Another title could have been "Third Year - Finally a Year in
Which I Can Excel."
Now, before I get too far into this post, I must explain that
common sense is a part of every year of vet school. However,
as a student, common sense can appear lost during the first two
years as we get into the weeds of microbiology, pharmacology, and
parasitology. As a 30,000-foot, big-picture-kind-of-guy, all
of this memorization left me floundering and looking for some
semblance of order. Well, thanks to third year, I found
it.
First year of veterinary school is about learning normal -
normal anatomy, normal physiology, normal embryology, normal
histology, normal, normal, normal. Which makes sense because
if you can't identify normal, you will never be able to identify
abnormal. Enter second year. Second year is about
identifying abnormal and learning the fundamentals about ways to
treat the abnormal. Third year is about putting it all
together in the classroom and laboratory setting. Medicine,
radiology, and surgery courses are set up in a disease centric
fashion. What does that mean? In each class, we take a
problem or a disease and learn the symptoms, diagnostic tests, and
treatment options. Most of the classes divide the disease
based on system. For instance, we will study all of the major
small animal gastrointestinal diseases at one time before moving on
to anther category. I love order!
In third year, we also get to play doctor. One of the
toughest, but in my opinion best, classes, in the entire vet school
curriculum is third year clinical correlates. Early in the
week, we get a case, usually based on a real case seen in the
clinics. The case includes some combination of patient and
disease history, physical exam findings, and blood work, but not
always all three. Then we have to identify the problems (much
harder than it looks), come up with some differential diagnosis,
create a diagnostic plan, and, if indicated, come up with treatment
plans we would start immediately. And then, we sit together
in class and a professor calls on us and forces us to explain why
we made our decisions, right or wrong. This is the closest we
have come to thinking like real veterinarians, and it is
exciting…..and scary.
How does common sense come into play? Well, lets say you
suspect a cat has liver or kidney disease. The best way to
test for either one is probably a biopsy. However, would you
really want to poke the poor cat that just walked in the door
before doing blood work? Heck no! For a simple little
mind like mine, this common sense, orderly approach is so
refreshing and comforting. Now the class is fraught with
challenges, and doesn't exactly mirror real life mainly because
there is a set of "rules" that must be followed. The rules,
though, are in place to get us to focus on the diagnosis and
treatment plans, and not whether or not our tests are lying to
us. And trust me, those tests will lie to you in
practice. Just ask your favorite doctor or
veterinarian. But, that is also where common sense comes into
play. If you have a perfectly healthy looking animal standing
in front of you and the blood work comes back with abnormalities
that are only found in dead Martians, common sense states that you
probably have a problem with the machine or the sample, not the
patient. What do you do? Run it again.
This reintroduction of common sense approaches can be hard after
spending two years focusing on theory and possibilities instead of
reality and probabilities. Trust me, every year and every
class is important, even though my colleagues and I have all said
differently at some time, but this return to clinical, common sense
approaches may be the most important. Third year is tough,
challenging, and exciting. We are making the transition from
book to fur, theory to real life. We are playing doctor
because very soon, we will be doctors.
One final note, how 'bout that Johnny Football!!