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Location: Somis, California
Type: Full Time
The goal of the internship program at Humphrey and Giacopuzzi is to give the intern experience and exposure to make them a competent and confident doctor. This is accomplished by a combination of mentorship and experiential learning. They will always have the support of the staff and the other doctors. They are encouraged to work independently as they learn, but they should take full advantage of the immense amount of experience and support available to them.
HGAE has taken on a greater educator role by its involvement with Western University veterinary students, as well as many visiting externs. Interns are expected to participate in this teaching program and to be welcoming and courteous to all visiting students.
The hospital intern is responsible for overseeing all in-patients 5 days a week. This includes evaluating patients’ daily problems and helping the technicians as needed. Every animal on the property should be assessed (SOAP) at least once daily, ideally before the first appointment of the day. This includes (but is not limited to); a thorough physical exam, surgical and catheter sites examined/palpated, orthopedic cases assessed for lameness status, foaling mares checked for signs of impending labor, and all breeding animals (mares, foals, and stallions) should be briefly examined. The intern is responsible for writing the daily orders; they are to be written at the end of each day after all changes have been made and a final walk through of the barn has been completed. Every patient is to receive at least a daily TPR; breeding animals need only to receive a TPR once a day in the morning, all others are at the doctor’s discretion for frequency. All critical patients (colic, foal, diarrhea, etc.) will receive ICU checks at the appropriate frequency. The intern will be added to the technician schedule on an as needed basis. The intern will have Tuesdays and Wednesdays off each week.
The intern will be primary on-call as scheduled in addition to working as the secondary doctor on each case at the hospital. The intern will receive, examine, and work-up after hours referral cases until the senior clinician on-call arrives. Once comfortable, the intern may receive cases on their own, unless a referral veterinarian is involved. If a referral veterinarian is involved, the senior clinician must be notified, in addition to the on call surgeon, surgical and anesthesia staff if indicated. The intern is also available to provide backup service on nights when they are not the primary on-call doctor. The intern will be involved in developing a treatment protocol with the primary clinician. Any changes in treatment and/or medication will be discussed with the primary doctor assigned to the case before implementing them. Unless otherwise specified, the hospital intern is responsible for updating clients daily regarding patient status, maintaining contact with referring veterinarians, and triaging referral calls. The hospital intern will be in charge of writing discharge instructions for hospitalized patients and in-house day appointments. They will also be required to write surgery reports. This hospital has been established for over 20 years during which protocols and policies relating to its operation were developed. These protocols and policies are not to be overridden or changed without consent of the hospital’s Chief Administrator.
The intern will also be responsible for primary on-call duties as scheduled both in the field and the hospital. The intern can expect to be primarily on hospital duty, although may be called upon during the day to see routine and emergency field appointments in conjunction with an associate veterinarian or alone. The intern will receive, examine and work-up after hours referral cases until the senior clinician on-call arrives. Once comfortable, the intern may receive cases on their own, unless a referral veterinarian is involved. If a referral veterinarian is involved, the senior clinician must be notified, in addition to the on call surgeon, surgical and anesthesia staff if indicated. The intern is also available to provide backup service on nights when they are not the primary on-call doctor. If the on-call doctor is overburdened with emergency calls and is unable to respond in a timely manner, then the intern will be asked to take over as needed. The intern is responsible for keeping the intern truck clean and properly stocked for emergency and routine field work at all times. The intern will also be in charge of all drop-off laboratory work where indicated.
The intern will induce, maintain, and recover patients for elective and emergency surgeries on a scheduled basis. This includes maintaining anesthetic records, restocking the anesthetic cart, cleaning the machine, changing the baralyme when needed, and reporting any malfunctions with the equipment. After a period of training, the interns will be placed on the anesthesia on-call schedule. Interns should plan on being present for all anesthetic protocols if possible, until cleared to go solo. “Clearance” from the training period will be based on the completion of the Anesthesia Skills Checklist provided by Technician Sharon, intern comfort/confidence level, as well as an evaluation by Dr. Mike, Dr. Cori and Sharon.
During business hours the intern is responsible for all in house surgical procedures. The on-call anesthetist will be active from 5pm to 8am the following day. The intern is to attend anesthesia rounds as they are scheduled.
The intern may be called upon to act as an assistant surgeon depending upon the surgery in progress. The most common procedure is assisting with the enterotomy during a colic surgery. The intern is responsible for writing surgery reports in a timely manner and ensuring the report is first approved by the surgeon, then a copy is placed in the patient’s medical record on Triple Crown. The intern will also communicate procedure estimates with clients as directed by the surgeon, as well as follow-up communication post operatively with clients and referral veterinarians. It is courteous to call owners (if not present), when horses have recovered (are on their feet after anesthesia) from procedures.
The intern is responsible for overnight ovulation checks with the frozen semen breeding mares (most often the midnight checks, plus/minus 6am checks), as well as checks throughout the day while senior clinicians have other appointments. The intern will be responsible for knowing the current reproductive status of all mares at the clinic, and maintaining communication with reproduction technician.
The Intern is expected to be present overnight when foaling mares are boarded at the clinic. If a near-term mare is present, the intern should expect to be at the hospital overnight (even on nights off) in case of delivery. Interns should call/text Dr. Richard to let him know about all parturitions and should call at the first sign of complication. If going off-site for a considerable amount of time during the evening with a foaling mare present, interns should check in with technical staff to let them know they are leaving and provide contact information. It is the intern’s responsibility to know which owners would like a call at the time of foaling and which are ok with waiting until the next day. Pictures/videos are always nice and can be emailed or sent front the front office iPhone. The intern will be responsible for the neonatal examination, IgG, mare post-partum examination and placental examination 12-14 hours after each foal is born/has nursed at the hospital.
The breeding animals will have minimal clinician orders; therefore, they are to be written on a “Breeding 3-day Order Form”. All mares with foals are to receive an extra flake of hay at noon and midnight in order to accommodate their lactation needs. Foaling mares will be monitored on a “Foal Watch Form” when they appear to be close to parturition; they are observed every fifteen minutes. Foaling mares will receive an extra flake of hay at noon, and then after they foal they will begin to receive the midnight feedings as well. Some breeding mares are exceptionally thin and will need to be fed accordingly; it is the intern’s responsibility to address these situations. All breeding mares and mares with foals should be part of the turn-out rotation if they will be boarded here for more than a few days. Stallions that will be boarded for greater than three days are to be hand walked daily behind the hospital – only by approved staff. Be sure that all reproductive work and sedations are notated on the patient’s orders.
All patients should be examined; SOAP’ed, bandages changed, and any assigned reproductive work completed prior to the beginning of the work day at 8am. Barn rounds will be conducted on Monday thru Friday mornings at 8:15am. Saturday morning rounds will begin at 9am. Owners and RDVM’s are to be called between 9-11 AM and all bills/SOAPS completed by this time. The intern is responsible for managing their time accordingly to ensure they are available to participate in the activities of the hospital, and to attend scheduled appointments in the hospital and the field. Aside from examining the patients each morning, a brief walk through at the end of the day is encouraged to check on the status of all patients. At this time, the clinician’s orders should also be written for the following day after consultation with the primary doctor.
Billing/Discharge Instructions/Client Communication/Laboratory Records/SOAPS and Social Media
All bills are to be completed by 10 am the day following when the case was initially seen, and interns are encouraged to bill and collect payment at time of service. All discharge instructions (when possible) and in-patient bills are to be completed the day before discharge so they may be reviewed by the senior clinician. If discharges are emailed or faxed, it is important to ensure a paper copy is also placed in the record and that all instructions are properly saved in the computer. Field and day-time appointment SOAPs are also to be input to Triple Crown by 10 AM the following day.
Clients are to receive updates and laboratory results in a timely fashion. In-patient owners are to be updated at least once daily between the hours of 9-11 AM (after rounds). The intern is responsible for all drop-off laboratory work. This includes ensuring the proper paper work is filled out, samples submitted, billing turned in, and communication with clients regarding results is timely.
Interns are encouraged to help add to the clinic’s website and social media (Facebook) pages. The intern should contribute at least once weekly to the page in some form. This should be done in a responsible and appropriate manner.