New residency boosts Veterinary Teaching Hospital's critical care service
Taking a program to the next level requires leadership and resources.
For the Small Animal Emergency and Critical Care service at the Veterinary Teaching Hospital, that leadership arrived in 2020 with the hiring of Bobbi Conner at the Virginia-Maryland College of Veterinary Medicine.
"When I came here five years ago, the idea was that we want to build up the emergency and critical care service, because we think that's really important for our students to learn," said Conner, clinical professor and service chief for emergency and critical care. "And I 100 percent agree. That's been my main focus for the past five years."
With the recent hiring of Tanya Mitjans as the first emergency and critical care resident, Conner’s initial vision has largely been fulfilled.
"When I came, I was pretty clear that I eventually would want to develop a residency to continue to develop the emergency critical care specialty and how we're training people,” Conner said. “So that was always, always very important to me."
Gift supports vision
An important infusion of funding to bring Conner's vision to reality came in the past year: a $4 million gift to the veterinary college at Virginia Tech from animal advocates Karen Waldron and Shawn Ricci. Half of that gift supported upgrades to large animal emergency service, while the other $2 million funded the hiring of another small animal critical care clinician and a resident for the service at the teaching hospital.
"It's the Waldron and Ricci gift that has allowed us to build the team in advance of dire need," said Conner, who also serves as president of the American College of Veterinary Emergency and Critical Care. "What often happens, in my experience, is emergency services grow way faster than we can keep up with, and that can lead to not providing the quality of patient care we hope to. It can also lead to burnout among the staff.
“So allowing us to hire an additional critical care expert and start the residency earlier than we had originally planned allows us to grow the team and establish the quality of care that we really want to, before we outgrew it, setting us up for long-term success and continuing to attract more and more quality people."
Growing and expanding
Michael Kato recently joined the team as an assistant professor of emergency and critical care, and Mitjans has been added as the service's first resident — an important milestone in the growth of the program, Conner said.
Another milestone lies ahead as a Veterinary Teaching Hospital expansion and renovation moves through the planning and design stage, with groundbreaking currently planned for December 2026.
The expansion, still seeking $9 million in private donations to maximize its full potential, would provide emergency and critical care with modernized space, enhancing the educational benefits to students and veterinary service to the regional community.
The service handles new emergency cases, including those brought in by pet owners and others referred by veterinarians for specialty care. The emergency team decides if a case needs to see a different specialty or if it can be managed directed by the emergency and critical care team.
The service can help prioritize which cases need urgent transfers to another hospital service and which can wait for an appointment. Some of the cases can be managed directed by the emergency and critical care team, reducing the burden on some of the other specialty services.
"We're building a team that people want to come work at,” Conner said, “and we've been really excited about the impact that has had.”
Ready to learn and teach
Mitjans exemplifies the importance of continued learning as a resident in emergency and critical care.
"I was in general practice for two years, and I would see the need for urgent care and emergency services even in a general practice setting," Mitjans said. "I felt that I needed to know more to help these patients in their most critical time. Those are the precious moments that we have to intervene."
Born in Chile before growing up in Miami, Mitjans earned her Doctor of Veterinary Medicine from the University of Florida in 2022. She spent two years in general practice in the San Francisco Bay area before transitioning to emergency medicine with the Veterinary Emergency Group.
“While in general practice, I found myself in emergency situations that pushed me to grow beyond my comfort zone,” Mitjans said. “I decided to take my education a step further by beginning emergency training with another company and seeking mentorship. The more I learned, the more I wanted to know. I kept pursuing every opportunity to expand my skills, and eventually came across this residency program—and here I am.”
Coming to Virginia Tech as the emergency and critical care resident in the Veterinary Teaching Hospital meant reconnecting with a previous mentor.
"Dr. Conner and I actually know each other from the University of Florida," Mitjans said. "She was my emergency professor when I was a veterinary student at the University of Florida. I already knew of her and knew and had worked with her in the past, and this is something I want to focus my career on. So it was the right time and place for me."
Mitjans looks forward to continuing to learn surgery during the residency and to the teaching aspect of her work, particularly given her master's degree in education.
“We’re expected to go out into the world and teach our nurses and educate clients, but no one really tells you how people learn,” Mitjans said. “Being in a course that focuses on that for three hours each week discussing how students learn, how we can facilitate that process, and how to tap into the psychology behind it made me realize that maybe the difficult concepts we teach don’t have to feel so hard for students.”
Mitjans said she is excited to pioneer the new role.
“I’m honored to be the first,” Mitjans said. “It’s exciting to contribute to a developing program. I have tremendous respect for my mentors and colleagues, it’s been a rewarding experience so far and hopefully for the entire length of the program. I hope to set a strong foundation and positive example for future residents.”
Plan begins to take shape
Conner said plans to improve the teaching hospital's emergency and critical care capabilities were "already in progress" when she arrived.
"There was a recognition before I got here that we need somebody to come and do this," Conner said. "My goal when I came here was that eventually I need to hire enough criticalists so that we can then start a residency."
Adding Kato to Conner and Laura Vega gave the emergency service three board-certified emergency veterinarians to oversee the handling of cases and teach students. The addition of Mitjans as resident expanded the capability to take cases around the clock without overburdening any individual clinician.
"What the Waldron/Ricci gift really allowed us to do was look ahead and say, not where are we right at this moment, but where do we want to be?" Conner said. "And rather than waiting until we got there with not enough resources and not enough people and not enough training, let's set ourselves up for success. Let's put the pieces in place. Let's put the resources in place so that we know, as we grow, we can continue to do a good job, and we're not playing catch-up."
Over coming years, as word spreads about the 24/7 availability of a dedicated emergency service and demand continues to increase for emergency veterinary services in the region, Conner expects further growth in the service.
"Five years from now, I see us continuing to grow," Conner said. "What I've seen over the last five years is we are in a community that is bigger than I would have thought. The area that we serve is really quite large and so there's a lot of people out there who still don't even know that we exist. I anticipate getting the word out, and the growth is going to continue.”
"This has been very exciting," Conner said, "because when you have those people in place, you can go to the community and say, 'We're here, we can see your cases, and we'll be able to provide you with a better service.'"
