Behavior Medicine Residency

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Objectives

• To provide the resident with the opportunity to become proficient in diagnostic and therapeutic methods in behavioral medicine with a canine and feline focus. 
• To provide experience in the clinical teaching of veterinary students participating in the clinical behavior rotation, as well as contributing to the didactic teaching of pre-clinical veterinary students. 
• To provide opportunity to design and implement one or more research projects in the area of clinical animal behavior. This research must lead to at least publication, in at least one of which the resident is first author, in an approved, peer-reviewed scientific journal in order for the resident to sit for specialty board examination .
• To provide opportunity to communicate clinical findings and concepts to members of the veterinary profession through case reports, scientific articles, seminars, or lectures. 
• To provide exposure to other clinical services in the OSU VMC, including but not limited to small animal internal medicine, neurology, dermatology,. Participation in and rotation through these services is arranged with the clinicians in those services. 
• To advance knowledge in behavior-related subject areas including the psychology of learning, ethology, species-typical behavior patterns, neurobiology of behavior, psychopharmacology, human-animal interactions and animal welfare, behavioral endocrinology, and other areas through participation in clinical rounds and self-directed study. 
• To prepare the resident to practice veterinary behavioral medicine in an academic or private practice setting or prepare them to pursue an advanced research degree in animal behavior. 
• To permit the resident to satisfy the requirements necessary for application for the examination by the American College of Veterinary Behaviorists (ACVB).

Prerequisites and Applications

• All potential residents must meet the minimum requirements and qualifications (see Residency Program Handbook)
• Applicants must be either U.S. citizens or permanent residents of the U.S. the Ohio State University cannot sponsor or process F, J, or H-1B visa applications for resident positions. We also cannot accept TN visas. Successful applicants must be available to report to The Ohio State University Department of Veterinary Clinical Sciences no later than the scheduled beginning of the program.
• Applicants must be graduates of an AVMA-recognized College or School of Veterinary Medicine and have completed a one-year rotating internship or acceptable equivalent clinical experience.
• All requirements must be met to hold and maintain a limited license to practice Veterinary medicine in the State of Ohio – click here for information on licensure requirements.

 Employment and Benefits (see Residency Program Handbook )

• Salary
• Health insurance
• Travel allowance
• Personal + Professional days leave (from policy)
• External consultation and employment
• Licensure
• Tuition assistance

Orientation

• During the first week of the residency program, all incoming residents participate in a comprehensive orientation program to introduce them to the department, college, and university, to complete necessary documentation, and to facilitate integration into our program and activities.
• The Behavioral Medicine Service will provide new residents with the following information as part of orientation:
  • Roster of all Small Animal faculty and residents
  • Behavior Medicine Resident orientation document
  • Resident Performance Evaluation
  • Behavior Medicine Senior Student In-House Elective Rotation Syllabus
  • Clinic Schedule

Advisors and Mentoring

Academic advisor 
The principal academic advisor is Dr. M. Leanne Lilly.

Masters committee (For those residents electing to complete a thesis Master's program)

Once the specific area of research is selected, an Advisory committee will be formed that will consist of the academic advisor and any other faculty members who may be able to provide advice in the development of a specific research project, during the project and to completion of the study. Typically, the Advisory committee serves as the Examination committee for the Masters defense. These committees must consist of at least 2 graduate faculty members.

Mentoring

Case management is carried out with the guidance and collaboration of Dr. Lilly.  For the first three months, the resident will participate in consultations with Dr. Lilly, contributing to analysis of cases and formulation of treatment approaches. Thereafter the resident will have primary patient care and case responsibility, under the regular supervision of Dr. Lilly.

Clinical Service Responsibilities

• The resident spends approximately 132 weeks in scheduled clinics within the Veterinary Teaching Hospital over a 3-year period.
• Clinical experience includes primary case responsibility (referral) of small animal behavior disorders including, but not limited to human-directed aggression, inter-pet aggression, separation anxiety, inappropriate elimination, fears, phobias, compulsive behaviors, and cognitive dysfunction.
• Additional clinical experience is obtained through 2 week rotations on 2 or more of the following services: internal medicine, neurology, dermatology.
• Clinical rotations facilitate development of clinical proficiency, clinical skills, and knowledge of medicine through exposure to a wide variety of cases at all levels of complexity. This goal is facilitated by location of the teaching hospital in a large metropolitan area that provides a rich variety of case material as well as a referral base that includes Ohio, Indiana, Pennsylvania, Kentucky, West Virginia, and Michigan.
• Residents are responsible for all client communication follow up for each clinical case seen, including follow up that may occur while the resident is off clinical behavior service. This follow up includes 3 months of email and phone changes for clients and a final follow up contact at the 6 month point.
• Case rounds will be held with Dr. Lilly at her discretion before and after clinical service days.
• Residents are expected to keep a log of all clinical cases observed and conducted by the resident. This log will include patient signalment, diagnoses, follow up contact points, medications dispensed, and 6 month outcome and any additional log required by the ACVB.
• Residents must complete their medical records within 24 hours of patient departure. 
• Residents should be available for internal consultation from other clinical services during all clinic and non-clinic days, unless on vacation, away for business leave, or on rotation with another clinical service. Dr. Lilly take consults when the resident is unavailable or otherwise occupied.
• Residents must communicate with referring veterinarians in a timely fashion. Referring veterinarians should receive a telephone call within 1-2 days of the patient’s visit. Copies of referring veterinarian report are created in the electronic medical record system and shared with the referral partners. It is the resident’s responsibility to be sure client and referral reports are sent/shared.

Time off clinics - To facilitate research opportunities, residents are given personal enrichment blocks during which they are not seeing cases on behavior service. Enrichment time is provided to allow pursuit of independent study, research, case report writing, publication, or other clinical service rotations. The off-service time available for each resident enrolled in the 3-year residency program is 24 weeks. All personal time (vacation) and professional leave is taken during off-clinics time. Off-clinic residents are expected to perform their off-clinic activities 

•   They must still check their phone messages at least once daily and handle all follow-up communications with previous clients
•     Be available for in house questions about their current patients.
•     A special request can be made for up to 4 additional weeks off clinics – this must be justified for completion of resident research studies or other acceptable activities. It should be noted that residents will not be allowed to accrue this “off clinic” time such that is taken all at once in the 3rd year for boards preparation or the like.
•     All leave of absences (Personal and Professional Leave) require approval of Dr. Lilly and research advisor if not Dr. Lilly using the required University form (available from the Department of Veterinary Clinical Sciences).

Teaching Responsibilities

• Teaching responsibilities include clinical teaching of senior veterinary students assigned to the in-house behavior medicine clinical service elective.
• During appointment days, the resident should strive for a balance between efficiency and the learning needs of the students. Prior to the start of appointments, the resident will meet with students to review their problem lists, differential diagnoses, and questions that the students would like to ask the owner during the appointment. The resident will help the students fine-tune their questions so that the appointment can run efficiently and the students can learn appropriate communication skills, such as asking open-ended questions and politely prompting owners to provide the details necessary for forming an accurate diagnosis and treatment plan. Rounds should end promptly at the start of appointment times so that there is no client wait time upon arrival.
• Residents are expected to provide verbal or email feedback to students on each case and each discharge and brief Dr. Lilly on this feedback if verbal, CC her on feedback if via email.
• Residents will also be evaluating students on Entrustable Professional Abilities for document real time feedback.
• Residents also participate in teaching small animal technical skills to pre-clinical veterinary students during laboratories. All residents are required to teach in the Introduction to Animal Behavior and Handling laboratories as assigned.
• Interested residents will be given the opportunity to develop lecture skills by preparing and delivering selected formal classroom lectures to professional students. 
  Project Presentations are held in the last week of the rotation block – time and location TBD each week, depending on clinical schedule. Project presentations involve formal presentations by each student enrolled in the behavior medicine elective rotation. Both Dr. Lilly and the resident will supervise presentations.

Educational Opportunities

• Graduate-level coursework or Masters Degree
  • Courses are offered at the College of Veterinary Medicine as well as by other colleges at The Ohio State University. Courses that may be taken include advanced animal behavior, research methods, statistics, behavioral genetics, and psychopharmacology, amongst others.
• Numerous specialty seminars and conferences are available to residents.
• Dr. Lilly will hold weekly journal club or book club rounds with the resident.
• Residents are expected to attend the annual Veterinary Behavior Symposium, the ACVB Resident Short Course as well as the behavior tracks at the Midwestern Veterinary Conference.

Research and Scholarly Activity

• As required by the ACVB, a research project will be planned and executed by the resident during the 3-year training period. Dr. Lilly will assist the resident
• Dr. Lilly will assist in identifying potential research projects and provide guidance in preparing proposals to seek intra- and extramural funding early in the residency. The research is typically hypothesis-driven and may be clinical or shelter-based depending on the selected area of study.
• If the resident choose to pursue a Masters degree, the MS research has to be completed and defended prior to completion of the 3-year training program.
•  The resident is required to submit at least one scholarly paper to a refereed journal prior to completion of the residency program. This must be done by March 1st in order to sit for boards directly after residency completion..
• Residents are expected to present at Research Day and at Veterinary Behavior Symposium
• Interested residents may have the opportunity to collaborate in research conducted by Dr. Lilly.

Case Reports

• Submission of 1 formal case report reviewed by Dr. Lilly prior to submission will be required before April 1 of the second year of residency.
• Two additional formal case reports without review by Dr. LIlly are required for submission by October 1 of the final year of residency.
• All case reports should follow the strict guidelines provided by the ACVB.

Evaluation

• Residents receive verbal feedback from Dr. Lilly on clinical duty during each clinical rotation. Dr. Lilly will perform a formal evaluation every 6 months, with additional input from clinicians in other specialties with whom the resident has interacted.
• A formal resident evaluation form (as adopted by the Graduate Studies Committee) is completed, presented to the resident for discussion. Once finalized the evaluation is distributed to the resident, Department Chair, Service Head and the Graduate Studies Committee Chair as a matter of record.

Specialty College Requirements

Each resident must register with the American College of Veterinary Behavior within 90 days of beginning the residency. 
Information about registration and the General Information Guidelines of ACVB can be found at: http://www.dacvb.org/resources/for-veternarians-become-board-certified.

Board Certification

• We offer a comprehensive didactic and clinical training program that we believe provides excellent preparation for successful completion of the ACVB board certifying examination.
• Residents will be encouraged to participate in board preparation courses offered at other institutions during the 3 years of residency. This will be particularly important in obtaining experience in non-companion animal species.

Expectations

What we expect of the resident:

• 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.
• Behavioral Medicine Clinic appointments are of 1-2 hours’ duration, including a behavioral interview with pet owners, physical examination, and laboratory diagnostics, discussion of treatment plan and demonstration of behavior modification. The resident is also expected to formulate, discuss and demonstrate treatment approaches and behavior modification.
• Residents are responsible for seeing clinical appointments one Saturday per month, unless otherwise specified by Dr. Lilly.
• Residents will be expected to see late afternoon clinical cases 1-2 days per week to accommodate exam room space and client needs.
• Residents must be readily available during clinics so that students can find them easily. A major part of the clinical teaching commitment involves residents teaching students both in clinics and during rounds.
• Patient management decisions ultimately are the responsibility of Dr. Lilly. Advice from faculty and other residents during rounds is encouraged and should be given due consideration by the attending clinician.
• The Behavioral Medicine Clinic functions as a team. Students, residents, support staff and Dr. Lilly should work together to provide optimal patient care, client communication, and student learning.
• Consultations with other specialty services should be sought as needed. The recommendations of the consulting experts are followed unless there is some extenuating circumstance. 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.
• The resident will be expected to partake in the perpetuation of evidence-based handling techniques utilized throughout the hospital and pre-clinical years. 
• Residents should develop a comprehensive knowledge of the veterinary behavioral medicine literature in order to provide a sound scientific basis for their medical decisions. Regular use of books, journal articles, and on-line databases (e.g. PubMed, GoogleScholar) will facilitate this process. Medical information management is an essential skill for any clinical specialist. Personal clinical experience is important, but should not be used in a vacuum.
• Residents must treat all team members (e.g., interns, veterinary students, technicians, reception staff, laboratory staff, etc.) with respect and collegiality.
• Students pay tuition and hospital staff are permanent employees who constitute some of our program’s most valuable resources. If conflicts arise, they should be resolved with the guidance of attending faculty, faculty advisor, service head, hospital director (for hospital staff), or department chair (for veterinary students or faculty) 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 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. Consultation with faculty can serve as a valuable learning experience.
• The resident is expected to participate in all new and follow-up out-patient cases of the Behavior Clinic with the exception of planned vacations, attendance at professional meetings, absence due to illness or special arrangement, or when enrolled in other services. The resident will also participate in other behavior services offered through the OSU VMC, including but not limited to Puppy Kindergarten, Shelter Enrichment Team, and Behavior Club activities.
• The behavior caseload of the Behavioral Medicine Clinic is approximately 430 new cases per year (5-10 cases per week) with dogs and cats. The resident will see over 400 new cases during the three-year residency. Telephone and e-mail follow-ups of existing cases are expected. The resident will have opportunities for both brief and extended telephone or email consultations with veterinarians and other animal health professionals, as well as answering queries from pet owners.
•  The resident will be expected to respond to telephone queries and questions routinely referred to the behavior clinic. The resident is expected to take primary responsibility for such consultations as needed, under the supervision of Dr. Lilly. In compliance with ACVB guidelines, and OH state law initial formal behavior consultations will require an in-clinic visit with the animal in order to appropriately establish a veterinarian-client-patient relationship. Rechecks inside the legal VRCP can be done remotely where reasonable.
• The resident will be expected to engage in considerable self-study using textbooks, review and data-based scientific papers as recommended by the diplomate and as suggested by the reading list of the ACVB. Self-study will include learning theory, ethology, psychopharmacology and endocrinology. The residency will focus on behavioral science but will also include related disciplines of anatomy, clinical pathology, ethology, internal medicine, neurology, neuroscience, neurosurgery, pathology, pharmacology, physiology and psychology.
•  Residents are required to log their readings, self studies, and rounds/seminars per ACVB.

What the resident can expect of his/her mentor:

• Availability for evaluation and advice on primary cases and on cases submitted for consultation from other services.
• On-floor availability for advice during clinic receiving.
• Active participation during sit-down rounds.
• Availability to complete consults with resident or to critique consults performed by resident.
• Availability to review referral letters and client discharge instructions as necessary (especially during year one of the residency program).
• Provision of timely feedback to the resident about their clinical performance.
• Timely completion of the standardized resident evaluation forms.
• Participation in formal resident evaluations made at 6 months and yearly thereafter.
• The clinical advisor provides guidance and suggestions to the resident as needed.
• The academic advisor provides guidance in development of research proposal, obtaining funding, carrying out research, analyzing results, and writing and defending the MS thesis (if applicable), and submitting manuscripts for publication.

Updated 8/22/2022