At the Tufts at Tech clinic, veterinary students take ownership of cases under the supervision of experienced veterinarians, including alumni volunteers
Bryan Gagnon, D.V.M., V23, works with veterinary student Daniella Banton (center), V27, and a Worcester Technical High School student (left) at the Tufts at Tech Community Veterinary Clinic at Worcester Technical High School. Photo: Alonso Nichols
Inside the Tufts at Tech Community Veterinary Clinic, a client is advised about their pet’s condition by someone wearing scrubs. The speaker sounds like a veterinarian, recommending blood work and prescription medication, but they’re actually a fourth-year veterinary student at Cummings School of Veterinary Medicine at Tufts University.
Third- and fourth-year Cummings School students gain hands-on experience being in charge of cases during their rotations at the Tufts at Tech clinic in Worcester, which is based at Worcester Technical High School and provides affordable veterinary care to clients who qualify to receive significantly subsidized animal care.
Students treat the animal patients under the direction of experienced veterinary professionals, including clinic director Gregory Wolfus, D.V.M., V98, associate clinical professor, and three full-time clinic faculty members: Jennifer Grady, D.V.M., DABVP, V12, associate clinical professor; Kayla Sample, D.V.M., DABVP; and Nicole Freeman, D.V.M., V02, both assistant clinical professors. New veterinarians working as residents or interns are also part of the mix.
But with 8-12 high school students, 10-14 veterinary students, and 8-10 patients in the clinic at a time, all in need of oversight and instruction and treatment, three faculty members couldn’t possibly do it all on their own. They also rely on an army of alumni veterinarians who volunteer at the clinic.
“So many of our students have a fondness for our community clinic that they want to participate as volunteer veterinarians and support the next generation,” says Wolfus. “The students of today become the volunteers of tomorrow.”
One of the longest-serving alumni volunteers is Stephanie Sapowicz Fullerton, D.V.M., V15, who has been lending her time to the clinic for about 12 years. Though she works full-time as a primary care veterinarian, Fullerton and other volunteers join Tufts at Tech between once a week and once a month.
Selimah Harmon, D.V.M., V20, and Bryan Gagnon, D.V.M., V23, are pictured outside the clinic during a recent volunteer shift. Photo: Alonso Nichols
The clinic has been a part of Fullerton’s life since it opened in 2011, during her first year as a student at Cummings School. She remembers Wolfus telling students about the new effort and encouraging them to get involved. She was interested right away, as the mission was close to her heart, having grown up in a single-parent, low-income family.
When the clinic opened, Fullerton helped manage the schedule of volunteer veterinarians and veterinary students. Though it has changed a lot over the years, she says one thing has stayed the same: everyone there is very passionate about the mission of the clinic and caring for pets in the community.
That passion is what drew Selimah Harmon, D.V.M., V20, to Massachusetts from Pennsylvania, where she completed an internship and residency after graduating from Cummings School.
“Being part of Tufts at Tech again was a big part of why I decided to come back to the area, honestly,” says Harmon, who volunteers once a week. “As a student, I didn't recognize how much the volunteers were involved, so it has been interesting to be on the other side and see what a big part of the program the volunteers are.”
All in a Day’s Work
During a typical shift at the clinic, alumni volunteers offer their services in a number of ways. Depending on what’s needed, they will either pitch in by helping with appointments or with surgeries.
On the appointment team, as patients arrive, veterinary students take control of the cases. As an appointment comes in, it’s posted on a cork board, and students can grab any appointment. They get the animal’s history from the owner and physically examine the pets, then in consultation with a veterinarian, they develop differential diagnoses and recommend any testing or next steps.
“At Tufts at Tech, the students get to do everything themselves, which is overwhelming and eye-opening for a lot of the students,” says Sarina Selleck, D.V.M., V17. “They get to place catheters, administer medicines, and work on their own patient records. It's fun and rewarding to be involved, get to know the students, and share my own experiences both as a student and in the professional world.”
Selimah Harmon, V20, reviews a case at the Tufts at Tech clinic with veterinary student Shakthi Sivaram (right), V27. Photo: Alonso Nichols
Alumni volunteers talk students through the process, make sure what they’re doing is appropriate, go over all test results, and advise the student on communication with the animal’s owner.
“I'm usually overseeing two or three cases at the same time, as many as 10 cases a day,” says Bryan Gagnon, D.V.M., V23, who volunteers every other week. “But it depends on how many students and doctors are at the clinic.”
On the surgery side, fourth-year students act as primary surgeons on cases, which may include pre-surgical tasks like performing x-rays or getting blood work, as well as the procedure itself. Those may include spay and neuter surgeries, tooth extractions, cystotomies, foreign body surgeries, mass removal surgeries, and even amputations.
“There's a doctor with them scrubbed in and ready to help the whole time, but soon they’ll graduate, and they’ll be flying solo,” says Fullerton. “It’s nice for them to feel like they're owning the case and learning things that will stay with them for future patients.”
Layers of Learning
Students from the high school’s veterinary assisting program are each paired with a veterinary student. High school students help at the clinic by taking patient histories, assisting with lab work, and other tasks.
Selleck, a full-time emergency medicine veterinarian, and Megan Salgueiro, D.V.M., V21, who lives and practices in Rhode Island, were drawn to volunteer at the clinic by their passion for mentorship and teaching.
Veterinary student Emma Gerry, V27, performs a procedure on a small dog under the supervision of Bryan Gagnon, V23. Photo: Alonso Nichols
Salgueiro earned a master’s degree in teaching from Brown University and was a high school science teacher for many years before she went back to school to become a veterinarian. Salgueiro credits Kate Zukowski, a certified veterinary technician at Tufts at Tech who specializes in dentistry, with inspiring her passion for small animal dentistry.
“Kate’s technical skill is outstanding, and even now as a practitioner, I learn a lot if I have the opportunity to meander into the treatment room and listen to her,” Salgueiro says. “Kate helped me do my first partial mouth extraction in a cat that had a condition called gingivostomatitis, and that helped solidify my passion for oral health in small animals. Now I do dentistry three mornings a week in general practice.”
Education travels in many directions at the clinic, and even experienced practitioners come away with new information during their volunteer shifts. Gagnon recalls an opportunity he had during a volunteer shift to observe a surgical procedure that he wouldn’t normally see as a full-time primary care veterinarian in New Hampshire.
“Recently, a dog presented with a complex abdominal mass that needed surgery. Normally, if I saw that in practice, I would refer that patient to a veterinary surgeon. But referral to a specialist can be expensive and is not always an option for Tufts at Tech clients,” Gagnon explains. “A boarded surgeon ended up volunteering his time to come in and help the DVM students to perform the procedure to remove it. It's nice that I get to learn more while teaching here.”
Selleck recalls a unique case involving a cat with a urinary obstruction, that the clinic had hospitalized—which is unusual since Tufts at Tech is not an emergency care facility. But as an emergency medicine veterinarian, she took advantage of the teaching opportunity to instruct the students on best practices in fluid stewardship.
“There are different ways of handling fluids, but the industry is trying to move more toward careful calculation of how much fluid a patient needs, because fluids are not as benign as we used to treat them, and a patient can be overloaded,” says Selleck. “I got to help the students calculate a more evidence-based plan for fluids for their hospitalized patient, which is not something they routinely do there.”
Selleck adds that, as an ER veterinarian, she values the learning opportunity that Tufts at Tech provides her to find out more about primary care medications she doesn’t normally use in her full-time role, like vaccines and allergy treatments. Harmon, who is also a critical care specialist, expresses similar sentiments.
Selimah Harmon and veterinary student Jenna Cosby, V27, discuss a case at the Tufts at Tech clinic. Photo: Alonso Nichols
Lessons in Empathy
Fullerton says it’s important for veterinary students to experience working with clients who have limited resources, because it teaches them not to be judgmental and not to be disappointed in a client if they can’t afford the most intensive and expensive level of care.
“Some students may think that if a client can’t afford the top-of-the-line treatment for their pet, that they don't care about their pet, but they really do care,” says Fullerton. “Having a pet can be such a source of joy and unconditional love, and as practitioners, we want everyone to be able to have that and take care of their animal appropriately.”
Sometimes, she says, veterinarians must be flexible and holistic. They have to make an educated guess based on their top differential diagnoses, without fancy tools or equipment, and attempt treatment. A response to the treatment, whether positive or negative, can indicate whether to stay the course or course correct.
“It’s easy to make assumptions about people, and, even if they qualify for subsidized care at Tufts at Tech, we never want to assume what clients can or can't do or afford for their pets,” says Harmon. “I encourage the students to treat everybody the same, tell them what the gold standard is, explain other options, and then empower the person to decide what is feasible for them.”
Although Tufts at Tech provides subsidized care at 25% of the national fee average, clients still may struggle to afford all the recommendations for care. With support from grants, veterinary students are empowered to make decisions on how to further subsidize care.
For example, Harmon was on duty recently when a cat came in with a fever of unknown origin, but the owner could not afford the full diagnostic workup. With support from grants, a few students pooled resources to look in the cat’s chest, where they found fluid, and Harmon walked a student through performing a chest tap to take a sample.
“I frequently hear, if you can't afford pets, you shouldn’t have them. That narrative shouldn’t exist,” Harmon says. “Having the responsibility of taking care of a pet has taught me a lot in life. It empowers people that they’re not just living for themselves, there is another being depending on them. Everyone deserves the love of an animal.”
