Learning is career-long journey

I rewrote my original column for this month.

Originally it was written as a blueprint to prepare for the credentialingprocesses of the American Board of Veterinary Practitioners.

But two things happened: First DVM Newsmagazine did not receive the copy,and I recently finished reading two books, "Walking Through Adversity"by Rob Bryant and Mahatma Gandhi's Autobiography (for the sixth time).

Those two issue kindled in me the urge to rewrite the following articlein first person and as a bit of a testimonial. Some readers do not likethat format, and to those I apologize.

Elusive time

Recently a client was in with a bulldog that had a cauda equina crisis,as she recalled, "...it was last March". We looked it up; herprevious visit was August of 1999. Not a few months ago, but nearly threeyears ago.

This is a message that today is the tomorrow we have been planning.

It is time to look back at a career to see what happened. Personally,my professional goal was to be conscientious, to learn from life's dailyclinical lessons, to be better today than I was yesterday and be bettertomorrow than I am today.

A very simple and basic daily plan.

I set out to build a foundation, expand it, experience it, learn thoselessons of clinical medicine and human development.

Now that nearly 25 years have passed, I realize that a career and longterm planning must be developed and broken into baby steps.

Baby steps

With our complex lifestyles it is getting increasingly difficult to findtime to specifically put long term projects on the calendar.

The idea of adding another duty to our day to address long term goalsand planning can set us back, as living day-to-day is a challenge.

The idea is to approach each day with an "empty cup," to considereach day like a prayer on a rosary chain, and each day to take "babysteps" on the way to learning larger issues and moving toward our longterm dream.

We can learn clinical, professional, and communications skills one dayat a time - using today's events as the teacher - if we put that "spin"on our daily schedule.

Determining mettle

Only those who have accomplished little to nothing with their professionalor personal life can claim to have never slipped, stumbled, struggled orjust plain goofed.

Many a father has shared with children: "The only mistake in lifeis never to have made any mistakes."

It has been said, that "life is not fair", but "it isnot what happens to you but what you do with what happens to you that determinesone's mettle."

If we make our daily life a pattern of taking one day at a time (withan ear trained on our inner voice), if we live each day as a lesson, considereach day a prayer on the rosary, a penny in a change jar, a piece of a largerjig saw puzzle, then as the time quickly slips by we will reach our long-termgoals because we broke a 10-year plan into 3,650 daily steps. Or a 20-yearplan into 7,300 daily steps.

Lifestyle adaptation

The essence is then that we live the long term plan one day at a time;simply it becomes a lifestyle.

It is the lifestyle adaptation that makes us who and what we are, andwhat we will become.

If we wish to be "physically fit" in 20 years, do somethingdaily for 90 percent of the 7,300 days and one will be fit in 20 years.If we wish to be a "good, conscientious practitioner in 20 years"practice conscientiously each of the 7,300 days in between and you willreach your goal.

It becomes a lifestyle.

Tackling goals

Lots of questions have come my direction by folks seeking to study forand prepare to dive into the process to take the certifying test of theAmerican Board of Veterinary Practitioners (ABVP).

My message is this, one can achieve the ABVP certificate by putting togethera lifestyle plan for about three years and live, experience and enjoy theprocess of putting together the data, information and skills needed to surpassthe expectations of but one ABVP test.

The hidden key to ABVP test success is that one's practice life and skillswill grow and develop one day at a time by using the daily challenges ofthe clients, patients and clinical challenges you face each day.

It is so much easier than "breaking out" an extra hour everyday to read.

Does practice ever get easier? I don't think so. I get stumped just asmuch on a daily basis as I did 25 years ago. But, I honestly admit the degreeof difficulty of clinical and personal issues that are faced on a dailybasis are much more challenging than 20 years ago.

In fact, things that were difficult 15 years ago may be easy now, butI also know that the difficult challenges of clinical medicine today willbe a whole bunch easier in five years.

Yet in five years a whole new generation of challenges will be waiting.

This means, to go through the ABVP process is to make a lifestyle commitmentto study and learn good medicine.

Clearly there is no way all of us will have all the data crammed intoour heads to get all the answers correct, anymore than we make 100 percentaccurate decisions in daily practice.

So we make the ABVP certifying process a goal; a goal designed to makeus "better generalists" in our species categories. Thus we useour daily generalist caseload as the teacher.

The AVMA recognizes disciplined specialists, such as surgeons, internalmedicine, and anesthesia that crosses species lines and species specialists- primarily the ABVP.

The ABVP process focuses on species, such as avian, feline, canine, porcine,and food animal categories that cross the aforementioned discipline lines. So each day we do a little surgery, a little internal medicine and a littleanesthesia in our chosen practice category.

What does it mean to make a lifestyle adaptation? For those who havevisited Northwest Animal Clinic & Hospital in Albuquerque, many willask:, "Why do you have this and not that?" Or "Why don'tyou do this or that?" And the answer is simple: We consider all ideas,we are open to many new ideas, but some issues were in conflict with theday-to-day schedule and practice style needed for me to prepare for thenext ABVP test.

Cakewalk

Once one passes the ABVP test we might think it will be a cakewalk topass the next test - but recertifying veterinarians are just as likely tofail the species specialty test as new candidates.

So, gosh I now have eight years left before I take my canine-feline testsagain and so the preparation for the next test has already begun.

Yet, with full personal knowledge, small animal medicine is my vocation,horses are my avocation. So many years ago, without really thinking aboutit, I made lifestyle changes to bolster my equine background, my equinefoundation, all with the idea that I loved the daily stimulation of equinetopics. Never really thinking that someday I might take the ABVP test forequine (until recently ABVP allowed a veterinarian to only take one speciesspecialty test.)

As it turns out, day-by-day, week-by-week, month-by-month the range anddepth of my passion for the horse has grown-as one learns more about aninterest the passion grows.

Follow this lead, then you too, will be able to identify with the book,"Do What You Love and the Money Will Come."

Next level

Here are some thoughts do go to the "next" level of your passion.

• Immerse yourself in the discipline. Not just academically, for horses this means, living breathing and becoming a part of the whole horse world. Join the organizations, take up dressage, endurance, show some halter, spend time at the sale barn.

Go to one of the farrier schools, shoe, feed, shovel manure and train your horse.

The hints and tips from the practical side of one's chosen species will be more important on many levels than the academic classroom and text-reading.

• Round out the education. Thinking outside of the educational box is essential to developing the vision needed to improve the skills in one's chosen species. Go spend a week at Penn for lameness, a week at Davis to "experience" their equine critical care, a week with a respected colleague, or really add a booster rocket to the program and go to Newmarket, England, and be swept up with the British horse synergy.

For small animal practitioners, places like the Animal Medical Center can be a feast for one's mind.

At this juncture I have a hunch that alternative medicine plays a small role in the equine ABVP boards, but personally, with your own horses, get some magnets and objectively see how they work. Try products like MSM, yucca and Mirracoat.

For horses, take all the lay magazines that you can read. Subscribe to Equus, Practical Horseman and such and find out what is hot, what is not, and get in the swing of things. The same is easy enough to do with avian, feline and other disciplines.

Take in the whole offerings of the discipline even if some aspects may not be too appealing. Really become informed in your chosen species.

The following additional tactics help.

• Sabbaticals - Do a self-assessment; have a friend, colleague, staff member find your area of weakness and then go spend some weekends making the weakness a strength

• Mentor - find someone to help you discuss your discipline and another perhaps to discuss the ABVP process.

• Read - plan on spending one hour a day for two years. Don't become obsessed. Even if you're reading something for the second time, you'll be surprised at what you missed the first time.

• Attend a (one) major meeting - In your area of passion. The good and bad of meetings stimulates energy and perhaps synergy of the learning process. But don't be fooled. The real learning goes on in the day-to-day lifestyle adjustments.

• Get organized - Break the species into systems and tackle them one by one. In my writings, two acronyms have been offered and have become standard fare in some places. For the body's systems: MENSCHRUG: musculoskeletal, external systems, neurologic, cardiovascular, respiratory, urogenital and gastrointestinal.

And for the differential and rule out lists: NITSCOMP DH; neoplasia,infectious, toxic, structural, congenital, other, metabolic, parasitic,diet and husbandry.

• Find your weakness every six months - either objectively or ask a peer to help.

• Look up a case a day - in a practice that desires to get better, it is essential to take cases that walk in the front door and make academic use of a case a day.

• E-communication - Go online and start asking questions. NOAH and VIN are widely used and available but please know that it is not the current data online that is so important as is the issue of familiarity with the e-medium. I don't know how the postal service can stay in business.

Increasingly heads-up clients will come looking and interacting with our practices via the Internet- it will be nice to have that service available for them before they ask.

• Take the test questions with articles- Merely, to get into the swing of things, I admit I have the current offerings, but we take tests every day when we walk into an examine room, we might as well round out our minds by taking these multi-choice questions so we are familiar and not intimidated by the process.

We have reviewed the specifics in preparing for the professional lifestyleadjustments that must merge with your financial, recreational and personallife.

Please go back and read the first part of the article again ­ 7,300baby steps is the easy way to get the job accomplished.

Enjoy your career and achieve a long term goal like taking the ABVP testof your choice.