An Extern Abroad

Submission by Catherine Lang, Texas A&M.  Congrats on your 1st Place Experiences Award!

         Fourth-year. Clinics. The year we all daydreamed of while zoning out in first-year anatomy lab. The year we finally face live patients, as opposed to cadavers. The year we finally get to apply our book knowledge in a clinical setting. Instead of spending all day in the library pouring over books and powerpoints, we spend all day in the hospital – ordering lab work, running to the pharmacy to pick up medication, and learning how to think like a doctor.

         I’m tracking small animal because I’m interested in going into a small animal private practice when I graduate. As a result, I’ve spent the majority of my year in the Small Animal Hospital at Texas A&M. Built into the small animal track are four weeks of externship that I can use to learn about how veterinary medicine is practiced outside of the University walls. Most people use this time as an opportunity to work in a private practice in the U.S. – perhaps as a way to learn more about a clinic that they’re interested in working for after graduation. I decided to expand my options, leave my comfort zone, and do my externship in Faxe, Denmark.

         Why Denmark? Well, I have studied abroad twice before in Padova, Italy: first, studying physiologySidse (5th year veterinary student at the University of Copenhagen) and I with a patient recovering from a foreign body surgery. during the summer of 2012, and second, participating in a food safety and public health seminar during the summer of 2014. I consider each trip to have been an invaluable portion of my veterinary education as a rare opportunity to learn about veterinary methods and practices worldwide. Because of these past travels, I learned that outside the arena of scholastic learning, I really enjoy traveling and experiencing new cultures – especially those in Europe. I knew I wanted to spend at least part of my externship time at a foreign clinic.

         Denmark originally came up after hearing great things from some classmates who had previously studied abroad there with Dr. Wasser. While I was struggling to decide between countries, the Universe seemingly made my decision for me: my boyfriend, a law student at the University of Texas, had finalized his plans to study abroad for the fall semester in Copenhagen, Denmark. Knowing that I had a free place to stay in Copenhagen (a huge plus when you are living abroad as a student), having heard great things from Dr. Wasser, and having never visited the Nordic region of Europe previously, all of the pieces fell perfectly in place.

         The clinic where I worked in Denmark was called Evidensia Faxe Dyrehospital, located about 78 km outside of Copenhagen in a small rural town called Faxe. They have both a small animal and large animal hospital. The small animal hospital (where I spent the majority of my time) is a general practice, an emergency clinic, and a referral practice specializing in orthopedics. They will see any problem, and might refer in certain situations; one such example was a dog with mitral regurgitation that needed specialized diagnostics performed, such as an echocardiogram. I was surprised to find out that the clinic had advanced diagnostics that are not always found in standard U.S. private practices, including a CT scanner, ultrasound machine, arthroscopy, a water treadmill, digital radiography, and dental digital radiography.

         During my time there, I was able to observe and scrub-in on multiple surgeries, such as a dorsal hemilaminectomy, foreign body removal, arthroscopy for a fragmented medial coronoid process, and a Tibial Tuberosity Advancement (TTA) surgery. Many of these procedures are ones we had learned about in school, but it was the first time for me to see them in person. The doctor I spent a lot of time with in surgery was named “Ken,” known as one of the best orthopedic surgeons in Denmark. Not surprisingly, Ken had previously spent time in Houston to observe the surgeons there and learn more about their technique. Ken was just another example in a common trend I began to see among the best veterinarians: almost all had a tendency to branch out and expand their learning in places around the world.

         I really enjoyed observing surgery because the clinicians were very knowledgeable. Because there were no clients in the surgery suit, they would speak in English so that I could understand what was going on. I also spent some of my time observing medical treatments, and went into the rooms with veterinarians for regular appointments. This was challenging at times because they would speak Danish during the appointment, so I would carefully watch the physical exam to see if I could pick up on what the problem was. I don’t know if y’all have ever heard/tried to understand the Danish language before, but let me tell you – there’s a reason Denmark is known as the best English-speaking country in Europe. Because only 5.5 million people speak it worldwide – and due to how notoriously difficult it is to decipher – Danish students learn English from a very young age, and must take various courses entirely in English to earn a degree from the University of Copenhagen. After each appointment, the veterinarian would give me a synopsis of the appointment in English. Although Faxe was far more rural than the capital, their English was still more than understandable.

         Denmark has been named the happiest country in the world, and I can definitely agree after visiting. Everyone at the clinic was very welcoming and friendly. When I was organizing this externship, I was nervous about the amount of traveling between my boyfriend’s house in Copenhagen, and the clinic in Faxe, located 78 km away (1.5 hours by car and 2 hours by public transportation). The trip involved a 15-minute walk to the train station, a train to the town of Koge, then switching to another train to Faxe. From there, I would need a bus from the train station to the nearest bus stop by the clinic, and 15 more minutes of walking from that bus stop. The clinic could tell I was a little apprehensive through my emails (again, their English comprehension was amazing), and reassured me that it wouldn’t be too difficult. They even offered me a place to stay with one of the veterinarians in Faxe during the nights I would be working. How insane is that – offering up your home to a random girl from another country, whom you’ve never met before and had contacted you out of the blue. My boyfriend likes to joke that in this regard, the Danes may be TOO trusting, as I can be a handful to live with. I’ll take a page from his law school books and “plead the fifth” on that one.

         Even though I was nervous, I decided to go for it, knowing this was a once-in-a-lifetime (ok, maybe three-times-in-a-lifetime for me) opportunity, and trusting that everything would work out. After my 17-hour flight, I took the two trains to Faxe on no sleep to start my first day at the clinic, fully prepared to spend the night at the veterinarian’s house that I was about to meet for the first time. At the end of the day, one of the veterinarians had heard my boyfriend was staying in Copenhagen and happened to live there herself. She commuted every day between the two cities by car, and offered to give me a ride home. It just so happened that she lived just a 7-minute walk from Jordan’s house. I couldn’t believe my stroke of luck – instead of having a crazy commute every morning and night, I was able to ride with this young veterinarian named Rikke every day. She is only a couple of years older than me, so we had a lot in common. We had no trouble filling the commute with conversation: we talked about veterinary school, life as a new veterinarian, Christmas traditions, relationships, and everything in between.

         In another happy coincidence, a 5^th-year veterinary student at the University of Copenhagen was spending a week externing at the clinic in Faxe during the first week I was there. “Sidse” had actually been to College Station before, and studied with Dr. Wasser at A&M in 2013. She even knew some of my classmates from when she visited. I was thankfully to have her there because it made me much more comfortable. She would translate conversations between the client and veterinarian when they spoke only in Danish. I introduced her to different resources I’ve used as a student that are free to students worldwide, and she told me things I should check out while I was in Copenhagen.

         While in Europe I also used my two-week vacation, and was able to travel to Munich, Germany for Oktoberfest; Budapest, Hungary; Vienna and Salzburg in Austria; visit my cousin in Zurich, Switzerland; visit friends in Lucerne, Switzerland; paraglide in Interlaken, Switzerland; and relax in Lugano, Switzerland.

This was an amazing opportunity, and I am very thankful to the veterinarians and staff at Evidensia Faxe Dyrehospital that made it possible. I also couldn’t have gone there without the help of the International Program Advisory Committee and the travel stipend that they awarded me. I highly suggest everyone get out of their comfort zone and learn about veterinary medicine in another country.