New graduate growth hinges on mentoring

You have selected your perfect job and have a contract that allows you some degree of financial security. Your first day of work starts tomorrow, and you are armed with the latest in medical knowledge and the finest technical skills of anyone in your class. You even won the prize for best student surgeon.

But before you start, try to answer some of these questions:

Have you ever stood alone in an examination room with a client and a sick pet, or in a barn with a farmer and a sick cow, and had to examine, make a diagnosis and treat that animal? At this point, you might not know what drugs and equipment are available to you, and a technician might tell you the next client will be there in 15 minutes.

Have you ever stood in an operating room with a technician you don't know and been confronted with a spay that turned out to be a pyometra? Your new employer has gone to play golf.

Have you ever had to see 30 patients in one day in order to meet your production quota?

Has the owner of the patient you are treating ever been convinced that you don't know what you are doing and insisted on seeing an older doctor?

Have you ever accepted a position with a solo practitioner who is badly in need of a vacation? As soon as you arrive, he or she decides to leave for two weeks, but the non-licensed technician who has been there for a long time will know what to do if you need help. Your first patient is a 15-year-old unsprayed toy Poodle that has anorexia, vomiting polyuria and polydysia. Are you ready?

These are a few of the scenarios you could face on your first day, and if your answer to most of these questions is "no," you better hope you have chosen a practice that is willing to help you through these trials in the form of a mentoring program.

Gap between education, practice

The gap of inexperience between education and practice for new graduates manifests itself several ways. Some of these examples as noted by practice owners who have hired new associates are:

• Poor client communication: New associates talk too much. They try to tell clients about veterinary medicine in an hour as they try to explain to clients what is wrong with the animal. A major complaint is that new associates use big words to sound more authoritative and spend more time talking to the animal than they do the client.

• The money barrier: New associates tend to have a reluctance or embarrassment about asking for money. A sure sign of this is the new graduate apologizing for having to charge whatever the fee might be.

• The decision barrier: Clinical skills vary a lot. Some new graduates are brave and excited about cases. Other new doctors are intimidated.

• The time barrier: They tend to take a lot of time to perform examinations and procedures, routine or otherwise. Whether it is being timid, slow in surgery or too long in the exam room, taking too much time is frustrating for everyone.

If your only actual clinical experience with patients has been in the college setting, you have not been well prepared for what you are about to encounter. If you have worked as a technician before veterinary school or completed an externship in a private clinical setting, you probably are better prepared. A major difference between teaching hospitals and private hospitals is the latter has an absolute need to be successful financially and show a profit, whereas the college clinic does not. This means that the culture of a college clinic and the doctors who were your teachers is different then private practice.

You need guidance

Hopefully you have accepted a position that recognizes the gap between education and practice, and the owners know it is to their advantage to provide you with the mentoring that will narrow and ultimately eliminate this gap completely and in as little time possible. How this will be done depends on the philosophy of the owners, number of veterinarians and technicians on staff and how much experience you brought with you.

The most important part of this equation is whether or not the owner recognizes that you are not going to be able to perform your first day at the level they might expect. Practice owners who have not employed new graduates before are most apt to fall into this trap. This is the reason that one of your new intern questions was to find out if your employer had hired new graduates in the past. Your new employer should recognize that the more help you receive in the beginning, the sooner you will meet their expectations.

The second most important part of the program is recognizing that you need this mentoring.

Mentoring timeline

• Week one: Become acquainted with staff and their responsibilities. Find out who the clients are, learn what supplies are kept and how they are used, what pharmaceuticals and vaccines are stocked, and how and when to use them, even if you aren't familiar with the particular product. Learn how appointments are made, how surgeries are booked, and how the paper work is done, particularly if the practice is computerized. As a new associate, you are responsible for using computer data codes and forms.

• Week two: The new associate shadows the experienced veterinarians in surgery, the exam room, returning client calls, writing up medical records and taking histories. In the case of a large animal practice, this time should be spent with the experienced veterinarians making calls.

• Week three: The new associate continues to shadow the experienced veterinarian but begins to interpret radiographs, lab results and perform some surgery, such as suturing wounds and bandaging.

• Weeks four and five: The new associate should be ready for independence by taking patients performing uncomplicated surgeries. The experienced veterinarians should be available if needed and should spend some time critiquing the new associate at the end of each day. Medical records and charges will be scanned to be sure the new associate is comfortable with those procedures.

• Week six: The new associate should be working alone, performing solo surgeries when there is an experienced surgeon on the premises. Depending on the number of veterinarians in the practice, after-hour emergencies might not be part of the to-do list. By now, the new associate should be able to make solo decisions.

• Three months: The new associate is working to hone routine skills and reduces the time each procedure takes. More complicated surgeries should be done with an experienced veterinarian shadowing.

• Six months: The new associate should be expected to complete procedures in an acceptable time frame and should have eliminated or greatly narrowed the gap between education and practice.

Many practice owners will not allow this much time to be spent on a mentoring program. They will feel that they can't afford to pay you and not get production from you. This will cause friction between you and your new employer. Many new associates will not need this much time. However, a planned program to narrow this gap starts with an understanding that the new associate will progress quicker and more successfully if time and effort are spent on mentoring. As the new associate, you should feel privileged that time and effort was spent on you to develop your skills and knowledge, preparing you to be a productive member of the staff.

Performance evaluation

An important part of any mentoring program is the evaluation. You should want this evaluation; you should request it if it is not forthcoming; you should not be apprehensive of the evaluation and possible criticism coming from it, and you should learn from it. During your mentoring period, you should have been receiving advice and feedback on your performance on a daily or even hourly basis. However, your first official performance evaluation will most likely come at the end of the six-month mentoring period. The veterinarian who has been the most closely associated with you throughout the mentoring period should perform the evaluation. The evaluation should be done in a quiet, private setting. Ideally you will have been given a self-evaluation form to fill out prior to the meeting. If your evaluator has the same form, you will begin by comparing them and then discussing what each of you determines are your strengths and weaknesses. Some of performance areas that should be considered by you and your evaluator are:

• Performance competence: your knowledge of medicine, surgery, radiology laboratory findings and your thoroughness and accuracy in planning treatment regimes.

• Attention to professional responsibilities: your humane treatment and compassion for patients, record keeping, case follow-up and regard for hospital procedures.

• Client management skills: how clients accept you and their satisfaction levels.

• Hospital management skills: your intra-staff communications and relations.

• Professional and practice growth: This area will become more important at subsequent evaluations and should then include activities within the practice to promote services, as well as your community services supporting your practice and the profession.

• Personal qualities: your ability to initiate on your own, your judgment, your attendance record and your appearance.

Learning experience

If you have self-evaluated prior to the formal evaluation, then you have identified most of the same areas of strength and concerns pointed out by the evaluator.

An effective evaluator recommends how to make corrections. This will be the learning experience for you. An effective evaluation should emphasize strengths as well as weaknesses. Accept the criticism that comes with the praise. You should have an opportunity to discuss your experience with the practice and developmental areas that positively or negatively effect your performance. If a personality conflict exists between you and another employee, point that out to the evaluator.

Performance evaluations should become a routine part of your employment with the next coming at the end of your contract term six to 12 months later. Each subsequent evaluation will start by assessing the prior and determining what has improved.

An evaluation held at the end of a contract term may be used to determine future employment, salary and benefit changes.