Virginia Tech: Stop Letting Vet School Residents Practice Without Faculty Supervision

The Issue

My beautiful cat Bertram, who had always been happy and healthy, was suddenly very ill and his regular veterinarian couldn’t figure out what was wrong. She referred him to the Veterinary Teaching Hospital at Virginia Tech expecting that one of the faculty would see him and evaluate his problem. Neither of us realized that the Hospital permits advanced residents to see patients without faculty supervision. This is something they don’t talk about – their website actually says “Residents and interns work closely with clinical faculty-members to provide you and your animal with an excellent health care experience.” They have admitted that they couldn’t write a press release that would make their referring veterinarians think letting residents practice unsupervised is a good idea.

The resident who saw Bertram didn’t pay attention to the information his regular veterinarian sent about him. The resident decided that he had pancreatitis, not an infection, and she discontinued the two antibiotics his regular vet had prescribed. No one was checking her work, so her conclusion went unchallenged.

Bertram continued to get sicker and sicker, and I took him back to the Teaching Hospital several times. On one visit, he was seen by a resident who had just started the program and couldn’t answer my questions – and the faculty member who was supervising her wouldn’t talk with me because “Everything has to go through the residents.” There is no evidence that he did anything other than sign off on her notes.

A few days later, Bertram died in the intensive care unit of the Teaching Hospital – this time cared for by an intern and a resident, still with no faculty involved. I asked for an autopsy, and learned that he died not of pancreatitis, but of a ruptured pulmonary abscess! The first resident who saw him said he didn’t have an infection (which is what his primary veterinarian was concerned about) and no one else ever questioned her conclusion.

I asked for a review of what went wrong. The review done by outside experts (four board certified veterinarians not affiliated with the Teaching Hospital) was very critical of Bertram’s care and made recommendations for changes, but the internal review made excuses. And when it became clear that I actually expected the Teaching Hospital to admit its mistakes and change its practices, the VA Tech legal department told the head of the Teaching Hospital to stop talking with me.

There is nothing more I can do to prevent this from happening to someone else. Please help future patients by signing this petition to tell the Veterinary Teaching Hospital at Virginia Tech that they are more than a training program – they are also a specialty referral center. Their patients deserve the attention of the faculty, at every visit, and on every day of inpatient care. Residents are there to learn, and they aren’t ready to handle complicated referrals on their own.

Victory
This petition made change with 18,607 supporters!

The Issue

My beautiful cat Bertram, who had always been happy and healthy, was suddenly very ill and his regular veterinarian couldn’t figure out what was wrong. She referred him to the Veterinary Teaching Hospital at Virginia Tech expecting that one of the faculty would see him and evaluate his problem. Neither of us realized that the Hospital permits advanced residents to see patients without faculty supervision. This is something they don’t talk about – their website actually says “Residents and interns work closely with clinical faculty-members to provide you and your animal with an excellent health care experience.” They have admitted that they couldn’t write a press release that would make their referring veterinarians think letting residents practice unsupervised is a good idea.

The resident who saw Bertram didn’t pay attention to the information his regular veterinarian sent about him. The resident decided that he had pancreatitis, not an infection, and she discontinued the two antibiotics his regular vet had prescribed. No one was checking her work, so her conclusion went unchallenged.

Bertram continued to get sicker and sicker, and I took him back to the Teaching Hospital several times. On one visit, he was seen by a resident who had just started the program and couldn’t answer my questions – and the faculty member who was supervising her wouldn’t talk with me because “Everything has to go through the residents.” There is no evidence that he did anything other than sign off on her notes.

A few days later, Bertram died in the intensive care unit of the Teaching Hospital – this time cared for by an intern and a resident, still with no faculty involved. I asked for an autopsy, and learned that he died not of pancreatitis, but of a ruptured pulmonary abscess! The first resident who saw him said he didn’t have an infection (which is what his primary veterinarian was concerned about) and no one else ever questioned her conclusion.

I asked for a review of what went wrong. The review done by outside experts (four board certified veterinarians not affiliated with the Teaching Hospital) was very critical of Bertram’s care and made recommendations for changes, but the internal review made excuses. And when it became clear that I actually expected the Teaching Hospital to admit its mistakes and change its practices, the VA Tech legal department told the head of the Teaching Hospital to stop talking with me.

There is nothing more I can do to prevent this from happening to someone else. Please help future patients by signing this petition to tell the Veterinary Teaching Hospital at Virginia Tech that they are more than a training program – they are also a specialty referral center. Their patients deserve the attention of the faculty, at every visit, and on every day of inpatient care. Residents are there to learn, and they aren’t ready to handle complicated referrals on their own.

The Decision Makers

F. William Pierson, DVM
F. William Pierson, DVM
Director, Veterinary Teaching Hospital
Responded
To all who have signed and/or shared Ms. Henkel’s petition concerning residents in veterinary medicine: In response to the petition you signed, we wish to provide additional information. Please know that ALL residents and interns at the Virginia-Maryland Regional College of Veterinary Medicine do in fact practice with supervision and under the mentorship of highly qualified faculty members. Our residents are all Doctors of Veterinary Medicine who have had, in addition to their four-year veterinary training program, at least one year of advanced post graduate training as an intern or years of practice experience. Those admitted to internships represent the brightest and best graduates from veterinary colleges/schools, while those admitted to residencies represent the brightest and best of those completing internships. Residencies, depending on the specialty, are typically three or four year commitments. Only a Chief Resident may see patients unsupervised, a common practice at most, if not all, veterinary teaching hospitals across the country. However, boarded faculty are always available should a chief resident wish consultation or back-up. Chief Residents are promoted to this rank in the last year of their program and only after demonstrating to the faculty that they are skilled, knowledgeable, and competent to serve in this role. The promotion requires nomination by their section, a two-thirds majority vote by the department, and approval by the Hospital Board. Both our interns and our residents are very capable veterinarians who have been selected through competitive processes. They receive extensive training and supervision by our faculty. The Veterinary Teaching Hospital has a dual mission of providing excellent patient care and training the next generation of veterinarians and veterinary specialists. Both missions involve extensive faculty supervision, oversight, and teaching. We are very proud of the high quality of animal care our Teaching Hospital provides. We met with Ms. Henkel on many occasions, shared many pages of correspondence, and explained the intricacies of the case with her in a compassionate manner. We share Ms. Henkel’s sorrow on the loss of her beloved cat, Bertram. Animals and their proper care are of utmost importance to us and a primary reason for our existence. We, like many of you, consider our animals as family. We know the joys they bring into our lives and the incomparable pain that comes with their illness and passing.
Gregory Daniel, DVM
Gregory Daniel, DVM
Head, Department of Small Animal Clinical Sciences
Timothy Sands
Timothy Sands
President
Mark McNamee
Mark McNamee
Senior Vice President & Provost
Cyril Clark, PhD
Cyril Clark, PhD
Dean, VA-MD Regional College of Veterinary Medicine

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