Saturday, August 9, 2014

1449. TALK NO. 6 - MYANMAR YESIN VET SCIENCE FINAL YEAR STUDENTS



TALK TO FINAL YEAR VET STUDENTS
UNIVERSITY OF VETERINARY SCIENCE, YEZIN, MYANMAR
Aug 15, 2014

YOU CAN BE A VERY GOOD VET  IN MYANMAR
- Belief, Passion, Drive, Perseverance and Focus.

PART 1. INTRODUCTION

 I am a veterinarian who graduated from Glasgow University in 1974. During the past 40 years, I  had worked as an army vet (Guard and Tracker dogs), a government vet (pigs and poultry), a horse vet (racehorses) and a small animal vet. I started Toa Payoh Vets in 1982 and am still practising there.

40 years ago, I was a final year veterinary student like all of you. I had to buy veterinary books and subscribe to veterinary magazines to acquire skills and knowledge to become a competent young and inexperienced vet. Now, you have online sources of veterinary information anytime to help you with your research and study for examinations.

Veterinary medicine and surgery is too large a subject for any vet to master. Vets are expected to know how to diagnose and treat many animals, unlike the general practitioner who can refer difficult cases to the specialists who focus on only human. 

So, how can you be a very good vet in Myanmar?  My opinion is that you must acquire or possess at least 5 values - Belief, Passion, Drive, Perseverance and Focus for the many years of practice as a vet.  


1.  BELIEF. A feeling that veterinary medicine and surgery is good, right or valuable for you.

*Curing sick animals is what you believe in. You want to practise veterinary science and do it well.

What goals do you set for yourself in 5 years' time and longer? You want to be a successful self-employed vet or a partner? Or just marry a rich spouse or change profession?

2.  PASSION. A strong enthusiasm or interest for practising veterinary medicine and surgery for as long as you live.

*Motivation is said to be either internal or instrumental. Internal refers to being self motivated. You look forward to every new day to practise vet medicine without considering how much money you will make. Instrumental refers to a person wanting to make more and more money. Be a trader, banker or property developer as veterinary medicine does not make the average vet rich.

3.  DRIVE.  A determination to always try very hard to acquire veterinary knowledge and and be successful in treatment outcomes.

*Lots of energy to do emergencies, read up, research and be available for clients. Hard work, most time spent at work. Lack of sleep. You may age faster, get burned out or divorced. If you want a  work-life balance, office hours 5 days a week job, it is your choice.  

4.  PERSEVERANCE.  A continued effort to become a very good veterinarian despite difficulties, failures or opposition from other people.

*Your reputation of delivering good outcomes in the diagnosis and treatment will get you many referrals. Referrals sustain your practice but you must work hard and be available for clients. If you keep going abroad for holidays, your clients just go to the competitors.  It is much easier to retain an existing client compared to getting new ones.  

5. FOCUS. An ability to concentrate on how to provide better veterinary diagnosis and treatment and pay particular attention to the case/surgery handled. 

*Need to focus on the bigger picture of what you hope to be 10 years later. Do you want to start your own practice? 


IMAGE

--------------------------------------------------------------------------------------------------------------------


PART 2 - PROBLEMS OF CLIENTS/PATIENTS AND THEIR SOLUTIONS


Some case studies from my past 40 years of practice illustrating how I applied the 5 above-mentioned values may be useful in your final revisions before your September examinations.

These are:

*  1. The young military German Shepherd Guard Dog had Patent Ductus Arteriosus.
2. The egg-laying hens produced more abnormal eggs.
3. The professional dog breeders wanted the cheapest Caesarean sections.
4. More racehorses were being shot by the vets.
5. Giving back to the animal veterinary community.



 Case Study 1. The young military German Shepherd Guard Dog had Patent Ductus Arteriosus.

He became tired easily after a few minutes of dog patrol with his handler, guarding the Tengah Air Base. The Army wanted me to put him to sleep. He was young and had a curable congenital heart diagnosed by me as Patent Ductus Arteriosus (PDA). He needed a heart surgery. What should I do to help him avoid death by lethal injection?



SOLUTION

1. The Ductus Arteriosus is a foetal blood vessel that connects the pulmonary artery to the descending aorta. During pregnancy, it shunts blood away from the collapsed foetal lungs as the foetus is still not breathing inside the womb. After birth it closes by around 8 days of age and becomes a fibrous tissue called ligamentum arteriosum.

If it is still present, it is called Patent Ductus Arteriosus. In this case, some of the unaerated (venous) blood from the pulmonary artery by-passes the lungs and goes to the the descending aorta via the PDA. As he had less oxygenated blood, he tired easily and was useless as a military guard dog.    

In 1976, Singapore vets did not have diagnostic imaging like echocardiography and angiography. I diagnosed PDA based on a characteristic continuous (machinery) murmur heard at the left axillary region and a palpable cardiac "thrill".

I got Dr James Tan, an experienced veterinary surgeon to operate free of charge. Intercostal thoracotomy at the left fourth space. The PDA in dogs is around 1 cm wide and less than 1 cm in length.  The lungs would collapse when the thorax is opened and since we did not have the mechanical ventilator, I pressed the anaesthetic bag regularly as a manual ventilator to inflate the lungs. He ligated the PDA. The dog was cured as he no longer felt tired so easily. He went back to work.




Case Study 2. The egg-laying hens produced more abnormal eggs. The Egg Drop Syndrome 76 (EDS 76) virus caused severe drop in the egg production in Singapore's large commercial poultry farms. This disease was confirmed by the government lab tests. But the Primary Production Department prohibited EDS 76 vaccine imports from Europe unless it could be proven locally effective. This big  farmer with over 100,000 layers did not do illegal import of the vaccine.  

I could see the egg layers producing soft-shelled and abnormal shaped eggs for many months. The farmer was losing a lot of money as the egg production was less than 50% instead of 80%.


I was the government vet in charge of extension work. Seeking vaccine import approval from the big boss was the responsibility of the Vaccine Production Unit. There was a solution - I proposed a vaccine trial in which 50% of the layers in the long building would be vaccinated and 50% would not be. 


SOLUTION

I suggested an EDS 76 trial with Dr Ng Fook Kheong and the poultry farmer Mr Chew consented. Half the layers in one house would not be vaccinated. The other half vaccinated. HI titres taken from each group. The vaccinated half of the house did not have egg production drop or abnormal eggs. With this evidence of the efficacy of the EDS 76 vaccine, the government approved import.






Case Study 3. The professional dog breeders wanted cheap Caesarean sections. A vet provided cheap Caesarean sections for $250 and sold dog hundreds of vaccines/week to the professional dog breeders instead of vaccinating the puppies personally. He was suspended from practice.

Jenny, my nurse asked if I wanted to offer similar cheap C-sections to a big breeder with several hundred female dogs?

Should I work 24 hours/day, 7 days a week? Should I sacrifice my free time and not switch off my hand phone after 9 pm?  For the first 2 years, I provided $300 C-section services for all the professional dog breeders at any hour of the day. I gained valuable surgical skills with over 300 C-sections. In most cases, I took images after the C-section. These images are at:

http://www.bekindtopets.com/animals/20081201PAGE2_Dog_Surgery_Anaesthesia_ToaPayohVets.htm









Some vets who start their own practice may have insufficient number of cases. Volunteer to spay and neuter stray dogs and cats cheaply and get yourself well known by the animal welfare people for doing good work. Be humble and spend time to learn from more experienced vets.  



Case Study 4. More racehorses were being shot by the vets - Adding value to my employer. Singapore Turf Club employed me as a vet on a 3-yearly contract. At one time, Singapore's economy was in recession. I could see that the horse owners were not paying their horse trainers and the number of race horses were dropping as they had to be put down.

In one race, there were only 3 racehorse running. Ideally, there should be more than 10. This decline in horse racing was a serious financial loss to the Club.. As a horse vet, I should not bother with the management problems of the racing industry. My job was to the health of racehorses. What could I do besides advising on health care of racehorses?

SOLUTION

I was a member of the task force to look into the racing problems. We visited the racing clubs of Hong Kong, South Korea and Thailand. The Racing Manager would get our feedback and write a report.

I suggested interviewing two respectable horse owners who were stock brokers and loved horse racing. They provided valuable feedback. I wrote to several racing clubs in the USA, South Africa and Hong Kong to ask them to send me 5 years of their annual reports for my research. I read up marketing books as I did not write management reports as a vet. The report I produced is shown in the following images.

A new racing magazine wanted an article and I submitted the following report entitled "What makes horse racing profitable?" and got paid $200. The board and management got a copy of this magazine. See my report at:
     



Case Study 5. Giving back to the community.  When the internet started around 1997,  I believed that it would would be very useful in educating the pet owners in Singapore as they can read the contents anytime. The usual method was to print out articles on diseases or show the text book. This is time-consuming in a busy practice. 

SOLUTION
With knowledge, they would be better vets and pet owners. I started a blog and wrote case studies. 

IMAGE OF FIRST BLOG PAGE was written in 2007.

 http://singaporecatskittens.blogspot.sg/2007/06/1-lady-who-loved-cats-was-chased-by-dog.html



In the last 2 years, I started You Tube videos with the help of the young and energetic interns who want to study veterinary science.

BE KIND TO PETS VETERINARY EDUCATIONAL VIDEOS
PRODUCED IN 2014


1. Spay of a cat - Myanmar language
2. Castration of a dog - Myanmar language.
3. Mammary neoplasia - surgical techniques - Myanmar language
4. Traumatic Proptosis of the eye - surgical techniques -  Myanmar language
5. Hamster video - English
6. Turtle video - English
7. An experienced vet giving an I/V drip by Dr Thein Tun Aung

CONCLUSION

HARD WORK AND TIME ARE NEEDED TO BE A VERY GOOD VET
Be proactive in helping the animals or clients to solve their problems. Add value to your employer. This makes your veterinary career so much more interesting as you wake up every morning.

At the of the day, nobody in Myanmar know who you are if you are inexperienced.  You may need to work hard and usually long hours with an experienced vet. Or get a job in Singapore, Japan or overseas to improve your skills.  Distractions and pleasures nowadays are many - online gaming and partying  till 3 am, and watching online movies at work place take up the time you could use to gain more veterinary  knowledge. It is a pain to write case studies and research more on medical cases.  

These 5 values, amongst others, must be present to acquire lots of veterinary knowledge to be a very good vet in Myanmar. 


I hope you enjoy this talk and wish you all good luck to your final year examinations.

I thank Dr Tin Tin Myaing, President, Dr Secretary and committee  of the Myanmar Veterinary Association for organising this talk. I thank Drs Ling Ling Soe and Thein Tun Aung of Royal Asia Veterinary Surgery for sponsorship.

-----------------------------------------------------------------------------------------------------------------






No comments:

Post a Comment