Vet students and the real dog: Learning on live patients in veterinary school
Have you ever thought about how medical personnel learn to perform a procedure? I often liken it to what people say about surgery: It’s like making sausage. You really don’t want to see how it’s made but it almost invariably tastes great when it’s served.
It seems there’s an interesting debate going on in Australia over how veterinarians and veterinary technicians come to acquire their knowledge. The RSPCA (the Aussie version of the ASPCA, I gather) and the local shelter have suspended their teaching program in conjunction with the University of Queensland’s veterinary school. They say vets and vet students can no longer practice their trade in school on their to-be-euthanized animals.
Apparently, it’s common in Australia for vets and vet techs to learn on pets condemned to a shelter death. They spay or neuter them then perform additional procedures (cystotomy, enucleation, splenectomy, etc.) to learn how to manage real patients in living color before taking on the procedure in the real world of owned pets. Then they euthanize them.
We do the same in the US—well, almost. We wake them up when we’re done. And we stick to spays and neuters—exclusively.
But in the late eighties at the University of Pennsylvania we were denied access to these pets. Although they were doubtless the same pets (dogs in our case) that ended up in the County crematorium, we were barred access to our spays and neuters (who were excellent candidates to receive loving homes, by the way).
It seems no one wanted us to “experiment” on pets.
For several years (about three, I think) no student at The University graduated having completed a whole surgery on his/her own. Precious few were granted the ability to actually practice on live, paying vet school patients. Instead, we went out into the world bookishly brilliant but practically challenged.
Finally, after lobbying hard to keep the spay/neuter program (against PETA, et al), we were granted the right to learn on real dogs. As I remember, these dogs typically found homes within the vet school’s student body or faculty. Either way, they were treated with profound respect.
In Queensland, the vet students are arguing much the same: We treat these animals with the reverence they deserve. Would you rather we learned on animals in a setting where the client wasn’t being told you’d never actually done a spay before?
I know it’s hard to imagine for the average pet owner but that’s the way it works. If the new vet needs experience the new vet usually gets it. And clients aren’t meticulously informed about the new vet’s inexperience.
Sure, we get watched carefully by other vets and techs (techs are usually the best teachers, by the way) and the case lands in the experienced person’s hands if something goes wrong but we’re waaaay green on the first dozen procedures. After that it’s easier but still it’s not a breeze. Only by the time we’ve got a hundred or two under our belts can we consider ourselves proficient.
Atul Gawande, in his excellent book Complications writes at length on this issue with respect to the human side. He describes how, despite his experience with cadavers in med school, he still managed to F up his first few procedures—on real patients! But what’s the alternative?: Never learning at all.
P.S. By the way, I really appreciate it when you send me great post topics. Thanks S.F. for sending this one along. Your ideas are typically excellent but I don’t always get jazzed enough about the issue to spend a couple of hours banging away at the keyboard—or I put it off and then forget about it. Good thing there’s no shortage of stuff to blog about.)