A musical journey in discovering dermatology

Fetch Nashville officially commenced at the Music City Convention Center in Nashville, Tennessee. The Fetch conference kicked off with a keynote address delivered by Julia Miller, DVM, DACVD, on Friday, May 30, from 9:15–10:15 am. Her keynote address, billed as a musical journey of discovering one’s passions through veterinary medicine, chronicled her path from studying opera and theater at Indiana University to becoming a veterinarian.

Julia Miller, DVM, DACVD was the star of the show at dvm360’s Keynote Presentation, where she talked about her career trajectory and some of the most important lessons she learned. Photo Credit: dvm360 team.

A musical journey from start to finish

Miller’s keynote was truly a musical journey. As she shared the story of her career—punctuated by the various “dreams” she got to live—she incorporated musical performances inspired by Broadway productions (Wicked), Disney films (Moana), and Nashville’s iconic country stars, such as Shania Twain.

Her “dreams” included pursuing opera at Indiana University, earning her veterinary degree from Cornell University, joining the Cornell faculty, working in mixed-animal general practice, and ultimately settling into her current role in private practice at Animal Dermatology Clinic in Louisville, Kentucky.

Some of her renditions included (but were not limited to):

• “Man, I Feel Like a Horse Vet” (Shania Twain’s “Man! I Feel Like a Woman!”)
• “What Can I Say Except It’s Scabies” (Dwayne Johnson’s “You’re Welcome” from Moana)
• Veterinary-themed versions of Journey’s “Don’t Stop Believin’” and Wicked’s “Defying Gravity”

Julia Miller, DVM, DAVCD (left) greets Dr. Adam Christman, DVM, MBA, at Fetch Nashville in the Music City Convention Center. Photo Credit: Bob Alaburda, dvm360 associate editorial director

Miller’s "down and dermy" tips

After sharing her career story, Miller transitioned into the second half of her keynote: her 5 “Down and Dermy” tips, drawn from her experiences in dermatology.

1. If it’s itchy, it’s probably scabies.
   Miller explained that pruritus is one of the most common dermatologic complaints, and clinicians should always consider scabies as a differential diagnosis early on.
2. Cytology is a dermatologist’s best friend.
   “Cytology allows you to see your baseline impression, and it really does change what you do with your dermatology cases,” Miller said.¹ “This goes for rechecks as well. First appointments can get really busy, and you may not have the time you want. But when that dog comes back, you have to do something different. This goes back to my mantra: if you don’t succeed, you missed something. Do your diagnostics.”
3. Use references and books.
   “There are a lot of dermatologic diseases out there, and it can feel overwhelming,” Miller noted. “If you can get a really good description of the lesions—what they look like and where they are—you can narrow down your differentials.”
4. Take good-quality pictures.
   “Dermatology is a visual sport,” Miller said. “A physical description is good, but a picture is worth more than 1,000 words.”¹
   She added that photos are helpful not only for clinicians but also for clients, who can see the pet’s progress over time.
5. Have fun.
   Miller emphasized the importance of injecting joy into the day-to-day, particularly given the repetitive nature of dermatology.

“I think it's also important to love our patients and our clients,” she said.¹ “When you see a cat with the best angry resting face you’ve ever seen, take a picture of it. Do the things that bring you joy. Yes, it can get monotonous—we see the same things over and over—but finding those moments in your day reminds you why you love the profession.”

Career paths are not linear

A core message of Miller’s keynote was that most veterinarians won’t follow a clear-cut career path.

“My path was far from straight,” she said. “It was incredibly windy.”¹

Miller’s journey to discovering dermatology mirrors that of many aspiring country music artists who come to Nashville seeking success. Through twists, turns, and various jobs, they learn more about themselves—and what they’re meant to do.

“When change needs to happen, it needs to happen,” Miller concluded.¹

Reference

1. Miller J. Discovering the delights of dermatology: One woman’s journey into derm and how you will learn to love it too! Presented at: Fetch dvm360® Conference; Nashville, TN. May 30, 2025.