Class of 2021 . . . how ya doin?

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yo if people need neuro help i'm always happy to answer stuff. for real. sometimes too eager?
I'm just not sure what I don't know, you know? I need to know all the stuff so I don't get publicly humiliated by he-who-must-not-be-named

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Wait neuro isn't... required at all schools???
It's a selective here meaning it is a service that needs students (so there are always students on it) but not every student takes it. Which kind of makes sense to me, I'm not gonna be doing MRI and hemis and ventral slots in GP lol I got to practice my neuro exam skills on community practice and ER
 
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Neuro isn't mandatory for us probably cause we have 0 tracking. You just model your elective and off blocks to what you want to do.
Yeah, that's why a lot of the specialty services aren't required here too. If you end up with a selective you don't want, you just have to try to swap with someone who does want it. Harder to do that with some rotations than others, because of their reputations lol
 
Neuro rotation is mandatory here and pretty well-staffed and very busy.

I'm low key terrified for it because I did not do well in neuro as a course (and much of our neuroanatomy in 1st year was "teach yourself" and/or treated as bonus questions on our anatomy head exam, which is not the best model for learning the most complex and esoteric organ in the body. I mean... maybe some people can learn it like that, but I cannot.)

...But I'm also excited because it's obviously incredibly important. Plus, I have a neurologic cat, so. Gotta learn the deep dark secrets of why the little fuzzball be like that.

And who knows, maybe I'll finally confirm @Caiter92 's suspicions about him and diagnose the first case of chronic rabies ever documented in the medical literature. :thinking:

(He's a very strange cat, and I'm no stranger to strange cats. Lol)

Someone jokingly said a patient had rabies on internal this week, and the resident was like that’s not possible he’d be dead. And I told them it could be chronic rabies and then giggled thinking of your kitties :laugh:

Also I get credit for this discovery when it occurs! He has the rabies. I just know it :p
 
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It's a selective here meaning it is a service that needs students (so there are always students on it) but not every student takes it. Which kind of makes sense to me, I'm not gonna be doing MRI and hemis and ventral slots in GP lol I got to practice my neuro exam skills on community practice and ER

I have so much to say about this, but suffice to say that I think for a person intending to go into small animal ER or GP that neuro is actually very important. It's not because you'll be doing the surgeries or interpreting MRI. It's because you are going to see the cases before they come to us, and man are things 700% easier if you know how to properly communicate with both the owners and us. And I hate to say it, but ER/community practice rotations at vet schools that have neurologists available are NOT going to teach you all of that. You can learn how to do a neuro exam, but the neuro exam that they are going to do on those services and the interpretation of said exam is not going to be the same as what you'd get on a dedicated neurology service.

Source: students here who have been through those services before coming to us on neuro.
 
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I have so much to say about this, but suffice to say that I think for a person intending to go into small animal ER or GP that neuro is actually very important. It's not because you'll be doing the surgeries or interpreting MRI. It's because you are going to see the cases before they come to us, and man are things 700% easier if you know how to properly communicate with both the owners and us. And I hate to say it, but ER/community practice rotations at vet schools that have neurologists available are NOT going to teach you all of that. You can learn how to do a neuro exam, but the neuro exam that they are going to do on those services and the interpretation of said exam is not going to be the same as what you'd get on a dedicated neurology service.

Source: students here who have been through those services before coming to us on neuro.
Sorry, that probably came across as more dismissive than I intended. I do think it's important, my point wasn't to say that it's not, and it's more situational and specific to my school than maybe I articulated.

I think the cost/benefit is skewed here because of how insanely busy the rotation is. There is a point where you are so exhausted and overrun with patients that it is a detriment to your learning. This is from many many of my classmates coming off that rotation (even one who wants to do neuro), with some variation based on how many students were on. Much better reviews when there were 3+ students on the rotation. Similar stories from previous classes, and the only change they've made afaik is that they no longer require students to stand in on surgeries. There were plans to increase minimum # of students, but most of the time in the past year there were still only 2 when minimum was supposed to get bumped to 3 - this is perhaps an argument for it being core in the new curriculum.

Our community practice tends to keep their patients rather than transferring them to other services as much as they can, and if they do bring neuro in for consult the original student on the case is encouraged to participate. The latter part goes for ER too, time permitting. So knowing I didn't have neuro in my schedule, I took advantage of those opportunities. Have done similar things while on radiology and (currently) on anesthesia so I can get some of that exposure without going through the hell that is that rotation.

Anyway, I didn't mean any offense to neuro, as I stated before I love it as a subject and I do agree it is very important. I just also feel I dodged a bullet from the perspective of my own wellbeing by avoiding the rotation here (and you can only fit so much in your schedule - if given the choice I'm gonna take an extra ER or exotics rotation anyway).
 
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Here you have to take 2/3 out of neuro, ER, or onco. So I took neuro and ER cause in WA you can’t do any sort of chemo in a GP hospital so anything I diagnose with cancer is gonna have to get referred anyway, so neuro seemed the most useful to take. Glad I did, really liked neuro. Was probably one of my busiest rotations but the residents and clinicians and techs are amazing so they try to do whatever they can to make it not awful. Probably the least stressed I’ve been while in the VTH in a long time lol just cause I didn’t dread having to come in and deal with passive aggressive BS like on other super busy rotations I’ve been on.

And getting to help with a hemi was super cool, even though it was another day I didn’t get home until like 3 am :laugh:

It also was probably one of the most (in comparison) immediately rewarding rotations. Getting to see owners cry of happiness because their pet came in for cluster seizures or for being down and be a totally different animal when they pick them up was great. Normally when owners are crying and hugging you it’s because you just gave them really bad news and you’re trying to comfort them. I just need some happiness man :laugh:
 
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Not in some states, no.
I should clarify -- it's not that cut and dry. Some states like Washington and California have very strict regulations for handling hazardous medications and I think it makes it difficult for GPs to acquire, store, and administer chemo drugs. Someone can correct me if I'm wrong.

When we lived in CA the only way we could put our cat on a chemo protocol was to have it directly administered by an oncologist. The GPs in the area will not do it. Thankfully we had an amazing oncologist at a network of specialty clinics near by :)
 
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And it makes sense -- a lot of these drugs are no joke and pose major risks to pets and staff alike. Extravasation of doxorubicin, for example...yikes.

And oncologists obviously have more experience anyways, so they can adapt protocols to get the most effective treatment regimen for an individual pet.

Just tough in areas that may not have a high density of specialists.
 
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Yeah, I think a lot of it is OSHA-ish guidelines (not sure if actually OSHA or something else) regarding chemo administration and prep? Like you have to have a dedicated prep area with a fume hood that specifically ventilates a certain way or use a negative pressure room or slmething, you can only draw up drugs using a closed system, etc. So like Pippy said it’s usually not gonna happen in GP since you may only give non-pred chemo a few times a year. My residency location had to renovate the pharmacy to comply.
 
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GPs cant do chemo?
Not in some states, no.
I should clarify -- it's not that cut and dry. Some states like Washington and California have very strict regulations for handling hazardous medications and I think it makes it difficult for GPs to acquire, store, and administer chemo drugs. Someone can correct me if I'm wrong.

When we lived in CA the only way we could put our cat on a chemo protocol was to have it directly administered by an oncologist. The GPs in the area will not do it. Thankfully we had an amazing oncologist at a network of specialty clinics near by :)

Yep, this is it it. You can rx oral chemo drugs and many do. But there are so many regulations around everything about it most clinics aren’t set up to be able to store or dispose of injectable. So most don’t. I only know of one GP clinic around where I worked that still did injectable chemo, and I think there set up is no longer going to be up to code so they’re discontinuing it’s soon.

I wouldn’t want to touch injectable chemo with a 100 foot pole. That stuff is literally poison and if you don’t do everything surrounding it correctly, the animal, you or your staff is going to suffer. I would not want someone giving my pet or myself chemo who isn’t well trained and gives it daily.
 
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That makes sense. Part of our teaching hospital upgrades is redoing the pharmacy to better serve our oncology department. A lot of that stuff sounds like the stuff they're installing.
 
I'm scared enough giving chloramphenicol to horses, let alone chemo to wiggly small animals :laugh:

Although tbf...I know someone who had aplastic anemia from chloramphenicol exposure when he was younger, and being 5'1" makes me well within "projectile drool" range for almost all horses. I think I am very good at overcoming my height to administer oral meds to horses after being made to give all my horses' dewormers etc growing up (and facing the wrath of my trainer if I ever sheepishly told her I let half a syringe get splattered on the walls), but sometimes it's still messy. But still. I'd want really good PPE and waaaaaay better IV catheter placement skills to give chemo to patients.
 
I'm scared enough giving chloramphenicol to horses, let alone chemo to wiggly small animals :laugh:

Although tbf...I know someone who had aplastic anemia from chloramphenicol exposure when he was younger, and being 5'1" makes me well within "projectile drool" range for almost all horses. I think I am very good at overcoming my height to administer oral meds to horses after being made to give all my horses' dewormers etc growing up (and facing the wrath of my trainer if I ever sheepishly told her I let half a syringe get splattered on the walls), but sometimes it's still messy. But still. I'd want really good PPE and waaaaaay better IV catheter placement skills to give chemo to patients.
Our BacT professor just told us yesterday that we should also wear masks when we give chloramphenicol to horses :laugh:
 
I wouldn’t want to touch injectable chemo with a 100 foot pole. That stuff is literally poison and if you don’t do everything surrounding it correctly the animal, you or your staff is going to suffer. I would not want someone giving my pet or myself chemo who isn’t well trained and gives it daily.
Same dude.

BUT -- in case anyone out there in the internet-verse who is not a vet is perusing these forums... please don't let this discussion turn you off of chemo for your pets! Chemo can do amazing things for a pet's quality of life, and researchers are always looking for safer, more effective drugs and protocols. /end pitch
 
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Same dude.

BUT -- in case anyone out there in the internet-verse who is not a vet is perusing these forums... please don't let this discussion turn you off of chemo for your pets! Chemo can do amazing things for a pet's quality of life, and researchers are always looking for safer, more effective drugs and protocols. /end pitch
Oh it's amazing and I would 100% do chemo on any of my pets. But by specialists. Who know what they're doing. That's the best way to make sure unwanted side effects don't happen for the patient or the people administering it.
 
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Really it's the same as a person getting chemo. Would you want your family practice doctor or nurse giving you (injectable) chemo when they maybe do it once a year and don't have as much training as an oncologist surrounding it? I doubt it. I want the same care for my pets and my clients pets as I would myself and human family members.
 
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I think the cost/benefit is skewed here because of how insanely busy the rotation is. There is a point where you are so exhausted and overrun with patients that it is a detriment to your learning. This is from many many of my classmates coming off that rotation (even one who wants to do neuro), with some variation based on how many students were on. Much better reviews when there were 3+ students on the rotation. Similar stories from previous classes, and the only change they've made afaik is that they no longer require students to stand in on surgeries. There were plans to increase minimum # of students, but most of the time in the past year there were still only 2 when minimum was supposed to get bumped to 3 - this is perhaps an argument for it being core in the new curriculum.

If it were core it would likely have more students on it at a time. Seems like a chicken or the egg thing, doesn't it?

And believe me, I know about the insanity of it being too busy to keep up. That happens to all of us. For nearly a year now we have been the only neurology department covering a very large swath of the lower midwest including a couple of major cities. We have had to adjust. Over the holidays when we had reduced students, staff and house officers (and when I say reduced I mean that for a full week I was the only house officer on, and we had only 3 students and 1 technician) it was madness and I don't think it was a great learning experience for any of us (except my surgical skill, that certainly improves when I have to do more than one in a day!). But in talking to the students who were on then, most still felt that overall the rotation was a positive experience, and we try really hard to make it one, even when we're really busy.

Our community practice tends to keep their patients rather than transferring them to other services as much as they can, and if they do bring neuro in for consult the original student on the case is encouraged to participate. The latter part goes for ER too, time permitting. So knowing I didn't have neuro in my schedule, I took advantage of those opportunities. Have done similar things while on radiology and (currently) on anesthesia so I can get some of that exposure without going through the hell that is that rotation.

I mean that's all really good to do, but I don't think it's a substitute for immersion.

Anyway, I didn't mean any offense to neuro, as I stated before I love it as a subject and I do agree it is very important. I just also feel I dodged a bullet from the perspective of my own wellbeing by avoiding the rotation here (and you can only fit so much in your schedule - if given the choice I'm gonna take an extra ER or exotics rotation anyway).

I'm sorry that the rotation is like that there. Again I think that making it core would probably take that away a bit. Less students = more work for each individual student and more stress which then equals less students who want to take it.
 
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Have been skimming because I'm preoccupied with my dog situation (see my post in the rave thread if you have no clue what I'm talking about) but just chiming in to say that neuro's elective here as well. It's really interesting to see the differences between different schools!
 
OKState sees quite a number of neuro cases, so even though they don't have a specialist, I feel my education was adequate for what I need to do correctly as GP. I know how to do a basic neuro exam and when to tell folks that they are at a critical point and need specialty treatment, or when I can try medical management. While it would be awesome for everyone to go through an entire rotation dedicated to only that, I personally don't feel like I've missed out at this point in my career.

I am incredibly thankful that there are people who are specialists so the ones who can afford it can get that expertise, but I think there is very limited time to learn everything in the course of 1-2 clinical years, so as long as the baseline is taught and taught well, the rest is special interest and experience based on the types of cases seen at one's practice from there.
 
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If it were core it would likely have more students on it at a time. Seems like a chicken or the egg thing, doesn't it?

And believe me, I know about the insanity of it being too busy to keep up. That happens to all of us. For nearly a year now we have been the only neurology department covering a very large swath of the lower midwest including a couple of major cities. We have had to adjust. Over the holidays when we had reduced students, staff and house officers (and when I say reduced I mean that for a full week I was the only house officer on, and we had only 3 students and 1 technician) it was madness and I don't think it was a great learning experience for any of us (except my surgical skill, that certainly improves when I have to do more than one in a day!). But in talking to the students who were on then, most still felt that overall the rotation was a positive experience, and we try really hard to make it one, even when we're really busy.



I mean that's all really good to do, but I don't think it's a substitute for immersion.



I'm sorry that the rotation is like that there. Again I think that making it core would probably take that away a bit. Less students = more work for each individual student and more stress which then equals less students who want to take it.
I'm not sure if it is the plan to make it core in the new curriculum or not, but as I mentioned I don't necessarily think that would be a bad idea based on supporting the service. On the other hand, all the specialty services kind of think they should be core, and I think sometimes it gets lost that there are a fair number of students who might be better served in other areas. For instance, neuro very rarely consults on large animal here (they did once when I was on farm animal!), so since we don't track, someone who is going into large animal would probably not be as well-served on that rotation. In my own case, if all goes well I will be in small animal part time for 3 years max before moving onto the zoo world, where the ability do a neuro exam on an awake patient is a luxury! Right now we can fix that by trading rotations around, if it became core you lose that flexibility. Unless they institute tracking here, I'm not sure making it core would be the best solution. Increasing the minimum to 3 was the solution we came up with, it seems it just wasn't instituted this clinical year.

My comments were based on how it exists now and how I would have been taking it here if I'd had it in my schedule - which likely would have been with one other student and consistently so many cases that the amount I learned would not, in my opinion, overcome the detriment (and that's based on many years of student feedback). Perhaps it is different where you are, and that's great. I am talking from the perspective here though, where the feedback is consistently that with less than 3 students on the rotation, learning suffers. And welfare suffers. The benefits of immersion stop when as a student you are not actually given the time to perform the neuro exams you are supposed to be practicing, because there is so much going on.

I'm sorry if I offended you by voicing that, it wasn't my intention. I am glad for the learning I've gotten through working neuro-adjacent. I hope things improve here over time so it becomes a better experience for people.
 
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I'm sorry if I offended you by voicing that, it wasn't my intention. I am glad for the learning I've gotten through working neuro-adjacent. I hope things improve here over time so it becomes a better experience for people.

I hope so too. It's not about "offense." It's about being able to apply a certain level of knowledge in a specialized field when you are seeing cases that can't afford a specialist or even in communicating when you intend to send to a specialist. And that's what I emphasize to all of the students that I work with. All of the patients are going to have a brain (okay, some dog breeds...and horses....maybe excluded... ;)) and a spinal cord and nerves and muscles. And things go wrong with them. And when they do, you can either be the person who is super mean and checks for deep pain in a dog with motor or the person who understands that they don't need to. I'd rather communicate with the latter any day, and I suspect most pet owners would also.
 
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Neuro (and all the other small animal specialty rotations) are required here if your CAE is SA. Not the case if your food animal or mixed or equine or individualized.
 
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I loved my neuro rotation that I took an elective week after I had my 2 week required block where we only had three students including myself unlike the typical 4. It was really busy but I enjoyed it?

Did I enjoy some other rotations where I was crazy busy? No.

must be neuro ;)
 
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I hope so too. It's not about "offense." It's about being able to apply a certain level of knowledge in a specialized field when you are seeing cases that can't afford a specialist or even in communicating when you intend to send to a specialist. And that's what I emphasize to all of the students that I work with. All of the patients are going to have a brain (okay, some dog breeds...and horses....maybe excluded... ;)) and a spinal cord and nerves and muscles. And things go wrong with them. And when they do, you can either be the person who is super mean and checks for deep pain in a dog with motor or the person who understands that they don't need to. I'd rather communicate with the latter any day, and I suspect most pet owners would also.
I had a whole thing typed out and realized I was probably being unnecessarily defensive, so trashed it. I think we have different perspectives on this and probably won't agree - that's fine. You went to school somewhere that tracks, I don't, probably creates different priorities/viewpoints. We're also interested in different things. I will say though that I don't think it's fair to say that you have to have had a neuro rotation to know the basics, which include that you don't need to test deep pain in a dog that still have motor function. That's something I learned in class. There are many vets that have graduated without taking a neuro rotation and I'm sure they don't all suck (maybe I'm biased because I don't think I'll suck too bad). And at this point it doesn't even matter if I wanted neuro or not - it wasn't in my schedule, nothing I can do about that now. So I'll have to make do with what I've got and hope I don't disappoint the neurologists too much if and when I have to refer things to them.
 
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Neuro (and all the other small animal specialty rotations) are required here if your CAE is SA. Not the case if your food animal or mixed or equine or individualized.
See that makes sense to me since you track (or I'm assuming that's what CAE is) so for instance if you're small animal you don't have core equine and farm animal rotations taking up your time. Since I'm planning to be the most generalist of all specialists, I appreciated not having to take all of the small animal specialties (that's like, at least 6 rotations here?) in place of my exotics and zoo electives/externships. Makes more sense to get more specific with your core courses in a tracking system.
 
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See that makes sense to me since you track (or I'm assuming that's what CAE is) so for instance if you're small animal you don't have core equine and farm animal rotations taking up your time. Since I'm planning to be the most generalist of all specialists, I appreciated not having to take all of the small animal specialties (that's like, at least 6 rotations here?) in place of my exotics and zoo electives/externships. Makes more sense to get more specific with your core courses in a tracking system.

Ehhh not really. I still have to take two blocks of equine and two blocks of food animal. Plus pathology and prev med. So that’s like 3 months of stuff I’ll never use beyond NAVLE. It’s not real tracking. Just food animal people take less small animal stuff and vice versa. Would way rather fill those with more surgery blocks, which would actually be useful to me.
 
See that makes sense to me since you track (or I'm assuming that's what CAE is) so for instance if you're small animal you don't have core equine and farm animal rotations taking up your time. Since I'm planning to be the most generalist of all specialists, I appreciated not having to take all of the small animal specialties (that's like, at least 6 rotations here?) in place of my exotics and zoo electives/externships. Makes more sense to get more specific with your core courses in a tracking system.
I am taking zero large animal rotations, it might hurt me a little on the NAVLE but in the end I think it'll really help me in my career (because it'll help me figure out what I want out of life lol)
 
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I am taking zero large animal rotations, it might hurt me a little on the NAVLE but in the end I think it'll really help me in my career (because it'll help me figure out what I want out of life lol)

All of my LA and equine rotations were after the NAVLE, I passed. Not taking them will not make or break you on NAVLE :p
 
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Honestly my most useless rotation this year has been soft tissue lol

It was two weeks of 14 hour days, and at least 8 hour days both weekends, and lots of paperwork. I got to use the electrocautery and some skin sutures. And sit in the ICU waiting for temps to get up above 99. I learned nothing new lol we were so busy we didn’t even get to do topic rounds, which might have actually taught me something.

Some clinicians let students do more, but at most you’re gonna be ligating some vessels and maybe closing. They’re not gonna let students do much of a 6k+ surgery. Would have much rather spent that time anywhere else lol

I will say I’ve heard the other two clinicians are great about talking to you about what they’re doing during procedures and making things a learning opportunity. But the one I was on with could have cared less and got annoyed when asked questions by students lol so yep, was a very useless rotation overall and I wish I could have taken something else.
 
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@Caiter92, has a super good point here. Vet school surgery rotations are really kinda pointless to me from the perspective of training future GPs.
 
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Ehhh not really. I still have to take two blocks of equine and two blocks of food animal. Plus pathology and prev med. So that’s like 3 months of stuff I’ll never use beyond NAVLE. It’s not real tracking. Just food animal people take less small animal stuff and vice versa. Would way rather fill those with more surgery blocks, which would actually be useful to me.
Oh interesting. That's actually not any less large animal core stuff than we have, I think it's...8 weeks core large animal and 8 weeks core small.

Things like anesthesia (4 weeks) and radiology (4 weeks) are technically both but of course you see way more small animal than large. Path (2 weeks) and diagnostic skills (2 weeks) are pretty broad.

We have to do a certain number of selectives (12 weeks maybe? If you wanted to and could make the right trades) you could do all the small animal specialties!) and then have 4-6 weeks for electives, 4-8 for externships, and 2-4 for vacation.
 
Honestly my most useless rotation this year has been soft tissue lol

It was two weeks of 14 hour days, and at least 8 hour days both weekends, and lots of paperwork. I got to use the electrocautery and some skin sutures. And sit in the ICU waiting for temps to get up above 99. I learned nothing new lol we were so busy we didn’t even get to do topic rounds, which might have actually taught me something.

Some clinicians let students do more, but at most you’re gonna be ligating some vessels and maybe closing. They’re not gonna let students do much of a 6k+ surgery. Would have much rather spent that time anywhere else lol

I will say I’ve heard the other two clinicians are great about talking to you about what they’re doing during procedures and making things a learning opportunity. But the one I was on with could have cared less and got annoyed when asked questions by students lol so yep, was a very useless rotation overall and I wish I could have taken something else.
That is kind of what Ortho was like for me except that we were also slow af. We did one really good rounds session where we practiced an orthopedic exam and that was the most useful thing I did the entire two weeks. Hours were still stupid despite the relative slowness because they wouldn't send us home early, ever. We had both the 1st and 2nd year resident on with us so I didn't get to do anything in any surgery (this is one way in which equine surgery was actually better than Ortho lol). It's why I bounced out of soft tissue and into ER as soon as I could after that. I've heard soft tissue is a little better but I'd had enough of standing around where I couldn't see anything anyway. And feeling like the only reason I was there was to do paperwork and after hours treatments on patients in the wards.
 
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I am taking zero large animal rotations, it might hurt me a little on the NAVLE but in the end I think it'll really help me in my career (because it'll help me figure out what I want out of life lol)

I wish this was an option for us.
 
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finally got my block schedule!!! How do you guys add it to your postings? I want to be special too! lol!! can't believe this is happening in a few months
 
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finally got my block schedule!!! How do you guys add it to your postings? I want to be special too! lol!! can't believe this is happening in a few months
Signature button under your account! :)


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We have to do 4 weeks food animal, 4 weeks equine, and 4 weeks rural mixed, and 4 weeks small animal. But in 590, which is the huge course where all the electives go, there's lots of room to design the rest of your year around what you want to be when you grow up.

We get our schedules next week (but the school can still change them if stuff goes sideways).
 
Sitting in the regulatory medicine breakout course. Took it last year (obvs). Exam is open book. Still have no plans to ever export livestock.

Need something stronger than coffee.

Save me....

(thank god it's only a week!)
 
Sitting in the regulatory medicine breakout course. Took it last year (obvs). Exam is open book. Still have no plans to ever export livestock.

Need something stronger than coffee.

Save me....

(thank god it's only a week!)
Oh god I HATE regulatory medicine. I will never ship cattle internationally. Still gotta deal with it for a semester (or more). Sorry Squeaks! *hugs*
 
Oh god I HATE regulatory medicine. I will never ship cattle internationally. Still gotta deal with it for a semester (or more). Sorry Squeaks! *hugs*
I was talking with my husband over twitter messages and at one point he told me to stop talking to him and pay attention. I was like eff that... the exam is open book and he's talking about exporting chickens!

It may be only a week, but it's all day every day.
 
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