Spay clinics give veterinary students early surgery experience

Some veterinarians will perform thousands of spay surgeries in their career, but there is always a first one.

Second-year students at the Virginia-Maryland College of Veterinary Medicine are being afforded that rite-of-passage opportunity this semester while helping regional pet owners receive free treatment and vaccinations for their dogs and cats.

“It’s the first time that we take the training wheels off,” said Virginia Edwards ’07, DVM '12, collegiate assistant professor and service chief for Animal Care in Education. “We guide them a lot in this lab, but the level of responsibility that we expect from them in this lab is at a much higher level than what they have experienced thus far in the curriculum. The students know that this is a big deal. This is the first time they’re going to get to practice all those doctor things they’ve been learning for two years.”

This semester was the first time that dogs and cats for the spay lab were mostly drawn from those owned by individuals and families as opposed to primarily shelter animals, although shelters can also participate in the program. Although the spay clinics have filled up this spring, qualifying pets can be spayed in the “animal instructor” program free of charge to owners in future terms.

“We started the animal instructor program late last year and rolled it out for the first time this semester” said Edwards “It allows anyone to go online and sign up their patient, there's a questionnaire that you fill out about your patient just to make sure that they meet the minimum age and weight requirements that we have for the lab.”

The process begins on Wednesdays with setting up the table for surgery, organizing supplies, performing physical exams and diagnostic workups on the animal patient, and preparing anesthesia machines and developing anesthesia protocols for each patient, who are delivered to the college that day for their initial health checks.

Thursdays are surgery days, though students have rolled it over in their minds for days before.

“It’s the anticipation, everything building up before,” student Taylor Holmquist said. “Every wrong scenario going through your head beforehand.”

“For me, literally just the buildup to it is the worst part,” student Drew Myers said. “And then as soon as we enter the operating room, we are perfectly fine. So the preparation aspect is the hard part for me.”

And other coursework doesn’t stop. “The most difficult part of the whole surgical experience was trying to balance time spent on surgery preparation and studying for classes,” student Roberto Steele said. “In the days leading up to the surgery, I put all of my focus on preparation for it. Therefore, the weekend afterwards was particularly difficult for me because I had two exams the following Monday.”

Michael Nappier, clinical associate professor in community practice in small animal clinical sciences, said his “head is on a swivel” as he supervises students performing their first spay surgeries. A dozen “stop points” are worked into the procedures where the most common mistakes can be made.

“It’s easier to work with students doing their first surgeries because they know what they don’t know than it is someone who thinks they know more than they know,” said Nappier.

While there is constant beeping of machines and the scurrying to and fro of gowned and masked veterinary students and instructors that one might expect, the atmosphere is not tense, with popular music playing in the background and professors’ comments occasionally drawing a laugh.

“The clinicians definitely do a lot to lighten things up, to help ease our stress,” Holmquist said. “And our teammates, we help uplift each other.”

Students are divided into pods of three people who alternate roles as surgeon, anesthetist and assistant surgeon during the course of three labs spaced four weeks apart for each group.

Edwards said that while most students will say surgeon or anesthetist is the hardest position, she points out to them that the assistant surgeon may be the most difficult role, as that person has to step in as either surgeon or anesthetist if someone filling one of those roles can’t participate or continue for some reason.

The importance of the assistant’s role wasn’t lost on Mike Migliore, who served in that capacity in a late February spay lab.

“So for my role as assistant, I have to be able to anticipate my surgeon's needs, so I need to be aware of what steps we are on and what is coming next,” Migliore said.  “The assistant needs to be aware of everything, all of the procedures for the whole thing. And so last night, I went and rewatched a video that goes through the whole spay process for a feline patient.” The college regularly creates these teaching videos for the tasks ahead of them.

Once the surgeries are complete, the patients are wheeled into a recovery room where they gradually recover from anesthesia under the close care of students and their instructors. The pets are given extensive health checks by the students on the following evening and morning before being released back to their owners.

That leaves students to reflect on all they’ve learned and experienced, and to prepare for their changing role in the next round.

“The hardest part of my first spay surgery was actually handling real tissue and getting a feel for it compared to the suture pads we practice with at home,” said student Derwin Foreman. “It also was difficult to remember everything in that moment because it is a rather stressful - and fun - process.”

But there should also be time to appreciate what they have accomplished.

“When we finish that surgery, I tell the students to give each other a high five, you deserve it,” Edwards said. “You have done an amazing thing just now. you should celebrate. It’s a big deal.

 “In the end, everyone wins: the patients, the students, the faculty that nurture the learning, and the local community.”