VetScript Editor’s pick – July 2018

Buckets of organs in the pantry, early childhood encounters with post-mortem freezers ? life with veterinary parents was sometimes confronting, but not enough to discourage Jocelyn and Nicola Wichtel from the profession. Bette Flagler meets a family of four high-achieving veterinarians spread between New Zealand and Canada.

When Jeff Wichtel assumed his role as Dean at Guelph University?s Ontario Veterinary College, one of his challenges was to respond to a province-wide veterinary shortage, and another was figuring out how to adapt the veterinary curriculum to better prepare graduates for the plethora of jobs they might have during their careers. These were professional concerns, certainly, but personal ones as well: Jeff?s daughters Jocelyn and Nicola, and his wife Maureen, are also veterinarians. ?We?re four for four,? says Jeff.

Their paths have (so far) involved eight universities and three countries.

Jeff graduated from Massey University in 1981 and worked in a mixed practice in Dannevirke. He says he loved everything about the job, but knew it wasn?t where he?d stay forever. After four years, he applied to a veterinary internship and residency matching programme, and was placed at Iowa State University (ISU) in the US.
?I didn?t even know where Iowa was,? he laughs. ?I was completely clueless.?

Lo and behold, he started at ISU on the same day as Maureen, who had graduated from the Virginia-Maryland Regional College of Veterinary Medicine in Blacksburg, Virginia. Maureen was there for a large animal internship, Jeff for a residency in theriogenology. Two years later, Maureen applied for a three-year large animal internal medicine residency at North Carolina State University. Jeff followed, got a job, and started a postgraduate degree in epidemiology.

?We came to New Zealand to get married, then went back to North Carolina. I finished my residency, and we moved to New Zealand,? says Maureen.

?I had a job offer at Matamata Veterinary Services,? says Jeff. ?Being a dairy practitioner was my only desire in life, but Maureen wanted to be near an academic institution. I had passed my boards, but Maureen was still studying for hers, so we moved to Palmerston North in 1990.?

Jocelyn was born within weeks of their arrival, and Nicola a couple of years later. During their time at Massey, Maureen became board certified and worked in anaesthesia, Jeff worked in farm services and they both finished their PhDs (hers is in physiology). In 1998, they moved to the Atlantic Veterinary College (AVC) at the University of Prince Edward Island, Canada.

The AVC?s population-medicine approach to veterinary medicine appealed to Jeff ? it resonated with what he?d done at North Carolina State and at Massey ? and there was large animal internal medicine work for Maureen.

?It was perfect for both of us,? she says. ?It was everything that I had worked for, and it was great for raising kids, too.?

?Everyone [assumes] we were pressured into being veterinarians,? says Jocelyn. ?But I actually think my parents tried to convince me out of going into veterinary medicine.?

?We were trying to be realistic,? says Maureen. ?We tried to warn them that it is a tough profession, that you?re going to be indebted when you graduate, your pay is not going to be as great as that of other professionals who have spent as much time at school, and that the work can be quite stressful, with long hours.?

Says Nicola: ?I think growing up we had a different view of what being a veterinarian was because they were both working in academic institutions. For us, they had nine-to-five jobs, and could pretty much take leave when they wanted. They took us on trips to conferences, so we travelled a lot as kids. For us it was, ?Oh that?s a great lifestyle; let?s just do that?.?

Not that there wasn?t blood and guts ? or family banter.

Jocelyn: ?One of my favourite memories of growing up with veterinarian parents was of Mum having a bucket of organs in the pantry.?

Maureen: ?That was when I was working on my PhD, but it was stored in the basement.?

Jocelyn: ?It was literally in the pantry.?

Nicola: ?We would come home and they?d be all over the kitchen table; she?d be sitting there studying them.?

Jocelyn: ?My other favourite memory was going on farm calls with Dad. I remember this downed cow ? I think he was doing a C-section, but it was down for some reason ? and I was straddling the cow peering into this giant abdomen. To me, it was just blood and guts and blob, blob, blob. I remember feeling so little sitting on this cow and looking down into this giant crater of blob, and trying to comfort her.?

Nicola: ?It was also their inability to recognise situations that might be harmful to us. I was at work with Dad one day, just waiting to go home, and he?s like, ?Oh I just have to pop into this room?, and he opens this door and it is a massive freezer of dead animals.?

Jocelyn: ?The post-mortem freezer.?

Nicola: ?There were pigs hanging from the ceiling, and a pile of dead dogs in the corner.?

Jeff: ?Start at a young age!?

Nicola: ?He did not even warn me, and I?m pretty sure I cried and ran out. Then we just went home, and there was no apology or anything.?

Jeff: ?We bring ?em up tough.?

After three years of a biology degree, Jocelyn applied for and was accepted at the AVC. ?That was very odd, teaching our own daughter,? says Maureen.

In 2013, Nicola, who had done two years at Dalhousie University in Nova Scotia, moved to New Zealand for veterinary school. She admits that she partly didn?t want to go to veterinary school, because everyone else in her family had, but there was a bigger part that did. Coming to New Zealand was a way to forge her own path.

In 2015, Jocelyn graduated from the AVC and accepted a rotating internship at an emergency and referral centre in western New York state. She liked working in small animal emergency, and moved to London, Ontario, where she worked in general practice and in an emergency and referral centre.

The same year, Maureen and Jeff, who by then was associate dean of graduate studies and research at the AVC, moved to Guelph.

?A few things happened,? he says. ?Both girls left home and left the island. I had been an associate dean for five years, and we were coming to the end of that term and were re-evaluating what we wanted to do for the rest of our careers. We could have stayed on; there would have been work for Maureen. I was back doing farm service work and going out in the truck with students, and I just loved it; it was so simple compared to what I?d been doing. But we said, ?We think we have another adventure left in our careers, and maybe we should start looking around?. I applied for a couple of positions in the States, and then this one came up. The Ontario Veterinary College is a top school, and I feel very blessed to have been given this responsibility.?

In December last year, Nicola began a full-time, mixed animal position at BayVets in Whakat?ne.

?It?s great, and I?m getting everything out of a new grad job that I could hope for,? she says. ?I love doing a bit of everything; it?s a perfect balance. The large animal lifestyle is awesome, because you?re driving around and meeting farmers and working towards their livelihoods.?

In February of this year, Jocelyn joined her parents in Guelph to cover a parental leave position as manager of clinical skills. ?I?m part of a team that assists in the development of clinical skills that veterinary students are required to learn. I?m really enjoying it. The job has challenged me and helped confirm that teaching is something that resonates with me. Surrounded by specialists in an academic environment has helped me grow as a veterinarian. I?m always learning.?

The younger Wichtels see a lot of contrast between their job experiences and how clinics are run in New Zealand versus North America.

?I think New Zealand has a long way to go when you compare the roles of technicians and nurses in North America,? says Nicola. ?The other day I was telling Jocelyn that I was on-call and had an emergency, and I said I had no nurse, and she said, ?So you had to draw up your own drugs??, and I was like, ?I always draw up my own drugs?.?

?In most of my clinical experiences, I haven?t even had access to controlled substances or been the one to draw up or administer medication,? says Jocelyn. ?Because of the high volume of cases and fast-paced work environment, the bigger hospitals have adopted ways to become more efficient. I feel that in contrast to New Zealand, the veterinarian?s role is more focused and limited to examining the pet, requesting and interpreting diagnostics and formulating a diagnosis and plan. Technical skills are delegated to animal care attendants or veterinary technicians. It?s not an effective use of our time when we have support staff who have gone to school to master these technical skills and excel in them.?

?To be fair,? says Nicola, ?a lot of the stuff that I do, that I know over there is delegated to technicians or nurses, is actually stuff that I enjoy doing. To me, that sounds almost like just a production line, and it?s just all business, business, business, getting as many animals in and out as possible.?

?It?s one of the reasons they can afford to pay their veterinarians more, though,? says Jeff.

?True,? concedes Nicola.

?Although you often feel like you?re running from case to case,? says Jocelyn, ?I think the North American system is more efficient. Everyone knows their role and gets the job done in a timely fashion. This translates into feeling like you?re helping more pets and doing more good.?

Jeff says that he?s pleased to see Nicola doing a job almost identical to the one he had in Dannevirke. ?For the past 15 years, we?ve been saying that the mixed animal practitioner is going to be defunct and a dinosaur, but in Ontario and in New Zealand it seems there are still a lot of veterinarians who work on all species.?

There?s no predicting where this family will go next. Jeff has settled into his role in Ontario, while Maureen locums at the Western College of Veterinary Medicine in Saskatoon and returns to the AVC when they need her. Jocelyn enjoys her current role and is open to new opportunities; she?s considering applying to the residency matching programme. Nicola is happy where she is, but can?t see herself staying in clinical practice forever. She?d never write off the academic option, but it?s too soon to know.

?We all need to battle the feeling that we want to stay in our comfort zone,? says Jeff. ?When doors open a bit, you should at least peek inside and step through. That?s what got me and Maureen to where we are. I intended to come back from my residency at Iowa State and be a dairy practitioner ? that was my only objective. But when opportunities arise, you have to take them.?

Life over there

Ontario faces similar challenges to New Zealand: an evolving medical environment, paired with rising client expectations, a shortage of veterinarians and veterinarians moving into non-traditional roles.

?We don?t have good data on how many people move to part-time or drop their veterinary careers altogether, but it?s somewhat clouded by the number of other careers they pursue where their veterinary degrees are useful, but may not be considered typical career paths,? says Jeff. ?I?m convinced that the veterinary degree is the most interdisciplinary degree you can get, and graduates who find practice isn?t what they expected have a large range of options to retool themselves. However, we haven?t been particularly good at preparing students for that diversity of career path.?

One of Jeff?s goals is to develop the veterinary curriculum to better prepare students for those diverse careers, and also to improve their cultural, data and text literacy, as well as their ability to form teams functionally ? in other words, to be veterinarians fit for the modern world.

How data, informatics and genomics can help livestock and crops is an area of focus for the University of Guelph, and the veterinary school is collaborating on research into integrating data with better agricultural practices. The use of informatics to inform a One Health approach is another area of interest, as are zoonoses and public health (the school has a Master of Public Health programme).

?Climate change is a big deal in Canada, and we are seeing massive increases in diseases coming from the south, such as Lyme disease. We have an expansion of the tick vector in our wildlife population and, consequently, significantly more human infection. That?s an active area of research for us.?

The veterinary school is taking a lead on antimicrobial resistance and drug stewardship in all species, but particularly in poultry and swine. How the gut microbiome affects an animal?s ability to adapt to stress and disease is another area of research. Tools like personalised medicine, telehealth and telemedicine are also gaining steam.

?Digital technologies will permit veterinary practices to have more contact with animal owners before and after visits, so there won?t be as much pressure on appointments. You can imagine pet owners uploading body weight or other relevant case information to medical records, for example.? Ontario, he says, has progressive legislation for these emerging technologies, but practices are grappling with how to integrate telehealth on an everyday basis.

These technologies will also have a role in reaching and protecting the health of vulnerable, underserved populations. ?Despite the fact that many people don?t have a lot of money, they often have smartphones and internet access. There?s a lot of information we could provide inexpensively to those pet owners to help them manage their pets and engage them in preventative healthcare. It won?t prevent accidents and emergencies, but it will lead to a healthier pet population.?

Veterinarians will need to engage with these techniques, and learn how to respond to an increasingly affluent population putting pressure on practices. ?We?ve seen huge growth in companion animal caseload in most Ontario practices. It has really struck home this and last year how we?ve underestimated the demand for veterinary services. We went through quite a long flat period when there really was no expansion of veterinary practices in our cities and small towns for companion animals, but that has turned around. Now almost every practice in Ontario is trying to hire.

?I don?t think anyone completely predicted the shortage that we have in New Zealand, Canada and the US. But it?s happening, and the question is whether this is a cyclical thing or the new reality. As long as the economy stays relatively strong and people have disposable incomes and are spending them on their pets? health, I think we are looking at a tight market for veterinarians.?