CPD
CERTAVP
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View from the Finishing Line - module summary extracts and essays
Module A summary comments:
“When I first read the titles and description for module A I did not think that the course was likely to help me develop into a better veterinarian… This view changed greatly… I am now much more aware of how I put across information to an owner… dramatically reduced stress I experience at work… consultation … business aspects… hope that it (change) does not occur as I think that the veterinary profession needs to expand its knowledge in this area… enhanced my abilities not only as a clinician but also with many aspects of being a veterinarian.” Robert Quinn
"I was disappointed that the first module was not clinical… I now have a renewed enthusiasm and… I understand the relevance of these topics to my career… The RCVS Guide to Professional Conduct has been pivotal for researching this module…" Victoria Phillips
“Like some other veterinarians I was a little sceptical about how much I would gain from completing this module and saw it as just a "hoop to jump through" to achieve my qualification. However, like many who have completed the module, my original opinions have changed dramatically and I have seen a huge value in undertaking this assignment. Initially I thought the subjects covered were 'soft' and I would already be capable of the majority of learning outcomes. However, it very quickly became a wakeup call on how little I actually knew about the aspects of being a veterinarian other than the clinical work. I realised how inadequately the veterinarian degree had prepared me and thus I had a lot to learn…I would therefore like to see the A module, in some shape or form, become compulsory to all new vets, either during their university education or once graduated, possibly incorporated into the PDP. At the end of the day the qualification is the Certificate in Advanced Veterinary Practice and the undertaking of this module has definitely made me a better practitioner – improving my professional work.” James Guthrie
“In conclusion, although on first glance this module has been criticised as irrelevant to veterinary studies I have found it extremely eye opening and informative. It has made me think about topics that I deal with on a daily basis, but never consciously thought about or focussed on how I could improve when dealing with these areas, and how this would benefit me as a clinician.” Claire Walker
“Starting this certificate has improved my knowledge, skills and enthusiasm. I feel the active process of researching and writing is a far better way of learning and developing than the passive style of most CPD courses. It has given me the discipline for self study and also my confidence has grown. I would strongly recommend pursuing this course…”David Moore
“When I first embarked on the certificate in Advanced Veterinary Practice (CertAVP) the most daunting aspect by far was module A; ten essays on a variety of non-clinical subjects. I feel that a lot of my education prior to this certificate has been somewhat “spoon-fed,” so I ound the self-learning aspect of the CertAVP a huge challenge, and it took me a while to get going. The first essay on the list
was regarding “physician agency,” a term I had never heard before. Thus began a process where, over some weeks, I would teach myself about a novel subject before starting an essay which invariably I would find surprisingly interesting and relevant … I now realise that the very action of being enrolled in a certificate has increased my clinical standards and my personal expectations of practice already.” Simon Ratcliffe
“The module has been incredibly valuable as it has allowed me as a practicing veterinary surgeon to reflect on many areas of my professional life… I feel that the whole module has enabled me to assess many different areas of the veterinary profession and has changed and evolved my approach and behaviour towards cases and clients.” Victoria Ludlow
My experience of learning throughout this module has been at times challenging, but also very rewarding. Many of the subjects I had to write about were unfamiliar to me and presented new learning experiences. Having explored these subjects I have become more competent and experienced as a veterinarian. I have gained much knowledge in the various subject areas whilst researching for the essay using peer reviewed articles, on the internet and through university libraries. Prior to this module I had no experience and minimal understanding of how to gain access to such resources. I now access these databases regularly to find articles relating to various problems I have encountered in practice. James McCurrough
“Studying for the Professional Skills module has formed part of my continuing professional development, at first I saw it as a means to an end of achieving my Cert AVP, but now I realise it has given me so much more. CPD not only provides specific training and career development but moreover it is a means of personal development, life-long learning, provides employers with assurance of competence and the general public confidence in the profession (Friedman and Phillips 2004). Apart from these benefits I am just happier in myself, work is less stressful, I can manage my time better, I am more motivated than ever …The benefit of learning constructive self-reflection has been invaluable…...... Sabrina Verjee
“I must confess that I have not particularly enjoyed the process of working through the CertAVP Module A, essay writing not being my strongest point. However, I do recognise the fact that the process has improved my knowledge of various aspects of veterinary practice, which will have long term effects on my attitude to practicing.”
Matthew Green
“I have been surprised at the increasing frequency with which I have turned to the RCVS website and the Guide to Professional Conduct, and alarmed to realise the gaps in my working knowledge of the guide. I therefore feel more engaged with my professional body and more professional in my approach to work as a result.” Jane Shipsey
B-SAP.1 summary comments:
Karl Underhill BVetMed MRCVS
Karl lives in the UK and has been working on a Surgery CertAVP since April 2009
Since completing the B module I have noticed various changes in my approach to clinical cases. I feel that there has been a natural progression involving the identification of weaknesses and using sound
planning and research to correct these. Undoubtedly the internal medicine question is the best example of this. My interests lie in the surgical field and the majority of my continued professional development to date has focused on this area. It was therefore tremendously useful to remind myself of the problem based approach and I now feel my approach to such cases is more systematic and logical. The technique is particularly useful when patients present with multiple clinical problems. Assimilating these problems in this manner enables sound decisions to be made with respect to the best next diagnostic step and improves the chances of obtaining significant results.
Module B of the Cert AVP has encouraged research around each individual case that I treat, has encouraged a more systematic and thorough approach and has therefore helped maximise the chances of a successful outcome for each individual case. I feel that my confidence in areas other than my main interest has increased and my client communication has improved significantly. I am now better prepared to recognise when a second opinion from a more experienced colleague, or even referral to a specialist, would be indicated. I understand in more depth the limitations of which each diagnostic modality provide and therefore find myself better able to request more advanced diagnostics like magnetic resonance imaging for example.
Dan Makin BVMS MRCVS
Dan lives in the UK and has been working on a Medicine CertAVP since February 2011
To conclude, completion of this B module has proved beneficial in several ways as well as being an enjoyable process to complete. The general requirement to examine in detail techniques and approaches to routine surgery, medicine and imaging have allowed a better awareness of mistakes or habits I had developed and how small alterations in these processes can have much more significant benefit. I have had to revisit subject matter that I had not reviewed since university and have found that now being a little more experienced those subject areas are more easily understood, this was particularly noticed during the work for the anaesthesia and therapeutics reports. I would consider the most valuable thing I have learned which will be essential when completing the small animal medicine C module is the technique and format required to successfully complete a medical case report. The benefit of having my first draft report assessed was invaluable and I feel confident now to have a clear understanding of the thought processes and writing technique required for future case submissions.
Philip Witte BVSc MRCVS
Philip works in a referral centre on the south coast of the UK. He is working on a surgery CertAVP since May 2009.
The further reading involved with the writing of the medicine, therapeutics and anaesthesia cases has been a useful reminder for me that merely doing what others around me are doing is not a sufficiently high standard of practice. Whilst learning from what others do is no bad place to start, a good clinician should be able to fully justify decisions made. I have enjoyed researching some subjects to which I am infrequently exposed and would otherwise not have devoted time to, and other subjects which are a relatively common part of my routine work and deserve more thorough understanding.
Sharon Lewis MA VetMB MRCVS
Sharon is from Essax and is working on a small animal CertAVP.
Having been in practice for several years I found CPD available could be repetitive, so I decided to do online CPD. In completing these courses I became enthusiastic about how much could be gained from study that involved constructive feedback and decided that I would benefit greatly from studying for the modular certificate. Having been away from academia for many years, I initially found the process of writing essays and case reports daunting. However, I felt I needed the challenge to improve my knowledge, develop my ability to handle difficult cases and enhance my expertise through reflective learning. Previously, I would start to develop new techniques and skills only to let them dwindle when time pressures at work increased. The structure of the module allowed me to take my time while providing ongoing challenges with each new case report.
Dawn McClung MVB MRCVS
Dawn is currently working as a locum in Bristol. She plans to study either three small animal medicine modules or possibly two small animal medicine modules and a clinincal pathology module.
The completion of the small animal practice B-module has certainly been a challenge and taken much longer than anticipated. It has been my first experience of writing detailed accurate case reports since university and I had forgotten the number of hours of work needed to research, produce and reference them. Despite the pressures of veterinary working hours and job changes slowing progression through the module, I am now very satisfied and somewhat relieved to have reached its endpoint. The skills I have developed range far wider than expanding my knowledge base. Time management, recognition of the need to set myself targets and deadlines and the importance of detailed and accurate referencing have been key learning points.
Natalie McDonald BVMS MRCVS
Natalie is working part time in a mixed practice in the Scottish Borders. She has chosen C SAM 8 to enrol on next and is planning to work on the A module simultaneously.
This module has enhanced my small animal practice skills across all disciplines. I now justify everything I do for a case which has improved my attention to detail and has reduced errors. I have improved my writing style throughout the module and have learnt to be concise and reference correctly. I have enjoyed studying for this module and feel motivated and confident in all aspects of small animal practice as a result.
Jacquie Griffiths BA(Hon) VetMB MRCVS
Jacquie works in a small animal hospital in SW London with both first opinion vets and referral vets. She will be selecting a surgical module, a diagnostic imaging module and poss another surgical module, poss medicine or an emergency and crticial care module.
Overall I feel I have benefitted greatly as a general practioner from undergoing the studying required to complete this module. It has reignited my desire for learning and self-improvement, highlighted weaker areas in my knowledge and approach to cases and increased my confidence in my abilities. I am now more comfortable criticising my approach to cases and changing as necessary. Having recently been the owner of a very sick dog myself I found the most reassuring qualities in my vet were confidence, clarity and kindness; I aim to emulate this to the best of my ability.
Jacqui Ward BVSc MRCVS
Jacqui is an Aussie (Uni. of Qld grad) working in a small animal practice in Wales. She is hoping to do ophthalmology C modules if they become available for assessment. Or feline med
icine and/or clinical pathology C modules.
I now understand the value of reflecting on cases to identify areas of weakness, in order to improve my methods. Assessment has highlighted the importance of finding the most up to date scientific papers on a topic, as even current editions of textbooks can contain out-dated information. The confidence I've gained through this research, has helped my clinical decision-making and also helped me to educate my clients, in order for them to make informed decisions. This will benefit my patients by improving the efficiency of investigations and will reduce unnecessary costs to owners by using the most appropriate tests to reach a diagnosis. I have also gained an improved sense of job satisfaction. I will continue to apply what I have learned so far, both at work and when embarking on Module C.
Richard Rallings BVetMed MRCVS
Richard works in small animal practice in Aylesbury and enrolled on the Cert AVP in 2009. He is planning to do three small animal medicine modules (C-SAM.8, 9 and 10).
In conclusion, the process of writing the Module B case reports has reiterated to me that continuing professional development is not the attainment of specific goals but to derive the benefits of improved knowledge and skills learned during the studying process. I feel that my approach to problem solving has become more logical and that I give more consideration to the selection of appropriate therapeutics and am better able to justify the use of diagnostic procedures. I have also been able to make a transition from writing in an objective, factual style to a more reflective one which has helped me to critically assess the way in which I work and question our protocols rather than accepting the status quo. This has been reinforced through my further reading to help integrate more up to date thinking and has enabled proactive discussions with my colleagues to help effect change based on current best practice.
Experiences from candidates who have passed the CertAVP:
Harriet Thomas VetMB MA MRCVS
Harriet lives in the UK. She enrolled June 2008 and completed September 2010.
Essay-based Module A covered topics as diverse as welfare and ethics, practice management, communication skills and health and safety. The daunting task of essay writing several years after leaving vet school was greatly facilitated by the online support offered by the RVC alongside this module in the form of a discussion board shared by other candidates and email advice from module administrators. A further source of support came in the form of feedback based on essay plans from the module examiner which made sure that I wasn’t miles off the point in my interpretation of the set essay titles.
After completion of module A, I moved on to Module B in which I chose the Small Animal Practice option. This consisted of more clinical material and was useful in highlighting a logical clinical problem solving approach. This was explained in detail with practical examples when I attended a CPD day at the RVC provided by the course organiser. This approach whereby a problem list is constructed and ordered based on history and clinical signs and then narrowed down to a relevant body system and then a list of differential diagnoses has been useful not only for passing the module but also in complicated clinical cases encountered in practice. Module B essays whilst being clinically focussed are still very broad and cover medicine, surgery, anaesthesia, diagnostic imaging and clinical pharmacology.
The second part of module B was an internet exam which seemed to be a feat of technology and was launched this summer. The timing was carefully
chosen so that people in different time zones would be able to participate! The infrastructure was tested twice before the real exam and worked well on the day. The internet exam format was super efficient at marking such that I received my grade for the exam immediately after I clicked the ‘submit’ button. It felt very bizarre to have completed an exam alongside several other people and received the results within 1 hour without actually seeing another soul and without leaving my front room. Such are the wonders of modern technology!
I chose the three emergency and critical care modules for section C and it was really exciting to be able to study in depth a subject which truly fascinates me and which has not previously been offered as a certificate subject. Each is run as a stand-alone module but there is some cross over and I would highly recommend sitting all 3 for a rounded take on the subject. Online support was in the form of a discussion board which had direct input from the course organiser. Current papers from the Journal of Emergency and Critical Care were highlighted including a hilarious study looking at the correlation of emergency cases with Friday 13th and the full moon – I’m sure this has crossed every emergency clinicians mind when dealing with a ridiculously busy night on call when you can certainly believe some of the clients have been affected by celestial activity!
The written work comprised case reports, case logs and reflective essays as well as an essay discussing a current area of human critical care with direct veterinary relevance. Because the field of human critical care is much more established than its veterinary counterpart, reviewing human studies can offer greater insight into corresponding veterinary conditions. I looked at a fascinating paper on the crystalloid/colloid debate in sepsis which has obvious direct veterinary relevance. The case log and guidelines for the three written exams held over 3 consecutive days, placed emphasis on practical techniques and clinical approach to cases rather than on esoteric theoretical concepts.
I completed the Cert AVP in 2 years. In this time it has allowed me not only to improve my understanding of emergency and critical care but also to revolutionise my approach to complex medical cases. An unexpected outcome has been enhancement of my awareness of veterinary management issues and approach to welfare and ethical problems and after writing 27 essays and case reports, I have definitely overcome any fear of essay writing!
Elaine Ng VetMB MA MPhil MRCVS
Elaine lives in Hong Kong. She enrolled June 2009 and completed May 2011.
I am delighted to have passed the CertAVP. It has been a valuable and rewarding experience.
It is never easiest to achieve CPD for an overseas practitioner, especially when it comes to acquiring new qualifications. Some of the difficulties I found in the process included a lack of veterinary libraries, bookshops for veterinary textbooks, instructional conferences, and also the lack of study peers and, available and supporting supervisors. I was working towards the traditional certificate initially, but due to an unfortunate circumstance missed the opportunity to complete it. As it was being replaced by the new CertAVP, I was unable to enrol in the former again. I had my case reports and case logs well formulated by this time however, and I was determined to overcome any obstacles that laid ahead to work towards the new CertAVP qualification.
Even though at first sight the CertAVP might appear less demanding than the traditional certificate, I would argue that it is not any less demanding. Besides the modular structure, the new requirements differed from the traditional in two main ways.First, we need to exhibit not only specific-veterinary knowledge, but also a general knowledge base in areas that affect our professional lives, such aswelfare, ethics, marketing, communication skills, legislation, and management. Second, the new system required personal reflection and review of our professional work. The required essays were
specifically designed to promote self-reflection, and to elicit thought-provoking considerations.This is actually the part I found most challenging.
The CertAVP has actually shifted my perspective of CPD, and learning as a whole. It is not only about attending courses, reading journals, or performing specific academic tasks and passing exams. It is about developing ourselves as people and professionals, and the CertAVP program further helps to foster a deeper understanding of the veterinary industry as a whole.I feel well equipped now to pursue my career with the added advantage of the CPD qualification.
Adrian O'Shea MVB MRCVS
Adrian lives in the UK. He enrolled in April 2008 and completed in September 2011.
My decision to undertake a Cert AVP was based on a personal desire to advance myself professionally, clinically and academically. While I was well aware from the outset that studying towards a Cert AVP involved extensive background reading in areas such as small animal medicine, diagnostic imaging and pharmacology, it was always my intention to focus on surgery in my final module. While I have always had a passionate interest in both orthopaedic and soft tissue surgery, studying towards a Cert AVP has allowed me to greatly expand the range of surgical procedures I can offer my clients and their pets. For example I am now in a position to offer a wide variety of advanced soft tissue reconstructive techniques, which have become instrumental in the successful treatment of many of my surgical oncology cases. Arthrodesis techniques and Tibial Tuberosity Advancement surgery for cruciate disease regularly now feature among my orthopaedic caseload. It cannot be disputed that with falling household incomes and with insurance premiums becoming increasi
ngly more expensive often to the point of being prohibitively so, referral to specialist veterinary surgeons is frequently no longer an option. It is therefore imperative, in my opinion, that as a veterinary surgeon in first opinion veterinary practice, I am proficient in a wide variety of advanced surgical techniques.
I must admit that I found the prospect of writing essays on such matters as communication, multidisciplinary teams, staff appraisals and veterinary ethics a little daunting, however once I put pen to paper I was able to progress through the module with relative ease. Certainly being involved at managerial l
evel for the past number of years made the task easier and enabled me to draw on a wealth of previous experiences. On reflection the module A was extremely rewarding. For example, I now not only use my practice management system for the recording of clinical details and the analysis of financial data, but I find it invaluable in the area of clinical audit. It enables me to systematically critically analyse the quality of care we offer our patients and in doing so, make necessary adjustments through regular multidisciplinary team meetings and staff appraisals.
I chose the Small Animal Practice option for module B and thoroughly enjoyed writing case studies in medicine, pharmacology, anaesthesia, diagnostic imaging and surgery. The summary essay involved both self-reflection and critical appraisal, which were to become an integral part of the essay writing in Module C.
Module C was a mixture of case diaries, case reports, essay writing and finally two written exams. I completed the ‘core’ surgery module first and then chose an orthopaedic and soft tissue surgery module. This involved extensive reading in areas I am passionately interested in. Studying for these modules has undoubtedly changed the way in which I approach and investigate cases and it has enabled me to employ more complex and challenging surgical treatment options where appropriate.
In conclusion I found the Cert AVP to be a thoroughly rewarding experience from start to finish. I’m glad I chose to be assessed by the RVC. Joanne Jarvis the Cert AVP manager was always extremely knowledgeable and made every effort to offer prompt support when required. Apart from gaining a valuable postgraduate qualification, the process has without question changed the manner in which I approach my work. It has not only given me a great deal of personal satisfaction but through constant reflection and critical appraisal, it has given me the impetus to greatly improve my practice and in doing so contribute greatly to the level of service I offer my clients and their pets.
Sarah Mason BSc BVSc PhD MRCVS
Sarah enrolled in the CertAVP in 2008 and is currently doing a residency at the University of Liverpool
I started the CertAVP in 2008. I decided to enrol with the RVC for all of my modules as I thought it would be more streamlined to work with just one provider. I liked the modular structure of the qualification; as a relatively new graduate when I started I considered doing various combinations of clinical modules before finally focusing on medicine.
I did the modules in order, I found module A quite useful and most of the topics were interesting. It was a good way of developing a thorough understanding of my professional role before progressing to clinical case reports and it definitely gave me more confidence at work. The B module was helpful for getting into the way of writing case reports and I particularly enjoyed the therapeutics part of the module.
I took three C modules in Small Animal Medicine, starting in 2009. I completed and passed one of the modules in 2010, and the other two in 2011. This was partly because I wanted to “test the water” with the first one and partly because it took me longer to collect the cases for the others. Each module comprised three case reports, a log of 50 clinical cases, a reflective essay and a one hour written exam.
Finally I took the RCVS synoptic exam in September 2012 and was very pleased to pass as this was one of the most nerve racking experiences of my professional life. The exam comprised half an hour to look over the material for three clinical cases, and then an hour of oral examination of the three cases.
Overall I would recommend the CertAVP, I enjoyed the experience. The qualification provides a structured and manageable system to improve your knowledge and professional skills. The RVC CertAVP is essay based and the time limits on each module are broad, which means you can fit the work around your other commitments.
