Students spend two and a half years in classrooms and labs before they begin seeing patients in clinical rotations. Rotations are where all that knowledge comes together to examine, diagnose, and treat animals—and the Primary Care Service is central to that process.

For many clients, animals are full-fledged members of the family, so it makes sense to Jane Merrills, DVM, DABVP, head of the Primary Care Service and assistant professor of primary care medicine in the Department of Small Animal Clinical Sciences, that the VMC’s new model for Primary Care Service functions like a family doctor. The clinicians and students on the Service do not simply administer vaccines, but examine nutrition, life- style, and behavior. Taking into account all of the factors that play into quality of life and longevity makes it easier to address patients’ complex health and wellness needs over the course of their lives.

“Our vision for the Primary Care Service extends beyond what we used to call general medicine,” says William Horne, DVM, PhD, chair of the Department of Small Animal Clinical Sciences. “It’s an integrated service that brings together primary care medicine with the existing services for behavior, nutrition, hospice, shelter medicine, rehabilitation, and exotic pets. The Hospital has offered all these services, but this new structured relationship will help students see patients from the standpoint of all of those different modalities, services, and specialties.”

Teaching Better Practice

Because 80 percent of DVM students become primary care veterinarians, this training is particularly important. Rotations provide students with a range of skills that prepare them for primary care practice and complement the skills developed in clinical rotations in other specialty areas.

“Rotations provide important experience for the students,” says Merrills. “As a teacher, my goal is to empower students, and make them feel like they have control over their education and are in charge of their cases.”

The Service is modeled to provide students with that experience. Students take patient histories, develop differential diagnoses and treatment plans, and communicate diagnoses and financial estimates with owners. Every animal is examined by a veterinarian and owners are able to speak with the veterinarian, but every case is primarily handled by students. Teaching communication skills is an important part of what students are learning during rotations.

“Our goal is to teach students to be effective clinicians. We’ll be putting into use a camera room where students, with the clients’ permission, are videotaped. We’ll use that to provide feedback to students and discuss what can be done better,” says Merrills. Rotations provide students opportunities for extended communication with clients because routine visits are good opportunities to explore the relationship between clients and their pets. That includes behavior issues, nutritional needs, and weight and exercise habits.

Having nutrition and rehabilitation under the umbrella of the Primary Care Service makes it easy for the veterinary student to make referrals when there is, for instance, a weight problem. When the client expresses concern over behavioral issues, the behaviorist is easy to reach from within the Service.

“The overlaps in these services make the reorganization make sense, including the focus on communication,” says Marie Hopfensperger, DVM, assistant professor in the Department of Small Animal Clinical Sciences. “We want students to learn how to discuss a range of issues with every client,” explains Hopfensperger, who divides her time between the Primary Care and Behavior Services. “That includes issues like behavior and nutrition, which can be delicate subjects.”

The carefully crafted curriculum aims to build a seamless—and rigorous— learning experience that prepares students for the successful pursuit of careers in primary care, specialization, research, public health, or policy. “We want a mod- el that puts students in the driver seat,” explains Horne. “Our mission includes research, treatment, and education, and with this model we are able to achieve the highest level with each.”

Posted: December 2013

Contact: Casey Williamson