Moving forward in small animal surgery
I graduated a keen all-rounder with a bias in small animal medicine initially. It was actually a locum who suggested I may have a talent for surgery and got me some experience by actively encouraging me to take on additional surgical cases under his supervision.
I’ve since gone on to do a BSAVA small animal surgery certificate and now the Improve diagnostic imaging certificate. In the last few years I’ve learned key-hole and TTA surgical techniques as well. My caseload is varied and split between soft tissue surgery and orthopaedics, and I am an RCVS advanced veterinary practitioner.
Advanced Veterinary Practitioner vs Specialist
I do feel it’s important here to stress that I’m not a specialist. It’s important to convey to clients that you are an advanced practitioner and not a specialist as well as highlighting the meaning of this distinction as well. Clients that are specifically looking for a specialist, or in cases beyond your ability or facilities must be referred on appropriately.
I’d certainly have liked to have undertaken diploma training, but at my age the priority became family. It was a tough decision, but equally I have not had to give up on my passion for surgery thanks to the advanced practitioner scheme.
Interested in growing in surgery? How about giving it a try
Obviously, I didn’t jump to more advanced surgeries - there was a substantial period of growth. Every new technique I’ve learned has involved an often-stressful new learning curve! It’s important to let owners know you are inexperienced when you are trying new techniques; for honesty but also to ease some of the pressure and expectation. Negotiating discounts with your bosses for cases you learn from can help too.
I’ve advised several younger vets how to grow in surgery, and I usually suggest starting by scrubbing in with someone with a surgical bias and watch them work (this may mean seeing practice if there aren’t suitable teachers at your practice). This way you can learn to assist and see if it’s really for you.
My own path was a solid practical course on cruciate lateral sutures and patella surgeries first (you learn a lot about tissue handling, and these are often the most common cases first so you will see them). I then developed that with a basic fracture repair course (mine was with the AOVET organisation). Again, these are surgeries where there may be gaps at your practice, and where your boss may allow you to practice at fairly discounted rates in appropriately easy cases. For soft tissue surgery I went on a TECA course, but more advanced practical courses in gastrointestinal surgery would be helpful too, just make sure they are hands on, because that’s what your interest will be.
3 steps to help you develop a surgical interest:
- See practice or assist colleagues to get actual hands on feel for the job
- Aim for courses that will allow you to do more surgery, ensure they are practical
- Ask your boss to do discounted procedures as long as the clients are informed you are training
Getting a certificate
Having achieved a good grounding, both watching/assisting my experienced colleagues, and going on courses that might allow me to fill a niche for charity cases, I felt confident enough to enrol on a certificate. There are many different providers: Improve cpd, CPD solutions, BSAVA, or the self-directed scheme with the RCVS. I rank these courses in no order, but personally preferred a structured learning approach that was less self-directed so I would have deadlines to motivate me!
The certificates seem to be more accessible and achievable since the changes brought in by the RCVS with the “new-style certificates” and none should seem excessively daunting. I have heard people worry about having enough cases for casebooks, or having enough time to get them done, but all the providers work to ensure that they are set at the level of the general practitioner with a realistic acceptance you are not going to be seeing a pure referral caseload!
4 steps to help you gain a certificate:
- There are multiple providers, review what you want from a course as you compare them
- They are very expensive but many practices will work with you to cover the costs, have an informal discussion with your management team
- Realise that the modern certificates are more achievable in practice than you may feel, they typically make allowances as their aim is to be for general practitioners with an interest
- Discuss with the RCVS if the certificate you pick is AVP recognised
Moving forwards from the certificate
Finding a structure for moving forwards since completing my first certificate has been a challenge, that’s likely why I started the second certificate. It’s worth joining appropriate organisations such as the AVSTS to allow for more tailored CPD, but because there are often new procedures to learn, there is typically some new CPD to aim for.
Once you’re an AVP:
- Join appropriate organisations
- Foster links with specialists, it improves referrals, a working relationship and they will advise you on good organisations to joint for CPD
Examples of organisations to join, or research for ongoing CPD, especially their congress meetings:
- Association of Veterinary Soft Tissue Surgeons
- European Society of Veterinary Orthopaedics and Traumatology
- European College of Veterinary Surgeons