There's a First for Everything

By: Megan Cassels-Conway

University of Georgia, Class of 2012

A first-hand account of Ruffian Equine Medical Center’s first extern and her first experience with orthopedic surgery

When you first get to an externship, you don’t really know what to expect. Of course, you’ve done your research- read the website, looked at brochures and talked to other students who have been there.  But what if you are the practice’s very first extern? How do you know what to expect?

When I was looking for externships, a friend had told me about a new equine hospital that was being built in Long Island, NY. Living in northwest Pennsylvania, where I am originally from and spend my holidays and summers, there are no equine hospitals for hours. In fact, there are no equine vets at all within 90 minutes. Potential surgeries are taken five hours to the University of Pennsylvania or four hours to Cornell University Veterinary Schools. With the severe lack of opportunities for a hopeful equine surgeon, I was excited to hear about a state-of-the-art equine hospital being built five hours away.

Going to my faithful source, Google, I found virtual tours and articles about the 18 million dollar Ruffian Equine Medical Center being built and set to open Spring/Summer 2009. When it came time for me to apply for summer summer externships after my second year, the website wasn’t quite up yet but after much searching I found an e-mail and scheduled my summer externship.

When I drove into Long Island, right alongside Belmont Racetrack. Across the street from the track barns was Ruffian Equine Medical Center. I would have driven right past it if it weren’t for the huge metal silhouette of a horse race on the front of the building.

The intern came out to greet me and gave me a tour of the hospital: two surgery suites, treadmill, radiology room, nuclear scintigraphy stalls, CT room, and a 30-stall barn. After all the virtual tours and articles I read, I expected a nice hospital but this little building had everything you need in a compact package complete with massive flat screen TVs in the surgery rooms.

Upstairs were the offices, conference room, lab and extern housing. Conveniently in the middle of the hospital and next to the kitchen and bathrooms, the room had a pull-out double bed, dresser, desk and was stocked with sheets, towels and pillows. The surgeon even brought one of his own TVs and set it up for me.

My first morning everyone was very friendly and helpful. Since the practice wasn’t even a year old yet, they were still building a client base. That day there was nothing on the books so the anesthesiologist, Dr. Rachel Carpenter called Dr. James Hunt, the director of REMC who practices racetrack medicine at Belmont.

Dr. Hunt picked me up and I got my first taste of the high-speed world of racetrack medicine. We literally ran from the car to into the barn.  Almost before you even walked in the stall it was time to start to the next barn. I had never seen a community like this. Behind the racetrack there was a whole miniature town with over 60 barns and thousands of horses. Injections, jugs, lameness exams. The next few hours were a blur. I learned about racetrack culture, common problems and treatments. I met renowned horse trainer, Bill Mott, and a many notable horses, a few of which ran in the Belmont Stakes two weeks later. I loved the constant excitement but Dr. Hunt did this everyday from 4 a.m. to 6 p.m. or later.

If you go to REMC or are just interested in racetrack medicine, I would highly recommend spending some time with Dr. Hunt. He was more that willing to share his years of knowledge and experience and there’s never a moment of boredom.

By the time we returned to REMC around lunch, a horse had come in for a lameness exam. Some jogging, flexion tests, nerve blocks, joint blocks and radiographs. They had suspected a P1 chip but radiographs showed not only a P1 chip, but also a condylar fracture, a stress fracture in the cannon bone, and a chip in the other fetlock. This case just got a whole lot more exciting. The surgery was scheduled for the next morning.

I woke up the next morning and headed down for morning rounds in the barn, excited for my first orthopedic surgery. I had always thought I might be interested in orthopedics and seen videos, but this would be my first live, in the OR orthopedic surgery and I was getting to see four procedures in one.

The surgery was more exciting than I would have thought. I knew I wanted to do surgery and had seen plenty of colics, but this was a whole different world. Right then and there I decided orthopedics was my new path in life.

Dr. Chris Byron, a board certified surgeon, was great about answering questions and explaining what was going on during the surgery. When boarded anesthesiologist Dr. Rachel Carpenter was in surgery, she talked me through the procedures and what needed to be done for the patient following.

The afternoon was filled with lameness exams and so it went for the rest of the two weeks -- surgery in the mornings and lameness exams in the afternoon. My two favorite things. Most of the horses walked over from the track but there was the occasional sport horse and different cases—hematoma, abscess, etc.

The nice thing about REMC was that since they didn’t do emergency surgeries, the day wrapped up around 3 or 4 every afternoon. This left me time to explore long island. Within a ten-minute drive there was every restaurant and all the shopping you could want. Weekends were mostly free too (other than the emergency colic surgery one day). I spent time watching races at the track and the intern and techs even invited me to come out with them one night.

REMC was planning on doing colic’s but weren’t starting until July. Friday was the first colic surgery and initial run through to make sure everything went smoothly before fully opening their doors to any colic. Since I had been a large animal emergency surgery technician at school, I was recruited to help the techs through their first colic surgery. That weekend another colic surgery came in.

During my two weeks at REMC, I learned so much about orthopedics. Dr. Byron even took time to show me old cases, teach me his method to perform a lameness exam and give nerve blocks. Dr. Byron was still in full professor mode, having been an equine surgery professor at the University of Illinois vet school up until coming to REMC a year before. Since I hadn’t had radiology yet, he taught me about reading a radiograph and CT and about the common problems in racehorses. The intern at the time, now a resident at UC Davis, explained her research on radiographing spiral condylar fractures using a skyline view and CT.

I would recommend anyone interested in lameness, surgery or racetrack spend time at REMC. They only have housing for one extern at a time but you get one-on-one treatment. It is not extremely hands on but was much more so than other externships I have done. Their specialties are lameness and orthopedics with a main caseload of racehorses and some sport horses. They are now doing colic surgeries 24/7, so you probably won’t have the free time that I had but will get more experiences. They also had multiple educational seminars for their intern and techs, which I was invited to participate.

On the downside, some afternoons were slow, as they were still building a client base. I was there when there were a lot of horses coming to Belmont for the Belmont Stakes. I had heard from a friend who went later in the summer that it was much slower. Since I was there, they also added a second surgeon. There are now four vets there: two boarded surgeons, a boarded anesthesiologist, and a racetrack veterinarian.

In the two weeks of May 2010, I spent at Ruffian Equine Medical Center, I found my passion for the racing industry and a new direction for my career. I learned so much about orthopedics and racing, which helped me in classes and other externships. The friendly staff made me feel right at home and at the end of two weeks I started to feel like I belonged there. If racing, lameness and surgery are your interests, REMC was a great learning opportunity. Be engaged and involved and the veterinarians will be more than willing to teach.

For more information go to ruffianequine.com, email info@ruffianequine.com or recarpenter@ruffianequine.com, or they are now on facebook.