Starting off on the wrong foot

Starting off on the wrong foot

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Jul 01, 2007

Working at a 24-hour emergency and referral hospital, I see cases that clearly haven't received an acceptable level of care from the primary veterinarian. My first reaction is usually to think, "Who is this idiot? This is malpractice!" But then I take a step back, breathe deeply, and think, "There but for the grace of God go I."

Every veterinarian's attitude toward medicine is rooted in the culture of his or her first practice after graduation. Some of the substandard care I've seen has been provided not by an "old guy" but by a recent graduate who was corrupted by a bad practice. If experienced doctors cut corners, skip indicated lab work, neglect to intubate anesthetized patients, or give a dexamethasone injection to every patient regardless of disease, a new graduate can quickly follow their lead and lose the better judgment he or she learned in school.

Mentoring is critically important in our profession. Through pure dumb luck I found myself in an excellent practice after graduation working with dedicated veterinarians. But it could easily have turned out much differently. I received a job offer in October of my senior year in veterinary school. For the rest of the year, as my friends panicked about finding jobs, I gloated that I already knew where I was going.

Then, two weeks before graduation, the offer fell through. I was devastated. Desperately scrambling, I sent resumés to dozens of clinics in two states. In the end I narrowed my choices down to an appealing pair of prospects. One practice was near Chicago, the other near Milwaukee. I chose the latter because it offered a better mentoring opportunity.

I'm grateful for all I learned from my colleagues at Pahle Small Animal Clinic in West Allis, Wis. From little clinical tips like using methylprednisolone to treat "rodent ulcers" in cats and advice about surgery ("Remember you're apposing the skin edges, not ligating them"), to encouragement ("It's OK. The incision heals from side to side, not end to end"), every day was a valuable learning experience that has stuck with me.

I've often wondered what kind of doctor I would be today if that first offer hadn't fallen through or if I'd ended up at the Chicago-area practice. That clinic was beautiful and had all the "toys," but I would have been practicing by myself for much of the time, with little or no mentoring.

How can new grads be sure they'll receive high-quality mentoring? This is a serious challenge facing our profession. Internships can definitely help, but some practices treat interns like glorified kennel attendants. It's up to the future doctors to take the initiative. When senior students are interviewing, they need to ask probing questions about the quality of medicine practiced and the availability of other doctors for mentoring.

A practice may not have a fancy marble reception area or a surgical laser, but if the other doctors there are willing to mentor, it may be the best place for a new graduate and a deciding factor in his or her success down the road.

It was for me.

Dr. Laura McLain Madsen practices at Central Valley Veterinary Hospital in South Salt Lake, Utah. Send questions or comments to

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