Mind Over Miller: Hold off on choosing your animal specialty
Dr. Miller is an author and a cartoonist, speaker, and Veterinary Medicine Practitioner Advisory Board member from Thousand Oaks, Calif. His thoughts in "Mind Over Miller" are drawn from 32 years as a mixed-animal practitioner.
Young veterinary grads will be smarter and more career-flexible if they look to mixed practice for their first job.
Looking for a ratite-only practice? You may want to broaden your horizons, says mentor-to-the-profession Dr. Robert Miller. (Shutterstock.com)As a speaker at veterinary schools and conferences, I have frequent contact with veterinary students. My practice career included domestic and exotic species (I treated zoo animals as well as food animals, pets and equines), and my large group practice included several veterinary specialists. For those reasons I'm often asked for advice about where students might get jobs in species-specific or specialty practice after graduation.
My answer has always been, and still is, to look for a position in a mixed practice with experienced, permanent staff and to plan on spending a minimum of two years there. Then, if you're still interested in a specialty, seek it out or take a residency, if one's available.
Students are always disappointed in that answer, so I explain: “Mixed general practice, to which you are exposed only minimally in school (necessarily so, since our profession is complex, diverse and constantly growing), will give you a foundation that will enhance your competence throughout your career.”
Let me give you some examples from my life.
Giving up a scalpel for a blood test
As a student, I was particularly infatuated with surgery. I loved the atmosphere of the OR. But after practicing a few years, I realized that my real love was diagnosis. Problem solving. Thus I began to seek CE on laboratory tests and radiology, subjects that had not been especially interesting to me as a student.
During my practice years, I frequently consulted with radiologists, most of them board-certified faculty members. They were, of course, very helpful, but the best and most informative specialist I ever dealt with was the late Dr. William Zontine. Bill practiced in a successful mixed practice (livestock, horses and pets) in Lancaster, California, for 30 years before obtaining a residency in radiology. What a foundation for him, and what a help he was to me.
Another example: During the first half of my career, my patients were about 50 percent large animals and 50 percent small animals. During the second half of my career, with a group of six or more associates, I did only large animals (exotics can be large or small). In the final decade before I retired, I was doing over 90 percent equine. Having done it all, including dolphins and whales, and loving horses and working outdoors, I was content.
Only once did I make a confirmed diagnosis of acute pancreatitis in an equine. And if hadn't seen numerous cases in small animal practice, I never would have included pancreatitis in my list of possible diagnoses when confronted with a mare with an excruciatingly painful belly. But because of my small animal experience, I ran a lipase on her. The results confirmed my diagnosis.
Similarly, my equine experience improved my ability to localize lameness and classify it in small animals and also broadened my experience in gynecology.
Practice owners, give back with internships!
In my practice, we had an annual internship for 25 consecutive years. We offered several permanent positions. Only one intern ever accepted, although a few returned after a few years hoping that the offer was still good.
Of the 25 interns, we've maintained contact with half, including four Europeans. All are successful and content with their career choices.
Now that group practices have become so common, I urge those hospital groups to establish annual internships for new graduates. The experience will be of great value to young doctors. Moreover, every intern we had brought something new into our practice. It is of mutual benefit.
Are any of us sure what kind of DVM we'll be when we grow up?
Several decades ago, when there was a sudden increase in ratite farming, a senior veterinary student asked me, “Can you recommend a ratite practice I can apply to for an internship?”
“Well,” I responded, “I know a few practices, including mine, that treat a few ratites, but I don't know of any that treat them exclusively. When you graduate, I suggest you look for a job in a mixed practice that includes ratites-that will give you a broad foundation.”
She shook her head. “No, I only want to do ostriches!”
I despaired of offering further advice.
Most of us think we know how we want to spend our careers, but a decade after receiving our doctorate degrees, most of us are doing something a little (or a lot) different.
For instance, I knew I wanted my practice to include horses, but I never imagined I'd end up doing primarily equine practice or that I'd develop methods of shaping equine behavior that would influence the entire equine industry and lead to a teaching career that would change my life and take me all over the world.
The same goes for my veterinary class of 1956.
Only one student ended up doing exactly what he planned to do-mixed practice in his rural hometown.
Two of us ended up 30-year veterans in the military veterinary corps-not our original plan.
Two ended up as executives in major corporations. They had planned to practice.
Half the class, aiming for primarily food animal practice, ended up in small animal practice.
Two, to their own surprise, became faculty.
One went to medical school and ultimately became an ophthalmologist.
Two returned to their family ranches and in time became clients of other veterinarians.
One committed suicide three years after graduating, an all-too-common story today.
Two were driven to the racetrack.
In the end, most of us as students are going to end up happy with our choice of profession. But many of us will be in a branch of veterinary medicine we hadn't foreseen during our school years or even during our early postgraduate years.
Explore your preferred species early on
Regardless of what you think you want to do as a doctor of veterinary medicine, try to spend your first couple of years in a mixed practice owned by a dedicated doctor or doctors. Who knows-you may want to stay there!
Robert M. Miller, DVM, is an author and a cartoonist, speaker and Veterinary Medicine Practitioner Advisory Board member. His thoughts in “Mind Over Miller” are drawn from 32 years as a mixed-animal practitioner. Visit his website at robertmiller.com.