Small Animal Internal Medicine

Objectives | Faculty and Staff | Prerequisites and Applications | Employment and Benefits | Orientation | Advisors and Mentoring | Clinical Service Responsibilities | Teaching Responsibilities | Educational Opportunities | Graduate Program | Research and Scholarly Activity | Evaluations | Specialty College Requirements | Expectations |

Objectives

  • Acquire comprehensive expertise in the state-of-the-art practice of small animal internal medicine
  • Fulfill all ACVIM criteria for Board Certification in Small Animal Internal Medicine
  • Prepare for the Small Animal Internal Medicine Specialty Certification Examination
  • Attain additional experience relevant for future career goals in teaching, clinical research, scientific publication, or specialty practice
  • Earn the Master of Science degree following completion of appropriate-level research endeavors

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Faculty and Staff

Faculty 

  • Susan E. Johnson, DVM, MS, DACVIM (SAIM); SAIM Service Head
  • Julie K. Byron, DVM, MS, DACVIM (SAIM)
  • Stephen P. DiBartola, DVM, DACVIM (SAIM)
  • Chen Gilor, DVM, PhD, DACVIM (SAIM)
  • Valerie J. Parker, DVM, DACVIM (SAIM)
  • Karen M. Tefft, DVM, MVSc, DACVIM (SAIM)
  • Robert G. Sherding, DVM (DACVIM-SAIM) (Professor Emeritus)
  • Dennis J. Chew, DVM (DACVIM-SAIM) (Professor Emeritus)

Current Residents

  • Alicia Dudley (2011 – 2014)
  • Melanie Hall (2011 – 2014)
  • Katie McCool (2013 - 2016)
  • Adam Rudinsky (2012 – 2015)

Staff Members

  • Joy Quang, RVT (Special Procedures Room Supervisor)
  • Robin Richardson, RVT (Service Coordinator)

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Prerequisites and Applications

  • Applicants must meet all admission requirements to The Ohio State University Graduate School without conditions (refer to Residency Program Handbook, CVM Graduate Program Handbook, and Graduate School Handbook).
  • Applicants must be graduates of an AVMA-recognized or faculty-approved College or School of Veterinary Medicine, with academic standing in the top 50% of their class.
  • Applicants must have completed a one-year rotating internship or acceptable equivalent clinical experience.
  • Residents who are foreign nationals (non-US citizens) must be in possession of appropriate visas and work authorization as outlined in the Department of Veterinary Clinical Sciences Residency Program Handbook. In addition, foreign nationals must also meet OSU Graduate school requirements for the Test of English as a Foreign Languages (TOEFL) or Michigan Test of English Proficiency (MTELP).

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Employment and Benefits (see Residency Program Handbook)

  • Salary
  • Health insurance
  • Travel allowance
  • Personal and professional leave allowance
  • External consultation and employment
  • State licensure benefits

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Orientation

  • All new residents participate in a comprehensive orientation program during the first week of their program; purpose of this mandatory orientation is to introduce them to the department, college and university, allow completion of all necessary documentation, and to facilitate integration into OSU and College of Veterinary Medicine program and activities.
  • New small animal internal medicine residents are provided with the following information during their orientation to the service:
  • Roster of all small animal faculty and residents
  • SAIM residency program description
  • SAIM Clinic Schedule
  • Journal Club Schedule (Fridays, 8:00 – 9:00 AM)
  • Small Animal Intern Orientation Handout
  • SAIM Senior Student Rotation Syllabus (VM 7700.03)
  • SAIM Senior Student Topic Presentation Schedule
  • SAIM Senior Student Morning Rounds Schedule
  • Resident Performance Evaluation Form

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Advisors and Mentoring

Clinical advisor

Each resident is assigned a clinical advisor at the beginning of the program.

Research/Academic advisor

Dr. Gilor serves as the interim academic advisor for all incoming residents. A permanent research advisor is assigned once the resident has identified a research area of interest.

Thesis committee

Once the specific area of research is selected, an Advisory committee will be formed to provide advice in the development and execution of a specific research project.  The Advisory committee typically serves as the Examination committee for the thesis defense. Advisory committees must consist of at least 3 members of the graduate faculty.

Mentoring

Case management is carried out under the guidance of and in collaboration with faculty who are recognized experts in their respective fields.

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Clinical Service Responsibilities

  • The resident spends approximately 126 weeks in scheduled clinics within the Veterinary Medical Center over a 3-year period.
  • Clinical experience includes primary care of dogs and cats with urinary, gastrointestinal, endocrine, respiratory, neurologic, infectious, hematologic, immune-mediated, cardiac, and multi-systemic disorders.
  • Additional clinical experience is obtained through rotations on the oncology, cardiology, and neurology services, and one week in ultrasonography on the diagnostic imaging service. Other specialty services available for clinical interaction and consultation include emergency/critical care, dermatology, ophthalmology, clinical nutrition, clinical pathology, anatomic pathology, diagnostic imaging, theriogenology, anesthesiology, soft-tissue surgery, and orthopedic surgery.
  • Residents provide back-up consulting support of interns during their rotations through the emergency service.
  • Rotations facilitate development of clinical proficiency and knowledge of internal medicine through exposure to a wide variety of cases at all levels of complexity. A rich variety of case material is referred to the OSU Veterinary Medical Center from the greater Columbus metropolitan area, as well as a referral base that includes Ohio, Indiana, Pennsylvania, Kentucky, West Virginia, and Michigan.
  • State-of-the-art equipment and facilities are available to develop technical expertise in advanced diagnostic and therapeutic procedures.
  • Residents are responsible for assuming primary care of emergency transfers from evening and overnight emergency clinics, regularly scheduled daytime clinics, and from the daytime emergency service. 
  • All hospitalized small animal internal medicine cases and any cases transferred from the emergency service must be examined by residents by 8:00 AM (or earlier, if residents are in class from 7:00 – 8:00 AM).  Residents are expected to be on the clinic floor (both visible and engaged) at all times during clinic receiving. Daily morning House Officer Rounds start at 9:15 AM.  Be prepared to succinctly yet completely present any emergency transfers and to update the service on your hospitalized patients.
  • Afternoon senior student rounds are Monday through Thursday from 4:00 – 5:30 PM. Patient releases and owner visits should be completed prior to 4:00 PM, or not start until after 5:30 PM, so that students are able to participate in all aspects of patient care.
  • Residents are responsible for reading and commenting on student SOAPs for all hospitalized cases.
  • Residents are expected to help the SAIM Service Technicians (Joy Quang and Robin Richardson) and Special Procedures Room Technician (Pam Pugh) maintain the FileMaker Pro clipboard. This database of cases allows information on any patient to be retrieved by name, case number, or other identifying information.
  • Residents must complete their medical records in a timely fashion. Please diagnose charts promptly.
  • Residents must complete their endoscopic reports on the same day that procedures are performed.
  • Residents must communicate with referring veterinarians in a timely fashion. Referring veterinarians should be called when the animal is hospitalized, and again when the animal is released. Copies of hospital release instructions are distributed to medical records, the referring veterinarian, and the owner. It is the clinician's responsibility to be sure a copy of the Release Instructions is placed in the Referral box for faxing.
  • Residents are scheduled for personal enrichment blocks to facilitate research opportunities, during which they time they are free from scheduled service duties and clinical case responsibilities. Enrichment time is provided to allow pursuit of course work, independent study, research, thesis writing, publication, or other elective endeavors. The off-clinic time available for each resident enrolled in the combined 3-year residency-graduate (MSc) program is 24 weeks.
  • Residents who are 'off clinics' are expected to come to work every day and primarily perform their off-clinic activities on the Veterinary campus. Phone messages must be checked at least once daily and all follow-up communications with previous clients are handled by this resident until the patient returns to see another clinician.
  • All personal time (i.e. vacation) and professional leave must be taken during off-clinics time.
  • All leave of absences (both Personal and Professional Leave) require approval of your supervising faculty members and the Service Head using the required University form (available from the Departmental office).

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Teaching Responsibilities

  • Primary teaching responsibility of all residents is clinical teaching of senior veterinary students assigned to the small animal internal medicine clinical service.
  • The resident should strive for a balance between efficiency and the learning needs of the students during receiving of clinic appointments. Students should be encouraged to develop their Temporary Problem List (complete with problems, differential diagnoses, and treatment) while waiting for the clinician to discuss the case. If time is short, the clinician and student can develop the TPL together. A detailed discussion of pathophysiology involved in the case should be deferred until after receiving is finished. The wait time for clients should be minimized when possible (or realistic estimates of time required for initial evaluation, and options such as leaving the patient for the day or hospitalization, should be discussed). Release instructions for outpatient visits should be brief and target client information and recommendations.
  • Residents also participate in teaching small animal technical skills to pre-clinical veterinary students during laboratories. All residents are required to teach when assigned in the third-year Small Animal Medicine Techniques laboratories. Attendance at these laboratories is mandatory.
  • Interested residents will be provided with opportunities to develop lecture skills by preparing and delivering selected formal classroom lectures to professional first through third year veterinary students.
  • Topic Presentations are held on the second Friday of each 2-week block from 3:00 – 4:30 PM in VMC 1103. Topic Presentation rounds involve formal presentations by each core student on the SAIM Senior Student Rotation. Faculty and residents in SAIM are assigned to supervise Topic Presentations according to the published schedule. Brief planning ward rounds are held promptly at 4:30 PM after Topic Presentations.

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Educational Opportunities

  • Numerous specialty seminars, conferences, and journal clubs are available to residents.
  • Attendance at weekly Clinicopathologic Conference (Tuesday 8:00 – 9:00 AM in VMC 1103) is required.  Case presentations by faculty, residents, and interns provide an opportunity to enrich clinical problem-solving skills and pathophysiology.
  • Graduate-level courses in small animal medicine provide residents with course material for partial fulfillment of MSc degree requirements. In addition to graduate courses required by the Department (i.e. the VCS Research Methods series), SAIM residents are required to enroll in 'core' Internal Medicine courses, including Respiratory, Gastroenterology, Hepatology, Urinary, Neurology, Cardiology, Hemic-Lymphatic, and Ultrasonography.  Residents not enrolled in the Graduate School are still required to attend all core courses. It is the view of the SAIM Faculty that these courses are essential for clinical residency training and specialty board preparation.
  • 2nd- and 3rd- year SAIM residents typically attend the annual ACVIM Forum in conjunction with sitting the board examinations. The 1st year resident is scheduled to be on clinics during ACVIM Forum week.

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Graduate Program (see Residency and Graduate Program Handbooks) 

  • Continued satisfactory progression in the Small Animal Internal Medicine residency requires concurrent enrollment in the Master of Science program, and all residents are expected to maintain their coursework without compromising clinical responsibilities. Senior faculty and other residents on the rotation will maintain flexibility in scheduling so as to accommodate required coursework.
  • Significant research and a thesis leading to the MSc degree are required of residents in the 3-year combined program. The college's Council on Research reviews proposals and administers funds for research projects. Opportunities also are available to collaborate on extramurally-funded research projects with faculty in the Department of Veterinary Clinical Sciences, Department of Veterinary Biosciences, or other departments on campus.
  • With the assistance of the research advisor, residents should identify potential research projects and sources of funding early in the residency, and within the first 3 months, begin developing a research grant proposal to obtain funding for their research project.
  • Residents must enroll in College graduate courses each quarter to accumulate sufficient credit hours to fulfill MSc requirements. Enrollment in "Research Methods" courses should occur as soon as possible.

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Research and Scholarly Activity

  • Residents must submit at least one scholarly paper to a refereed journal prior to completion of the residency program.
  • Residents in the graduate program must prepare and defend a thesis of their research endeavors in partial fulfillment of requirements of the MSc degree.  Preparation and submission of thesis research for publication is expected.
  • Additional opportunities may arise for original research on extramurally-funded research projects with faculty in the Department of Veterinary Clinical Sciences, Department of Veterinary Biosciences, or in other departments on campus; resident participation in these activities is encouraged.

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Evaluations

  • Residents receive verbal feedback from faculty clinicians on clinical performance during each clinical rotation.
  • The clinical advisor and other members of the SAIM faculty, with additional input from clinicians in other specialties with whom the resident has interacted, formally evaluate all residents every 6 months.
  • Faculty members complete a resident evaluation form (as adopted by the VCS Departmental Graduate Studies Committee) and present their assessment to the resident for discussion.
  • Once finalized, the evaluation form is signed by the resident and the clinical advisor and other evaluating faculty members, and distributed to the resident, Department Chair, Service Head, Residency Director, and the Graduate Studies Committee Chair as a matter of record.
  • Please refer to the Residency Program Handbook for additional information about the VCS evaluation process for residents.

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Specialty College Requirements

  • We offer a comprehensive didactic and clinical training program that provides excellent preparation for successful completion of the ACVIM general and specialty board certifying examinations.
  • Residents must register with the American College of Veterinary Internal Medicine within 90 days of beginning their residency. Information about registration and the General Information Guidelines of ACVIM can be found at: http://acvim.org/websites/acvim/File/2012-2013%20GIG,%20final.pdf
  • Residents are responsible for being familiar with all requirements for ACVIM Board Certification and with the General Information Guidelines of the ACVIM (http://acvim.org/websites/acvim/File/2012-2013%20GIG,%20final.pdf)

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Expectations

What we expect of residents

  • Residents must provide service to the patients and owners of the Veterinary Medical Center, and be active participants in the teaching and research missions of the Department of Veterinary Clinical Sciences.
  • Residents serve as primary managers ('chief operations officers') of the internal medicine service. They work long hours and manage the majority of cases admitted to the service via standard clinic appointments, transfers from other services, and emergency transfers. Senior faculty may in some instances admit cases to facilitate case flow during appointment times, and are available for consultation on all cases on the service.
  • Residents serve as the first level of supervision of senior veterinary students and interns.
  • Cases admitted by senior faculty may in some instances be managed by the resident, depending on the needs of the resident and faculty.
  • Residents are not required to take on primary after-hours emergency duty, but must be available to provide back-up consultation and assistance for interns on the emergency service.
  • Residents will manage most patients admitted to the ICU. Even when not directly managing ICU cases admitted by senior faculty, the resident should follow these cases and check treatment orders.
  • Weekend coverage of small animal internal medicine service patients are the responsibility of the resident(s).
  • Residents must be readily available during clinics so that students can find them easily. Resident clinical teaching commitment includes instruction of senior students both in clinics and during rounds.
  • Scheduling of procedures (e.g., endoscopy) during receiving and rounds should be avoided whenever possible, and requires approval of a faculty member.
  • Patient management choices ultimately are the decision of the attending faculty member. Advice from faculty and other residents during rounds should be given due consideration by the attending house officers.
  • The Small Animal Internal Medicine service functions as a team. Students, technicians, interns, residents and faculty work together to provide optimal patient care, client communication, and student learning.
  • Consultations with other specialty services should be sought as needed. Residents should obtain the approval of their supervising faculty clinician before choosing not to follow a consultant's recommendation. It is best to notify the consultant verbally when anticipating the need for a consultation. Be sure to completely fill out the general consultation request form.
  • Consultation from the Small Animal Internal Medicine Service may be requested by other services in the hospital. We encourage residents to make a preliminary assessment and recommendations. These should then be reviewed with the attending faculty member. Be sure to notify a SAIM Technician so that consultation fees are appropriately charged.
  • Residents should develop a comprehensive knowledge of the veterinary internal medicine literature via regular use of journal articles, textbooks, and on-line databases (e.g. PubMed) in order to provide a sound scientific basis for their medical decisions. Personal clinical experience is important, but should not be used in a vacuum.
  • State-of-the-art equipment and facilities are available to develop technical expertise in advanced diagnostic and therapeutic procedures. Residents will perform gastrointestinal endoscopy, urethrocystoscopy, rhinoscopy, bronchoscopy, and laparoscopy, and may assist faculty in performing lithotripsy. 1st-year residents must have back-up by a faculty member (or approved 2nd or 3rd year resident) to perform any endoscopic procedure. 2nd or 3rd year residents may be approached by other non-SAIM services to perform endoscopic procedures on their cases; this should be coordinated with the resident's ongoing service duties.
  • SAIM residents on clinic duty will have the opportunity to perform endoscopic procedures on cases being managed by intern. Residents should involve interns as much as possible (i.e. allowing them to introduce the scope or collection of a few biopsies) to provide them with an appreciation of endoscopic techniques. Residents who are off service will not be involved in a primary role in procedures except in exceptional circumstances, as their priority is to use of off clinic time for research requirements.
  • All team members, including interns, veterinary students, technicians, reception staff, laboratory staff, and fellow residents) must be treated with respect and collegiality. If conflicts arise they should be resolved with the guidance of attending faculty, faculty advisors, the service head, hospital director, or department chair, as dictated by the situation.
  • Residents are responsible for complying with all university, college, and departmental policies, including official university policies on discrimination, sexual harassment, romantic relationships, academic misconduct, and financial misconduct.
  • Although residents are expected to take considerable initiative and assume a tremendous amount of responsibility for patient management, they must also recognize their limitations based on their level of clinical experience and professional development. A residency is a training program, and residents should actively seek advice and assistance from senior faculty when it is in the best interests of the patient and client.
  • All residents will share equally in weekend duty and emergency back-up for the interns. SAIM residents on clinics (but not rotating through other services such as cardiology or oncology) will establish an 'on call/weekend' schedule, which is mutually agreeable and equitably spaces out weekend assignments. This schedule will be posted on the bulletin board in the IMED Suite and in the Treatment room. The resident who is on weekend duty will supervise all SAIM cases and be on Emergency back-up during the week preceding the weekend duty, and pick-up emergency transfers during the day on Friday.
  • Third year residents are responsible for organizing the weekly Journal Club (or Pathophysiology Review session). All residents, regardless of year, will share equally in the assignments.

Skills to be acquired by Small Animal Internal Medicine Residents

  • Ability to evaluate and treat patients with urinary tract diseases including chronic renal failure, acute renal failure, infections of the upper and lower urinary tract, idiopathic/interstitial cystitis of cats, urinary incontinence, urolithiasis, obstructive nephropathy, protein-losing nephropathy, urinary tract neoplasia, and systemic arterial hypertension.
  • Ability to evaluate and treat patients with fluid, electrolyte, and acid-base disturbances.
  • Ability to evaluate and treat patients with gastrointestinal disorders including inflammatory bowel disease, protein-losing enteropathy, infectious enteritis, colitis, megacolon, megaesophagus, hepatic cirrhosis, chronic hepatitis, hepatic toxicity, hepatic lipidosis, cholangiohepatitis, hepatic encephalopathy, congenital or acquired portosystemic vascular anomalies, pancreatitis, and exocrine pancreatic insufficiency.
  • Ability to evaluate and treat patients with endocrine disorders including diabetes mellitus, diabetes insipidus, insulinoma and other APUDomas, hypothyroidism, hyperthyroidism, pheochromocytoma, hyperadrenocorticism, hypoadrenocorticism, hyperparathyroidism, and hypoparathyroidism.
  • Ability to evaluate and treat patients with chronic or acute nasal disease, upper airway disease, lower airway disease, acute and chronic obstructive or restrictive pulmonary disease, and pleural cavity disease.
  • Ability to evaluate and treat patients with infectious diseases including FeLV, FIV, FIP, respiratory viral infections, common bacterial infections, systemic mycoses, toxoplasmosis, rickettsial diseases, and other infectious diseases.
  • Ability to examine and accurately assess fresh urinary sediment
  • Ability to perform routine upper and lower gastrointestinal endoscopy (gastroduodenoscopy, colonoscopy) including patient preparation and routine care of endoscopy equipment.
  • Ability to place PEG and esophagostomy tubes.
  • Ability to retrieve esophageal and gastric foreign bodies by endoscopy.
  • Ability to perform routine urinary endoscopy (urethroscopy, cystoscopy).
  • Ability to perform routine respiratory tract endoscopy (rhinoscopy, tracheoscopy, bronchoscopy).
  • Ability to assess routine diagnostic images (including digital radiographs, abdominal ultrasonography, computed tomographic, and magnetic resonance images).
  • Ability to assess cytologic preparations of lymph nodes, liver, spleen, and masses, and diagnose commonly encountered abnormalities, including criteria of malignancy.

What residents should expect of the Small Animal Internal Medicine faculty

  • Evaluation of and advice on SAIM cases as well as cases submitted for consultation from other services.
  • On-floor advice during clinic receiving.
  • Evaluation and admission of some regularly scheduled cases for teaching of veterinary students and training of residents.
  • Guidance and assistance during special procedures as needed.
  • Active participation during sit-down rounds.
  • Completion of consults with residents or to critique consults performed by resident. Review of referral letters as necessary (particularly during 1st year of the residency program).
  • Timely feedback about clinical performance.
  • Participation in formal resident evaluations at 6 month intervals and completion of the standardized departmental resident evaluation forms.
  • Guidance and suggestions from the clinical advisor as needed.
  • Guidance from the research advisor in development of research proposal, obtaining funding, carrying out research, analyzing results, writing manuscripts for publication, critiquing the MSc thesis, and scheduling and completing the thesis defense. The research advisor also insures compliance with graduate school procedures and deadlines, and monitors completion of coursework and other graduation requirements.

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Updated 10/29/12