Life at the RVC as a North American student

Reflections on the first year

2010-07-28T06:15:00.000-07:00

That's one year down, with four left to go. We finished our last exam and got our results just about three weeks ago, and my brain is finally functional again. What can I say about the first year? A series of one word adjectives spring to mind: intense, rewarding, frustrating, scary, overwhelming, challenging. I notice that there are quite a few seemingly negative adjectives there, but they're not intended as such. Rather, they're to impress that the first year was an experience that has completely changed my outlook on medicine, education, and life in general.

I should mention that just before my third term started, I did two weeks of a required placement on a sheep farm in Lancashire (which is part of the historic Yorkshire Dales, for those of you who are fans of James Herriott), itself an eye-opening experience which I'll say something about later. However, I made the slight mistake (in hindsight) of finishing that placement up just two days before third term was set to start - and as a result, I started the third term with a massive energy deficit.

Advice (unsolicited): when booking placements, leave yourself a week (if possible) between the end of the placement and your next commitment - you'll be tired.

So third term was short short short, only six weeks of actual teaching (and the last one was so sparse with lectures that the total might as well have been five weeks). But those six weeks were very very very full of information. We ran the entire nervous system, from cranial nerves to spinal nerves, and all the pathways betwixt and between. I think that earlier in the year I mentioned an introduction to the nervous system that took a week of first term. The material of that week was essentially comprised in the first lecture or two. So the three weeks of neurology was voluminous. I have a very strong biochemistry background, so when we were studying the alimentary system in term two, I was able to draw a lot on that to help comprehend the lecture material. However, with the nervous system, I had very little previous knowledge to work with. Which is where the part about "changing the way I look at education" comes in.

Medical education is often described as putting a fire hose in your mouth and turning it on. It's cliche. But it's not too far from the truth. You're not going to be able to take in everything that is given, and the three weeks of neurology taught me that. Some of it was intuitive, and some of it still evades me. That's ok - I've managed to get past the conceit that I'll be able to master everything, which as someone who has until this past year never not mastered anything I actually cared about, was not the easiest. However, if you can learn that particular bit early on, you'll be well served. Which is not to say that you can't try to master everything - goodness knows that I tried to do so, and will continue to try and do so. But my expectations for results are somewhat more realistic than they were going on.

Oh yes, results - they are after all what school is about, right? I'm not so sure I agree with that any more either. I passed my end of year exams (85% of the final grade - zoinks!), and passed fairly well by the RVC's standards. So I get to move on to the second year. I only failed one test the entire year, and achieved some fairly impressive scores along the way, as well as some fairly middling average scores. However, what do those results actually say? That there are some subjects that I am more comfortable with, that there are some assessment methods that I'm more comfortable with. Well, I could have said that without the tests. So here's what it comes down to: the tests (for the most part) are not how they measure your precise knowledge of everything that's been taught (although if you think about it, they do test a fairly good amount of it). The tests are how they measure your learning process, your thinking process. Since the stated goal of the RVC is to produce competent practitioners and life-long learners, then necessarily they need to assess our ability to learn. So the passing results (and good grades) which I achieved are nice, but they're secondary to the fact that I've started to grasp how to think about and learn this type of information.

ISF exams and yesterday's tutorial

2010-02-18T00:15:00.000-08:00

I said yesterday that the assessment method that my American colleagues (at the least, since I'm not too knowledgeable about Canadian education methods) may have the greatest difficulty adjusting to is the viva, or oral exam. Now, I'm excepting those who have defended a PhD or MA/MS thesis, since those often involve an extensive oral defense. However, for most undergraduates in the USA, the experience with oral assessment is limited to the speech/debate class that you *may* have taken back in high school, or else an occasional presentation given in a freshman seminar or an upper division class. This is quite different.

The name actually describes the test in total. ISF stands for Integrated Structure and Function, and as that implies, is designed to test understanding of the entire organism. However, unlike a presentation where you have time to read the paper, digest the contents, figure out the salient points, and write a presentation script; the ISF literally requries you to do all of those things in a fifteen minute window. Your examiner will start by giving you a "level 1" question, such as "Please identify the scapula." You may be looking at a live animal, a fresh dissection, and skeleton, or an image; and you may be looking at any species of animal. To begin with, you need to know what the scapula is. Assuming that you don't confuse it with the patella, you get to move on. If you can't identify the scapula, you get a backup opening gambit - but those "byes" are limited. So, if you identify the scapula correctly, you'll move on to "level 2" questions, which may ask details about the different aspects of the scapula, its structure and function, how it interacts with its environment, etc. These questions are designed to probe your depth of knowledge about the particular subject, and the follow up questions will be based on the answers you give, and the examiners' perception of your understanding. Assuming that you successfully enter into a dialogue with the examiners and pass the second level, you'll get "level 3" questions, which test your extended knowledge about the minutae of the subject.

(Note: by the time you reach level 3, you're doing quite well on the exam, and can actually relax and enjoy the experience of having a mature scientific discussion with professional colleagues.)

We get about two weeks at the end of the year (after the first four final exams are completed) to study for this ISF viva, which is important, since there are approximately 13 pages of "level 1" questions that they draw from (provided in advance), but each of those questions likely has 12-15 followup questions that might be asked, and those are NOT known until you hear them. It's a massive body of knowledge, and any/all of it is fair game for the exams. This is why I might classify the ISF exams as the hardest ones you'll sit in your time at the RVC. And I say that without ever actually having taken one. :-)

The tutorial I had yesterday focused on the gastrointestinal tract of Misty, one of the Camden Campus' two resident cows. A second year student took myself and one other first year from the front to the back, asking us questions in the ISF style (e.g., "what is this structure?"), and then asking us to elaborate. Unlike the actual exam, he did give us the correct answers when we made errors. This is one of the things about RVC that I find most gratifying, namely that the upper classes take a very active interest in the success of ther junior colleagues. This is so vital in a professional training program, since those who follow you will be the ones working with you for a long period of time. It therefore behooves (my mom's word, I hate it, but it's appropriate here) each class to actively involve themselves in the school's academic program, help refine it, and prepare future students for meeting its challenges.

Just over halfway . . .

2010-02-16T10:00:00.001-08:00

Well. The first year is just over halfway done, so a few thoughts on the end of the first term and the beginning of the second. The pace picked up incredibly over the last four weeks of the first term, and it hasn't really let up since then. We went from the nice easy "overview" of each system, to the alimentary system, which definitely stepped things up a notch, both in quantity and detail of information. I guess I can understand that - the majority of this second term is focusing on ingestion, digestion, and the development of the associated organs.

One of the really nice things that happens here at the RVC, which I touched on very briefly in my introduction, is the integration of core concepts into practice. For example, as part of this second term (the Alimentary Strand), we've had two lectures over the past two weeks that were very clinical in nature. The first was on a condition called Exocrine Pancreatic Insufficiency (EPI), and tied in nicely with the lectures on digestion and absorption of nutrients (since EPI is primarily a disorder of absorption); while the second should be instantly familiar to anyone who has worked at a vet practice: diarrhea (or, as they spell it here, diarrhoea). So not only are we getting the basic sciences, but we see instantly how they will apply in our future practice, which really underscores the importance of solid understanding.

I think that the part of this course which might be the hardest to get your mind around, as a North American student, is the assessment system. I come from a similar background to most of you: four or five classes a term, three to five exams per class, regular quizzes, maybe a paper or two; plus associated laboratory grades. From stories you've no doubt heard from your friends at vet school in the US/Canada, things aren't much different. Nope. Not at RVC. Our entire first term (remember, that's 11 weeks and 6 subjects) was assessed on the basis of 30 multiple choice questions (MCQ). To call this surprising would be a major understatement. To call it easy would be a major mistake. However, on the whole, the system is terribly fair (e.g., the term one exam was only worth 5% of our year end grade, the term 2 exam is shorter, and only worth 2.5% - the bulk of our year grade, 85%, comes from the exams in June/July).

We're assessed based on five methods: MCQ, problem solving, essay, SPOT, and ISF. The first three are probably second nature to most of us. MCQ is just like back home - although the questions tend more towards the generalities, and you might be presented with something you've never seen before -they want to see if you can work it out based on the knowledge that you do have; so the key is to parse out the key phrases and concepts that you know - the answer will almost always be discernable based on that. Problem solving is an extended short answer question, based on an image or a chart or something related. You'll need to identify the key to the problem, and then answer five to seven questions based on that identification, demonstrating that you've grasped the key associated concepts. Essay - it's an essay, although you do need to cram a lot of detail into a short amount of time. The SPOT is just like a lab practical back home - 30 stations, 2-3 minutes at each station, identify the specimen and answer a few questions about it. Each of these exams is worth a percentage of the year end grade, and if you're comfortable with the material, are challenging but not impossible. The one that is probably the hardest for most North American students is the viva, or oral exam. I'll talk about that next time - I've got a tutorial session on it tomorrow.

A not so brief introduction

2009-11-18T06:54:00.000-08:00

Almost four years have passed since I made the decision to pursue a career in veterinary medicine. I come from what may be considered an atypical background - I haven't known since I was five that I wanted to be a veterinarian; I haven't even known since I was twenty five. I majored in sociology as an undergraduate student, with a dual focus on organizational theory and criminology; and a minor concentration in classical piano and conducting. Although quite interested in both areas (intellectually in the former, and quite passionately in the latter), neither figured into my career choices. I left college with no clear path. So I did what any 21 year old would do - I moved to New York City and got a job with a temp agency. The big difference in my case is that I was originally from the city, so there was no adjustment period. I did eventually begin full time employment with a classical music publishing company, but as a database manager and promotions/publicity "specialist." This eventually led to a more focused position as an web applications project manager and DB programmer. Wow. How unfulfilling that was.

The one constant has always been animal rescue work, with a firm focus on cats, particularly "special needs" cats with social and medical problems. Three of my "projects" are currently living in my household. The most recent rescue group was affiliated with a veterinary clinic in Brooklyn, and through them I saw the dedicated work of the medical teams that work with animals on a daily basis. One particular hard-luck foster piqued my interest, and I realized what it was I wanted to do for the rest of my life.

However, the decision didn't make the path any easier. I had none of the required science background, and even less of the clinical knowledge which is so essential for acceptance to veterinary school in the United States. Each of you reading this, whether undergraduate applying directly from college, or mature student with an entire life of experiences behind, will recognize the rest of the story. I took science classes for three years and worked as a veterinary technician (first as a volunteer and then in a paid position), gained clinical experience, worked with a large animal practitioner, and essentially made a case for the admissions committees that I was aware of the challenges of the field, and wasn't just looking for puppies and kittens.

Which brings me to the crux of this entire blog. Why the Royal Veterinary College? Why London? Why . . . why . . . why . . .

In the United States, say "institution" and you conjure up an image of staid and fixed, with little capacity for change, and no motivation for innovation. The Royal Veterinary College (from hereon RVC) is certainly an institution, but it doesn't fit the stereotype - not in the slightest. As the oldest veterinary school in the English speaking world, it has had plenty of time to mire in tradition. Consequently, it has done nothing of the sort. Particularly in the past few years, innovation and change have been the bywords, in curriculum, approach to teaching, and just general attitude. I'll certainly have a lot to say about this over the next few months.

So, I loved the approach to learning, and I loved the idea of studying outside the United States. The benefits are amazing. For example, did you know that a degree from the RVC is recognized not only by the AVMA, but also by the European Union, Australia, New Zealand, any former or current commonwealth nation . . . that encompasses all of the English speaking world, and a large percentage of the rest. Everywhere else? They recognize the quality of education, and don't make you jump through too many hoops if you want to practice under their auspices.

So, without sounding like too much of an advertisement, I'll say this: you're in the game and you're considering your options. Consider the RVC very seriously. Check this blog for updates on my experiences. Let me know if you have any questions. And good luck!