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Teaching veterinary medicine outside the classroom

By Don “Doc” Sanders

Many of you may know that I am a field service veterinarian who trains fourth-year veterinary students at Ohio State’s field services satellite clinic in Marysville. I am one of five veterinarians on staff. We work with a graduate veterinary intern, who is in advanced training, and eight to 10 fourth-year Ohio State veterinary students. All Ohio State vet students are required to spend at least two weeks training with us as we visit farms where we diagnose, treat, and prevent disease in farm animals. While training with us, most of the students live in an apartment OSU provides in our clinic. At night, the students answer phones, perform custodial duties, do laundry and prepare packs for the next day’s surgical cases. Sleep for the students is at a premium.

I am proud to say that the students get meaningful hands-on veterinary experience every day. And I mean every day. Our clinic operates 24-7, even on Christmas.

Those students interested in large animal practice can repeat our two-week rotation up to four times. I am pleasantly surprised by the increased interest in large animal practice demonstrated by vet students, many of whom did not grow up with large animals but have become excited by our work and our clients, who are the salt of the earth.

We pregnancy-examine about 45,000 cows a year and we perform an abundance of C-sections in all farm species, surgically correct twisted stomachs in dairy cows, and treat sick farm animals. Our rotation is very much like Marine boot camp. The students attend seminar each morning at 7, if they’re not assigned to accompany a doctor on farm appointments that begin at 6 a.m. or earlier. Students who attend morning seminar must share their notes with the other students so they’ll be prepared for the next to last day’s exam, which we call the “motivator.” We call it that, because many fourth-year vet students figure they have their knowledge in the bag and aren’t ambitious about learning more. If they don’t pass the test, they get a chance to take another test. But if they don’t pass the second test, they must repeat the rotation.

Most students live in the clinic, await emergency duty, attend seminar and train all day and into the night. Interestingly, students give our rotation the highest rating of any rotation in the vet school — and we work their tails off! And because of our clinic’s reputation, we frequently attract students from other U.S. vet colleges.

I’ll share with you an example of a typical night in our clinic — a night I was on call. At 3 a.m., a student living at the clinic paged me about a call for a cow having difficulty calving. The owner reported that, “the calf is coming backwards.” I knew this owner to be relatively astute, so I believed his diagnosis was likely accurate.

His farm is northeast of West Liberty, near Bellefontaine and about 45 minutes from the clinic. The student, following my previous instructions, had called my intern (I’ll refer to him here as Dr. Klinker) before calling me, as he was on call under my supervision.

Dr. Klinker called me shortly after this to ask if he should come in, or was I taking care of it. I think he called because he didn’t want to get out of his warm bed.

I told him to plan on covering the case. Then he asked, “What if it’s a case needing a C-section?” Then he asked, “What if it’s a breach presentation (butt coming first with hind legs doubled forward)?”  What if it is deformed?

At this point, he wasn’t inspiring my confidence, considering the number of cases Dr. Klinker had already seen and the fact he already had his veterinary medicine degree (not from The OSU, I might add).

So I told him I would come in also. (I was afraid that since he lived in Hilliard, he would be forever getting to the clinic.) I had decided to drive over to the clinic, where I would be close enough to the emergency in case I’d have to assist Dr. Klinker.

I was relatively annoyed with Dr. Klinker for talking to me as though he had never seen a dystocia (difficult calving) case, although he had assisted me and my colleagues with a number of them.

Fortunately, for his sake, Klinker called as I was going through Urbana to report that he was at the clinic, ready to leave. I told him to take the students with him, and I would catch up in my own truck.

I at least had confidence in the two female students who would be accompanying him. They were from Mississippi State and were here to get additional large animal experience. They had their act together. I knew that they wouldn’t be a problem and could handle the case themselves should Klinker freeze up over a complication in the case.

As I drove to Marysville, I thought, “Get a grip, Dr. Klinker.” Here I was, taking a bit of a risk. I was putting him in a position where he would have to rely on his training. He would have to sink or swim without a certain peeved veterinary professor standing guard to rescue him.

Still, I wanted to be close enough, just in case.

Dr. Klinker called me about 30 minutes after he arrived at the farm to report he had delivered the calf. Unfortunately, the owner had attempted to deliver the calf on his own before Klinker arrived. In doing so, the owner had inadvertently pulled the hoof off one of the calf’s hind feet. I suspect the owner was in a panic when he called the clinic, and failed to mention what he had done.

This kind of stuff happens when an amateur gets involved in a difficult delivery and doesn’t double loop the obstetrical chains above the fetlock and hooves before applying traction.

I advised Dr. Klinker to bandage the hoof stump, administer antibiotics, then schedule the calf for a bandage change at our clinic in three days. The injury gives the calf about a 50:50 chance of survival. It will likely take the calf three to four months to grow a new hoof. In the meantime, the calf faces the risk of infection, which could be its Waterloo.

At this point, the calf is doing well. Dr. Klinker has mostly stopped being in a panic when presented with an unfamiliar medical problem.

And me? I still do my best to intimidate students (and Dr. Klinker) forcing them to learn things about farm animal practice that often can’t be found in a textbook.

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