Veterinary medicine has many career opportunities, from general practitioners to specialists, each with unique challenges and benefits. In this series, veterinarians in different fields discuss the realities of their daily work and help bridge the gap between specialties.
Emergency room (ER) work requires timely decision-making, emotional resilience, and expertise. An unpredictable workload full of life-or-death cases is normal for ER veterinarians. Kelly Bradley, DVMa; Shammi Dhawan, DVMb; and Angie Callahan, DVMc provide a glimpse into the life of an ER veterinarian.
What brought you to emergency medicine?
For Dr. Callahan and Dr. Bradley, a career in emergency medicine wasn’t what they had originally planned.
“It was kind of a necessity,” said Dr. Callahan, who had recently relocated and been unsuccessful in finding a general practitioner position. “One of my best friends works at the hospital I’m currently at, and she said, ‘Why don’t you come work for me?’, so I decided to give it a try. It was the best choice I could have made because I really like what I do.”
“I thought I was going to be in primary care for the entirety of my career, but I was not enjoying it,” said Dr. Bradley. “I didn’t enjoy the routine and appointments. I was only excited when something weird would come in. I’m finding that this excitement is exactly why I got into veterinary medicine in the first place, and I feel like I am really making a difference.”
The excitement of working in the ER also attracted Dr. Dhawan. “The main motivation for me is doing something that satisfies my adrenaline and gives me that excitement,” said Dr. Dhawan. “I wanted something that would have the element of surprise every time, something that would challenge or stimulate my mind frequently, if not daily.”
In a few words, life in the ER is …
“Challenging and stressful but so much fun,” said Dr. Bradley.
“Fast-paced; we all have to be a little quirky at heart to do it,” said Dr. Callahan. “It’s fast, it’s fun, and asking ‘what’s wrong with this one? Let’s figure it out’ is exciting.”
“Exciting, fulfilling, thrilling, humbling,” said Dr. Dhawan.
How does being in the ER differ from other specialties?
A primary difference from general practice is the unpredictability of the caseload on a given day.
“I guess the glaringly obvious difference is we don’t have scheduled appointments,” said Dr. Callahan. “We take patients as they come. Sometimes there are 5 triage cases that come in at once when there are already 10 to 15 patients waiting to be seen. I could see 3 patients in a day, or I could see 15.”
“You work weekends, holidays, and overnights. There’s no way to predict what your schedule will be, in terms of what patients you’re seeing,” said Dr. Bradley.
Another difference is the nature of the cases.
“There are true emergency cases,” said Dr. Callahan. “We see patients that are critically ill and dynamic (ie, can be stable, then completely unstable). We try to figure out what’s wrong with the patient as quickly as we can, then how to support and keep them alive until the next phase of care.”
“We don’t see healthy patients, we see patients that are suffering and in need of immediate help,” said Dr. Bradley. “Our clients are suffering as well, and they are likely having the worst day of their life when they come through our doors. You have to approach that in a different way than a wellness appointment. It can be very challenging and stressful.”
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“As an ER veterinarian, I’m uniquely positioned to address a stressful situation, such as an owner coming in in the middle of the night concerned their pet is not doing well,” said Dr. Dhawan. “Having the opportunity to use my knowledge to help the pet but also to help ease the client’s anxiety is extremely fulfilling.”
What are the best parts about working in the ER? What are the challenges?
One of the highlights of working in the ER is helping critical patients.
“The best part of my role is being on the clinic floor; that’s what I love,” said Dr. Dhawan. “I get to make quick decisions and work with patients who are usually in distress. Being able to help them is really satisfying.”
Clients, at times, need as much help as their pets.
“One thing I didn’t realize I would like is providing comfort for clients in their time of need,” said Dr. Callahan. “As I become more seasoned as an ER veterinarian, I’m better at knowing what’s appropriate to say when clients are stressed.”
“I get a chance to help clients, set expectations, and work with them,” said Dr. Dhawan. “That is an amazing feeling. The feeling of seeing tears turn into a smile is unparalleled.”
With the best parts also come challenges.
Dr. Dhawan said the challenges (or opportunities) can be placed into 2 categories: patient needs and client needs. In critical patients, teamwork and communication are needed.
“You cannot deliver everything by yourself. Include your team and help everyone be on the same page. This means getting the whole team to identify the medical need, then help them understand why and how the conclusion was reached. That’s an opportunity as a veterinarian and leader in the clinic.”
The second opportunity for Dr. Dhawan is anticipating client needs.
“There are many components to ER work: emotional, financial, and clients feeling as though coming to the ER is a doomsday scenario. How do we help clients not feel that way? How do we establish meaningful conversations?”
Another challenge is unpredictability.
“Time management can be overwhelming,” said Dr. Callahan. “When we have several different cases coming in, I try to manage as many as I can without overstressing myself. There’s always a lump in my throat when there are 30 patients waiting to be seen, especially on the weekends. I have to remind myself to preserve my energy. In doing so, I can provide a higher level of care.”
One difficulty occurs in all fields of veterinary medicine.
“Everyone is understaffed. That has been quite a challenge for our industry,” said Dr. Bradley. “I think that can be said for shelter medicine, general practitioners, academics, and emergency medicine. There’s not enough of us to go around.”
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Do you have any advice for those considering ER work?
“Don’t be intimidated,” said Dr. Bradley. “Don’t have imposter syndrome and think you’re not going to be good enough. If you’ve got the right mentorship and goals in mind, then you’ll do great.”
“Whenever we have any new team members (not just veterinarians) I tell them to give it a month,” said Dr. Callahan. “In time, you will adjust to the workflow. You have to enjoy that fast-paced lifestyle. It is a lot of fun!”
“Our profession needs you,” said Dr. Dhawan. “Younger veterinarians can bring in so much with their energy, training, and resources.”
aKelly Bradley, DVM, Emergency Veterinarian, Veterinary Emergency Group
bShammi Dhawan, DVM, Senior Veterinarian, Saint Francis Veterinary Center Of South Jersey
cAngie Callahan, DVM, Emergency Medicine Veterinarian, MedVet Cincinnati