Team Work Makes the Dream Work at Tufts at Tech
There’s never a dull moment at Tufts at Tech Community Veterinary Clinic. I had the privilege of starting my clinical year, with the Cummings School of Veterinary Medicine, at this exciting and well-loved rotation. At Tufts at Tech, veterinary students get to be a doctor. It’s the perfect combination of autonomy and mentorship. Students are expected to take histories, complete physical exams, propose diagnostics and treatments, and work directly with clients to ensure that the medical plan matches their client’s expectations and available finances. There are veterinarians to help every step of the way.
A clinic like no other.
Located inside Worcester Technical High School, Tufts at Tech is a unique clinic. The clinic houses high school students studying to be veterinary assistants. Having attended a vocational high school, Norfolk County Agricultural High School, I understand the importance of this type of education. Students have the opportunity to learn by doing at career technical high schools. The high school students are invaluable to the clinic. They are helpful and competent. Whenever I’d start to think to myself something like, “I should draw up vaccines now,” I’d look over and my high school student, Amanda, had already drawn up both vaccines that I needed for my current appointment. Amanda was able to prepare laboratory samples for evaluation, create estimates and invoices, restrain vaccinated animals, and much more. She hopes to become a doctor someday. I was not surprised to learn that the most recent group of high school seniors had each passed the Approved Veterinary Assistant Examination.
At the beginning of the week, Dr. Wolfus asks each veterinary student what skills they’d like to improve. Many of the senior students wished to advance their surgical skills. I sheepishly said I needed more practice with phlebotomy in small animals. I’m more used to the veins of ruminants and horses, which are substantially larger than the blood vessels of cats and dogs. The Certified Veterinary Technicians at Tufts at Tech, Kate Zukowski and Pam Houde, are fantastic teachers. They walked me through multiple blood draws that week and never hesitated to let me try. These newly acquired technical skills carried through to my next rotation, when I needed to draw blood from a patient. I was able to hit the lateral saphenous vein on my first try!
The case of the itchy bulldog.
On my first day of clinics, a young bulldog with a diffuse rash walked into the lobby of Tufts at Tech. A high school student put a clipboard on the whiteboard and asked, “Who wants this case?” I said I’d be happy to take the case. My high school assistant began taking a history from the client, while I looked over the previous medical records. After performing a physical exam, I talked to Dr. Grady about my findings. I told her, “This dog has a terrible rash and is itchy.” Dr. Grady kindly reminds me to give her the signalment first and to use my doctor words when presenting a case. I gave the signalment and rephrased my previously colloquial statement and said, “This patient has generalized erythema, excoriations on its face, patches of alopecia, and papules in the inguinal area. The owner grades the dog’s pruritus as 5/10. The physical exam and history was otherwise unremarkable.” Dr. Grady responded by saying, “Good! So, what are your differentials for this case, and what would you like to do today?” I proposed a skin scrape and tape cytology to help rule out demodicosis, scabies, food allergy, atopy, or flea allergy dermatitis. Then, I had to create an estimate for these procedures and potential treatments and discuss the cost with the owner before proceeding. Tufts at Tech is a cash-only clinic, so it’s critical to stay within the client’s budget.
Thankfully, the puppy’s owner had the finances available to proceed with the entire proposed plan that day. Dr. Grady instructed me, while I performed my first skin scrape, saying, “Remember, deep for Demodex!” Then it hit me, “Oh yes, and superficial for Scabies.” I didn’t go deep enough on the first scrape, so Dr. Grady coached me, “You need to go deeper. Continue scraping until you see capillary oozing.”
After briefly looking at the skin scrape slide under the microscope in the lab, I found a long cigar-shaped mite and showed it to my high school assistant. It was eureka moment. There was a treatable diagnosis for this puppy – juvenile demodicosis! Finally, all those long hours of dermatology homework were starting to pay off! I sent the pup home with Bravecto to treat mites, a topical rinse, several months of parasite preventatives, and a prescription for antibiotics for secondary infection. At the end of the week, I called the owner to check on her puppy and was happy to hear that my patient was doing much better.
My first day on clinics got even more exciting after the demodicosis case when a senior veterinary student, Kelly Fiore, pulled me aside and asked if I would be interested in assisting her with a neuter that afternoon. She didn’t need any help from me, but Kelly took the opportunity to teach me. Tufts at Tech is a “see one, do one, teach one” type of institution. While preparing to perform half of a dog neuter, Dr. Wolfus said something along the lines of, “This is a Tufts at Tech moment – someone who knows what they’re doing is teaching someone who doesn’t know what they’re doing yet.” Kelly removed one testicle, carefully describing each step, and then guided me through the rest of the surgery. We had a classmate monitoring anesthesia and a veterinarian watching over our shoulders, just in case we needed extra help.
Team work makes the dream work at Tufts at Tech. Patient care is a cumulation of efforts from technicians, clinicians, veterinary students, visiting doctors, high school students, and volunteers. Everyone plays a vital role. I am not a doctor yet, but I’m getting there, thanks to my education at the Cummings School of Veterinary Medicine at Tufts University. I’m grateful for the clinical experience that I gained during my first week of clinics and all the people at Tufts at Tech who are supporting me in my journey to becoming a full-fledged DVM. Tufts at Tech helps hundreds of students like myself move onto successful careers in veterinary medicine every year.
*The original version of this story appeared in the April 2016 MVMA Newsletter.
March 20, 2017
March 06, 2017