It's 11 p.m. in a small South Korean clinic. A family dog is in emergency labor. The veterinarian is working alone. Grandparents are about to faint. And a 10-year-old girl steps forward to help deliver five puppies.

"It was the most fascinating experience ever," Clair Park recalls of that night decades ago. "That was one of the determining moments."

Fast-forward to today: Park is about to enter one of only seven joint replacement fellowships in the United States at the Virginia-Maryland College of Veterinary Medicine. It's the longest surgical fellowship available — three years, 100 cases, and the pinnacle of what's possible in veterinary orthopedics.

That fascinated little girl? She's now preparing to perform surgery on patients so small their bones are no bigger than chicken bones.

The path to specialty training

Park's journey wasn't direct. After earning her veterinary degree from Cornell University in 2016, she worked three years in general practice with a high surgical caseload.

"I really loved that experience," she said. "It gave me invaluable hands-on exposure and I was fortunate to have opportunities to attend courses and continuing education programs, where I learned new skills and techniques — but it also made me recognize the limitations as a general practitioner. I knew I wanted to offer the most advanced treatment options to my patients, which meant I had to pursue specialty training in surgery."

Park began her specialty training with a rotating internship at the Virginia-Maryland College of Veterinary Medicine, where she was first exposed to total hip replacement surgery under Otto Lanz, professor of small animal surgery and a founding fellow of the joint replacement surgery subspecialty.

This exposure would prove pivotal. Joint replacement surgery requires exact placement of implants, often within a margin of just a few millimeters — precision that becomes even more critical when working across the dramatic size differences in veterinary patients.

"The precision, the skills that you have to have — you have to have a great understanding of anatomy and excellent orthopedic surgical skill," Park explained. "You can't just go in and kind of wing it and do an average job."

Park's fellowship will focus particularly on advancing mini total hip replacement procedures for the smallest patients — those who previously had limited treatment options.

"There has been a change in trend and quite a bit of advancement in mini total hip replacement systems," she said. "It used to be just large breed dogs like German shepherds, but now we have advancement in implant systems and technologies where they can make a femoral stem as small as 3 millimeters (0.12 inch) for small dogs and cats."

The smallest patient that's received a total hip replacement at Virginia Tech weighed just 4.4 pounds. Before these advances, small dogs with hip problems typically received femoral head ostectomy — removing part of the hip joint—which provided satisfactory outcomes but often resulted in decreased muscle mass and persistent lameness.

"When they compare femoral head ostectomy to total hip replacement, the patients with total hip replacement do much better," Park said.

The difference in outcomes reflects the broader evolution of veterinary medicine toward human-standard care.

Advanced imaging technology 

The Virginia Tech joint replacement program currently performs two to three surgeries per week using a C-arm fluoroscopy unit that provides real-time X-ray imaging during procedures.

"We can see exactly where the implants are positioned as we work, which makes a huge difference, especially for our smallest patients where even a millimeter matters," Park explained. "In human joint replacement, computer-aided navigation is standard. While million-dollar navigation systems are not widely available in veterinary medicine, a C-arm gives us a significant advantage in accuracy."

This technology aligns with the college's broader vision for growth and modernization. Last fall, Virginia Tech's Board of Visitors approved a $4.3 million planning authorization for renovation and expansion of the Veterinary Teaching Hospital, with the ultimate scope depending on philanthropy through an ongoing $9 million fundraising campaign.

"This is not just about expanding a building," said M. Daniel Givens, dean of the Virginia-Maryland College of Veterinary Medicine. "This is about our ability to heal. This is about teaching the next generation of students and pushing the boundaries of veterinary medicine."

Global impact and education

Park's influence extends beyond the operating room. She has delivered talks to veterinarians and students worldwide and remained actively involved in global outreach through volunteer surgical work in Thailand, Ecuador, Indonesia, and South Korea.

"I'm planning a total hip replacement course in South Korea next year, which will be the first official course to be held in one of the Asian countries," Park said. "We are also visiting other practices around the world to help them with total medial elbow replacement, which is in development right now."

In recognition of her work, she will present her research in feline total hip replacement at the American College of Veterinary Surgeons Summit.

The future of specialized care

As Park prepares for her fellowship, she reflected on what drew her to this demanding field.

"Once you get there, there's nothing above this. This is the most training you can get as an orthopedic surgeon," she said.

Her mission extends beyond developing surgical expertise to elevating standards globally and advocating for a more inclusive future in veterinary orthopedics.

"Surgery requires what they say — 33 percent of your brain, 33 percent of your heart, and 33 percent is in your hands," Park said. "I think that's the best part — you need to have everything come together to become a good surgeon."

NOTE: Clair Park will start on October 27, 2025.

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