Q&A: Bettina Dunkel on specialising in equine internal medicine
As part of a series of articles on veterinary specialisms, My Vet Future is talking to vets about their route to specialisation, with the aim of helping vets better understand how they can become specialists.
Name: Bettina Dunkel
Job title: Lecturer, senior lecturer and associate professor in equine medicine at the Royal Veterinary College (RVC)
- Oct 1995- January 2001: Berlin University Veterinary School
- Jan 2001 – June 2001: Fellowship in equine neonatology at Tufts University, Massachusetts, USA
- June 2001 – July 2002: Rotating (medicine and surgery) equine internship, Leesburg, Virginia, USA
- July 2002 – July 2005: Two residencies (large animal internal medicine and large animal emergency and critical care) at the New Bolton Center at the University of Pennsylvania
- July 2005: Became a diplomate of the American College of Veterinary Internal Medicine (ACVIM)
- October 2005: Became a diplomate of the American College of Veterinary Emergency and Critical Care (ACVECC)
- Oct 2005 – Oct 2008: PhD in equine platelet and neutrophil function at University of London/RVC
- Oct 2008 – present: Lecturer, senior lecturer and associate professor in equine medicine at the RVC
When and why did you decide to become a vet?
My first dream was actually to become a pirate! My parents discouraged that of course and immediately after I decided I wanted to become a vet - I think I was around six or seven years old. I can’t recall exactly why I wanted to become a vet, but that ambition didn’t change, and I entered vet school at Berlin University in 1995.
Did you have a career plan?
I always wanted to become a professor in equine medicine, working in an academic setting. It was also clear to me that I wanted to specialise in horses, as I’ve always ridden and worked around them. As a self-confessed ‘nerd’, I enjoyed studying and learning from early on, so I knew I wanted to work in an academic environment. However, after I graduation, I wasn’t entirely sure how the specialisation process worked.
How did you succeed in becoming a specialist?
As I wanted to improve my English language skills, I went to the UK for an EMS placement. While discussing my interest in horses and internal medicine with clinicians at the Animal Health Trust in Newmarket, the specialists working there encouraged me to look into internships and residency programmes in the USA. I applied for different EMS placements at university clinics in the USA that offered these programmes and spent five months in Tennessee, Virginia and Massachusetts focusing on equine medicine.
"As a self-confessed ‘nerd’, I enjoyed studying and learning from early on, so I knew I wanted to work in an academic environment"
During those externships, I made several contacts and I ended up spending four and a half years at different places in the USA. I did a fellowship at Tufts University, an internship at Leesburg, Virginia, and two residencies at the University of Pennsylvania. The level of expertise and complexity of the cases really impressed me, as well as the way the clinicians shared knowledge and skills in training. It was truly inspiring.
In 2005, I successfully became a diplomate of both the ACVIM and ACVECC.
Missing the European lifestyle, I came back to look for a suitable PhD programme. I liked the RVC’s PhD programme best as it was well structured and had excellent support staff and facilities. My future PhD supervisor from the RVC and I applied for a prestigious Horserace Betting Levy Board (HBLB) PhD scholarship and I got it.
I moved to London to complete my PhD from 2005-2008, investigating equine platelet and neutrophil function in horses with airway inflammation. Having already had clinical training from my residencies, the PhD gave me additional research training that I hoped would benefit me in finding a job in academia.
Can you describe the commitment involved?
Personally, the commitment in the USA was huge. I worked extremely hard while also studying in my spare time, which meant putting my personal life to one side for the entire time. After the end of the residency programmes, I was worn out and missed Europe.
In comparison, the PhD was a walk in the park – I was very organised and driven, and compared to my time in the USA, felt that I had a lot of spare time. This helped me to get back into normal life. Whilst the internship and residency programmes in the USA were great for learning a lot in a short time, they were also extremely demanding.
How do you maintain your specialist status?
Continuous learning and keeping up to date with new developments is crucial. Going to international conferences is therefore very important, and so is keeping up with all my colleagues in the various forums we use to exchange ideas. You can’t just sit back and say, “I’m a specialist now, that’s that done.” It is a continuous learning process and that requires never ending dedication.
What’s it like working in academia?
I’ve always wanted to work in academia, combining clinical work, research and teaching. At the RVC, I do mostly clinical work, all with referred patients that have usually been seen by a different vet and due to the complexity of their disease, need specialised diagnostics or treatment. In fact, 70% of my time is in the clinic with patients and students, so I actually spend quite a small amount of time on research. At the moment my research area is largely critical care in horses.
"I believe that any form of specialisation, be it a certificate or diploma, will enhance a person’s knowledge and skills"
I also teach a broad range of students and qualified professionals, including vet students, nursing students, qualified nurses, and upcoming specialists. I enjoy that a lot, too, as these are all people that share my passion.
All in all, I think I’m in the perfect spot with my career. I want to make little steps upwards but I’m very happy and enjoying my work, which is exactly where I want to be.
How do you maintain a good work-life balance?
Maintaining a good balance is difficult because as your career advances, so do your responsibilities.
I think finding the right work/life balance is one of the main challenges in being a vet as we naturally want the best for our patients and their owners. However, everybody needs time away from work.
What advice would you give to vets considering becoming specialists?
Make sure to preserve time for your private life and never let work encroach on that.
I would also like to encourage anybody with a vision and a passion to go for it. We spend so much of our life working, so we might as well pick a career we enjoy, that drives us, and that makes us happy!
I believe that any form of specialisation, be it a certificate or diploma, will enhance a person’s knowledge and skills and ultimately improve the quality of care we can deliver for our patients.
However, we also have to acknowledge that we cannot be experts in everything. I’m very good at internal medicine, but I’m probably not the best person to ask if a horse is suffering from a complicated lameness – there are experts in equine orthopaedics who are better placed for that.