Review and Proposed Improvements of Exotic Animal Teaching at GUVS An open letter to be brought up at staff student liaison meeting, 04.11.09 To whom it may concern, Over some time now, it has become apparent to a number of students and alumni of the University of Glasgow Faculty of Veterinary Medicine that there are several shortcomings in the content and structure of the course with regards to the exotic animals. The purposes of this letter are to give an evaluation of the current place of exotic animals within the curriculum and to provide a number of suggestions for improvement. It is appreciated that, at this time, there is much upheaval due to the recent relocation of the Small Animal Hospital. While this may be considered by some as poor timing on our behalf, the new building has given the hospital a blank canvas for improvement in numerous areas. It would be ideal if exotic animal medicine could benefit too. Exotic animals in the UK The umbrella term “exotic animals” is used to cover a huge number of very different species which are kept either as pets or as specimens within public or private collections. The broad nature of this category means that within one field of veterinary medicine we have a ridiculously large quantity of husbandry requirements, breeding data, medical and surgical techniques to be aware of. While it is reasonable to say that we cannot feasibly learn all of these facts, the same amount of time and effort should go into training veterinary students in the area of exotic animals as goes into teaching on far less commonly encountered fields: the commercial porcine/poultry industries for example. Exotic animals are commonly encountered in practice. Allowing students to qualify as BVMS MRCVS without having the necessary skills and knowledge to treat these animals can lead to easily preventable errors of practice which, had they occurred in a dog or cat, would be seen as negligence. Client expectations Shortcomings in the realms of practical, clinical and preclinical training do little to change the exotic clients often low opinion of veterinary surgeons. It is not uncommon for clients to have had negative experiences based on an apparent lack of knowledge or compassion. Unfortunately, many veterinarians now refer all exotic animal cases to specialists, even for the most basic of conditions. It is often expected that new graduates exit vet school with a good working knowledge of exotic animal medicine, and as such many senior vets in practice look to them for advice and support in this area. To better prepare them for this, each Veterinary Institution should be doing its best to arm its students with a comprehensive knowledge of the basics, just as they do for other species. There is no reason why any graduate should have to consult a “specialist” (all too frequently just an interested party) in order to ascertain basic husbandry or clinical information. The veterinary surgeon should be considered an animal expert by the lay person. However, where exotic animals are concerned, a very poor is image is projected, which can bring the profession itself into disrepute. It would be a worthy thing to win back the trust of the exotic animal client. Current situation and proposed improvements This is where The University of Glasgow Faculty of Veterinary Medicine comes in. Already, it has made significant efforts to accept exotic animals into their syllabus. These consists of: Anatomy (and to an extent physiology) of fish, birds, reptiles, amphibians and small mammals. (detailed and comprehensive course) Basic husbandry and handling (theory) of small mammals Basic husbandry of reptiles Exotic animal pharmacology Fish medicine (commercial) Small mammal medicine and surgery (brief overview) Reptile medicine and surgery (brief overview) Avian medicine and surgery (brief overview) (no preclinical husbandry) These are often presented by experienced and well thought of lecturers, but have poor student attendance due to timetabling – such “additional” subjects are all too often pushed to the end of term, before holidays and exams. The perception of exotic animals as “extra” or even “unnecessary” is compounded by a low incidence in examinations. Despite the fact that exotic animals are frequently encountered in practice, there are no practical handling sessions for these animals. As such, untrained students are encountering these animals whilst on EMS (or worse: as a graduate) – a potential danger to the student/graduate and patients alike. Often, the teaching which we do get is a repetition of preclinical husbandry advice. Whilst optimal husbandry is the cornerstone of exotic animal medicine, by fourth year one would expect vet students to know the dietary requirements of a parrot, and that lizards require UV lighting, so a more clinical focus should be adopted, with only brief reminders of preclinical husbandry. To be facetious, it would be laughable to start every lecture on small animal medicine with a discussion on dogs eating dog food and cats eating cat food: a degree of prerequisite knowledge is expected here, and likewise should be expected from a veterinary student in their clinical years. A structured list of exotic animal Learning Outcomes should direct students as to what specifically is expected of them at various stages through the course. What follows is a list of suggested improvements to the existing course. 1. 2. 3. 4. 5. 6. Preclinical years Detailed lectures on husbandry of all exotic animal groups (Amphibians, Birds-including raptors, Fish, Invertebrates, Reptiles, Small Mammals-including ferrets) within the preclinical years would remove the need for reiteration in clinical years. Ideally, at least one full lecture should be dedicated to each, with more for the larger groups. Other aspects of the animal husbandry course could easily be condensed to make room for this. It would be of tremendous benefit if the reptile unit were moved to a more easily accessible area (for example, the old small animal hospital). Doing so would raise awareness of their place in the curriculum. Other exotic animals could be purchased – small mammals, birds, fish and invertebrates can all be easily maintained, require little space, are inexpensive and would be greatly beneficial to the students. Similar to the old “kennel duty” in first year, preclinical students could be actively involved in the upkeep of these animals. This would reinforce the importance of such species, as well as allowing hands on experience with these animals and their husbandry. Potentially, it could be a preclinical EMS opportunity. Practical classes on the handling and management of different exotic animal species could take place in the aforementioned proposed new exotic animals unit. Including a much larger proportion of exotic animals questions in the exams for preclinical years would encourage students to take a bigger interest in this area, and lay the foundations for further clinical learning. Doing so allows clinical years to focus on less remedial examination material in this section. “Exotics” covers a huge number of species from completely different taxonomic groups, and as such cannot be examined by one or two questions about one or two species. Have an exotic component of the practical exams – at least one exotic OSCE. 1. 2. 3. 4. 5. 6. 7. 8. Clinical years Include more lectures (of greater depth) on medicine and surgery of all major groups of exotic animal. This could be as individual lectures per group of exotic animal, covering the entire of medicine and surgery of that group, or by having “common disorders of exotic animals” at the end of the relevant body system sections of the CAS course. Lectures should aim to cover common presentations and emergencies which are likely to be encountered in the field of small animal practice (such as anorexic chelonians and hypocalcaemic parrots). Provide more practicals on clinical examination and restraint of a broad spectrum of species. These can be held in the proposed new exotic animals unit (see above). Clincial case studies should be provided, even if only to be worked through in students own time. Exotic animal PBLs or VILAs would be highly beneficial. Exotic animals should be made far more examinable, making up a significant proportion of written papers. Other veterinary schools have entire examinations and rotations dedicated to this field. At least one clinical exotic animals OSCE per year should be provided – not preclinical ones at this stage! Above all, exotic animals should be taken far more seriously by the Small Animal Hospital. A long term goal would be to install a clinical exotic animals department to allow proper clinical teaching on the subject. (Exotic animals are common and can be of a high economic value. They can also be insured!) For the short term, inclusion in rounds would be very useful in making students more aware of what is happening with exotic animal cases. To help move towards these goals, GUVS could liaise with other veterinary (or indeed zoological) institutions which already possess a bank of resources we could request access to. The time has come for GUVS to start taking exotic animals as seriously as any other aspect of the profession. When we consider certain aspects of the RCVS ten principals on the responsibilities of a veterinary surgeon, it can be seen that it is a professional responsibility to have knowledge of the husbandry, medicine and surgery of exotic animals which may very easily be placed in our care. “1. A veterinary surgeon must: a. treat all patients of whatever species, humanely, with respect, and with welfare as the primary consideration” http://www.rcvs.org.uk/Templates/Internal.aspNodeID=89720∫2ndParentNodeID=89717∫1stP arentNodeID=89642 It can be appreciated that, in this current economic clime, a complete overhaul of the teaching of exotic animals, as well as setting up a dedicated, diverse and accessible exotic animals unit may be considered difficult in terms of the expenditure of financial and temporal resources. We do, however, firmly believe that this is a necessary step in order to ensure that Glasgow remains at the forefront of veterinary education. We are very keen to discuss these proposals further, and are available to offer our assistance in achieving these goals. We thank you for your time and look forward to your feedback Mark Naguib BVMS MRCVS mark.naguib@virgin.net Liam Reid BVMS MRCVS liamreid@gmail.com Samuel Kerr, final year student 0505985k@student.gla.ac.uk