The veterinary clinical work that you face immediately after graduation is challenging. Your head has been filled with loads of theory, but your experience of clinical practice has been more about watching than doing. Yet now you need to be the one who is doing - and it feels very different. The buck used to stop at the vet who you were watching, but now, all of a sudden, the buck stops at you. You cannot hide, and it’s scary.
You have been trained to be competent, and you now need to learn to be confident.
The great news is that you have been well trained, and you have passed a series of theoretical and practical exams to prove this fact. So although you may not realise that you are competent, you have demonstrated your competence to independent, critical, experienced assessors. Perhaps the only person who needs to be fully convinced of your ability is yourself. And that takes three things: time, patience and journalling.
The passage of time is probably the most important factor that will improve your veterinary clinical skills, and sadly, it’s the one aspect that you can do nothing about. It is almost certain that after five years in practice, you will be a skilled, confident practitioner, comfortable in your role as a vet. You will know your skill sets, and you will know your limits. You will have no problem getting a job: you will be an “experienced vet”.
You can’t hurry up time, but you can, at least, make sure that your time spent in practice is in workplaces that treat you with respect, that have high standards, and that take steps to nurture your developing talent.
As time passes, week on week, month on month, year on year, you will gradually learn to believe in your clinical skills as a vet, and bit by bit, your confidence will grow.
As a new graduate vet, it’s easy to get frustrated with yourself. In your enthusiasm to diagnose a case of Addison’s Disease, you miss a linear partially obstructing foreign body. And in your efforts to make an accurate diagnosis of a dog with a complex allergic skin condition, with skin scrapes, biopsies and blood tests, you lose the client to a local vet who prescribes prednisolone to anything that itches. It’s easy to become disheartened, and it’s important to be patient. Don’t blame yourself. You are learning about this stuff. Perhaps next time you will judge a client differently and spot the signs that they are not fully accepting your message. As time passes, you will get better at matching client expectations with the best possible scientific approach. But be patient with yourself over such hiccups: they are not the end of the world.
The third way to gain confidence in your own ability is the simple technique of journalling. This means literally keeping a journal of the cases you see. You don’t need complicated technology to do this: a simple notebook in your pocket is all that’s needed. And you don’t need to write down every consultation that you take: most vaccine boosters and new puppy/kitten consults can be skipped over. But you should try to write down the details of every case that you find medically or surgically intriguing. You will have no problem deciding on the appropriate investigations and treatment: you have been trained to do this. But you may have a challenge really believing that your approach will fix the problem, and this is how journalling helps. There are three aspects to it:
a) Write down the case details at the time.
Be honest; write down everything about the case that you noticed. It can be difficult fitting this into a busy day of consulting, so you may prefer to simply write down the owner details, and go back to the clinic consulting notes later. Or you may prefer to go high-tech, using a speech-to-text programme on your mobile phone to dictate the text rapidly into a mobile phone app to store the information. It doesn’t matter how you do it: the key thing is that you record that you have seen this animal. If you don’t do this, it will soon be lost in the swirl of an over-busy medium-term memory.
b) Do some research into the case during a quiet time
When you have free time, read up about the case. So it was an itchy ear? Read a summary of the best way to approach itchy ears. It was a cat that was drinking more water? Remind yourself of the right way to work up this type of case by spending ten minutes reading up on it. There’s so much information available online now that there are multiple outlets that will let you double-check that you have done everything you ought to have done.
c) Follow up the case
This is critical: make a note in your diary to contact the owner two or three days later. A simple phone call is all that’s needed. “Hi, this is the vet. I’m just calling to make sure that Fido has settled down well now”. Many young vets worry that this type of phone call might be perceived as a sign of weakness, as an indication of lack of confidence in your treatment. The truth is that nearly all owners adore this type of interaction; it tells them that you care, and above all else, caring is what pet owners want vets to do.
In most cases, the patient will be doing very well, thank you very much. And you will have earned another few degrees of the self-confidence and self-belief that gradually accumulate inside you as you become the confident, self-assured experienced vet that you aspire to be.
Journalling as a career-long habit
As time passes, you may feel less inclined to do as much journaling, and you may not wish to follow up as many cases. But it’s a good habit to learn for the long term as well: as a vet, you see interesting cases nearly every day, but if you don’t find some way of recording them, you will soon forget all about them. So a few minutes spent every day writing down some of your more intriguing cases will create a long-term interesting resource.
When you are asked to give a talk at a local school, it’s handy to be able to refer to real-life cases. And if you have to write a piece for a local paper, you can’t beat an animal tale from your own clinical casebook.
James Herriot, the world’s most famous veterinary author, started his writing career by journalling; without the resource of the many years of cases that he’d seen, he could never have written his best-selling books.
You never know where the simple discipline of journalling may lead.