Practicing General Practice
During another wellness check, Chalam exclaims, “this is a nice bladder” while palpating the abdomen of a gray and white kitten named Rascal. Chalam turns Rascal over to Cates to feel while explaining how the shape and feel of the bladder is pristine and will serve as a good example for Cates to use in the future when checking other bladders. “You need to establish what are your normals that you're feeling so that when abnormals walk in through the door, you know how to identify them,” Chalam explains.
The duo also give a long-haired Daschund puppy named Agnes her first wellness check and inject an identification microchip just below the skin between her front shoulder blades.
Finally, Cates palpates a leg mass on Bella, a sweet American Bulldog. She and Chalam also inspect a mass inside Bella’s mouth. Hopefully they are benign, but both masses will need biopsied to determine if they are cancerous. Cates and Chalam came up with a game plan for talking through this reality with Bella’s owner. As part of her education, Cates will take the lead in communicating with the owner and explaining next steps. “I have them really take as much charge over those appointments as they feel comfortable doing,” Chalam says.
At the beginning of the week, it was this client communication that Cates found most difficult. “I think the biggest challenge for me is just being confident in what I'm saying, because if I don't say things confidently, then the owners aren't going to believe the things that I'm saying. And I want them to believe me, and I want them to trust me,” she says.
But now on the final day of the rotation, with numerous conversations under her belt, Cates steps into the appointment room and clearly lays out the potential seriousness of Bella’s condition while also offering hope and optimism and several possible outcomes and treatment plans depending on what the biopsies show. Bella’s owner listens with concern and asks a few questions to clarify. She agrees to the biopsies and initial next steps.
Cates credits Chalam with modeling how to approach these situations. “She really knows how to talk to clients well. She knows how to explain things in ways that they'll understand. And she also has a lot of veterinary knowledge that she's sharing with me in making diagnostic and treatment plans,” Cates says. “So I'm learning a lot from her veterinary knowledge and also her communication styles.”
Padding Out the Partnership
This elective rotation builds on a long-standing partnership between OHS and the CCVM.
Since 2007, all fourth-year veterinary students at the college have spent a few weeks at the OHS Holman Medical Center across the parking lot from the new Community Veterinary Hospital. The medical center provides veterinary care, including spaying and neutering, to the humane society’s shelter animals that are up for adoption. During the medical center rotation, every CCVM student performs an average of 35 surgeries, primarily spays and neuters.
Dr. Kris Otteman, a 1986 veterinary graduate of the college, provided leadership in implementing the partnership with OHS. She worked at OHS and led the OSU partnership from 2006 until her retirement from OHS in 2021 to work on national projects in veterinary medicine. She was OHS’ first in-house veterinarian and led the opening of the Holman Medical Center. The partnership with Oregon State was the first of its kind in the nation between a veterinary college and a shelter, and is often cited by graduating students as one of the most valuable and memorable parts of their education. “For me the opportunity to design and implement a hands-on learning program for senior veterinary students was professionally and personally indescribably rewarding,” Otteman said. “Seeing the students grow their competency and confidence as part of a well-organized successful shelter medicine operation was incredible. I too learned a lot along the way and am very proud of the lasting legacy of this course.”
Otteman spent almost 10 years of her time at OHS on the design team for the new Community Veterinary Hospital, and once the groundwork and facility were designed, saw an opportunity to hand off the leadership of the new hospital to her colleagues. She also saw the opportunity to continue building the educational partnership between her alma mater and OHS by expanding it into the new primary care facility which opened in October 2022.
Otteman’s spouse Dr. Jeff Brant, is a fellow alumnus, graduating with his veterinary degree in 1985 After graduation, the couple opened a mixed-animal practice in Klamath Falls, Oregon. In the early 1990s, they helped establish what is now the Banfield Pet Hospital chain, eventually both serving in vice-presidential roles. Otteman then moved OHS, and following his own retirement from Banfield, Brant co-founded LegacyVet and became an operating partner with private-equity firm Cimarron Healthcare Capital.
With a gift through the OSU Foundation, the couple (see photo) established the fellowship that Chalam holds, providing the funding for this faculty position embedded in the Community Veterinary Hospital. “Our education at the Oregon State University Carlson College of Veterinary Medicine prepared us for our veterinary practice and is the foundation of our professional journeys which have been varied and very rewarding. We are dedicated to supporting our alma mater and the student experience at OSU. Because of our experience with OHS, it’s our hope that this fellowship bolsters the partnership and encourages both OSU and OHS to do all they can to insure the longevity and success of collaborative veterinary education,” the couple said. “This is something we would encourage all our colleagues from the college to consider looking into. We all have ‘special interests’ in the field, and it’s been super rewarding for us see our donation at work with the OSU-OHS program and in scholarships for shelter medicine. Even if you don’t have a specific idea about what to donate to the college make some kind of contribution to help the college continue to grow and thrive. You are needed and appreciated!”
Chalam joined the college in July and is embedded full-time at the Community Veterinary Hospital. A 2014 veterinary graduate of Tufts University, she worked in general practice for nine years.
This is her first experience in academia. “I felt really comfortable in clinical practice, but I wanted a challenge. I wanted to grow. And so this is my foray into doing something different,” Chalam said.
She views this challenge as an opportunity to connect with students like Cates and build something together. “I can identify with how they feel, because this is my first time in such a teaching role, and this is their first time in a clinical practice role,” Chalam said. “I get it, it’s super scary, and you’re kind of feeling your way through. And that's all of us. And 30 years from now, you're going to have a case that walks in through the door and you're not going to know what it is. You've never seen it before, and that's OK. It's just can you learn how to find those answers? Half of veterinary medicine is, I haven't seen that before, but I'm going to figure this out.”
Her hope for the rotation is to help students leave school with confidence in being the doctors they’ve been studying to become. To be confident in evaluating their patients and working with their owners on treatment and care plans. “Because, it’s so stressful when you start a new job. You have imposter syndrome. [Students] are so book smart, they're such intelligent people, but now you have to translate that into practice. And that translation takes time. It's really hard. And for most of us it takes years and years,” Chalam said. “So my hope is that when they're here, that they can build that little bit of confidence so when they do go into practice, they don't feel blindsided by practice. That they've had a little bit more case ownership before they're fully the owner of that case.”
It’s early days, but at least for student No. 1, Chalam’s hope is becoming reality. “Dr. Chalam’s letting me take on the doctor role and just the experience of doing that I think is going to be extremely helpful moving forward. Just making that transition from vet student to doctor,” Cates said. “I want to go into small animal general practice, and so this is basically exactly what I want to do. I want to see cats and dogs, possibly rabbits, and just see those common things that people come in for all the time.”