Clinical Competency Requirements for Class of 2014
CORE MATERIAL: EVERY VETERINARY STUDENT MUST GET SIGNED OFF ON THE FOLLOWING TASKS
Skills must be signed off by an NCSU faculty or staff member unless a practice training program has been approved or the skill is starred. Approved practice training programs are listed on the Clinical Competencies website. Starred skills may be signed off during any extramural practice experience.
Husbandry/Restraint/Routine Client Education skills
- Demonstrate the ability to identify the major categories for common domestic species. Includes being able to identify yearling heifer, steer calf, brood cow, etc. Identify common coat colors in the horse, mare, gelding, stallion, foal, yearling.
- Demonstrate the ability to safely catch and restrain a horse, a cow, a pig and a sheep. Includes haltering, leading, twitching, restraining for venepuncture, and picking up feet.
- Demonstrate a quick release knot and a quick-release halter tie or a quick release tail tie.
- Demonstrate the ability to safely catch and restrain a dog, a cat, a bird species, a reptile species, one small mammal other than a dog or cat.
- Demonstrate the ability to observe animal and state whether behaviors observed are normal/abnormal, one large animal species, one small animal species, one species of your choice
- Demonstrate the ability to identify and evaluate basic large animal foods types: at least 3 types of hay, 2 types of grain, 2 major pig feeds
- Demonstrate ability to counsel potential owner on pet/animal selection criteria (eg:spp/breed vs. owner lifestyle)
- Demonstrate ability to educate owner regarding the biological needs (housing, routine care, general feeding guidelines) of one small animal and one large animal species
- Demonstrate ability to educate owner regarding the socialization, behavioral needs, and training (including housetraining, if appropriate) of one small animal and one large animal species.
- Demonstrate ability to educate owner regarding routine reproduction of one small animal and one large animal species.
- Demonstrate ability to counsel owner on core vaccination requirements for one small animal and one large animal species
- Demonstrate ability to counsel owner on parasite control regimes for one small animal and one large animal species
- Demonstrate the ability to counsel potential owner on selection of, biological requirements of, and proper husbandry techniques for a zoological species commonly seen in practice.
- Load and operate projectile drug delivery device.
- Demonstrate nutritional assessment for any species
- Develop a complete wellness lifestage feeding plan for any species
Physical exam skills
- Perform basic physical exam dog, cat, horse, cow or small ruminant, pig, one reptile species, one bird species, one small mammal other than dog or cat, one other species of your choice. Includes TPR, demonstrating the ability to localize and describe sounds in the thorax, localize and demonstrate organs within the abdomen, demonstrate abdominal palpation and auscultation. Must know normal TPR for a small mammal, dog, cat, horse, and cow. Must be able to name and identify major lymph nodes in appropriate species. Must be able to perform rectal exam and express anal sacs in dog.
- Body condition scoring in dog, cat, horse, cow
- Perform the following specialty exams :
Orthopedic (lameness) exam on a small animal patient and a horse, including naming and identification of all major joints, recognizing normal angles and range of motion for major joints and the hoof, use of a goniometer, use of a hoof tester , use of a hoof pick, use of a hoof gauge, flexion tests, thigh circumference measurement in dog
Neurologic exam small animal patient, horse, must demonstrate:
Deep pain assessment
Pupillary light reflex
Ophthalmic exam, including use of direct and indirect ophthalmoscope, ocular pressure measurement, small animal patient, horse. Must demonstrate:
Pupillary light reflex
Schirmer tear test
Dermatologic exam, as appropriate for patient, Must demonstrate:
General dermatologic exam
Recognize primary and secondary dermatological lesions
Skin scrapings - deep / superficial
Skin cytology - tape/swab/aspiration
Appropriate methods of collection of samples for bacterial / fungal culture
Woods lamp examination
Cardiovascular exam, including identifying, describing, and assessing the clinical significance of transient heart sounds and murmurs, examining arterial and venous pulses, obtaining a resting standard 6-lead EKG, accurately measuring noninvasive arterial blood pressure in small and large animal patients
Oncologic exam, including fine needle aspirate, lymph node palpation and identification
- iObtan and interpret a vaginal smear in the bitch.
- Conduct a pregnancy exam on a bovine, equine, and canine female.
- Prepare and evaluate semen from either a stallion, bull, or a stud dog.
- Conduct an examination of the external genitalia of the intact bovine, canine, and equine male and female.
- Properly describe and correct malpresentations, positions, and postures in a case of bovine or equine dystocia. They should also be able to place obstetrical chains properly on either the fore or rear limbs of a bovine or equine fetus.
- Obtain a blood sample dog, cat, horse, cow, sheep, pig, one bird species, one reptile species, one small mammal other than dog or cat, one other species of your choice.
- Collect blood using needle and syringe
- Collect blood using vacutainer.
- Obtain a urine sample using catheterization
- Obtain a urine sample using cystocentesis
- Obtain a milk sample from a cow for mastitis evaluation
- Obtain a fecal sample
- Obtain a cloacal culture (bird)
Radiology, Necropsy, Clinical Pathology, Parasitology
- Perform radiographic exams for 5 patients (position, create, process, interpret radiographs)
- Perform complete necropsy on two mammalian species, one species of choice.
- Collect samples appropriate for 1) biopsy submission from 3 tissue types, 2)microbiological sampling, 3) toxicologic sampling.
- Be able to select a pig from a group for post-mortem examination. In the pig, be able to identify major lymph nodes, tonsils, area of lung most affected by pneumonia, sites of ulcers.
- Process a blood sample (PCV, TS, glucose, BUN, prepare and stain a blood smear, do a blood smear differential, estimate platelet count)
- Process a urine sample (reagent strip, specific gravity, sediment exam)
- Examine a fecal sample for parasites (direct smear, McMaster’s technique, centrifugation, double centrifugation)
- Microfilaria ID in blood drop
- Microscope technique specific to parasitology specimens
- Perform an ELISA test
Basic medicine skills, experience, problem solving and case management
- Obtain a complete clinical history for 5 patients. Obtain client histories with clinician supervision, demonstrating appropriate body language, eye contact, appropriate language, respect for client’s emotions and view of the problem.
- Define “chief complaint” and problem list for 6 patients, including one special species patient.
- Make a differential diagnosis list for 5 patients, including one special species patient.
- Choose the appropriate diagnostic tests for 5 patients.
- Create a problem-oriented medical record for 5 patients, demonstrating ability to organize and succinctly state facts and opinions with correct spelling and punctuation.
- Provide oral summary of 5 cases for peers, demonstrating organization and precise language
- Create laboratory flow sheet for 2 individual animals, demonstrate case management using flow sheet
- Follow 5 patients through treatment of a problem
- Discuss case progress with 5 clients, demonstrating ability to address client concerns, to discuss financial matters, empathy with client, appropriate boundaries with client
- Provide oral discharge instructions for 5 clients, demonstrating solicitation of client feedback to assure that the instructions are understood, solicitation of client’s point of view and concerns regarding ability to provide treatment, appropriate demonstration of techniques
- Write 5 discharge instructions, demonstrating ability to organize and succinctly state facts and opinions with correct spelling and punctuation
- Perform follow up phone calls on 5 patients to assure problem resolution or need for continuing diagnostics/therapy
- Participate in medical primary care clinic at least 5 days (wellness clinic, shelter, vaccination clinic, practice)
- Participate in the management of at least 5 medical referral patients (any species)
- Evaluate, workup and properly record a case involving a population of animals.
- Demonstrate oral administration of medications horse, ruminant, dog, cat, one bird species, one reptile species, one small mammal other than dog or cat, one other species of your choice. Includes demonstrating tablet administration, or the use of an oral dose syringe, as appropriate.
- Demonstrate SC administration of medication large animal, small animal, one bird species, one reptile species, one small mammal other than dog or cat, one other species of your choice
- Demonstrate IM administration of medication large animal, small animal, one bird species, one amphibian/reptile species, one small mammal species, one other species of your choice. Includes being able to show landmarks for muscle groups, knowing muscles used in food animals, knowing pros and cons of each injection site. Specifically be able to discuss sites used for vaccines, large volumes (procaine penicillin in the horse), iron shots in pigs.
- Demonstrate bolus IV administration of medication large animal, small animal, other species of choice. Be able to discuss how to manage perivascular injection of a caustic material.
- Choose, calculate amounts and administer intravenous fluids to 7 animals, including one small mammal.
- Place IV or IO catheter in 1 bird and 1 amphibian/reptile and calculate fluid amounts for 1 avian and one amphibian/reptile patient.
- Choose and calculate correct drug dosages for 8 animals, including one patient receiving constant rate infusion drugs and one bird species, one amphibian/reptile species, one small mammal other than dog or cat.
- Write 5 outpatient prescriptions in a format that would allow them to be filled at a compounding or human pharmacy
- Administer 5 controlled drugs, keeping correct records for each drug.
- Be able to load and operate a projectile drug delivery device (blow gun, air rifle, pole syringe)
- Demonstrate ability to evaluate and suggest treatment for a common behavioral problem, such as feline house soiling.
- Articulate the rationale for recommending a given diet for a given disease state
- Anesthesia and pain management, patient welfare
- Identify parts of an anesthesia machine
- Put together a circle system
- Put together a non-rebreathing system
- Place IV catheter in 3 small animals (dog, cat, small mammal)
- Place IV catheter in 3 large animals (horse, cow, goat, pig)
- Intubate 6 small animals, including at least 2 cats. Intubate or
- assist intubation of one bird species, one reptile species.
- Place blood pressure, ECG, and pulse oximetry monitors on 3 patients
- Perform anesthesia on 5 small animals, including record keeping and demonstrating knowledge of monitoring equipment, anesthesia/analgesia
- Perform anesthesia or sedation on a small mammal.
- Perform anesthesia on 1 large animals, including record keeping and demonstrating knowledge of monitoring equipment, anesthesia/analgesia
- Calculate and administer constant rate IV drug infusion.
- Design pain management/anesthesia regime for 3 small animal surgical patients
- Design pain management/anesthesia regime for 2 large animal surgical patient
- Design pain management/anesthesia regime for 1 special species patient
- Design chronic pain management treatment (any species)
- Perform pain scoring on 5 patients (any species)
- Perform 3 local analgesic blocks on any species. Be able to demonstrate the landmarks for commonly used local blocks (dehorning, standing procedures in ruminants, declaw surgery in cats, etc)
- Perform 1 epidural on any species
- Participate in one euthanasia (any species) and explain indications and methods of euthanasia, including methods appropriate for zoological species commonly seen in practice
- Participate in enforcement of a humane handling issue or Explain humane standards for one population of animals
- Educate one lay person on an animal welfare issue
- Dental exam on small animal patient, including charting of lesions
- Dental exam on a large animal patient, demonstrating the ability to age a horse and a cow by its teeth. Know eruption times used for aging immature animals.
- Demonstrate canine or feline dental cleaning and extraction
Basic surgery skills, experience, and case management
- Demonstrate knot tying (square knot, friction knot, one hand tie, two hand tie, instrument tie)
- Demonstrate correct instrument handling (three point grip, pencil grip, suture cutting)
- Demonstrate basic suturing techniques (simple interrupted, simple continuous, Connell, Cushing, Lembert, Ford interlocking, horizontal mattress, vertical mattress)
- Demonstrate pack preparation
- Demonstrate patient preparation
- Demonstrate sterile technique (scrubbing, gowning, gloving, draping, ability to keep a sterile field)
- Demonstrate wound closure, stent use, placement of mattress sutures
- Demonstrate drain placement
- Demonstrate bandaging techniques, small animal
- Demonstrate emergency bandaging techniques, large animal
- Demonstrate bandaging of an open wound (wet-dry bandage).
- Demonstrate suture or staple removal
- Act as primary surgeon for at least 10 surgical procedures, including feline castration, feline spay, canine castration, and canine spay. (LIST SURGERY PROCEDURES AT TIME OF SIGN OFF).
- Participate in the management of at least 5 surgical referral patients (any species)
Emergency and intensive care case management
- Demonstrate thoracocentesis in small animal patient
- Demonstrate abdominocentesis
- Demonstrate tracheostomy
- Demonstrate administration of nasal oxygen
- Demonstrate technique for gaining emergency venous access
- Demonstrate CPR for a small animal patient
- Demonstrate working knowledge of cardiac resuscitation drugs and goals for a small animal patient
- Outline steps for resuscitation of either a large or small animal in hypovolemic or septic shock including: goals of therapy, fluid therapy (choice of fluid, rate and amount, IV catheter choice), drug therapy and monitoring response of therapy.
Health promotion, disease prevention, zoonosis and food safety
- Health promotion/disease prevention
- See restraint/husbandry/routine education/TAU sections
- Demonstrate ability to educate lay person(s) on 5 zoonotic diseases including at least one that involves zoological species
- Demonstrate ability to educate lay person(s) on 5 diseases transmitted by food, the role of the veterinarian in preventing transmission, and the precautions the lay person should take.
- Design a population based disease control or prevention plan.
- Demonstrate proficiency in planning and execution of a simulated or real outbreak investigation.
- Be able to articulate and provide examples of how veterinarians in public practice promote and protect public and animal health.
- Evaluate a veterinary clinical facility for environmentally responsible clinical practices including disposal of discarded therapeutic agents, energy conservation, and emissions/discharge management.
- Evaluate a facility housing large numbers of animals (shelter, farm, zoo, lab animal) for environmentally responsible practices including waste disposal, human/production animal/wildlife interactions, energy conservation, and emissions/discharge management.
- Fill out and complete a Coggins test form
- Complete a health certificate
- Complete Credentialed Responder Training
- Complete Certified Rabies Vaccinator Training
Client communications and ethical conduct
- Present one ethical dilemma facing an individual veterinarian or the profession, demonstrate ability to choose a position based on system of values
- Demonstrate the ability to educate lay person(s) on an ethical or welfare issue
- Written Communication
- see Medicine skills
- Oral Communication
- See Medicine skills, Animal Welfare
- Client sensitivity/Grief counseling
- Participate in counseling of a client that has lost an animal or Explain stages of grief and techniques for helping client deal with loss
- Be a member of 5 teams and receive passing grades for team participation skills
- Conflict resolution
- Present one legal/conflict issue, demonstrating knowledge of the legal issue, both points of view in conflict, suggest possible resolution
- Diversity Training
- Attend one approved diversity training experience (i.e. Cultural Awareness Seminar) each of the first three years of veterinary college
Strong appreciation for the role of research in furthering the practice of veterinary medicine.
Each DVM student is required to have one research-related educational experience before graduation. Such experiences could include, but are not limited to:
1. Being in the Clinician Scientist Focus Area, with completion of its research requirements.
2. Performing a summer of approved research at NCSU or another institution. (Previous research work will not qualify.)
3. Research thesis option within Zoological Medicine Focus Area.
4. Successful completion of a research-related selective (i.e. Intro to Research at the CVM, Molecular Medicine Initiative selectives, research selectives personally arranged or already existing such as Advanced Pathology)
5. Attending a research-related conference and supplying a three-page report to your advisor on the experience.
6. Attending the annual CVM Research Forum and supplying a three-page report to your advisor on the experience.
7. Attending a research seminar at the CVM, elsewhere at NCSU or at another institution and writing a three-page report on the seminar and one related publication. (Attending clinical conference is not included.) Hand in the report to your advisor.
8. Writing and submitting a research proposal to an extramural funding agency.
9. Research experiences in Special Topics courses (i.e. Swine Medicine).
10. Being an author on a research paper (not a case report) while in veterinary college
The following skills will be checked off in
Health Maintenance and Animal Production I, II, III
Teaching Animal Unit
Must Learn Skills
Approach, catch and halter a horse
Lead and turn a horse at the walk
Lead a horse at the trot
Pick up a forelimb and hind limb of a horse
Groom and horse
Use hoof testers
Tie a quick release knot
Use a weight tape
Perform physical exam on adult horse
Perform physical exam on neonatal foal
Perform ocular exam
Place nose twitch
Perform skin fold twitch
Perform ear twitch
Place chain shank over nose
Place chain shank over lip
Complete written physical exam form
Collect blood into a vacutainer
Collect blood using a needle and syringe
Administer an oral medication
Administer an intramuscular injection
Administer an intravenous injection
Administer a subcutaneous injection
Fill out and complete a Coggins test form
Complete a health certificate
Perform lameness exam (including all flexion tests)
Perform neurological exam (including cranial nerve and movement exam)
Pass nasogastric tube
Correctly halter a cow
Tie a quick release knot
Cast a cow with a rope
Perform a Physical exam
Identify methods of identification of animals
Body condition scoring and relation to life cycle
Collect blood sample from jugular
Collect blood sample from the tail vein
Perform and interpret a TB test
Injection site identification (Beef Quality Assurance)
Identify and perform an intramuscular injection
Identify and perform an intravenous injection
Identify and perform subcutaneous injection
Identify needle sizes for IM, SQ, and IV injections
Administer an oral bolus to at least 2 cows
Pass a stomach tube and administer oral fluids
Know how to perform all procedures
Actively perform at least two procedures (tattooing, castration, dis-budding, implanting)
Pregnancy check > 5months
Collect a sterile milk sample
Perform a CMT test
Interpret a CMT test
Properly use a hoof knife
Restrain and lift a foot for trimming or lameness evaluation
Know and use FAMACHA system for parasite control
Blood collection from jugular vein
Identify jugular landmarks, lung fields, rumen location
Determine age of goats or sheep
Perform intramuscular injection (identify sites)
Perform subcutaneous injection (identify sites)
Perform a foot trim
Body condition score a goat or sheep
TB test a goat or sheep
Disbudding procedures and nerve blocks (goat only)
Perform an ultrasound pregnancy diagnosis
Interpret an ultrasound diagnosis
Perform a physical exam
Interpret ultrasound pregnancy diagnosis
Restrain a sheep or goat
Administer an oral medication to a sheep or goat
Safely restrain suckling, nursery, and finisher pigs
Safely move nursery or finisher pigs between pens or sort within pen
Identify which TAU pig housing facilities are for what age groups
Collect and interpret key performance/health indicators in sows and pigs
- average/expected litter size
- % of pigs liveborn
- % preweaning mortality for a farrowing group
- % nursery mortality
- % finisher mortality
Understand pros and cons of breeding herd housing systems
Identify the major feed ingredients in pig rations
Recognize normal feeding behavior
Perform pregnancy diagnosis in female pigs using different methods
Identify signs of estrus in the female pig
Complete physical examinations on individuals and groups of pigs
Restrain and collect blood from nursery and/or finishing age pigs
List the key criteria for selection of optimal pigs for diagnostic testing
Identify these key diagnostically significant anatomic structures:
Tonsils, turbinates, region of stomach prone to ulcers, ileum, spiral colon, lung lobes, lymph nodes
Catch and safely restrain a turkey for physical examination
Catch and safely restrain a chicken for physical examination
Perform a basic physical examination on turkey
Perform a basic physical examination on a chicken
Evaluate general health status of a turkey flock
Evaluate general health status of a chicken flock
Perform a cloacal swab on a turkey
Perform a cloacal swab on a chicken
Perform a tracheal swab on a turkey
Perform a choanal swab on a turkey
Collect a blood sample via wing vein on a turkey
Collect a blood sample via wing vein on a chicken
Perform a subcutaneous injection on a turkey
Perform an intramuscular injection on a turkey
FOCUS AREA MATERIAL: EACH FOCUS AREA WILL DETERMINE REQUIRED TASKS FOR STUDENTS IN THE FOCUS AREA