As an internal medicine specialist, Dr. Zikes daily practice life revolves around "difficult diagnoses" for her patients and their people. One year ago, she received her own life-changing diagnosis. This diagnosis deeply affected my life as well.
In this interview, learn what it takes to be "boarded" in internal medicine and surgery, the path that her career and life have taken, and what the two of us are working on these days.
Question 1: DACVIM stands for Diplomate, American College of Veterinary Internal Medicine. What is required to earn the DACVIM status?
Dr Zikes: It requires a really solid start in kindergarten followed by a lot of years getting to and through veterinary school. After graduating from veterinary school and passing national and state board exams a "rotating internship in medicine and surgery" is required for 1 year. That's when you REALLY pay your dues by working crazy long hours, but you get massive exposure to veterinary practice in one supervised year.
Then applications have to be filled out for a residency program. If you meet a program's qualifications and get accepted, then a medicine residency is either a 2 or 3 year program, depending on location. I was in a 2 year program at the Angell Memorial Animal Hospital in Boston. You still work hard as a resident, but now you've got "interns" under you to pay THEIR dues!
During and after your residency you must complete the established requirements stipulated by the American College of Veterinary Internal Medicine. During my program that meant 1) writing detailed case reports that had to be scrutinized/accepted by board certified internal medicine specialists, 2) publishing a paper in a revered veterinary journal, and 3) passing a one day general internal medicine board examination followed the next year by a two day specific board certification examination.
Question 2: How many years, on average, does it take to become board-certified in veterinary internal medicine?
Dr Zikes: It usually takes a veterinarian about 4 - 5 years to complete all the requirements and pass the exams for board certification in internal medicine.
Question 3: Describe a typical day while working in a veterinary referral practice.
Dr Zikes: Internal medicine specialists see a wide variety of cases. This includes patients with heart disease, endocrine diseases (eg. diabetes mellitus), liver, kidney, gastrointestinal, bladder diseases, etc. It often includes patients with cancers of various sorts. We have the option of referring some of these cases on to veterinary cardiologists, ophthalmologists, dermatologists, and even oncologists, but as veterinary internists, we are expected to know and treat all the different systems in the body.
The cases we see as internists are referred to us from general practitioners when a case requires advanced diagnostics or complex treatments with intense monitoring. As you can imagine, the clients that bring these pets are totally devoted to providing the best care available. These clients will often do anything they can to help their dog or cat, no matter what the cost, or what will be required of them at home. Many of my clients consider their dog or cat just like their child. (I've even had clients jokingly tell me they treasured their pet more than their husband/wife or child!)
I have treated a number of patients with cancer. As you can imagine, I often enter an examination room to introduce myself to a client for the first time and find them in tears. They are coming with a diagnosis of cancer in their beloved pet and they need my help. They are scared, worried, and sad. In fact, most of my patients have serious diseases when they come to see me and there are often lots of tears. Educating and comforting those clients can help a lot right off the bat!
After practicing internal medicine for about 17 years, I decided I wanted to branch off in a different direction. I wanted a chance to "cut and CURE"! Which leads me in to answering the next question...
