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Quick question for those of you who've gone: So I understand how the 25 hours of observing surgery works, but what do they mean exactly by the requirement that all pre-vet students must "study suture procedures and small animal anatomy"?
 
Just an FYI, as I think it relates to alliecat's question-this thread or a previous VIDA thread (not certain unless I look closer) is currently linked to/the topic of discussion on a VIN thread-several veterinarians are upset that pre-vet students are allowed to do surgeries, anesthesia, etc just because they're in a third world country. This forum is not as anonymous as you might hope.
 
A previous VIDA thread is the one that's linked.

FWIW, I've always been uncomfortable with this idea--one reason I didn't pursue it as a pre-vet myself.

But my own thoughts aside--I'd love to hear pre-vets answer that question. 🙂
 

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alliecat44 said:
Just to play devil's advocate...

...just because you CAN perform surgery in a third-world country with next to no training and no formal veterinary education...

...does that mean you SHOULD?


Discuss. 🙂


P.S. Do any of these organizations have actual numbers that indicate that the spay/neuter programs are making a dent in the country's overpopulation problem?
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And I will play devil's advocate for a second as well...

Just because we require surgery to be performed by a trained veterinarian, does that mean everyone should?

It's all a matter of perspective. Yes, it would be ideal if everyone who went was fully trained, but realistically, how much draw would a program like that have? These organizations are trying to do many things including:

1. Provide veterinary care to animals that would not have received it otherwise
2. Provide volunteers with a unique experience
3. Provide themselves the resources to do both of these

With VIDA, you are given a manual to read through before the trip. I agree, little training before you go. The entire first full day is spent going back through that manual, learning suture techniques, and going through what the rest of the days will be like. Again, little training before you go... However, when you finally have an animal who is there for surgery, you don't just do it without supervision with no idea what you're doing. With us, they literally took our hands and guided our movements, explaining why each step was as it is, at least through the first few surgeries. Each set of two was paired with a staff veterinarian who would watch over you like a hawk and who would step in immediately if anything went awry. I honestly think it is a reasonable way to handle non-trained people doing surgery.

I don't have any numbers specifically, but here's some perspective.

We did 30-50, maybe more, surgeries per day depending on where we were. We had 5 days of surgery. We had more surgeries on days where the program was well-established, and fewer surgeries in places where it has not been running so long. One of the main obstacles is showing the folks who live in these areas that it does not harm their animal, but it is growing in popularity. In fact, they have recently added another country to their list of where they go. I can't believe that it does not make a difference, especially considering that they do multiple trips each year to assist the same communities, while the list of communities grows. I should note, not all animals were owned... A fair number were from the streets.

ETA: The organization has spoken to vets who work in the area since starting the program. They have noticed no decline in business since the program is marketed toward people who would not have gone out of the way to get veterinary care anyway.

In the end, I think it's a personal decision. If you don't agree with this type of program, don't go.
 
scb44f said:
1. Provide veterinary care to animals that would not have received it otherwise
2. Provide volunteers with a unique experience
3. Provide themselves the resources to do both of these

With VIDA, you are given a manual to read through before the trip. I agree, little training before you go. The entire first full day is spent going back through that manual, learning suture techniques, and going through what the rest of the days will be like. Again, little training before you go... However, when you finally have an animal who is there for surgery, you don't just do it without supervision with no idea what you're doing. With us, they literally took our hands and guided our movements, explaining why each step was as it is, at least through the first few surgeries. Each set of two was paired with a staff veterinarian who would watch over you like a hawk and who would step in immediately if anything went awry. I honestly think it is a reasonable way to handle non-trained people doing surgery.

I don't have any numbers specifically, but here's some perspective.

We did 30-50, maybe more, surgeries per day depending on where we were. We had 5 days of surgery.
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Hmmm. So, you acknowledge that one of the primary goals of these trips is to provide people a unique experience, i.e. tourism. You say you do 30-50 surgeries a day there--but how many days of the year is that? And what is the homeless animal population? The sad fact is that even 30-50 surgeries a day for six months a year wouldn't make a dent in some of these populations, since population growth is exponential.

In fact, we were told this at school--that many of these groups (not necessarily VIDA specifically) exist mainly for the touristy-type experience and for the volunteers to feel good about themselves--when in fact impact studies are lacking or disprove any benefit, depending on the community. I haven't done the research myself, but just crunching some basic numbers I can agree with this.

Having one veterinarian per pair of "students" for even a single day (20% of the trip duration) doesn't seem very efficient to me. Might the veterinarians be able to spay more animals more quickly than untrained personnel?

With no anatomy knowledge, what happens in the event a pedicle drops? Or a ureter gets ligated? Or when a patient has weird/unique anatomical variation?

I'm not saying third-world animals shouldn't be spayed/neutered, I'm just wondering about the purpose of these trips.

Do you think your experience will cause you de-value your future veterinary education in your own mind? "Oh, spaying, piece of cake, anybody can do it."

I have some classmates who were illegally allowed to perform surgery prior to vet school. Overwhelmingly they say that they didn't know nearly enough to be as scared/respectful of the situation as they should have been. They express gratitude and relief for not killing something when they knew 0.0001% of what they know now.

My roommate last year spayed a few cats before vet school. He thinks junior surgery will be no sweat. Looking forward to seeing how stressful it is for him...

Just stirring the pot... 🙂 Nothing personal to anyone. 🙂
 
Okay, this may have crossed a line here.

I think most of us are fully aware of how thin the veil of anonymity can be here on the internet. However, pointing us out specifically on the forum (instead of just linking to the home page of a program like VIDA or WorldVets) is probably a bit uncalled for. I almost feel like, because we are applying this year, we will run the risk of having a vet reviewing our file that has read the thread on VIN and then sill see these experiences listed in our applications, and... well, if there's people that are saying these trips are bad, will that sway their opinion? As a coordinator, I'm probably especially easy to identify - generally, I don't mind, because I think that I represent myself well here and have nothing to hide. But I don't appreciate being directly associated with a big argument among a community of veterinarians.

Vets, if you want to discuss it... come and discuss it. We would LOVE to have more veterinarians on this forum. We are your future colleagues, and if we're participating in something you disagree with, come and tell us about it. We can't join you on VIN, at least not yet, so let's make this a discussion for all of us.

As for VIDA, I believe 100% in what they are doing for the communities there. We aren't monkeys - we're smart, industrious students who are trained well and monitored closely. I understand why it would be a source of discomfort - how could a student learn how to perform surgeries in a day? Well, we don't. I don't think any of us could sit down and spay a dog tomorrow. What we did learn was much more about the process - what do you look for to see if an animal is ready for surgery? How do you calculate dosages? How do you decide what medications to give? How to you place a catheter and prepare an animal for the surgery itself?

After all these things were checked by techs and veterinarians, we begin the surgery. How do you know where to make the incision? What if there is bleeding? How deep do you cut? Obviously there are a million factors here, and we in no way mastered any of them. But we got to try it ourselves with the watchful veterinarians peering over our shoulders, ready to assist.

These animals would not have been spayed or neutered otherwise. Nor would they have been vaccinated or treated for any other health problems they faced.

Maybe I'm just restating what scb has said, but it's important, and I think it makes all the difference. What alternate solutions would you propose for population control in these areas? Have all of the veterinarians arguing against these surgeries visited these countries? Has everyone helped out by volunteering their services as a veterinarian and providing free care to animals in need?

Allie, as a vet, will you be willing to volunteer in a program? Maybe if more licensed vets were volunteering, there would be fewer organizations aimed at pre-veterinary students?

Discuss. 🙂
 
alliecat44 said:
Hmmm. So, you acknowledge that one of the primary goals of these trips is to provide people a unique experience, i.e. tourism. You say you do 30-50 surgeries a day there--but how many days of the year is that? And what is the homeless animal population? The sad fact is that even 30-50 surgeries a day for six months a year wouldn't make a dent in some of these populations, since population growth is exponential.

In fact, we were told this at school--that many of these groups (not necessarily VIDA specifically) exist mainly for the touristy-type experience and for the volunteers to feel good about themselves--when in fact impact studies are lacking or disprove any benefit, depending on the community. I haven't done the research myself, but just crunching some basic numbers I can agree with this.

Having one veterinarian per pair of "students" for even a single day (20% of the trip duration) doesn't seem very efficient to me. Might the veterinarians be able to spay more animals more quickly than untrained personnel?

With no anatomy knowledge, what happens in the event a pedicle drops? Or a ureter gets ligated? Or when a patient has weird/unique anatomical variation?

I'm not saying third-world animals shouldn't be spayed/neutered, I'm just wondering about the purpose of these trips.

Do you think your experience will cause you de-value your future veterinary education in your own mind? "Oh, spaying, piece of cake, anybody can do it."

I have some classmates who were illegally allowed to perform surgery prior to vet school. Overwhelmingly they say that they didn't know nearly enough to be as scared/respectful of the situation as they should have been. They express gratitude and relief for not killing something when they knew 0.0001% of what they know now.

My roommate last year spayed a few cats before vet school. He thinks junior surgery will be no sweat. Looking forward to seeing how stressful it is for him...

Just stirring the pot... 🙂 Nothing personal to anyone. 🙂
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I am not going to argue about that "voluntourism" thing.

If you look at their schedule, you can see the trips that they have each year:

http://vidavolunteertravel.org/schedules.php

In fact, that schedule does not even show an entire year's worth of trips. It only goes until September. There are 7 trips to Costa Rica and Nicaragua together, where we went in August. If you look at how many trips are to Costa Rica, either alone, or paired with other countries, there are a total of 13.

I personally would rather not just sit by and let even just a few more animals go unspayed/unneutered, so I don't really understand your argument about it barely making a dent. Yes, numbers-wise, I see it, but unless there is movement toward change, change cannot happen; unless they start trying to fix the overpopulation problem, it's not going to happen.

About the veterinarians supervising surgery, yeah, maybe it would be faster for them to do the actual surgeries, but given that there were 4 veterinarians on staff, with I think 11 or 12 groups in our case, they could not have kept up, and would likely have lost momentum through the day. As soon as a surgery was done, the next was on the table. Remember though that besides watching over those doing surgery, they were also responsible for helping with consults in-between, and signing paperwork before animals were discharged. Surgery wasn't their only job.

Those complications you listed are exactly why a veterinarian is with you at all times during surgery. They told you where to tie, held clamps for you, voiced when you were doing something wrong, etc. Yeah, okay, anatomy may have been slightly helpful, but without surgical experience, I don't really see the difference between a pre-vet student and a first- or second-year vet student in this specific situation. A knowledge of anatomy only goes so far... I can't buy that knowing anatomy helps so dramatically in surgery that someone who knows it can do spays/neuters drastically more easily or safely than someone who doesn't when they are both being supervised and told exactly what to do.

This experience will absolutely NOT devalue the degree which I hope to earn one day. I don't think "anyone can do it". I don't agree with performing these in the States in this type of situation, as that is illegal, but I do think that these specific surgeries, spays and neuters, are able to be performed by those being constantly directly supervised (as in their attention is always on whoever is doing surgery) by licensed professionals.

You are arguing valid points. I just have different views on them 😉
 
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nyanko said:
So legality should dictate morality?
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No. I just said I don't agree with it. Nowhere did I say those who do are immoral. I volunteer at clinics that are not non-profit. That's not legal either but clearly I don't have a problem with it...

ETA: I think I have expressed my views enough. Please don't read anything into what I said. If I meant anything otherwise I would have stated otherwise.
 
This may or may not be an appropriate time to remind people that access to VIN is a privilege, not a right. It is very generous of VIN to allow vet students free access to their system (it's definitely not free for veterinarians) and rules on sharing VIN message board conversations can be found here.

tldr: be careful and don't mess up VIN access for the rest of us. If you want to share details, run it through the appropriate channels first.

Carry on. Pip pip cheerio.
 
I don't think it would have gone faster if the vets only did the surgery. One: it would be very difficult to get the same number of vets to go on this trip as there were students
Two: if you knocked us completely out of the surgery aspect, the vets will have to dose, prep, and perform the surgery... and I guess if you have the attitude that there is no way students should/can be trained to do things that are illegal in other places, then the vets will have to do the examinations too. How many animals do you think a handful of vets will get done if they had to do the exam/dosing/prepping/surgery... and I guess prescribing too.

The vets basically spent the entire day at a surgery table. Once an animal left, there was another one coming in right behind it. Sure, we were slower than the vets, but you'd still get more done than if you knocked all of the students out of the surgery process.

And what is this bull**** on not making a difference in the stray animal population??? My vet is currently holding a day where she is fixing cats for free. Does that mean she shouldn't do it because it won't make a difference in the overall population?

Also, VIDA isn't just about lowering the animal population. It's about educating owners and providing care to them that they cannot afford otherwise.

One of the vets on our trip has only ever seen one complication. A cat had stopped breathing during surgery... and it lived by the way. He's never had a student botch a surgery, no infections, nothing like that... I think that's great for few hundred students that "shoudn't be allowed to perform surgery"

I have to go get ready for class now 😛
 
These are my concerns. The talk about vets on the project only ever seeing one complication is a bit misinformed. Complications can take several days to manifest. I'm thinking of wound dehiscence and abdominal hernias in particular -- and these occur with more active dogs, unsupervised dogs and/or inexperienced surgeons. If the volunteers have moved on to a new site, they don't necessarily see that any complications have occurred.

I don't think limiting pre-vet students to tech duties would necessarily slow things down. Vets at high-volume spay/neuter places in the US are expected to handle 30 surgeries per day, with tech help. There is still plenty for pre-vets to do on the tech side of things: drawing up and administering pre-meds (which someone with experience would double-check), client education (with appropriate training), a first exam (to be confirmed by vet), clipping, prepping and recovering animals.

Also, I am concerned that these animals are being maintained on IV anesthesia, not inhalant anesthesia, which is suboptimal, but there doesn't seem to be the awareness that this is a method of anesthesia that is below the standard of care in North America. And, with inexperienced surgeons, the time under anesthesia, which should be absolutely minimized on IV protocols, is instead lengthened.

And finally, unless there is a spay/neuter vet's extended presence at a site, I suspect the numbers of dogs living and reproducing far outpaces the ability of volunteers to meaningfully curb overpopulation. I may be wrong if volunteer groups are holding clinics in small villages, or are returning to a place every month -- in fact, I hope I am wrong.
 
I just got back from a world-vets trip to Granada, Nicaragua. I talked to a few of the locals while there (ex-pats and nicaraguans) and they said that over the last 4 or so years the different volunteer vet trips have had a very large impact on the city. I believe World-vets, Ravs, and Vida all go to granada throughout the year, and they said that the animal population has had a noticeable decrease over time.
But I think we also make a big impact because while there we worked with local nicaraguan vets and vet students, teaching them surgery techniques, working through tough consultations, and just talking. While its true we just show up, do some work, and then leave a week later, the Nicaraguans stay, and become better vets because of the trips. Thus we have an impact on the city even when no volunteers are there. I think this was a very important part of the world-vets trip, (I can't speak for the other organizations).
On a side note, while we each did a cat neuter or two (under close supervision), on the world-vets trip only the vets did the surgeries.
 
+1,000,000 to laurafinn. Couldn't have said it better myself.

twelvetigers, to answer your question: as a vet, yes I would support a program PROVIDED that pre-vet students are allowed to do almost everything EXCEPT for surgery. I understand the laws are different elsewhere, but to me (as nyanko pointed out) legality and morality are two different things.

I think laurafinn made some excellent points. Most complications don't happen happen until several days after the surgery. As someone who has been instructed at an AVMA-accredited veternary school, I will tell you that the part of a spay that I stress out the MOST about is....closing the linea. Might be a surprise to some people.

Re: efficiency--I think it would be MORE efficient/faster for the docs to do all the surgery portion and the students/techs to do all the non-surgery stuff, as happens at high-volume low-cost spay/neuter in this country. You can easily do 30-45 surgeries a day with a SINGLE veterinarian who bounces from table to table. Compare that to the number of veterinarians involved per number of surgeries on these trips (I don't know from personal experience, obviously, but just to give folks a baseline).

Professionally, I don't really like the whole "let's get people to pay a lot of money to do surgery on these animals in a third-world country." I dunno, something about that really bugs me. A bit gimmicky. Would you have gone if you were just allowed assist with patient evaluation/care in the perioperative period? Would you have been willing to pay just as much money for that opportunity?

Re: impact on community--I think that's pretty hard to determine without crunching numbers (and crunching numbers about the human population as well). Anecdotes are great, but they're not data. And I'm sure these people have a vested interest in making sure Americans (and other Westerners) continue to make these trips.

I love that local veterinary colleagues are being educated--that is absolutely wonderful!!! And it no doubt has a lasting impact, which is great. 🙂

But is it truly necessary for the sake of the mission to have pre-vet students with no surgical experience perform surgery on these animals?

ETA: How about all the homeless pets needing to be spayed/neutered/receive vaccines and medical care in your own community? If that is truly the motive--why not volunteer at a high-volume spay/neuter clinic? Or have you always had a special place in your heart for Nicaragua's stray animal population? Or is it because these trips let you perform surgery, and you wouldn't get to perform surgery at home?
 
These are my concerns. The talk about vets on the project only ever seeing one complication is a bit misinformed. Complications can take several days to manifest. I'm thinking of wound dehiscence and abdominal hernias in particular -- and these occur with more active dogs, unsupervised dogs and/or inexperienced surgeons. If the volunteers have moved on to a new site, they don't necessarily see that any complications have occurred.
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Considering that owners are ignorant about post-op care, those types of complications will crop up. It isn't the vet's fault or the student's fault. I'm not sure how it is handled, but clients are given a number to call in case of an emergency or in case of complications.

Also, correct me if I'm wrong, but I think groups visit each area on a fairly regular basis... maybe two of three times for 1 day to 3 at a time? This is a volunteer organization... which relies heavily on donations... so they cannot afford to set up a clinic in one area and be available to the people 24/7.

Also, I am concerned that these animals are being maintained on IV anesthesia, not inhalant anesthesia, which is suboptimal, but there doesn't seem to be the awareness that this is a method of anesthesia that is below the standard of care in North America. And, with inexperienced surgeons, the time under anesthesia, which should be absolutely minimized on IV protocols, is instead lengthened.
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Once again, they rely HEAVILY on donations. They cannot afford inhalant anesthesia. Everything they have fits into a couple of trunks. Can you imagine trying to drag around a single inhalant anthesia machine and oxygen and whatever to the clinic site each day and pack it up when they're finished? If you only had one, that would really slow surgery down... so you'd need like three... and once again... they rely HEAVILY on donations. Most of what our group brought was used up over the 6 days.

So... are you saying that organizations like this shouldn't exist until a billionaire comes along and decides to throw tons of $$$ into a third world country so they can hire a hundred vets, buy a hundred anesthesia machines, build clinics, etc?

Why must you rain on everyone's parade? I'm the only person applying to my vet school this year that has willingly travelled to a country in need and provided care to animals who desperately need it. If I get an interview, I'm 99% sure that the VIDA experience alone is going to secure me a spot. Should mention that I'm only competing with ~50 applicants. If the big picture was really as grim as you're making it seem... all of these organizations will be going under, not doing better. I know that when I do become a vet, I'm doing more things like that.
 
alliecat44 said:
ETA: How about all the homeless pets needing to be spayed/neutered/receive vaccines and medical care in your own community? If that is truly the motive--why not volunteer at a high-volume spay/neuter clinic? Or have you always had a special place in your heart for Nicaragua's stray animal population? Or is it because these trips let you perform surgery, and you wouldn't get to perform surgery at home?
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I'd totally volunteer at a high-volume spay/neuter clinic... if we had one.

Maybe I should mention that before this trip, I only managed to get 300 of volunteering at shelters and job-shadowing and 130 hours of research... in the last 6 years. If I were applying to an american school or an international school, they would just toss my application in the garbage.

It would actually cost me more than this trip did to relocate and volunteer... or relocate and work for that matter. I'd need to make more than minimum wage in order for that to pay off.

And then admissions would be like "She has 1000 hours of cleaning kennels and watching vets... so what?" *tosses application in trash*

VIDA is one of the cheaper trips... and you get to do more. Why the heck not?
 
I'm going to throw this out there since it kind of came up:

There is a competition going on. You vote for an organization that you wish to see and the winners get money to establish the organization. The SPCA would like to start up a low-cost spay/neuter clinic in my province. I'd definitely volunteer for one if it existed.

http://www.avivacommunityfund.org/ideas/acf8394

Please vote. It might keep me from going back to third world countries if we get one 😛

(Seriously though... please vote.)
 
Don't mean to speak for laura here, but I think her point was not that injectable-only anesthesia isn't really the standard of care here--but that folks who haven't been to vet school won't be able to put these techniques/protocols in their proper context.

What is a license to practice veterinary medicine worth? The only three things a technician is not legally allowed to do (in this country) are prescribe, diagnose and perform surgery. What makes it okay for someone who is not even a licensed technician to perform surgery after crossing an imaginary geographical line (and paying a ton of money)? Should technicians get to perform surgery? How about for a client who really can't afford it? Morally/ethically acceptable to offer to train the technician in the surgery as long as you're standing over them? Certainly not legal, but...is it ethical? What if someone found a stray in the street with a diaphragmatic hernia that needed repair, your hand was in a cast and you couldn't do surgery? Okay to let your tech do it since nobody owns the animal and it needs surgery? Again, certainly not legal, but...is it ethical?

If not--what makes these trips okay?

I do think your intentions are very good and honorable. 🙂 Quite wonderful things in someone pursuing veterinary school! However, I'm not talking about your motivation or personal moral character--more about whether these programs should allow laypeople to perform surgery.

Backing away slowly again... 🙂
 
Haha, maybe I should mention that vet techs at some clinics here do cat neuters.

I think we had a debate about that a few years ago...
 
Honestly, it's not an attack on anyone's character that some DVMs disagree with the practice of surgeries being performed by pre-vets. I think that alliecat brought it up to spark a bit of thought and discussion as to the moral and ethical considerations involved in these things, as well as the implications to the veterinary profession, since inevitably not everyone is going to agree with the practice.

Consider this: you might get an adcom member reading your application who disagrees with it, and you might be asked at an interview what your thoughts on it are. I think it's important to think of the types of arguments people may have against it, in order to be able to more convincingly state your own viewpoints. If you're dismissive and defensive, it's going to leave a bad impression. If you can discuss it somewhat objectively, that would probably be ideal...
 
I don't think this thread was an appropriate space to bring this up. This thread was created for people who were interested in going and want to hear about other people's experiences. It wasn't created for debate. That should have went in a separate thread.

They probably aren't going to bring it up in my interview. It's closed file and they only ask you behavioral based questions 😛
 
You don't think it's appropriate for someone who is considering going on a trip like this to actually stop and think about it in these sorts of terms?

Then I don't know what to tell you. Nice backseat modding of the mod though. :laugh:
 
alliecat44 said:
Don't mean to speak for laura here, but I think her point was not that injectable-only anesthesia isn't really the standard of care here--but that folks who haven't been to vet school won't be able to put these techniques/protocols in their proper context.
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I'm sorry, but I don't think the argument about techniques and protocols is valid. Yes, we made incisions. Yes, we sutured. Yes, we did the things that, when compiled, make a surgery a surgery. However, we did not just start cutting without the vet acknowledging the correct incision site, nor did we start ripping organs out of the body like a madman, nor did we cut anything that wasn't being held by the vet overseeing us. The only thing some of us did truly decide for ourselves was what suture technique we closed with, and even then, I only decided for myself once.

To me, this says that we did the technical aspects, but nowhere in there did we really process through anything without the vet either guiding us or directly telling us what to do. Nowhere in that paragraph says to me that I was doing the job of a vet. I don't see how this can be translated into "a DVM/VMD is worthless". I did two kinds of surgeries. I'm not an expert. I'm just a person who hopes to be able to do these things someday.

To respond to your earlier post,

I do appreciate seeing those high volume S/N clinic numbers. The nearest one is at least 60 (possibly 90) miles away, so I have never had a chance to volunteer at one.

Personally, I would have gone on the trip, even if the opportunity was "just" tech duties. I would have still learned certain technical skills, still would have had fun, and still would have gotten an interesting view of veterinary medicine. I'm a perspectives kind of person (usually... admittedly, I can be stubborn with some things... who would've thought? 😛) so getting to see the facilities available for us to use, the conditions of the animals, the farms we visited, etc. was incredibly interesting and eye-opening.

It was not truly necessary to me for surgical experience to be part of the trip. It was a plus, but as Scarcely said, VIDA was a less expensive alternative to other similar options, and like I said before, I enjoy perspectives. It was also helpful that there were other SDNers who were going, which made it easier because I "knew" others on the trip before just showing up.

It's a personal decision whether or not to go, one which must be made taking these kinds of things into account. I think there are some who prefer to stay and help out locally, while there are others who help out internationally. I'm not sorry or embarrassed to say that I did something to help those in another country.
 
This thread was essentially a sign-up list and a way to find out more information.
You could have created a new thread and had this debate.
It would be like me crashing... I donno... a pro-life meeting and starting a debate.
 
nyanko said:
Honestly, it's not an attack on anyone's character that some DVMs disagree with the practice of surgeries being performed by pre-vets. I think that alliecat brought it up to spark a bit of thought and discussion as to the moral and ethical considerations involved in these things, as well as the implications to the veterinary profession, since inevitably not everyone is going to agree with the practice.

Consider this: you might get an adcom member reading your application who disagrees with it, and you might be asked at an interview what your thoughts on it are. I think it's important to think of the types of arguments people may have against it, in order to be able to more convincingly state your own viewpoints. If you're dismissive and defensive, it's going to leave a bad impression. If you can discuss it somewhat objectively, that would probably be ideal...
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I agree 100% and do appreciate the topics being brought up. A similar topic was brought up in the initial thread, but did not catch on as much as this one did.
 
BIG REQUEST: Would anybody who went on the last SDN trip be willing to talk about it with a parent? I'm coordinating a trip at my school (NC State) and one students' mother wants to be sure that VIDA isn't a front for a sex trade organization or something bizarre like that. I'd appreciate an email address (via PM) from anyone willing to answer questions about their trip.

You'd be my best buddy ever - the mother's just a bit of a worrywart. 🙂

Not trying to interrupt the debate, which I think is actually very important to have. You may get tough questions about the trip - better that you hash your opinions out with pre-vet forumers than adcoms!
 
scarcelyheard said:
Considering that owners are ignorant about post-op care, those types of complications will crop up. It isn't the vet's fault or the student's fault.
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Thing is, sometimes these complications *are* the surgeon's fault, especially abdominal hernias caused by improper closure of the linea alba.

This is a volunteer organization... which relies heavily on donations... so they cannot afford to set up a clinic in one area and be available to the people 24/7.
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And yet, there are organizations that do just that, for instance the Esther Honey Foundation in the Cook Islands or any number of organizations in Thailand.

Once again, they rely HEAVILY on donations. They cannot afford inhalant anesthesia. Everything they have fits into a couple of trunks. Can you imagine trying to drag around a single inhalant anesthesia machine and oxygen and whatever to the clinic site each day and pack it up when they're finished?
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RAVS does exactly this. All their surgeries are done with pre-meds, induction meds and isofluorane anesthesia. No pre-vets do surgery.

Why must you rain on everyone's parade?
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I don't think you understand my intention. I want to present an alternate point of view about these trips. If you don't agree, that's fine, but you should at least be cognizant of the issues surrounding them.

If the big picture was really as grim as you're making it seem... all of these organizations will be going under, not doing better. I know that when I do become a vet, I'm doing more things like that.
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I have done volunteer trips in the past, and will in the future. But I will likely work with local organizations directly, rather than paying an intermediary thousands of dollars. I have to say, I don't really see why people pay money to volunteer.


Well, I guess I haven't smoothed any ruffled feathers here. But I'm just putting my opinion out there as forthrightly as I can.
 
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laurafinn said:
RAVS does exactly this. All their surgeries are done with pre-meds, induction meds and isofluorane anesthesia. No pre-vets do surgery.
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This makes me jump quickly back in - have you seen HSUS's budget? Not arguing for or against VIDA trips, just saying that that is not in any way a fair comparison.

I volunteer with a feral cat TNR program in the United States, and we use injectable anesthesia. My personal opinion is that something not being ideal does not make it inhumane.
 
On that note, I would like to add that we didn't have electricity or a roof at one sugery site - just headlamps and a tent. All surgical equipment had to go over on the ferry (it was an island in the middle of a huge lake).
 
Just to add, I don't really want to make this an argument about the suitability of injectable protocols vs. inhalant protocols in third world countries. Or, for that matter, I don't mean to say some organizations are better than others -- I'm sure all have their advantages and disadvantages. My point rather is that you need to know going in which (if any) corners are being cut vs. North American veterinary medicine, and you need to be OK with that. You also should know that there exist options other than paying for volunteer experience. That's all.
 
I hate having to pay to volunteer too, but considering this included all of your hotels, admissions, fees, most of the meals, transportation, ect., the price is not bad. Do you really expect them to pay for that, being non-profit and all 😛

Should have went and got experience with sea turtles in Greece I guess... $500 for two weeks, but you lived in tents 🙄 and that still didn't include transportation to the site and meals.

I'm too poor to go anymore... and once I get rid of my debt, I'll still be too poor to go all the time... I don't see anything wrong with going once.

One of my vets went to... Peru I think ith WorldVets when she was a second year student. She actually had to teach the vets there to spay/neuter. After becoming a DVM, she still wants to do another trip, so what they do/don't do and what they have have to work with didn't seem to change her mind upon coming educated.

She also told me that a group from her university went to Africa the next year with WorldVets I think. She told me that when they arrived home, a lot of the girls started losing their hair. They think it was mercury poisioning. Scary.
 
Just thought I'd add my thoughts. 🙂

When I was considering going on the trip, I did a lot of research and communication with VIDA and previous students who went in order to gain a full perspective before I put my money into it. I also decided that once I got there, if I decided that the techniques used were unsafe or unethical, I would choose not to join a surgery team.

Pre veterinary students doing surgery is a scary thought. However, VIDA has been designed to give pre veterinary students the opportunity to experience a part of vet med they have only been able to observe, see a part of the world never seen before, and gain more experience hours in a safe, ethical, and educational environment.

This situation could absolutely go wrong in so many ways! Fortunately, VIDA has structured the program well and trained their employees to see a problem before it happens, to address the issue, solve it, and to move on. (This is the case whether we were in surgery or out on a "tourism" day)

I think perhaps in our excitement, we could have given a false impression of what we did. When we say the veterinarian guided us, we mean hand over hand. Literally. We were their puppets on a string. Were we given more freedom as the trip progressed? Yes. However, that was only after proving that we were quick to respond to direction and took the advice of the veterianarian every time. Thus, each of us had different levels of freedom by the end of the trip. 🙂

Would I jump at ANY chance to perform surgery? NOPE. I chose to go with VIDA because of the way they do their best to ensure that surgical time is spent , benefiting the animal, benefiting the individual student, and helping an entire population.

I completely understand the validity of debating whether this is moral and ethical. I think it's important to consider before going on a trip. So I guess my concluding thought:

I consider myself to value moral and ethical medical care of animals. I spent time discussing my trip with local US veterinarians before I went, I discussed the surgery techniques with VIDA, and I decided to go on the trip based off of these discussions. I believe my ethics and morals are still standing and given the opportunity to do it again - I'd LOVE to.

Now, what we really shoud be debating is how NASTY it would be to go on the VIDA med team. Two words: Pap smears. *shudder*
 
heylodeb said:
Now, what we really shoud be debating is how NASTY it would be to go on the VIDA med team. Two words: Pap smears. *shudder*
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:laugh:lol
I think the word "frothy" comes to mind.... 😉
 
nyanko's exactly right--I was wondering if any pre-vets who had participated in these trips had thought about the moral/ethical aspects of doing surgery when you do not have a veterinary license and you are not enrolled in an educational program to obtain one. I know that everyone on here is very dedicated and industrious and that everyone signs up for these trips genuinely wanting to do a good thing. And I'm sure that by and large a lot of good IS done.

However, nobody has yet answered what makes it different for them to pick up a scalpel in another country versus picking up a scalpel here--in an ethical (not legal) sense. I asked a few questions above about whether technicians here should be allowed to spay animals if they are unowned or off the street--as long as the vet is "directly supervising" them. What do you think? If not--why is it okay for you?

All I've heard so far is a lot of discussion about personal reasons for going on the trips and doing good and that sort of thing. Again, this is admirable, but I don't think anyone's posted much about the ethics/morality of it. Even though a vet is "holding your hands" at first does not, in my book, make it okay--whether there or here in the US. Of course, most people on here have a different opinion--I'm just curious as to why. 🙂

And yes, nyanko hit the nail on the head--I added this to this thread because I figured if anyone had thought about these implications--or should--it would be the folks actually participating on the trip.

Happy Thanksgiving, everyone!
 
If anyone is interested in my perspective on the situation, let me know. You're probably sick of hearing from me by now, so I figured I'd give you a break 🙂
 
scarcelyheard said:
An
Just a heads up... I ended up getting sick near the end of my trip with fever and stomach pains. The doctor told me I either picked up a virus or it was from eating salads. The guide wasn't always clear about what was safe to eat and what wasn't safe to eat. I had mild stomach issues on and off during the trip. A few people had an upset stomach at certain points, but no where near as bad as I had it. I tried sooo many different medications and nothing helped... I just had to let it run its course.

I just wanted to through that out there. I missed out on a lot during the last few days of my trip... I was well enough to do the last clinic, but I missed going out for dinner and drinks with the group and have you ever tried ziplining when your stomach is churning and you're aching all over? It's really not cool!

A
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Piece of advice: take Cipro with you... it is the best stuff ever.
 
How can you really judge if someone is capable of doing surgery?

Do you judge them based on their education?
Is someone who gets straight As in vet school more capable of performing surgery than someone who just passed?
Do you judge them on the amount of experience they have?
Is someone who has done 100 spays with a veternarian more capable than someone who has done 25 spays?
Do you judge them on how quick they pick up the technique?
Do you judge them on how they react in an emergency situation?

I've witnessed vet techs (some went through a program, some did not) perform cat neuters without direct supervision from a vet (but the vets are always in the room). These people have been techs for 15 years +. Majority of the cats they neuter make it through surgery great I'm assuming, or the vets would have taken it over. They ARE way better at cat neuters than 95% of new DVM graduates.

If they were doing spays all by themselves, I would be a lot more concerned because a heck of a lot more could potentially go wrong (but what the heck do I know, I haven't gone through vet school yet!).

It's not like the techs are getting more and more responsibility over time ("So, they've gotten the hang of cat neuters, so why don't we move on cat spays, and then next month, dog neuters!") People are always whining about how easy cat neuters are and how quick the procedure is, so why the heck can't a tech be taught this proceedure and be allowed to perform it? Blood draws, administering anesthesia, and dental procedures all have their share of risks, just like cat neuters do.

I think it's pretty difficult to draw the line and say that techs+others can only do these while DVMs can do everything. There are probably some techs out there who shouldn't be trusted with blood draws.

I donno.

Those are my thoughts of the moment. Can't really sum them up because I have class in 10 minutes.

ETA: What about vets who graduated 30 years ago and are still doing procedures the way they they learned it? Should it be required for them to upgrade their education in order to continue doing surgical procedures?

Like I said... there are WAAAY too many factors when it comes to who should and should not be "allowed" to perform surgery.
 
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Hey i was just wondering if anyone was really sure that they were going yet? I am really interested and very exicted.... just like many i looked up flights and would have to fly in early.. maye a bunch of us could meet up and share a hotel together to cut costs!
 
Well I just became aware of this debate... I'm not sure I have anything to add that TT, scb44f, heylodeb or scarecelyheard haven't gone over. I'm not even going to speak to the ethics situation as it is pretty clear people are just going to have different opinions regardless of how many ways we rehash it. The point I would like to make though is one about the whole negative connotation of the "voluntourism" thing. I understand that plenty can be done in our own communities and that it is unnecessary to travel abroad to contribute to spay/neuter programs. However, going abroad allows us to experience a different culture. Not only do we get to learn surface differences like language, food and dance, but we get to see the actual communities these people live in and the way animals are treated in places outside of North America. Going to another country for a trip like this really does give you a different perspective on veterinary medicine and leaves one with an appreciation for the luxuries we have at clinics back home. Aside from all of the hands on knowledge we gained on this trip, the cultural aspect has left us more well-rounded in my opinion.
 
alliecat44 said:
I think it would be MORE efficient/faster for the docs to do all the surgery portion and the students/techs to do all the non-surgery stuff, as happens at high-volume low-cost spay/neuter in this country. You can easily do 30-45 surgeries a day with a SINGLE veterinarian who bounces from table to table. Compare that to the number of veterinarians involved per number of surgeries on these trips (I don't know from personal experience, obviously, but just to give folks a baseline).
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👍

also, aside from possible surgical complications that may crop up later on and extra time under anesthesia, what about increased nociception wind-up? or increased inflammatory mediator release due to excessive tissue manipulation, or the potential increased release of blood -> iron -> fenton reaction -> generation of reactive oxygen species and injury? it seems to me there are more factors that are changed with a surgery performed by someone without experience than just the main procedure itself.

it's also just crazy to me that someone can go from never having even taken a temperature to performing abdominal surgery in the span of just a few days, bypassing even learning blood draws or catheter placement first. granted i have no experience with these trips either, but still. to me that's crazy!
 
squeegee said:
👍
it's also just crazy to me that someone can go from never having even taken a temperature to performing abdominal surgery in the span of just a few days, bypassing even learning blood draws or catheter placement first. granted i have no experience with these trips either, but still. to me that's crazy!
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I've actually never seen a vet take a temperature. But I've seen too many spays/neuters to count.
 
You said it's crazy to let someone do abdominal surgery who has never taken a temperature. Just saying that I saw a hundred of them before going on the trip.
 
so never seeing a vet take a temperature means they're inexperienced with doing so? and that you've seen spays and neuters means you are? sorry i'm still not seeing the meaning here. i was just going based on your statement that you've had zero experience with even the basics like taking temperatures, drawing up vaccines, etc. yet did surgeries in days.
 
Playing devil's advocate again... Is it not just as risky for someone in (or just graduated from) vet school to perform surgery? Do the same potential consequences not apply? By that logic, should they not perform surgery either? (I'm only talking experience-wise, since that's the only thing that was mentioned; there is clearly a difference in knowledge between me and someone in/out of vet school.)

Warning, anecdotes follow, so I'm not trying to give evidence, just saying what I saw:

I will just note, unless the size of the dog warranted a larger incision, the incisions that we worked with were less than an inch long. It has been a while since the trip, but if memory serves, I saw the same, if not less, blood loss on the trip, at least in the surgeries I was directly involved in, than I do back in an actual clinic in this country because of this factor alone. This also reduced the amount of time it took for us to suture the incision, unless the vet told the individual to use a technique s/he didn't know (which happened to me... I even made the vet very aware of the situation but she wouldn't change her mind). Anyway, I feel like they did their best to minimize the chances of some of these circumstances from occurring.
 
squeegee said:
so never seeing a vet take a temperature means they're inexperienced with doing so? and that you've seen spays and neuters means you are? sorry i'm still not seeing the meaning here. i was just going based on your statement that you've had zero experience with even the basics like taking temperatures, drawing up vaccines, etc. yet did surgeries in days.
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What exactly is your point? Now I'm confused.

How do you even define experiences? No, I hadn't done most of that stuff before my trip, and no, I haven't done surgery, but I had seen well more than the minumum number of hours over my 5 years of volunteering. It's not like I went in there not knowing what a uterus looked like.

I made the entire team well aware that I was new to this sort of thing. My first night there, we were asked what we expected to gain from this trip. I told everyone that I had practically no-hands on experience and that I would be estatic if I got to learn some tech duties. I also made all of my partners aware that I was new to this and asked them to teach me and help me. When I went to do something myself, I double checked and triple checked that I was doing it right, and when I wasn't sure, I always asked someone.

Like when the vet asked me to give an IM injection to a cow. I told them I had zero experience with cows, asked him if it was okay for me to do it, and got the vet to explain the procedure to me before doing it. When I had to do it a second time, I double checked with the vet to make sure I was doing it in the right place.

I know the group members were probably getting annoyed with me... but I sure wasn't about to start hacking nails off before I knew how to tell where the quick was... or how to apply that darn smelly flea spray.

I actually wasn't expecting to do very many surgeries due to my lack of experience. I was having difficulties with some of the sutures during orientation (I was just slower than everyone else), and I told the vets that during before beginning my first surgeries. I got the gist of it pretty quickly, which I wasn't expecting. And whenever a vet told me to "cut/suture/clamp here", I'd touch the area and say "Here?" before I'd cut or suture or clamp. They must have thought I was doing a decent job or they would have taken over. In a few cases, they did. The dog was beginning to wake up and I felt like I wasn't quick enough to finish closing the incision. Or, if I couldn't find the uterine horn after a couple of tries, they would correct me, and if I still couldn't find it, take over. I think I was most nervous when they got me to break the ligament or squeeze a testicle out of the incision. I was sooo scared of pulling or squeezing too hard.

It was a weird experience... I thought I was going to be more nervous than I actually was. Nothing broke my concentration while that animal was on the table... not a thunder storm... not a stomach ache... not the guide asking me what I wanted for supper... it's just part of my character and I think it played to my advantage out there.

I've never owned a dog, and suddenly I'm surrounded by people trying to muzzle dogs that are trying to snap at them, and I wasn't scared. A little hesitant, yes, because I didn't want to lose a finger, but it was weird. I take after my mom though... I always take my job seriously. Maybe it's genetic?
 
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all i was saying is that to me, having gone from not even temping an animal to performing surgery is like going from 0-100. just my opinion. i didn't ask you to or expect you to defend what you did or anything, again it is just my opinion. my background had me starting with watching only, then placing a doppler, drawing up vaccines, drawing blood, placing catheters, intubating...all very slow and systematic, with skills building over time. so hearing about such a steep learning curve is surprising to me. that's all.

what was confusing to me was your reply of "I've actually never seen a vet take a temperature." I don't see how that ties in to anything, except to maybe say it's not exactly a crucial skill?
 
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