Photo by Sonia Roselli
Dr. Michele Gaspar
You’ve done it! Four years ago, many of you couldn’t fathom that this day would ever arrive. For most, graduation is a culmination of a lifelong dream. For others, becoming a veterinarian may be a second or third career choice. But for however long you’ve held the dream, no doubt achieving this milestone will be one of your life’s fondest memories and achievements.
Against this backdrop of celebration, know that many of us, who are now your colleagues, realize that you are graduating in very challenging times. Many of you have significant educational debt, others will struggle to find a satisfying job and nearly every new graduate will enter a world of clinical practice that, at times, will confront and confound him or her in ways more significant than any final in a least-favorite class.
To help ease the transition from student to practitioner, I’d like to share what I call “Rules of the Road.” This list is by no means comprehensive, just some worldly advice as you embark on what I hope will be a long and fulfilling career.
Rethink your job description
Most if not all of us come out of the starting gate and think that it’s our job to treat and cure. The realization that many or even most of our clients might not be on board with lots of diagnostics and treatments can come as a shock. Fourth-year clinics often normalize MRIs and CTs, advanced surgeries and chemotherapeutic protocols. So, if you think that clinical practice is about the end-point (diagnostics and treatment), it’s easy to become angry with clients who can’t or won’t go the extra step, and find yourself down the rabbit hole of career disillusionment. Diagnostics and treatment, of course, are ideal, but I ask you to begin to think that your job as a veterinarian is to assess, evaluate and make recommendations. Nothing more. Thinking this way puts the onus of determining next steps on the client, and when you do get the chance to go further with diagnostics and current therapies, you’ll see it as the opportunity that it is.
Identify the clients and patients with whom you want to sleep at night
I don’t mean in the carnal sense, of course. What I mean is, you need to develop the skill to be able to walk out of the room or the hospital at night and not bring the day’s concerns home with you. Admittedly, this is a difficult task and easier said than done. Most of us have spent at least one restless night worrying about a particular patient or concerned about a certain client. I think it’s helpful to understand that we can do only what time and resources allow. Sometimes, the client is the limiting factor, due to finances, poor attachment to the patient or for myriad (and often good) reasons we are not privy to. But it’s important to understand that sometimes we are the limiting factor, either because we’re not at our best, our knowledge base isn’t where it should be or our hospitals and staffs aren’t ideal.
Give your internal critic the heave-ho
Most if not all of us are perfectionists. Psychologists consider perfectionism to be a maladaptive schema, an unhelpful thought process. Perfectionism definitely has some perks; it’s the reason that you made it through a professional curriculum. But the problem with perfectionism is that it often comes from a feeling that we are somehow defective. With this thought (which can be unconscious, so we can’t access it), we believe that we need to work harder and longer in order to rid ourselves of the defectiveness. Perfectionists not only are critical of others, they also are under the thumb of an internal critic who is particularly vicious. Please realize that in this world, there is no perfection. Also remember that when we point the finger at someone, three fingers point back at us. Try to use that pause button we all should have when it comes to criticizing one another. Be gentle with yourself. Treat yourself as a very good best friend would, with kindness.
Tap into your courage
Medical practice isn’t for wimps. It takes courage to go into the trenches each day and try to make the world a little better, a little kinder and a little healthier. Sometimes we feel like Sisyphus pushing that rock up against the mountain, to no avail. Realize that we have all chosen a life of service and that life needs to be considered a privilege; not something onerous. One of the biggest shifts in thinking about what we do is to realize that our job is more about being able to sit with suffering than it is to heal. I believe that many of us fail to understand and appreciate the gravity of this task. That’s not to say that we should tolerate suffering and not try to ameliorate it (as our oath stipulates), but we need to develop the personal resources and mettle that allow us to engage with suffering without being overwhelmed by it. There’s no way to sugarcoat it: Medical practice does mean hours that often extend beyond those of boutique retailers and it often demands that we give up some of ourselves for the greater good. There’s a fine line that separates altruism from masochism, however, so it’s important to know when we’ve crossed it and, if it’s a pattern, figure out why we continue to revisit it.
Set boundaries for yourself and others
We all want to be liked, and many of us have a difficult time establishing professional and personal relationships that allow us to maintain a personal separateness that is absolutely essential for good mental health. In our hospitals, this can play out as trying to be part of the gang when what is really needed is for us to be a leader within a team. As our boundaries with others dissolve, their respect for us often dwindles. I’m not saying that we shouldn’t be friendly. However, a functional hospital is not a democracy. Somehow, you need to learn to navigate that often tricky place of being friendly while having a bit of distance.
Know that your clients are not your enemies
This is especially important after days spent with individuals who don’t follow your recommendations, often preferring the advice of Dr. Google or an employee at the local feed store. A client might be generally unpleasant. Such is the way of the world in an increasingly contentious, disconnected and insular world. Know that no one should tolerate abuse, and allowing clients to tread roughly over staff and you as a veterinarian is not “good customer service.” However, somehow (and this does take time; been there and done that), we need to develop the skills not to take things personally. The cash-strapped client who tells you that if you cared about animals you would provide services for free knows your soft spot. That doesn’t mean that you must agree with or internalize the client's shame at being financially incapable of treatment. Realize that even in our darkest days, most of us in this profession get to meet individuals whose devotion to their animal companions, their good hearts towards us and their tenderness are priceless. These are the folks to treasure.
A bad first job doesn't necessarily reflect badly on you
I wish I had a foolproof guide to choosing a great first job, but I don’t. Even with due diligence on your part, some of you will find that first job sorely lacking in mentorship, development of job skills and opportunities. Fear not, as many of us have had less-than-desirable first jobs and have gone on to greener, happier pastures. Above all, don’t allow an unpleasant first job to lead you to believe that clinical practice is not for you, because that’s typically not the case. Use the hard-earned insights of that first job to help you choose a better second one. Also keep in mind that while a bad first job (and maybe a less-than-wonderful second one) isn’t the end of the world, if your work history resembles a revolving door, it’s probably less about the environments and more about you.
Appreciate that there are many ways of treating
There’s no doubt that you have been exposed to the latest research, diagnostics and treatments. A challenge for many new graduates is to realize that their colleagues, often with several years of experience, have a different way of approaching cases. Different is not necessarily incorrect. It's important to realize that your approach is not necessarily the only correct one. How we talk about differences of clinical opinion matters, and this is a time when learning to make your point collegially, non-judgmentally and without a strident tone is the mark of a professional.
Speak with other colleagues as you would like to be addressed. That goes for how you address staff and clients, too.
Know that your profession is part of your identity, but you are much more
Being a veterinarian is a large part of how many of us think about ourselves. But it cannot and should not be “all” there is to us. Work-life balance is essential, and by having a bigger life and, I’d recommend, a life that doesn’t revolve around animals, will make us happier and healthier. So, sit down and read a book, garden, hang glide, brew beer in your basement, shoot skeet; do whatever it is that makes you feel alive and allows you to recharge. Your family, friends, patients, clients, colleagues and staff will be the better for it. So will you. If you find yourself depressed and/or anxious, seek out professional help, sooner rather than later. Trying to help ourselves is a noble endeavor, but most of us can’t do it alone.
We are here for you
Twenty-five years ago, Drs. Paul Pion and Duncan Ferguson co-founded the Veterinary Information Network, an online community. Did you know that VIN and its nonprofit arm, the VIN Foundation, offer a variety of ways to help you navigate the challenges you'll face in your new career?
VIN’s message boards include Vets4Vets, a forum that offers mentorship opportunities. There's a VIN group for colleagues with personal and professional issues, a confidential forum for colleagues with addiction challenges and a group for those who have physical and mental hardships.
Want to increase your clinical confidence? There are VIN Foundation courses designed to make it so you don't want to run out your hospital's back door when that gastric dilation-volvulus walks through the front. The VIN Foundation also offers model employment contracts, a debt-repayment simulator and a club for startups and those dreaming of opening their own practices.
These services are free to all veterinarians, not just VIN members.
There you have it. A few recommendations for the coming years and the knowledge that you’re not alone. Welcome to the profession, doctors. There are few careers available today where the rewards and challenges are so great. Know and believe that you can do it, because you can!
About the author: Dr. Michele Gaspar is a 1994 graduate of the University of Wisconsin School of Veterinary Medicine and a diplomate of the American Board of Veterinary Practitioners (feline specialty). She has a master's in pastoral counseling from Loyola University Chicago and is a graduate of the Chicago Institute for Psychoanalysis's Adult Psychoanalytic Psychotherapy Program. Dr. Gaspar is a staff therapist at the CG Jung Center in Evanston, Illinois, and a psychotherapist at Live Oak Chicago. Dr. Gaspar is a full-time employee of VIN, consulting on feline internal medicine and facilitating mindfulness meditation training for veterinarians. She is a member of Vets4Vets, a VIN Foundation-sponsored group that provides support to colleagues with professional and personal issues. Dr. Gaspar's professional interests include using her psychodynamic training to bring awareness of psychosocial issues to the veterinary profession. She also develops resources to help veterinary colleagues navigate all-too-ignored mental issues that prevent enjoyment of and fulfillment in what she considers to be one of the best helping professions. She shares her home in Chicago with one very understanding husband, Dave Elsner, three bassets, three cats and a tankful of engaging fish.