What IS a Veterinary Specialist?

What IS a Veterinary Specialist?


Introduction to becoming a veterinarian

Good afternoon, everyone, and Happy New Year! It’s 2022. My name’s Dr. Greg Kuhlman. I’m a veterinarian. For some time now, I’ve been contemplating, starting a YouTube channel, specifically directed at your pet’s health, any questions that you have about your pet’s health. I have decided that I’m going to start a channel and want the audience to be able to ask questions. The first few episodes are going to be taped and put on YouTube, but eventually, I’d like to do these little episodes live to give you guys chance to ask specific questions that I can address in real-time. The first thing that I want wanted to do was to just give you some information on what it takes to become a veterinarian and the process that it takes to become a veterinarian. So I’ll start there

Then I will address what I do, which is I’m a veterinary internal medicine specialist. So that actually takes a little more training, actually, a lot more training than to become your family veterinarian. I will describe both of those processes. First of all, to become a veterinarian you generally need a bachelor’s degree, but you don’t always, not every veterinarian has a bachelor’s degree. There’s just a list of prerequisite classes at a college-level university that you need to take. It is very competitive to be accepted into a veterinary medicine program, about 10% of people that apply are accepted. And I know the year that I was accepted in a veterinary school at the University of Wisconsin, as you might imagine, that’s where I’m from, Madison, Wisconsin. There were about 33,000 people applying to all of the 29 programs in the US

And about 3200 or 3300 people were accepted. So about 10% of the people that applied were accepted into vet school. And as I said, there’s about 29 vet schools in the country. There have been a few new schools that have started recently, Utah, Arizona, Long Island, Tennessee, all have new programs. So we’re realistically probably in the 33 to 34 schools. If you compare that to medical school, human medical school, there’s about 130 human medical schools in the US. I can be off a little bit with these numbers, but those are pretty close. So I was accepted into vet school. It’s exactly, it truly is exactly the same as human medicine, where it’s a four-year program.

Going to Veterinary School

The first year is your basics as you might understand, anatomy, physiology. Then as we move through the years, we move into pathology. Then we start learning clinical medicine, internal medicine, surgery, dermatology, cardiology. Generally, it depends on the program, but generally the fourth is your clinical year where you work in a vet clinic alongside already qualified, already trained veterinarians. And then completing that at the end you graduate, and you are a doctor of veterinary medicine. Some programs have different definitions other than DVM, but in general, most veterinarians are doctors of veterinary medicine. And so I made that sound very easy, but it is an extremely difficult four years. Almost everyone makes it through those four years, a few people don’t, we did lose a few people out of our class of 80 that I started with, but I think we graduated about 76 people.

I think one of the other big things to remember is that vet school is really expensive. Most vet students, unless they have the ability or someone else has the ability to pay for their school, you’re going to leave with at least $120,000, that’s a minimum, $120,000 in debt. And if you go to some of the private schools, it could be $250,000 in debt. So this is a, it’s really a calling, you don’t go into veterinary medicine for financial reasons. I know that’s something I’ll talk about in a different series, but there’s a big financial commitment and most of my classmates are going to be paying off student loans for sometimes up to 30 years after leaving vet school. So at that point, you are qualified to work as a veterinarian. And of course, vets have many opportunities, what I’m going to be talking about is clinical veterinary medicine, taking care of dogs and cats specifically is what I’m going to be addressing. But there are other, of course, vets are able to take care of any species on the planet, say except for humans.

Most people go into clinical medicine. What that means is they become a general vet and they work in a practice, someplace taking care of dogs and cats, or horses or cows, special species. A lot of people like, more recently, taking care of special species, zoo animals has become more and more desirable, popular for people.

Now that you’ve graduated from vet school, what are you qualified to do? You are qualified to be a veterinarian. You can take care of any species on the planet. I’m going to be specifically, this series is specifically focusing on dogs and cats. That’s what I know how to do. And so I’m going to stick in my lane and talk about that. After you graduate vet school, most people get a job working at a vet clinic someplace, there are other opportunities that after vet school that you can pursue additional training. And that’s what I did. I knew going into vet school. That’s what I wanted to do.

Becoming a Veterinary Internal Medicine Specialist

I wanted to become a veterinary specialist. What does that mean? What is that? Well, it’s just like in human medicine, where you go see your cardiologist, or you go see your internist or your surgeon.

We have those specialties in veterinary medicine as well. Many people don’t know that. I start explaining what I do for a living as an internal medicine specialist and people, they don’t quite understand it. I had one of my good friends two days ago, he asked me about what surgeries I do. And I said “I’m an internal medicine specialist. I don’t really do surgery.” He was very confused. So I want to clear these things up, may not be in this video today, but we will do it in subsequent videos for sure. And we’ll clear this up. Now, so after vet school, if you decide that you want to go on and become a specialist, generally the first thing you have to do is be accepted to an internship program. And an internship program is generally year-long, and it is a rotating internship.


And what that means is you get accepted into a specialty hospital somewhere. It may be a university, it may be a private clinic, but throughout the year, you go through the different specialties multiple times, emergency, depends on what that clinic has, but emergency medicine, internal medicine, dermatology, cardiology, oncology, neurology, surgery, emergency, and critical care. You’ll generally spend anywhere from two weeks to four weeks to six weeks on a service working underneath that doctor that’s in charge of the service. So it’s a very intense year. It was my best professional year of my life, where I think I learned the most. I did my internship at a clinic down in Arizona, at a private clinic in Arizona. And I absolutely loved it. And it was a great learning experience, but it wasn’t easy.

I was tired most of the time. I was challenged most of the time, but I do remember going home many days just feeling amazing at what I had learned, what I had done. That was a good experience. It varies a lot, but I would say about 10% to 20% of veterinarians that graduate from vet school go on and do internships, some do them because they want the additional training. They don’t feel quite ready to be out taking care of dogs or cats yet, other species. And they feel like they have more learning to do. That’s becoming less and less common these days. Generally, people do internships because it’s their goal to go on and become a specialist, become a dermatologist, become an internal medicine specialist, a cardiologist. So at that point, they apply to residency programs, same as human medicine, no different, very competitive, difficult to get, some people aren’t able to achieve that goal or that dream of getting into a residency program.

The “Gregory House” of Veterinarians

Sometimes it takes multiple years and multiple attempts to be accepted into a residency program. So I am an internal medicine specialist and that’s also kind of, most people know what a cardiologist is, or they know what a neurologist is, but people don’t understand what an internal medicine specialist is. I don’t think my mother knows what I do for a living. My job is I’m a little bit like “House.” If you ever saw the TV series, “House, MD,” where our job is to try to diagnose difficult cases of illness, multiple system illnesses in dogs and cats. Generally, often what happens is, a patient presents to their general practitioner, a general vet, and they work with the case, and they realize at some point that it needs more care, more focus, more resources than what they have. And they will refer the case to us, to me as an internist. So the systems that I work with are generally any system other than generally the central nervous system, brain, spine.

Generally, I’m not working with cases of heart disease. Those are cardiologists, but pulmonary disease, immune-mediated diseases, liver disease, kidney disease, and a lot of what I really enjoy. Two areas that I really enjoy are diagnosing infectious diseases and diagnosing chronic gastrointestinal disease, dogs with chronic vomiting, diarrhea, weight loss, diseases of the intestines of the stomach, the esophagus, that’s an area that I really enjoy. And I really, as I said, enjoy infectious diseases as well. So that’s what internal medicine is, is when someone else can’t figure out what’s wrong with your dog or cat, they send them to me, and I may send them to a different specialty once I’ve looked at them, and I’ve had a chance to go through the case.

I might find out that they need the cardiologist, or they need the surgeon, or they need a different specialty, but I’m really sort of the gatekeeper if you will. They come in, they see me, and then it’s my job to figure out and diagnose them and come up with the treatment plan or to get them to the right specialist. So backtracking a bit. What did that take? What did it take to become an internist? So I did my internship. I did vet school. I did my internship. And then I was accepted to Texas A&M University into their program for residency in internal medicine. That was three years. And it was tough.


And I want to say most residents at some point in their career think about, was this the right thing to do? Is this crazy? Should I quit? I think almost everyone in my residency class, at some point, contemplated whether or not they were in the right place. Long hours, many phone calls in the middle of the night, being called in at all hours. I mean, I was there on Thanksgiving multiple times, scoping a Turkey bone out of a dog’s stomach, endoscopy, using an endoscope to remove a bone from a patient’s stomach. So it was a really hard three years, but it was well worth it. And you’re on clinics almost every day, working with the fourth-year vet students, working with the interns, you have your senior clinicians who are in charge of everyone.

But really the residents generally run the hospital. And then at the end of this process, if you get through it, you are what we would call a Board-Certified Diplomate of whatever college you represent, surgery, I’m internal medicine, I’m a diplomate of the American College of Veterinary Internal Medicine and those are my credentials DVM, DACVIM after my name. But it wasn’t that easy. I had to take two exams, two very grueling exams, one after my second year and one at the end of my third year of the program. And you have to pass those, both of those to become board-certified.

My college requires a research project and an accepted peer-reviewed journal article, which I had in that three years. And passing of the exams, a journal article, and a lot of minor other little requirements that you need to, but there are some people that it does take multiple years after finishing their program to finish all the requirements necessary to eventually become board-certified. You may see some specialists, some doctors at a specialty clinic that where it says “practice limited to surgery,” “practice limited to internal medicine.” What that means is they haven’t quite finished all the requirements. This isn’t saying, you shouldn’t go see them. You should. They are well trained, but to get those credentials after their name to be officially board-certified, they may just need their research project finished.

They may need to pass one section of one of their board exams. You don’t know, so don’t discount those people. They’ve gone through a lot to get where they’re at as well. The year that I passed my third-year exam, which is really the most difficult one, 57% of people pass the exam. And I don’t know how many were taking it, but there were over 100 people in the room. So it’s not an easy process and I wanted to just let you know what it takes to become a veterinarian, what it takes to become a veterinary specialist. So how the two of us work together, I think I kind of explained that. Generally, your pet is sick and you take him to your vet, and either he or she is unable to diagnose or doesn’t have the resources.

Working with Your Family Veterinarian

And they refer to a specialty clinic. Generally, at specialty clinics, we don’t have the ability to, we’re not there to be your general vet. We don’t do vaccines. We generally don’t do all of those sort of general wellness procedures that your general vet does. So you do need both, you do need your family vet, your general vet. And if you have a sick pet, you need a specialist to help diagnose and treat them. So we generally work very closely together, phone calls about the patient every day. If I have a patient in the hospital, I send his or her family veterinarian a letter, letting him know what we’ve done that day and how the patient is doing, so that’s how we work together.

Okay. Well, so this is our first episode and I hope it wasn’t too terrible. Thank you for joining in, and we will get back to you in about a week or so. So thank you very much. And I hope everyone has a great 2022. I hope it is much better than the last couple of years. So, all right. Thank you very much.

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