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Linda Merrill LVT, VTS (Small Animal Internal Medicine/ Clinical Practice)

 

Linda Merrill On the Internal Medicine Specialty

 

Abbi:                Why did you choose to become a small animal internal medicine technician?

 

Linda Merrill:            I have been in the field a long time. I have noticed over the years that I really appreciated and was fascinated by a lot of the medical aspects of veterinary medicine; why certain things happen, what's going on during certain medical issues. Endocrinology, I think, is really interesting. I found myself questioning a lot of these cases, wanting to know more about them and that's why internal medicine seemed to be a really good fit for me.

 

Abbi:               What all does internal medicine encompass then, in regards to those cases?

 

Linda Merrill:            It's a little bit nebulous. When the academy was originally forming, we asked the doctors of the American College of Veterinary Internal Medicine how they defined internal medicine. We discovered they didn't really define it. We have defined it as non-surgical cases. That's not to say surgery isn't often involved with internal medicine cases, but it's more the medical aspect of caring for the patient. It's also preventative care, health care type of issues, too, vaccinations and wellness exams and all that sort of thing.

 

Abbi:               Do you think there's a demand for more small animal internal medicine technicians?

 

Linda Merrill:            I think there is. There is, obviously, in specialty medicine. The Internal Medicine Academy encompasses five actual areas: small animal internal medicine, which is what I am a part of, it has the large animal internal medicine, which is also subdivided into equine only and production only, then, it has cardiology, neurology and oncology. Obviously, in specialty practices, all those are usually represented. For internal medicine, though, I think there is a lot of application in just general practice. Taking care of the hospitalized patients is, most of the time, in the internal medicine realm. I'm in general practice currently and I feel that my internal medicine skills are utilized very well in general practice settings.

 

Abbi:               About the specialty specifically, are there different levels that come with the certification?

 

Linda Merrill:            No, it's just accepted into the academy or not.

 

Abbi:               Do you have yearly renewals of certification?

 

Linda Merrill:            We don't have yearly renewals. Every five years, our members must re-certify.

 

Abbi:               As far as taking the test, what type of skills would someone expect completed and how would they be assessed?

 

Linda Merrill:            There's some skills on the exam, but we view the skills and knowledge as two separate items that we want to look at for every applicant. Skills are evaluated by their supervising diplomat for veterinarians. They have a skills list that their veterinarian must sign off on, that says they have mastered each skill. They have to complete 80 percent of those skills off the skills list for that section to have to be completed. Then, they write case logs, which are demonstrating their skills. Say there is a skill in performing some of the more advanced laboratory analysis tasks. When they write up their case log for that visit, say it's a dexamethasone suppression test, they just show what they did, their calculations, when they drew the samples and how they handled the samples that the veterinarian has also said they could do, has been demonstrated. The exam tests more knowledge. There may be questions that involve skills, but it also involves knowledge.

 

Abbi:               Do you have any advice for someone who would be studying for the exam, in what to focus on or ...

 

Linda Merrill:            We have, on our website, the different domains. We have five domains or areas that the examination covers. That shows the applicants what percentage of the exam is covering which area. I don't know the percentages off the top of my head, but, for example, one of the areas is anesthesia. It would be safely anesthetizing an internal medicine case. For example, if you have a animal with liver disease, what kind of anesthesia changes might you make to safely anesthetize a patient with liver disease? Then, we have a pharmacology domain asking about drugs, especially drugs that are more specific to internal medicine cases. We have a nursing section. We have diagnostics and laboratory testing. We have different areas. Then, that's broken down so that people can more readily decide which domain to study.

 

Abbi:               Do you have any advice or helpful resources to procure and write the in-depth case reports?

 

Linda Merrill:            Case reports are difficult to write for most of us, because we have never done that style of writing before. Some of the veterinary journals have doctors' case reports published in them. The journal for ACVIM has case reports in there. It's good to read those studies and case reports to get an idea of the technical level that we're asking. We do have some of our grading criteria published on our website. It goes into a little bit more in-depth of the kinds of things that we want to see. First off, they have to use good grammar, good spelling. We don't really want to see spelling errors in a case report. We always encourage people to have numerous people proofread them. Don't just depend on spell-check, but also have some people proofread for you. They need to be able to write and communicate clearly what their report is about. They need to demonstrate that they understand the disease or process or condition or whatever that case report is about. That they really demonstrate to the person reading that report they know the anatomy, the pathology, the pathophysiology, everything involved with the disease itself. They need to explain what test they're doing, what the expected results are, what the actual results are and then how they responded to those results. Then, they need to show us a clear goal of the nursing care and the therapy that they provided. We think of the reports as showing your knowledge and the logs as showing your skills. I always tell everyone who's working on a application, no matter what academy it's for, that, "The person reviewing this knows absolutely nothing about you. They are only going to know what they read." You might be the best technician in the world, but if you give a messy case report or a sloppy case log, that is going to be our impression of that applicant. It's very hard. We hate denying people, but when we do have to deny an applicant, it's very hard on both ends. You have to remember, that this is the only way we can judge you, is by what you submit to us. Even though spelling errors are a minor point, but if there are spelling errors, that shows a lack of attention to detail, which we don't want in our veterinary technicians. We want veterinary technicians who are detail-oriented.

 

Abbi:               What is the likely outcome of becoming an internal medicine specialist?

For example, would you see a pay increase, more opportunities presented to you, like travelling opportunities or career-type things? Would it give you an edge over competing applicants for job positions?

 

Linda Merrill:            I don't know if it's automatically a pay increase everywhere, but I think, in general, technician specialists are receiving usually a higher wage than their counterparts. Like I say, I don't think it's universal. I think a little bit depends on what part of the country you're in and that sort of thing. For the most part, yes. I know, in university settings and a lot of the specialty hospitals, they are always trying to have technician specialists now in their technician positions. As far as more opportunities, I definitely think there are speaking opportunities that technician specialists, again, would have an edge over the general technician, in that, technician specialists, when they're submitting speaking topics, have edge when they're being looked at by a panel for who's going to be speaking. Where you get travelling opportunities, the other travelling opportunity is I do think it's easier for you to change locations and get a job as a veterinary technician specialist. As I said earlier, universities and specialty practices are almost always on the lookout for technician specialists. If you're wanting to move to get a pay increase or more responsibilities, those jobs are out there. If you're wanting to move to a certain area, especially an urban area, then I think you have a easier chance of finding employment.

 

Abbi:               Okay, is there anything else that you'd like to add about your specialty tonight, that you think I may have missed?

 

Linda Merrill:            Let's see, there was some questions about continuing education.

 

Linda Merrill:            I think the big meetings are very well-populated with technician specialists speaking on scenarios. I do encourage people to try to go to some of the larger meetings. There's Western Veterinary Conference on the West Coast. There's North American on the East Coast. There's Central Veterinary Conference in the Midwest. Then, there's other regional meetings and there are state meetings, too. Besides just the medical information you get from these lectures, I think there is some value in interacting with your peers on a larger scale. We tend to get isolated in our veterinary clinics sometimes and I think it’s important to get out and meet other technicians and see what other practices are doing, get new information that way. There is a lot of information available in veterinary journals. Some are tailored to technicians and support staff and some are tailored to the veterinarian. I think there is value in all of those, looking through the journals. You may not read veterinary journals page to page, but leafing through veterinary journals when they come into your practice has a lot of value, too. Then, the online education has dramatically increased. I think there's some really great courses to do online for people who can't get away. I really like it when people make use of all three aspects of continuing education. I think it really makes a well-rounded technician.

 

 

Linda Merrill On What it's like to be a Clinical Practice Specialist

 

Abbi:               Why did you choose to become a clinical practice specialist?

 

Linda Merrill:            In my employment history, I spent about five years in specialty practice. Then, I returned to general practice and was intrigued with this group because it touches all the aspects that I do in my day-to-day general practice situation. It touches on surgery and dentistry and radiology and lab work and clinics and hospital and anesthesia. It just really touches on everything that we do in general practice day-to-day. Client education is so important in a general practice, the technicians talking with their clients. It's just really well-rounded. I do feel it compliments my internal medicine skills, in that, my nursing skills, I'm very confident in. I had my internal medicine specialty first. It does help me with, like I say, being a well-rounded overall technician, because it touches on so many different areas in the clinical practice.

 

Abbi:               Do you think there is more of a demand for clinical practice specialists?

 

Linda Merrill:            I think this one is very new and I think it's growing. I don't think there is as much demand for clinical practice specialty yet. I do think it is an up and coming area that, with continued education of the veterinary community, that demand will only grow.

 

Abbi:               What are the different levels and degrees of the certification?

 

Linda Merrill:            There are currently the canine/feline, there is a production animal and there is exotics. Those are the only three currently. If you look at the veterinary group, there are more areas in the veterinary group, yet, we don't have them yet in the technician group.

 

Abbi:               Are there yearly renewals along with this one?

 

Linda Merrill:            We are similar to the internal medicine, so there's not a yearly renewal, other than your membership dues. They do have a re-certification.

 

Abbi:               What type of skills would someone expect completed and how would they be assessed as far as testing and examinations go?

 

Linda Merrill:            It's a very similar process. The skills for the clinical practice group, though, are much broader. Like I say, they really cover everything in general practice. There's surgical skills, there's dental skills, radiology skills, nursing skills, laboratory skills, anesthesia skills. Pretty much all the different areas in practice that you work in have a skill set that they ask that you demonstrate.

 

Abbi:               Right, then, do you just have a mentor, again, to sign off that you have completed these skills?

 

Linda Merrill:            Yeah, either a veterinarian or a veterinarian technician specialist signs off on your skills. You have case logs to demonstrate your skills. Then, you have case reports to demonstrate your knowledge.

 

Abbi:               Would you see an outcome such as pay increase or travelling opportunities or edge over competing applicants for job positions?

 

Linda Merrill:            Again, it's a newer concept. I think, at least in a urban area, you would have an edge over competing applicants. I would believe that most would get a pay increase and most would have the increased opportunities for travel, either through speaking and travelling to meetings or through relocating. Because it is a newer concept, it may not be quite as much as the others.

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