Diary of a Fourth-Year Vet Student: National Board Exam

I took my national board exam today. It was grueling, and I am still reeling.

It doesn't help that, in my current large animal clinical rotation, I am spending 14 hours or more each day at the teaching hospital taking care of patients and being disrespected by techs, house officers, and clinicians. Every day, I am exhausted, demoralized, insulted, infantilized, and frustrated, shit on, peed on, covered in oral meds and spit, dust, mud, hair, hay, stall bedding. I have yet managed to avoid injecting myself with anything untoward and kept most liquids out of my mouth and eyes, but I have stabbed myself more than once with a pristine needle--and those wounds bleed and bleed and bleed. None of these physical or emotional states are conducive to performing well on exams.

I managed to horse trade (species joke, haha) my evening hospital shift last night and my on-call shift tonight so I at least had a break for this very special day to take my national board exam.

The national veterinary medicine board exam consists of six 60-question modules. One of the modules is experimental, intended to evaluate new questions, and it doesn't count towards your final score. You don't know which module is experimental, but to be honest, you can kind of guess. The entire thing is computerized. You are allotted 55 minutes per module plus optional breaks in between. I chose to power through, taking only a 10-minute break at the halfway point to pee and eat some snacks. Even with that plan, I was at the testing center for over six hours...and it was an hour drive there and back on top of that (mysteriously, there are no testing centers in Corvallis).

I'd say that for about half of the questions, I could confidently answer them within a few seconds, and for about 1/3, I had to choose between two answer choices (and I am a shitty guesser), and with another 1/3, I had no fucking clue. Yeah, that's more than 100%. Just roll with it.

Let me assure you that after six hours of that nonsense, if you put a picture of some parasite egg found in the shit of some animal up on the screen, I will always choose to "treat it with ivermectin" or "fenbendazole" if ivermectin isn't an option because jesus christ, it's yet another parasite egg in the shit of some animal. Throw some ivermectin at it and be done with it. Unless it is a tapeworm. Then you treat it with praziquantal. Do you want to know how I remember that? Tapeworms come out the butt in segments, quanta if you will. So praziQUANTAL is the treatment of choice.

And if you have the option of treating some food mammal (cow, sheep, pig) with an antibiotic, and you are pretty sure it isn't a gram negative bacteria and it isn't a virus, then throw some fucking penicillin at it and be done with that too.

Dog ate a wild rabbit and now has swollen lymph nodes and a fever? Tularemia. Turtle with shitty swollen eyes? Vitamin D deficiency. Outdoor cat with open-mouth breathing, neck wound, and muffled heart sounds? Stick a needle in its chest, it's drowning in pus.

I could go on. For hours.

Let's not talk about the complete wild guesses. Sometimes I would read the question and simply have no fucking idea what it was about. Infectious? Parasite? Metabolic? Cancer? (It's always cancer in real life, usually lymphoma). Do I need to think about the drugs to treat it? Sequelae to the disease if it progresses?

Am I a bad vet if I select "euthanasia" as the answer for the dog who drank ethylene glycol 36 hours ago and presents to your clinic comatose. Irreversible kidney damage has already occurred by this time. You can give it fluids but you won't be able to save it. But what is the right answer? To give false hope to the clients and offer to give IV fluids, or to get to the reality of the situation and tell them euthanasia is the only option. Does the national board of examiners want me to give false hope or give reality? I suspected the former so went with IV fluids. In reality, the comatose dog cannot be saved with any intervention after 36 hours. But the board exams don't test reality. They are testing a sort of performative theater of the ideal vet and ideal patient and ideal client, none of which actually exist.

The results of this first round of board exams will be sent out in early January. If we fail, we get a second chance to take the exam in April. The percentage of students that fail the first time is a closely held secret in most vet schools. They only report the pass rate for each class which means the percentage of students who pass the board exams before they officially graduate, not the percentage who pass on the first try.

I have no idea if I passed. It is understood that you are supposed to feel as if you did not pass, then surprise, we pass you after all! The scoring system is arcane, mysterious, shrouded in smoke and glittery distracting bits. Questions have different point values. Your percentile is relative to the scores of your fellow vet students taking the test at the same time as you, meaning your "score" is curved based on various group statistics. If you are stupid and all the other students taking the test that fall are smart, you are screwed. If everyone is stupid and you all do mediocre, then you all pass.

It's done now. I'm off to bed.

Diary of a Fourth-Year Vet Student: Absurd

So we are standing around a stall, looking at a horse we performed surgery on two days earlier. He had dozens of stones in his bladder that we removed. There are several procedures that can be used on horses to remove these kinds of stones, and none of them are all that great. The surgeon presented these options to the horse's owner and she opted for a perineal urethrotomy. In short, we got into his urethra via an incision that we made just below his anus.

Back to the five of us standing around the stall. The burning question was, how do we know which hole the horse was peeing from? There was indirect evidence that he was urinating (areas of wet bedding) but that wasn't sufficient. The surgeon was not willing to clear this horse to go home until we were sure he was peeing from his penis, not the hole we made in his urethra way upstream.

Even though the student had asked that techs look in on the horse every hour since the day before, nobody had actually seen the horse pee. Our discussion was lively but we had no solution to our problem.

Until the horse suddenly started peeing right in front of us! From his penis!

We (four men, one woman, three different countries of origin, mostly areligious) exclaimed as one "Praise Jesus!" Then we collapsed in a heap of laughter.

You know you are in fourth-year vet med clinical rotations when....the absurd becomes normal.

Here is a picture of all the food I made this afternoon. No matter how tired you are, if you come home from the hospital and sleep, you are wasting precious minutes and seconds. You need to prep meals for days in advance whenever you have a chance. And have plenty of pocket-friendly snacks on hand because you might not have the five minutes you need to heat up then eat that nice food during the 14 hours you are in the hospital every day.

Diary of a Fourth-Year Vet Student: Choices

You know you are a fourth-year vet student deep into your clinical rotations and lost to human norms of behavior when you take your pellas off to pee and your pen falls out of your pocket and into the toilet, and you think, "eh, it's been dropped into worse things three times already this morning and I kind of like that pen"... so you fish it out.

I had a dozen exam gloves stuffed into another pocket. No, I didn't use one. Yes, I washed my pen when I washed my hands. I'm not that far gone yet.

This cute goat, my patient for four days, says "hi!"