Extern Orientation Guide &
Welcome Packet
2015
Mid-Atlantic Equine Medical Center
40 Frontage Road
P.O. Box 188
Ringoes, NJ 08551
Phone (609) 397-0078
Fax (609) 397-2905
www.midatlanticequine.com
Welcome to the Mid-Atlantic Equine Medical Center!
Thank you for choosing MAEMC for an externship. We are happy you are here and want to
make this an excellent learning opportunity for you. Please take a moment to read over this
handout. It will provide you with helpful information regarding your externship. Feel free to
ask any questions in case we left something out!
We will make every effort to include you in the care of our patients and give you the
opportunity to ask questions, assist in surgery, expand your technical skills, etc. The more effort
you put into the externship the more rewarding it will be. Please remember there is no such
thing as a stupid question! Please contact anyone at the front desk or one of the Interns for
anything you need during your stay.
The phone number here at the clinic is 609-397-0078 or toll free 800-724-5358 in case you
want to provide this number to any family/friends that may need to reach you. If you are
expecting a call please let the front desk know and they will make every effort to find you when
the call comes in.
Our Doctors
There are 8 senior veterinarians:
Dr. Peter Bousum, V.M.D
Dr. Rodney Belgrave, D.V.M., M.S., Dip ACVIM
Dr. Dean Neely, V.M.D., PhD., Dip ACT
Dr. Patty Doyle, D.V.M., Dip ACVS
Dr. Janik Gasiorowski, D.V.M., M.S., Dip ACVS
Dr. Florent David, D.V.M., DACVS, MSc, DAVCSMSR
Dr. Gemma Gerardi, D.V.M.
Dr. Jennifer Feiner, V.M.D
Nuclear Scintigraphy
Internal Medicine, Neonatology, Critical Care
Reproduction and Ambulatory
Surgery and Nuclear Scintigraphy
Surgery and Nuclear Scintigraphy
Surgery and Nuclear Scintigraphy
Ambulatory
Ambulatory
There is 1 surgical resident:
Dr. Jessica Partlow, D.V.M.
There are 4 interns:
Dr. Nicole Finazzo, D.V.M.
Dr. Tasha Likavec, D.V.M.
Dr. Kathryn Livesey, D.V.M.
Dr. Libby Reidy, D.V.M.
The interns are here from June until the following June and during their time with us they rotate
services every two weeks: surgery, medicine, ambulatory and overnights.
General Information
Dr. Neely sees primarily reproduction cases at a
separate
reproduction
facility
located
approximately five miles from the main clinic. All
other cases (e.g., lameness, prepurchase, surgery,
medicine cases) are seen at the main clinic. Some
cases are admitted as “in-patients” and other cases
are seen on an “out-patient” basis. During the first
day or two of your stay, we ask that you stay in the
hospital so our doctors and staff can get to know
you and you get familiar with our hospital. Then you can begin to focus your externship to any
area you would like to focus on, including working at the repro facility or riding with our
ambulatory doctors. We will let you cater your externship to your interests, but ask that you
work with the other externs that are here at that time so that everyone gets their fair share of the
action.
Informal barn rounds are held during the week between 8:30-9:30 am. During foal season,
separate rounds may be held in the NICU.
We have a 5 stall Surgery Barn for emergencies, a Medicine Barn with 4 intensive care stalls
equipped with oxygen, a Back Barn with 7 stalls for Nuclear Scans and overflow, a 16 stall
Long Barn for elective surgeries and overflow, and a 4 stall Isolation Barn. The clinic has a
pharmacy, full-service clinical lab, radiology and Scintigraphy units, an emergency surgery and
recovery stall as well as an elective surgery with 2 recovery stalls, and general exam rooms with
stocks. There are several work stations throughout the hospital with access to the internet, and
please ask if you need assistance using the internet work stations. PLEASE BE SURE TO
ACCESS ONLY WORK APPROPRIATE WEBSITES WHILE HERE AT OUR CLINIC!
In addition to the digital photo of yourself that you have sent prior to the start of your
externship, please be sure to have your picture taken while you are here. THIS IS VERY
IMPORTANT FOR ANY STUDENTS INTERESTED IN APPLYING FOR AN INTERSHIP!
We keep these photos in your record, and will sometimes post them on the kitchen bulletin
board so everyone will know who you are. Please be sure to wear your school name tag AT
ALL TIMES! If you have forgotten or misplaced yours, please see the front desk and we will
make one for you. There is an “extern room” provided for you at the top of the stairs in the
back barn. It has beds, a small kitchen area, and a phone. Please make yourself comfortable.
You may also use the kitchen/lunchroom and washer and dryer located downstairs in the main
building. There are 2 showers, one in the back barn below the apartment and one in the locker
rooms of the new surgery building. There are two delis in Ringoes where you can get hot food,
as well as grocery items. About 6 miles North on Route 202 is Flemington, a much larger town
with a Shoprite, Panera, Applebees, fast food, etc. Please let us know if you need transportation.
If you do have a car, please park in the parking lot on the left side of the building.
How do you work the phones?
To dial an outside phone number, press the “outgoing” button, wait for a dial tone and then dial
your number with area code. To page someone within the clinic, press the “page” button,
followed by the number “1,” speak clearly into the handset and hang up softly (the person you
paged for will not be able to call you back if you do not hang up). Our receptionists answer all
calls during regular office hours. During all other times, calls made to the main clinic number
will be transferred to our answering service. You can receive phone calls after hours by having
the caller press the number “9” when the message comes on. If the phone rings after hours and
you feel comfortable answering, please answer it “Mid Atlantic Equine, this is (give your
name). How may I help you?” If you are going to answer the phone after hours, be sure to
conduct yourself professionally! If you do answer the phone after hours and have to put it on
hold, please ask the client/RDVM to hold for a “moment” (not a second!) and press the red
button on the phone. In order to transfer the call to another extension you must pick up the line
as if you were going to speak to the individual, press the transfer button, dial the extension you
want the call to go to and then hang up (the call will not be transferred until you hang up).
Responsibilities for In-Patients
Please ask for guidance from the techs and or doctors. You will be asked to assist in
numerous procedures (e.g. placing catheters, giving medications, tubing, etc.). Please be aware
that occasionally there may be numerous students, techs, volunteers etc. here and we may ask
that you limit the number of people in a room while clients are present. We would like no more
than 2 externs in a room with owners present. We would like you to participate in all areas of
the hospital. If there are several vet students here, you may be asked to rotate through services
(surgery, repro, medicine and farm calls) to limit the number of people in any one area. Please
contact one of the interns if you have any questions, problems, concerns etc.
If you are uncomfortable or unfamiliar with how to handle horses, please let the Interns or
technicians know. We do not want to have people or horses hurt. For instance, the improper
handling of foals can cause damage to internal organs. Many of the horses we see for lameness
are fit racehorses and can be a challenge to handle, please use caution.
Externs are asked to help perform daily physical exams including TPRs on all in-patients. If you
find a serious problem with a case (e.g., a high fever, diarrhea, laminitis, colic, etc.), please
immediately contact an intern, technician, or senior clinician to report your abnormal findings.
We use a computer based charting system at the hospital that you will be shown how to use.
In the morning we ask that you be ready by 8am, at the latest, and arrive in the intern office to
start the morning rounds. Externs are also asked to help the technicians perform patient
treatments during the day and assist the overnight intern and technicians at night (including 12
midnight treatments and special treatments between 12 midnight and 6am). Due to the varying
degrees of experience of our externs, shadowing of the interns and/or technicians during
treatments is generally required before undertaking any treatment responsibilities
unsupervised. Your clinical experience will dictate the level of responsibility assigned. If
you are unfamiliar or uncomfortable with performing certain treatments such as drawing blood
samples, administering IV medications, hanging IV fluids, etc. please ask a technician or intern
for guidance. Externs should not place IV catheters or stomach tube horses on their own.
General Allowance for Extern Treatment Responsibility(without supervision):
1st year students: Just TPRs
2nd and 3rd year students: Oral medications and TPRs
4th year students: oral and adult horse IV medication (with catheter) and TPRs
Externs may assist interns or technicians with changing fluids, eye medications, NG intubation
and gastric lavage, foal IV treatments, chest tube drainage, bandage changes and other special
procedures. Depending on your comfort with the patient, you may be asked to help handwalk/graze. Externs will not be allowed to do foal or isolation patient treatments without
supervision.
Guidelines for Administering Medication to Patients
Be certain you are clear about the amount of drug to give and its route of administration. If the
treatment orders are unclear, ask a clinician or technician for clarification.
Some drugs are located in the patient’s treatment box in the treatment rooms in the front of each
barn or in the medicine cabinets in the treatment rooms. During foaling season, most
medications for foals are kept on individual patient treatment carts located outside each stall in
the NICU.
Please sign and date anything written in the medical record and be sure to put notes and your
initials in the daily exam note section of inpatient records on the computer system.
When administering IV medications, always use a clean needle to draw up the medication.
Turn off IV fluids if they are running. Flush the IV catheter and extension set with 8-10cc of
heparinized saline flush solution, and then slowly administer your IV drug followed by another
flush with heparinized saline. Flush before, between and after all medications. It is important
to thoroughly flush IV lines when giving medications to prevent catheters from clogging and to
prevent drugs from interacting or precipitating with one another within the IV lines.
Discard all needles and syringes (except oral catheter-tipped dose syringes) in the red plastic
hazardous waster receptacles available throughout the clinic. The sharp ends of the venosets
must be cut off the IV lines and discarded in the red containers. The IV lines and coils without
the venosets can be discarded in the general trash.
Once you have administered a medication, please mark off the treatment on the patient’s
treatment order sheet in Vetstar as being given.
If cases are critical or receiving IV fluids, please walk by and check on them as frequently as
time permits in addition to those required by the treatment scheduler.
Whenever you are administering drugs through catheters, always check to be certain there is no
evidence of abnormal swelling, heat, or pain at the catheter insertion site. Please notify the
intern whose case it is of your findings.
Scrubbing Into Surgery
Externs are welcome to observe surgeries. Please ask the
Sx Tech where to obtain a cap and mask if you are just
observing. If you choose to scrub in with Drs. Doyle,
Gasiorowski or David and the surgery intern/resident,
clean scrubs can be provided.
Some surgeons may ask for a surgery report if you scrub
in. The surgery intern will assist you with the report.
Surgery reports must be entered into the computer system.
Please ask one of the interns to show you how this can be
done.
Dress code:
We ask that you wear professional, work appropriate attire during the week, especially when
you will be interacting with clients. For example, khakis with a polo or nice shirt are
professional and appropriate. You may wear more casual (yet appropriate) clothing and
footwear if you are helping with evening or weekend treatments.
General Barn Care
If you are asked to turn a horse out, please be certain you know which paddock it can go into.
The last paddock on the side of the building nearest the lunchroom is generally used for
isolation cases. Please be certain that the horse has a bucket of clean water. When you bring
horses in, please close the gates to the paddocks. If a horse should become loose,
IMMEDIATELY pick up a phone and hit page saying “Please close the gates.” That will
alert everyone that there is a loose horse and the two entrance gates on either side of the hospital
will be closed. The entire perimeter of the hospital is fenced, so once the gates are closed the
horse cannot get off the premises.
Feed rooms are located at the end of each barn. Shavings and straw can be stored here or in the
lofts above each barn. Interns, externs, and technicians are responsible for feeding and filling
water buckets for in-patients in the morning (7-8am) and in the evening (5-6pm). Healthy
mares with foals by their side often receive a late evening meal, as well. Water buckets should
be checked and filled as needed during the day.
Please clean up after yourself. Counters should be wiped down and trash discarded
appropriately. If you are working with clinicians in the general treatment areas, please assist in
keeping the floor and environment clean. Floors are generally cleaned and disinfected after the
exam is completed and the horse leaves. Please help keep the aisle ways clean and tidy. Sweep
the aisles whenever bedding or hay is tracked into the aisles by a horse that you have removed
from a stall. Please pick horses feet, if possible, before leading them out of stalls.
Pharmacy
The pharmacy is located in the new surgery building. This room has electronic locks that are
active at all times. If you need something you must find an intern or technician to let you in.
Medications must be signed out and billed appropriately through the treatment scheduler or
the billing screen.
Clinical Lab
The lab is covered by technicians Monday-Friday, 8am-5pm and on Saturday, 8am-12pm.
Specimen Submission:
General Lab Form— Please fill out top part and mark or write in test requests Label specimens
with horse’s name, owner name, and date.
Reception Area
Please feel free to ask the front desk if you need assistance with any general questions. Try to
refrain from having conversations around the reception area during business hours, or
discussing any cases. You never know when clients may be in the restroom, or around the
corner making a call. Confidentiality of patient/client information is critical.
Digital Radiograph Workstation and Image Viewing
To the right of the reception area is the office where we view digital radiographs, as well as film
radiographs. The Cuattro Digital Radiography viewing workstation is to the right as you go in
the office, and the Sound workstation for ambulatory images in under the window.
Radiographs taken in surgery exam room may be viewed here on high-resolution monitor.
These computers are to be used for viewing radiographs only! Please bear in mind that this
room is also used to discuss cases with clients, and is sometimes used as a “bereavement room.”
Neonatal Intensive Care Unit
Most NICU patients have their own individual
treatment carts outside the stall. Most medications
for a particular foal can be found on the carts.
Periodically mares with “high-risk” pregnancies are
admitted to the hospital for foaling out. These
mares are checked throughout the night for foaling
depending on how close we anticipate they are to
delivery. Externs may be asked to assist nurses in
the care of NICU patients.
Thank you for your time and effort while you are here as an extern at Mid-Atlantic
Equine Medical Center. We appreciate your help and sincerely hope you have an excellent
learning experience. Please visit the front desk before you leave to fill out a Housing Evaluation
(if there aren’t copies left in this binder). Again, if you have any questions, comments, or
concerns please don’t hesitate to come and talk to us. We hope you have an enjoyable
externship!
TYPICAL DAILY EXTERN SCHEDULE:
8AM: Meet in the intern office. At this point the interns will have rounded and will have a better idea of what
the day will be like.
8a-4p: Observe/help with cases- you may observe medicine or surgery cases but we ask that no more than 2
externs be in a room when owners are present.
4-6pm: Unless you are observing a procedure or surgery, we ask that you help with 6pm treatments. These are
started at 4pm.
6-10pm: Once 6pm treatments are completed, you are free until midnight treatments begin.
10p-12a: Help with midnight treatments.
Externs are on-call to help with emergencies 24/7. This is when we get to know you best and you can be
involved in some very interesting cases. If there are enough of you, you are more than welcome to rotate
treatment and emergency duty.
Ambulatory Shadowing- if you are interested in riding with one of our ambulatory clinicians, contact the intern
that is on the ambulatory rotation. They will help you arrange this opportunity.
This is a rigorous extern schedule, but it will give you an idea on what a private practice equine internship is
like. As always, please don’t hesitate to ask an intern if you have any questions.
EXTERN ORIENTATION CHECKLIST:
Please ask the interns to help you complete this checklist upon arrival
 Put name, school and phone number on the white board in the intern office
 Obtain orientation packet from interns
 Tour the facility
 Orientation to Vetstar (treatments, daily exam notes, schedule)
 Expectations of externs (see typical daily extern schedule)
 Introduce to clinicians, interns, technicians and staff.
 Learn how to use the phones.
 Have Chelsea (At the front desk) take your picture
 Go grocery shopping (usually best when first arriving to the clinic)
MAP OF MID-ATLANTIC EQUINE
MEDICAL CENTER
10
11
12
13
9
14
7
15
8
16
1. Reception Desk
5. Surgery Exam
9. Back Barn
13. New Surgery
2. Med Exam
6. Surgery Barn
10. Isolation
14. Pharmacy
6
3
5
4
2
1
3. Med Barn
7. Extern Dorm
11. Long Barn
15. Arena
4. Old Surgery
8. Bone Scan (under extern dorm)
12. New Exam
16. Isolation Paddock