By Dr. Alison Foucault DVM, MRCVS
Unlike human doctors, veterinarians do not require further training after vet school in order to practice. A vast majority of us will choose to go into general practice, sometimes after an internship, sometimes not, and remain at the front lines of the profession.
Over the last 30 years, however, medical advances in our field have led to a flourishing of disciplines in which vets can seek further training. One of these disciplines is emergency and critical care (ECC).
If you want to see what ECC jobs are out there, why don’t you register with The Vet Service and have a look at your options? If you are not quite at the specialist level yet, we have many other options including graduate vet jobs.
What does “Emergency and Critical Care” mean?
Emergency and Critical Care are actually separate specialities in human medicine. On one hand, emergency physicians are thoroughly trained in triage and managing urgent general practice cases, as well as handling the initial presentation of potentially life-threatening emergencies. Critical care physicians (also called intensivists), on the other hand, specialise in managing the long-term care of very ill inpatients, as well as postoperative care. In many countries, the training of intensivists closely parallels that of anaesthetists as the core areas of knowledge and competencies are very similar.
At the moment, probably for practical reasons, these two disciplines of Emergency and Critical Care fall under the same umbrella of “ECC” in veterinary medicine. While it is much more developed in the small animal field, the speciality also exists in North America for large animals as well.
What does an ECC vet do?
An ECC vet will typically work primarily in the emergency room and intensive care unit of a veterinary hospital. They usually manage the triage and stabilisation of emergency patients and perform life-saving diagnostics and procedures. They also oversee the care of critically ill inpatients. Depending on their training, their preference, and the facility/team in which they work, some ECC vets also perform emergency surgery.
What is the difference between an “ECC vet” and an “ECC specialist”?
While any general practitioner can further develop and focus their area of practice to being an ECC vet, the word “specialist” is reserved for those vets who have undergone higher qualifications through a significant amount of rigorous specialised training. They normally have also passed strenuous board certification examinations, and also make active contributions to their speciality through research, publication, and teaching of others.
The two main committees that have worked to provide training and certification in the world of veterinary ECC are the American College of Veterinary Emergency & Critical Care (ACVECC) which was founded in 1989, and the European College of Veterinary Emergency and Critical Care (ECVECC) which was founded in 2014.
How to become an ECC specialist?
To become a board-certified Emergency and Critical Care specialist, or “diplomat”, a vet usually has to:
- Have qualified from a veterinary college recognised by the governing body where they wish to specialise, such as the RCVS in the UK, the EAEVE in the EU, or the AVMA in the United States, to name the main ones.
- Complete a minimum one-year rotating internship, or equivalent, before being able to apply to a residency program. Residency applications in ECC are quite competitive and it is not unusual for a candidate to have to apply several times, or go and work for several years in their desired field in order to gain more experience and skills before being accepted in a residency program.
- Complete the rigorous 3-year residency program in an accredited facility, under the supervision of other board-certified critical care clinicians. Alternative residency training routes are sometimes approved by both colleges in exceptional cases, but this is not the norm.
- Have their research project published in peer-reviewed, scientific veterinary research journals during their residency
- Pass the certification examinations of the board they wish to join as a diplomat, namely, the ECVECC and/or the ACVECC.
How competitive are ECC residencies?
The competition to get into an ECC residency is stiff, both for small and large animal training programs. Large Animal ECC training, which is only recognised by the ACVECC at the moment, is only offered in 9 hospitals in the United States.
For Small Animal ECC residencies, there are at the moment just under 20 facilities accredited in Europe (3 in the UK), 50 or so in North America, and about 10 more in the rest of the world (in Australia, New Zealand, South Africa and Israel). Some of these facilities are recognised by both the ACVECC and the ECVECC, while some are only recognised by one of them.
When compared to other disciplines such as internal medicine or surgery, the fact that there are much fewer spots available for residency training makes it a very challenging programme to get into.
What are other options than specialisation?
Specialisation is not for everyone. The path is an arduous one, and especially in the UK and in Europe, the landscape of referral and speciality hospitals is still very much in development at the moment, which means it is important to think about what sort of role one would want to practically be working towards after achieving a specialist qualification in ECC.
When compared to other specialities, it is also worth bearing in mind that the unpredictable and out-of-hours nature of ECC work means it is one of the fields in veterinary medicine that can sometimes be the least accommodating in terms of lifestyle, despite achieving specialist status.
Diplomats are absolutely essential to furthering research and education in veterinary medicine, thereby raising the standard of care across the board in our profession. This being said, our industry, our colleagues and our patients are also very much in need of general practitioners who are willing to stay in the trenches of emergency work and raise the standard of care at a local level as well.
The field of ECC is no doubt challenging but also extremely exciting and rewarding. Thankfully, specialisation is not the only way to be a part of it. More and more rotating internships, training programs, and advanced ECC certifications are now available to help empower vets to become more proficient at critical care and emergency medicine in everyday practice, or enable them to work effectively in hospital settings if they wish to be “ECC vets”.
If working globally is something you’re interested in we have a diverse range of roles available worldwide: Vet Jobs in The UK, Vet Jobs in Australia, Vet Jobs in New Zealand, Vet Jobs in Canada and further international vet jobs
List of the ACVECC-approved training programs:
List of ECVECC-approved training programs: