When you see your family veterinarian for most of your small animal (meaning dog or cat) routine veterinary visits, you are probably seeing a general practitioner, or GP.
Most GPs have gone through four years of undergraduate college (usually resulting in a bachelor’s degree, which I always thought was odd for the married ones), followed by four years of veterinary school, after which most are granted the degree of Doctor of Veterinary Medicine, or DVM.
One school, just to be difficult, doles out their degree in the vibrant, living language of Latin and uses Veterhinoninarius Medium-rare-iciniuius Doctorfeelgoodius (I am pretty sure I got that right) or VMD. So, if you look on your veterinarian’s business card, you can tell right away if they went to one of the normal 27 schools that are not in Pennsylvania (DVM) or to the one school that has gone all batty and needs to be different, and also has piercings, tattoos and keeps its snake at the dojo just to show how unique it is (VMD). Note: I have many, many special Penn Friends, and my gentle and loving ribbing about their weirdness, degeneracy and insanity should not be misconstrued as evidence that I think they are weird, degenerate, or insane.
So, your average vet goes through eight years of training to be where they are. Some schools allow the four year undergrad to be fast-tracked, but for most US veterinarians, eight years is the norm.
However, if you elect to specialize, after your internship you apply for and hopefully obtain a residency (so called because the doctors frickin’ live in the hospital, the duty hours are so long) in the area you want to specialize in. It could be surgery, oncology, cardiology or, as in my case, emergency medicine and critical care. Some people, insane people, elect to specialize in more than one area at a time and are known as “double-boarded,” which means that someone should have taken two very large boards and beat some sense into them.
The 2- or 3-year residency program immerses you in the discipline at hand and gives you the skills you need to, a) become a specialist and, b) pass a big-ass test known as a board exam. Most board exams are 2-3 day sadism sessions that leave the test-takers with little self-respect, stomach lining or bladder control. Most folks take 2-3 months off from work to study for the board exam, usually living in a cave, not bathing and gnawing on a haunch of deer while surrounded by textbooks. (Vegetarians gnaw on a haunch of cauliflower).
Once you pass the test, as if by magic you are certified in your specialty and given magical powers, a cape, a tie pin and a swift kick in the ass.
As an example of what a specialist does, let’s look a little closer at surgeons. They are very special people.
Any veterinarian can do any surgery. Your family veterinarian, for example, could elect to do a kidney transplant if they felt competent and you agreed to the procedure (please sign here and write me a check for $15,000. Thank you for your patronage). But many surgeries (beyond spays and neuters and some abdominal procedures like foreign body removals) are done by specialized veterinarians who are board-certified in surgery.
There are lots of talented GP surgeons out there (and some GPs who are better than some boarded folks I have met), but, as a general guideline, the more complex and risky procedures are referred to boarded surgeons if the GP and pet owners think it best. Surgeons are amazing at what they do, and I have the deepest respect for them. I have seen a good surgeon put a busted and well-nigh unrecognizable pet back together, looking for all the world as if almost nothing ever happened. They can be as close to an artist as a veterinarian is ever likely to get (except, of course, for my balloon animal art).
Just like any of us bipedal hominids shuffling about this rock, though, surgeons are mostly just normal people who have the world go in and out of their bodies through the same holes the rest of us do. Some of them tend to be a little on the vain side, though; I worked with a guy once who wore pointy orange shoes to work every damn day, convinced they were the apex of fashion. Little elfy numbers they were, curled up at the tip in a let’s-see-what-Santa-is-making-in-his-shop-today way.
Some surgeons, though, run the risk of over-stating either their skillset or the benefits of surgery in general; not every condition known to man or beast can be fixed with a swipe of the scalpel in their well-manicured and bronzed hands.
The same principle also applies to internal medicine. This is the branch of medicine that deals with giblets; kidney, intestine, pancreas, liver – all of the variety meats. Internists are detail-oriented specialists who will gleefully listen to pet owners describe their pet’s bowel movements in excruciating detail. Repeatedly.
They have cases that play out over months or years, and are adept at long-term, complex case management. I could never be an internist, as my memory span is about the size of a baby newt (called an ‘eft’) – this is why I chose emergency medicine; hit by car – fixed up in 2 days – off to home, Bob’s your uncle. Emergency medicine doctors have flings with their patients, internists have marriages.
This is just a wee overview of what goes into making a specialist. So, the next time you see your veterinarian, or your veterinarian refers you to a specialist, tell them ‘thank you’ for all the schoolin’ and maybe ask for a balloon kitten.
Image credits: Both images from flickr creative commons. Top: cpeachok. Bottom: sean94110.
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