dunno. I guess I'm just getting grumpier, but it seems like everyone is awfully focused on "blood draws".

It's just one technical skill out of 1000. And it pales in comparison to the mental diagnostic process. Maybe it's time for an SDN break for me or something.

 

[DVMDream]

The other thing that bugged me is that the OPs view completely ignored the mental process leading up to the draw. The technician gets asked to do a draw and does it. The vet has to think "given this animal and its presentation/history, what can I learn from blood work? Which blood work do I need? Is it the best use of the client's funds? Is the client particularly limited on money? What's my next diagnostic step?" All of that is harder than the blood draw.

I mean, I know that for you vets that have been out in practice a year or two that's all automatic - but it's not for the new grad who has to think it through.

I was putting an NE tube in on Saturday night and that's what got me thinking about it. Normally putting an NE tube in is a quick, easy, no-brainer task. This dog was on his second tube after vomiting the first one up and biting it off and I had heard the first one had been a challenge (for an experienced tech....). I was finding it a challenge, too. Probably just the way the dog's nose was built. Whatever. But had some pre-vet been standing there he would have thought "man... this guy can't even put in an NE tube? It's just insert and push, right?" Never mind that I do it routinely as part of my job. And, if I were the vet ordering it up, never mind that I would have gone through the algorithm in my head: Is supplemental nutrition needed? If so, how much and what kind? NE tube? NG tube? E-Tube? G-Tube? Parenteral?

I dunno. I guess I'm just getting grumpier, but it seems like everyone is awfully focused on "blood draws".

It's just one technical skill out of 1000. And it pales in comparison to the mental diagnostic process. Maybe it's time for an SDN break for me or something.

I was having a lot of difficulty with this cat intubation on Friday. I will admit that I haven't done a lot of ET tubes on cats. This cat was particularly difficult. It was an 18 pound cat that had the longest palate I have ever seen in a cat, similar to looking down the throat of an awkward bulldog or pug with a ton of extra soft tissue in the way. To add to this, I could not visualize the epiglottis or the larynx. The epiglottis was actually getting stuck under the soft palate and therefore nothing could be seen. Once I could finally visualize the anatomy, it was like any other cat intubation, but had some pre-vet been watching me they probably would have thought I was an idiot.

 

[Bearby]

I'm going to avoid all the drama as much as possible:

Yes, there are many people who go into vet school without having ever restrained a dog or a cat or a horse or an alpaca. There are even more people who didn't do any "technical" things before vet school because some states don't allow people who haven't completed a CVT or RVT program to do things. As someone else mentioned, vet school is completely what you make of it. There are techs that will do all of the blood draws, catheter placements, etc if you don't ask to get practice. Even if you do ask, not everyone is great at teaching or making you feel like it's ok to not know.

I am very fortunate as I had about 4 years of experience as a small animal vet tech before vet school and I still work when I can during school to keep myself grounded and out of the "ivory tower" mindset. I know that I personally appreciate it when people like techs or classmates who are more comfortable with certain things (like equine catheter placement) who see I'm nervous or struggling ask me if I want help. Maybe not everyone feels the same way, but if I see someone struggling with a catheter or a blood draw, I try to go out of my way if I have time to help them out.

Clinics provide some opportunity for learning or practicing skills, but honestly, you're usually being pulled in about 5 different directions and are very tired so it's not as beneficial as many people think it will be. Outside of the core curriculum, there are usually tons of opportunities to practice skills in labs that are put on by different organizations and clubs. Those who recognize their weaknesses and want to improve tend to seek out these opportunities.

So again, you get what you want out of vet school. It's not required at this time that vet students pass a "basic skills" lab at any school as far as I know (I could be wrong, wouldn't be the first time), although I think some schools focus on this more or are moving towards a greater focus on it.

 

[NStarz]

I'm going to avoid all the drama as much as possible:

Yes, there are many people who go into vet school without having ever restrained a dog or a cat or a horse or an alpaca. There are even more people who didn't do any "technical" things before vet school because some states don't allow people who haven't completed a CVT or RVT program to do things. As someone else mentioned, vet school is completely what you make of it. There are techs that will do all of the blood draws, catheter placements, etc if you don't ask to get practice. Even if you do ask, not everyone is great at teaching or making you feel like it's ok to not know.

I am very fortunate as I had about 4 years of experience as a small animal vet tech before vet school and I still work when I can during school to keep myself grounded and out of the "ivory tower" mindset. I know that I personally appreciate it when people like techs or classmates who are more comfortable with certain things (like equine catheter placement) who see I'm nervous or struggling ask me if I want help. Maybe not everyone feels the same way, but if I see someone struggling with a catheter or a blood draw, I try to go out of my way if I have time to help them out.

Clinics provide some opportunity for learning or practicing skills, but honestly, you're usually being pulled in about 5 different directions and are very tired so it's not as beneficial as many people think it will be. Outside of the core curriculum, there are usually tons of opportunities to practice skills in labs that are put on by different organizations and clubs. Those who recognize their weaknesses and want to improve tend to seek out these opportunities.

So again, you get what you want out of vet school. It's not required at this time that vet students pass a "basic skills" lab at any school as far as I know (I could be wrong, wouldn't be the first time), although I think some schools focus on this more or are moving towards a greater focus on it.

Interestingly, at OSU we are required to work through a checklist of "clinical competencies" during clinics (new AVMA guidelines, apparently). These include things like catheter placement, cystos, ET tubes, and other "technical skills" but also include "vet skills" ie neutering, interpreting an ABG, suturing a laceration, and performing a necropsy. So some schools (and probably all schools) will be moving to this sort of system in the future.

 

[EdinBelle]

Although I do NOT agree with the demeanor of the OPs original post, it is relatively important for the doctor to be able to perform technical tasks when needed. Picture this, "Okay, were gonna do bloodwork on Toby today." "Okay.. Wait, I have a question. Where do you get blood from?" "Ideally, ma'am we like to pull blood from his jugular vein. It's larger and allows for the quickest blood flow." "Oh my goodness. His neck??! You're not doing it, right? You could kill him by stabbing his neck. I'd like the doctor to do it. And I want it done in the room so he can stay with me. He gets nervous whenever he leaves my side. Thank you."

Now how would the doctor feel if they physically couldn't pull blood (not missed the vein, legitimately did not know how) in a situation like that? It's not important for the doctor to be able to perform all of the technical skills all the time, but they need to be able to perform when the situation comes up.

 

[twelvetigers]

Interestingly, at OSU we are required to work through a checklist of "clinical competencies" during clinics (new AVMA guidelines, apparently). These include things like catheter placement, cystos, ET tubes, and other "technical skills" but also include "vet skills" ie neutering, interpreting an ABG, suturing a laceration, and performing a necropsy. So some schools (and probably all schools) will be moving to this sort of system in the future.

We have something similar to that as well. Unfortunately, it makes for a lot of extra work keeping track of things and filling out checklists, so I'm not too excited about that part.

 

[NStarz]

We have something similar to that as well. Unfortunately, it makes for a lot of extra work keeping track of things and filling out checklists, so I'm not too excited about that part.

Definitely agree. However, I think it's valuable in making sure that students are all graduating with a basic standard. Ours are online, so that may make it less of an issue, but I'll let you know when I get into clinics

 

[Trilt]

Interestingly, at OSU we are required to work through a checklist of "clinical competencies" during clinics (new AVMA guidelines, apparently). These include things like catheter placement, cystos, ET tubes, and other "technical skills" but also include "vet skills" ie neutering, interpreting an ABG, suturing a laceration, and performing a necropsy. So some schools (and probably all schools) will be moving to this sort of system in the future.

We have to do this, too. It's a 100ish page booklet for us, and covers tons of species and clinical/communication-based competencies. We need to complete 90% of it as a grad requirement.

 

[twelvetigers]

Definitely agree. However, I think it's valuable in making sure that students are all graduating with a basic standard. Ours are online, so that may make it less of an issue, but I'll let you know when I get into clinics

Ours is through E*VALUE.

Anyone that uses E*VALUE knows how much it sucks.

 

[NStarz]

We use one45, I think.

 

[Lissarae06]

I hate entering skills into evalue so so so badly. I really need to get caught up since graduation is just a few weeks away. I believe all schools have to have a clinical skills list that needs to be completed as a requirement of accreditation.

 

[LetItSnow]

Interestingly, at OSU we are required to work through a checklist of "clinical competencies" during clinics (new AVMA guidelines, apparently). These include things like catheter placement, cystos, ET tubes, and other "technical skills" but also include "vet skills" ie neutering, interpreting an ABG, suturing a laceration, and performing a necropsy. So some schools (and probably all schools) will be moving to this sort of system in the future.

We do a similar type of checklist. It's basically handed to us with a "complete by end of fourth year" due date. It's fairly .... easy. We also have clinical skill labs that include those skills and others.

I think what Bearby was more alluding to was an actual exam type of thing. I know at least some schools used to have fairly rigorous clinical skill competency exams. My mentor (a Univ WI grad from the 80s) talks about it being pretty stressful; a far cry from working through a checklist.

At least, unless your 'checklist' is more strict than ours. For ours you just have to basically do it and have a tech sign off that you demonstrated the skill. It's very basic compared to actually sweating through an exam with some grumpy resident breathing down your neck.

 

[orca2011]

Ours is through E*VALUE.

Anyone that uses E*VALUE knows how much it sucks.

Gah. That website. I just went on it for the first time in forever to look at reviews of externships because they apparently have them on there...who knew. I think I'll have to do them all for a class I'm currently taking as well if I want to get my grade.

 

[NStarz]

I know we get tested on surgical stuff third year (scrubbing, gowning, sterile prep, suturing, that kind of stuff), but I think that's the only formal skills exam we have.

 

[scb44f]

We have little lists of skills/procedures on several rotations that we have to complete to pass, but no master copy that we actually have access to or have to get signed off or anything.

 

[bbeventer]

Ours is through E*VALUE.

Anyone that uses E*VALUE knows how much it sucks.

We have evalue as well... No fun.

 

[Escalla]

Full day of clinical skills labs every week and three practical exams on said skills every year for three years.

And I thought MMIs were stressful. :/

 

[Kiwi210]

One of the doctors at my clinic never learned how to extract a tooth until she started to practice!

 

[DVMDream]

Our school also has a list of recommended skills that you have to either perform, assist with, or observe being done. But it isn't an official list and there really isn't anyone checking it off, it is just for your own benefit. I have this odd feeling these lists have "draw blood" and vet students do it once maybe twice, get it checked off and that is the extent of their "training" on it. Definitely no where near being able to do that skill with confidence. From what I know currently, our school doesn't check things off on the "list" they gave us.

 

[dovelover]

A few weeks ago when our professors were explaining our clinical skills field trip to the small ruminant farm, right in the middle of them explaining what they wanted us to do for the blood draw part of the lab, one of my classmates just raised her hand and said, "Wait, so we like for real get to a blood draw? On an actual animal?" Granted, we're still just first years, but it just illustrates how little we do in the way of blood draws and the like in the curriculum. Plus, they really don't have the resources for everybody to get to do lots of blood draws as part of the formal curriculum... aka, there just aren't enough animals available. The teaching horses get poked quite enough as it is for the more advanced clinical skills labs, and while I may sacrifice my poor cat to get prodded and squeezed by a horde of my fellow first years learning to do physical exams, there's no way I'd ever let a bunch of them try to stick needles into his veins especially if they've never done it before. We did just get some fancy new venipuncture models this year, but none of them are really all that exceedingly helpful unless you've never stuck a needle in the vein of anything in your life. There are definitely opportunities outside the curriculum to learn these things, and this year I've had the opportunity to do a number of blood draws on all shapes and sizes of dogs as well as to draw blood on my own cat. The opportunities are there if you choose to take them, but I know plenty of people who haven't, for whatever reason. But at the end of the day, after getting the excitement about my first few successful blood draws out of my system, I've found there are other things I have learned through these clinical experiences that have been far more valuable, like becoming more proficient at cat/dog PEs and communicating with clients.

 

[Bearby]

Cool, I'm glad to hear that some schools are already putting the new AVMA stuff into practice. I know that UF is working on getting our "clinical skills" lab up and running but it's still in the works. We don't use E-value for checklists or anything, just for scheduling but yes...it's awful

 

[pooter]

We have 4th year clinical competencies also. On top of that, they've apparently gotten tired of students getting to clinics without knowing which end of the horse to stick the thermometer in, so we all have to pass a basic skills practical on the horse and cow at the end of 2nd year. It's pretty basic stuff (how to put on a halter, how to get a BCS, how to auscult, ect.) but it does include some blood draws and basic blood work. Oh, and the whole thing is timed with barely enough time to finish if everything goes perfectly, which makes it super-fun and low stress. Unlike the surgery labs (which are pretty much impossible to fail), it's quite easy to flunk the LA practical, especially if the teaching animal decides to make your life difficult.

(Yes, I'm still annoyed a year later.)

 

[shortnsweet]

Our clinical skills are based on the medical school type of test ie OSCEs. Each year you have certain skills you must acquire, and by 4th year you have an exam that is 23 stations, 5 minutes per station, complete with a nightmare inducing buzzer. Final year they have made better in which you have to do DOPs, which are basically clinical skills the school deems as day one competencies, and you get graded on them during clinics. We have a large practical component to our course, but I still don't feel confident in a lot of skills. I think it is impossible to unless you do things every day over and over again.

We won't even talk about surgery experience....

 

[WhtsThFrequency]

For ****'s sake.

Diagnostic skills trump basic low-level clinical skills (restraint, blood draw, etc) ANY DAY OF THE WEEK.

Feeling insecure about a blood draw and wanting a tech to do it is nothing and does not infer that the vet is somehow deficient. Not being able to diagnose the animal's disease, which as a vet is the main part of your job, is a much bigger issue.

I don't think the OP understands the volume of vet school and how much of it is allocated (and rightly so) to disease and treatment knowledge over simple skills. Simple skills are easy to pick up, and you'll pick it up in your first year or two of practice even if you don't in vet school and will become at least competent (takes a lot more to be confident). It's not a big deal. Some people are more cerebral and some are more hands-on. The latter will pick up simple procedures very quickly. The former will figure the case out more quickly.

No one is going to be a fricking idiot at basic stuff when they come out of vet school. Many WILL be unsure. Hell, considering the oceans of stuff that was shoved in the space between my ears over those four years, of COURSE I'm going to be insecure about things or deficient in things, and it is most likely going to be the silly little things. Just because you have worked as a tech for X # of years and are proficient in XYZ does not give you the right to indirectly look down on new vets who are not as skilled as you. Could YOU diagnose everything that they can? No. Could YOU manage the complex medical treatment of their patients? No. But oh, you can place a catheter better...jeez, what do they teach these guys in vet school, right?

I don't give a flying **** if the attending clinician misses the vein or asks a tech to do it. I DO care if the vet makes a grave diagnostic or treatment error and the animal ends up on my table.

 

[Jamr0ckin]

I totally agree that vet school is for diagnostic skills, and that the technical skills should take a backseat. Vets really have no place trimming nails (seriously... you think this is an important task?). More often than not, a tech or an assistant will be doing the nail trimming, blood drawing, and anal sac expression. As a veterinarian, you will be doing joint taps, abomino/thoracocentesis, performing surgery, and lots of other technical skills that are limited to DVMs.

That being said, no one touched on this and I think it is a valid point: euthanasias. I know that the trend is heading toward placing a catheter in all animals before sedating them, so hitting a tiny vein on a hypovolemic, sedated animal in front of the owner might not be a common concern, but it is there. Many place will pre-sedate, but not place a catheter due to cost. I think it is important to feel comfortable in knowing how and where you can inject euthanasia solution and be fairly competent at it.

I worked with a new grad before I came to vet school. He had great diagnostic skills, and decent technical (surgical, etc) skills, but got better fast after being out for a long time. The practice owner did not allow the placement of IV catheters for just euthanasias, and this new vet would often have to stick the animal multiple times before successfully euthanizing the animal. If this is in front of the owner, it can cause distress. But, hopefully, IV catheters will become the standard of care and that concern will fade.

 

[DVMDream]

We do have clinical skills exams, but they don't include anything with blood draws, catheters, etc.

First year we did have animal handling exams, which was testing your ability to restrain horses, cattle, sheep, exotics and dogs but a good portion of that exam was also an oral test as to identify this type of feed, this breed, age this animal, where would you draw blood (not how), etc.

We had OSCE's last semester which tested our ability to put on gloves without breaking asepsis and tested our ability on suturing/hand ties (again without breaking asepsis).

Next year, we have OSPRE's which are exams that test your ability to do a full physical exam on horses and cows.

The ability to do a good and thorough physical exam is what our school is really looking for and we have had many practical classes focusing on just that and repeating the process of a physical exam over and over and over.

 

[dyachei]

I totally agree that vet school is for diagnostic skills, and that the technical skills should take a backseat. Vets really have no place trimming nails (seriously... you think this is an important task?). More often than not, a tech or an assistant will be doing the nail trimming, blood drawing, and anal sac expression. As a veterinarian, you will be doing joint taps, abomino/thoracocentesis, performing surgery, and lots of other technical skills that are limited to DVMs.

That being said, no one touched on this and I think it is a valid point: euthanasias. I know that the trend is heading toward placing a catheter in all animals before sedating them, so hitting a tiny vein on a hypovolemic, sedated animal in front of the owner might not be a common concern, but it is there. Many place will pre-sedate, but not place a catheter due to cost. I think it is important to feel comfortable in knowing how and where you can inject euthanasia solution and be fairly competent at it.

I worked with a new grad before I came to vet school. He had great diagnostic skills, and decent technical (surgical, etc) skills, but got better fast after being out for a long time. The practice owner did not allow the placement of IV catheters for just euthanasias, and this new vet would often have to stick the animal multiple times before successfully euthanizing the animal. If this is in front of the owner, it can cause distress. But, hopefully, IV catheters will become the standard of care and that concern will fade.

I tell owners that I will try to place a catheter (or have a skilled vet tech/assistant place one) but that in certain situations, veins collapse. I feel like this is less of an issue than people try to make

 

[DVMDream]

I totally agree that vet school is for diagnostic skills, and that the technical skills should take a backseat. Vets really have no place trimming nails (seriously... you think this is an important task?). More often than not, a tech or an assistant will be doing the nail trimming, blood drawing, and anal sac expression. As a veterinarian, you will be doing joint taps, abomino/thoracocentesis, performing surgery, and lots of other technical skills that are limited to DVMs.

That being said, no one touched on this and I think it is a valid point: euthanasias. I know that the trend is heading toward placing a catheter in all animals before sedating them, so hitting a tiny vein on a hypovolemic, sedated animal in front of the owner might not be a common concern, but it is there. Many place will pre-sedate, but not place a catheter due to cost. I think it is important to feel comfortable in knowing how and where you can inject euthanasia solution and be fairly competent at it.

I worked with a new grad before I came to vet school. He had great diagnostic skills, and decent technical (surgical, etc) skills, but got better fast after being out for a long time. The practice owner did not allow the placement of IV catheters for just euthanasias, and this new vet would often have to stick the animal multiple times before successfully euthanizing the animal. If this is in front of the owner, it can cause distress. But, hopefully, IV catheters will become the standard of care and that concern will fade.

I hope IV catheters become standard. We (almost) always used IV catheters and usually would take the pet to our treatment area to place it before bringing them back to the exam room with the client. For larger pets that could not move, then we would place the catheter right in the room with the client and send the client out of the room for a couple minutes if they did not like needles/sight of blood. Some clients insisted we do the catheter with them and then we would stick around in the room, but the techs still set that catheter in front of the client (occasionally a doctor would but usually techs did). I did quite a few of those catheter settings on euthanasia cases right with the owner watching and a few of them I could not get, but amazingly clients are quite understanding of that.

 

[Coquette22]

We have a bunch of practicals, though for time constraints/limited number of animals, a lot of skills don't necessarily get evaluated. It's not practical to have 60 students do blood draws in a timed exam. They do test other things though. Gowning, gloving, setting up x circuit on an anesthesia machine, doing a certain suture, tying an x knot (we have a ridiculous amount of knots to learn for our large animal handling), restrain this dog for x blood draw, auscultate this cow, tail wrap this horse, use a pig board, etc. Surgery has some skills evaluation too; we have a skills booklet that we have to get signed off on showing that we know how to scrub, gown, glove, handle instruments, a few types of suture patterns, etc. And they evaluate us during surgery too. Efficiency, tissue handling... If you're anesthetist, you get rated on catheter placement, ET intubation, etc. I know we have "outcomes assesment" for fourth year and a little in third year, but I don't know entirely how it works for fourth year yet.

 

[LetItSnow]

A butterfly catheter is your friend.

 

[pinkpuppy9]

What happens if you guys (vet students) feel that you aren't competent in a surgical skill, or just can't get the hang of it? I feel overwhelmed just reading about what you learn. I bet it comes with a lot of practice, but I still worry that I might end up being that one student who just sucks at something.