To specialise or not?
Image © kalafoto / Adobe Stock
Choosing the right career path is one of the hardest decisions a vet will ever make.
Many graduates prefer to get a few years in general practice under their belts before making any hard-and-fast conclusions about their long-term futures, while others opt to go down the specialism route at the earliest opportunity.
Path to specialism
It’s fair to say achieving genuine specialist status in one particular area of veterinary medicine is not an easy choice. It requires a huge investment of time and effort — often for limited financial reward in the early years.
Those who embark on this path are typically required to do at least one internship and a highly intensive, three-year residency programme before sitting a gruelling set of exams.
Residencies are run by both private practices and academic institutions, and are highly competitive to get into.
Several paths to becoming a specialist exist, such as attaining an RCVS diploma, completing a European College of Veterinary Surgeons (ECVS) diploma, or passing exams set by a speciality organisation recognised by the American Veterinary Medical Association.
However, to use the term “specialist” in the UK, a vet must satisfy the RCVS that he or she has achieved a postgraduate qualification at least at diploma level, make an active contribution to his or her speciality, have national and international acclaim, and publish widely in his or her field. Specialists must also be available for referral by other veterinary colleagues.
Several vets in Vets Now’s emergency and specialty hospitals in Glasgow, Manchester and Swindon have achieved specialist status, while several more are undertaking residencies. All agree it can be a hugely rewarding career path — but far from easy.
Small animal surgeon Ana Marques completed a surgical internship at a private practice in Manchester in 2003, before starting a residency programme at The University of Edinburgh in 2005. She began working for Vets Now in Glasgow earlier this year.
She said: “The beauty of becoming a specialist is you can do procedures very few other people can do and, perhaps, offer clients and pets a different type of care that otherwise would be impossible to achieve.
“I really wanted to be highly skilled in one area and that’s why I decided to specialise.”
Asked what advice she would give to vets at the beginning of their career journeys who are considering specialising, Dr Marques said: “It really depends on what you want from life and your career.
“It’s actually really difficult being a general practitioner because you have to know a lot about different diseases. But the decision to specialise is not one that should be taken lightly either.”
Vets can choose from dozens of disciplines to specialise in – ranging from anaesthesia, to zoo and wildlife medicine. Among the most common are cardiology, neurology and small animal surgery.
Dan Lewis, who works alongside Dr Marques at Vets Now Glasgow, is a specialist in emergency and critical care (ECC) and runs a residency programme in ECC that provides vets with experience in surgery, medicine, imaging, neurology, ophthalmology, cardiology and anaesthesia.
On securing their diploma, residents are recognised as European specialists and have the opportunity to apply for listing as an RCVS specialist.
Dr Lewis believes graduate vets should try to gain as much experience as they can in as wide a range of disciplines as possible. Then, once they’ve discovered something they love, they should do what they can to keep doing it.
He said: “If you keep doing something you really enjoy, you will become really good at it and people will seek out your opinion. That’s the beauty of specialising.
“For me, ECC is a great discipline. I once worked with a surgeon at the RVC who described ECC as being specialist general practitioners, and I don’t think that’s too far from the truth. We sit in between anaesthesia, medicine and surgery, and our work covers everything from x-rays and ultrasounds to blood work.”
Dr Lewis continued: “We will perhaps stabilise a pet when they arrive, then they will go into surgery, before coming back to us to do the intensive care. We essentially support the patient’s important organs and functions until we, or they, can fix whatever disaster has befallen them.
“As a result, we have a lot of fingers in a lot of pies and because of that, we possibly have a more holistic view of a patient’s pathway through the hospital.”
Tom Dutton, who is based at Great Western Exotics in Swindon, is a European veterinary specialist in avian medicine and surgery. He obtained specialist status in 2017 after completing a residency two years earlier.
He said: “There’s no right or wrong answer to the specialism question. For me, specialising in exotics was a good compromise because it allowed me to do internal medicine, surgery, diagnostic imaging, and so on.
“You’re specialising in a species or type of animal rather than a discipline, so you get the best of both worlds.”
Dr Dutton continued: “I think I would have struggled specialising in pure surgery or pure internal medicine as I’d have missed one of those disciplines. But, then, other vets really like having that high level of knowledge in one particular field. It really depends on the person.
“For some people, it’s a natural progression to specialise. It’s certainly becoming a more common career path.”
Marko Stejskal became a board-certified specialist in the US in 2016 after completing a three-year residency in small animal surgery at the University of Georgia (UGA). He achieved specialist status from the ECVS the following year.
Prior to his move to the US, Dr Stejskal spent 10 years at the University of Zagreb in Croatia, where he focused on surgery, orthopaedics and ophthalmology. He moved to the UK this summer to take up a role as a referral surgeon in Glasgow.
Dr Stejskal speaks passionately about his career journey and specialising. He said: “At the UGA, I remember them asking me ‘so what do you want us to do with you?’ I told them: ‘I want you to take me apart and put me back together the way you think a small animal surgeon should be’.
“They liked that response. I opened up completely. I was 38 at that time, but I felt great being there. I was very privileged because it wasn’t a regular career path.
“While all clinicians need to be rounded, it makes sense to specialise if you really enjoy one field of veterinary medicine. As a general practitioner, you have to deal with a broad spectrum of conditions. That’s really hard.
“My advice would be, if you have a really strong interest in something, pursue it.”
Like Dr Stejskal, Sara Jones wanted to gain experience in several disciplines before pursuing her dream of becoming a specialist. After graduating in 2011, she worked in small animal practices in Merseyside, Lancashire and Cheshire.
Dr Jones started a three-year residency in avian medicine and surgery at Great Western Exotics in late 2017.
She said: “The question of whether to specialise really depends on your own situation and what your interests are. If you’re a mixed practitioner and thrive on variety then that’s no bad thing, and you shouldn’t feel like you need to specialise.
“However, some people feel the need to specialise to be mentally stimulated. It depends on lots of different aspects of your life; people have different priorities. But I find in exotics, even though we’re specialising, we’re doing all the things a mixed practitioner would do.
Dr Jones continued: “We are essentially doing general medicine, but in a specialised area, with more challenging patients.”
However, internal medicine specialist Scott Kilpatrick (pictured left), has a few words of warning for anyone considering going down the specialism route – you have to sacrifice a lot to achieve your goals.
He said: “It’s a very individual choice to become a specialist. I worked extremely hard over four years, taking chunks out of my life to study for little money, and the exams were very tough.
“The whole thing was extremely stressful, so you really do have to dedicate yourself to it. However, it has allowed me to do a job I love and, looking back, it was definitely the right decision for me. People need to make decisions on what suits them the best.”
Vets Now runs internship and residency programmes for vets interested in specialist status. Visit www.vets-now.com/careers for details.
Extra info: specialising doesn't mean having to become a specialist
Vets can still choose to specialise in a field of veterinary medicine without committing to achieving specialist status.
Most of the 200-plus veterinary surgeons at Vets Now, for example, have chosen to dedicate themselves to advancing their knowledge in emergency and critical care, but only a small proportion are genuine specialists.
Increasing numbers of those vets are, however, opting to become advanced practitioners.
Advanced practitioner status is an official recognition of a vet’s particular knowledge and skills in a designated field of veterinary practice. To achieve this, vets must hold a postgraduate qualification, in addition to their veterinary degree, and demonstrate they’re keeping up to date with their knowledge and competence in their chosen area.
Tom Dutton, European veterinary specialist in avian medicine and surgery, said: “For a lot of people, the advanced practitioner step is a good halfway house as you’re not completely dedicating yourself to one field, but you are gaining important further knowledge in the area you’re working in.”