How Veterinary Education Is Changing & How to Get Involved with Dr. Sheena Warman

We are reimagining veterinary education and learning to understand professional identity to impact both career satisfaction and patient care!

In this episode of Vet Life Reimagined, Dr. Sheena Warman shares her fascinating, full-circle career journey: from growing up captivated by animal behavior to general mixed practice and internal medicine, authoring one of the most practical small animal medicine texts, and now leading educational innovation in both the UK and the US.  She also explains how inviting general practitioners into academic settings has bridged the gap between education and real-world practice.

✨ About our guest:
Dr. Sheena Warman, EdD, B.Sc.(Edin.), B.V.M.S.(Glas.), DSAM, DipECVIM-CA, is a professor, clinician, educator, and author passionate about veterinary education and student development. She qualified from Glasgow Veterinary School in 1997, spent 4 years in mixed general practice, and specialized in internal medicine. Today, she is the Academic Director (Teaching Excellence) at the University of Bristol. Her doctoral research focused on recent veterinary graduates' experience as they engage in reflective practice in the workplace. She also co-authored a "Guide to Assessment in Veterinary Education." She's also co-author of the popular textbook, 100 Top Consultations in Small Animal General Practice. She is also mum to two teenage girls, owned by a very wonderful tabby cat, Toby, and is an amateur triathlete and musician. 

Resources:

• Video episode on YouTube
• Dr. Warman's book, 100 Top Consultations...
• Elizabeth Armitage-Chan's work on professional identity: "I wish I was someone else": complexities in identity formation and professional wellbeing in veterinary medicine. 

Transcript

Sheena Warman: [00:00:00] And what I love about it is this collaboration is opening up normalizing conversations between specialists and primary care people. Valuing one another's skill sets,

Megan Sprinkle: welcome to Vet Life Reimagined. if you haven't caught on yet to the theme, careers are full of unexpected twists and turns. It's no exception with today's guest, Dr. Sheena Warman, who has one of the most incredible full cervical stories from growing up, fascinated by animal behavior, from her own dog to working in mixed practice, specializing in internal medicine, authoring one of the most practical small animal medicine books out there, and now leading curriculum innovation in the United Kingdom.

And the United States, Dr. Warman has seen veterinary medicine from a lot of different angles. We've had several people recently on the podcast whose careers have led them to help address the concern around access to care like doctors Kristen Jankowski and Emily McCobb. Dr. Warman, who [00:01:00] knows, both of them, shares how the UK's rethinking veterinary education, the rise of contextualized care, and how bringing general practitioners into the academic setting has transformed both teaching and the culture.

Dr. Warman also offers some powerful reflections on professional identity, how understanding who you are as a veterinarian can make the difference between burnout and fulfillment, and why collaboration between specialists and primary care veterinarians is very key to the future of our profession.

It's an inspiring, wide ranging conversation about. Education, leadership and what it really means to build a profession that serves both animals and the people who care for them. So let's get to the conversation with Dr. Sheena Warman.

when did you know you were actually interested in veterinary medicine?

Sheena Warman: Oh gosh, I haven't been asked that question in a long time. I think it was my first family dog who was frankly a behaviorist nightmare before veterinary [00:02:00] behavior was a thing. and I just loved kind of working through things with him. So I thought I wanted to study animal behavior and psychology. , and then that evolved into, into veterinary studies. so from the age of about 12, I guess I was spending as much time at the local riding school, spending as much time in the local vets as they could put up with me, and just getting as much experience and, and never really looked back.

Megan Sprinkle: I love that. Well, you talked about behavior so was that what you thought you might do going into vet school? Had you already changed? Like how did it kind of evolve as you were getting into vet school and then going through vet school?

Sheena Warman: I was really open-minded. , My experience as a teenager was with dogs mainly and, , at the local riding school, I spent a lot of time there at weekends and holidays. and I was, I, I'm basically a generalist at heart, although my career has taken me in different directions. I loved all aspects of vet school. I [00:03:00] felt like the bit that I was least prepared for. Small pets, so the small furries. So I got really interested in that because I didn't wanna let them down. Ended up running the , Glasgow Vet School Zoological Society with a colleague for a couple of years. I thought I wanted to be an exotics and wildlife vet for a while, so I went into general practice when I first qualified into a really lovely mixed practice. , Just north of London and we did all sorts. We had a, a veterinary nurse there who was really into his reptiles. We had one of the vets really into the birds. We did the local swan sanctuary, so we saw lots, all loads of swans. And so it was a really proper, proper mixed practice. And then at one point I applied for a residency, in exotics and wildlife and, and didn't get that.

And then I recalibrated a bit and thought, you know what? The, the patients that bring me the most joy are the dogs and cats. So that's when I, I started to focus more on small animals and small animal animal medicine in particular. But I, I love all of it, you know, if, if we're short of [00:04:00] people, um, at vet school to teach a calf handling practical, you know, I'll be straight in there. So yeah, I just love all aspects of it. , There's not many professions that give you that range. , And I think I'm easily bored. So just that constant, not knowing what's coming next and that constant variety. You know, one minute you're in vaccinating puppies and speaking to people about end of life care and the next you can be out putting uterus back in cows.

I just, you know, I love that variety in mixed practice. 

Megan Sprinkle: And this always seems to come up in conversation around how you felt starting as a new doctor and then kind of getting the experience and growing. What do you remember? From, you know, starting as a young doctor and, and how do you feel like you, you started to develop your own style as a veterinarian?

Sheena Warman: That's a great question. I think I was very lucky. I was in a super supportive practice where the recent graduates tended [00:05:00] to do a bit of everything, but we had very experienced mentors in terms of the partners in the practice who were more focused on small or equine or, or farm animals. So there was really properly good support. There was always someone to ask. It was never too much trouble for anybody if you were stuck or needed help, but equally they didn't look over your shoulders. So you were able to develop that clinical freedom, and pursue your own interests. And they were open to new ideas. You know, I, um. I started to get into, quite a lot of ultrasound and started doing a little bit of echocardiography.

, And, you know, asked the boss if we could get a table with a hole in it. And he came in one weekend with his drill and cut a big hole in a table for me. You know, they were just really supportive of the, , newer graduates developing and, and learning. So I think for me, I was very fortunate. the practice I was in and some of the research I've done since with new graduates has really highlighted to me that that's not everyone.

I mean, I knew that wasn't everyone's experience. Right. But hearing [00:06:00] some of those stories as a, you know, more experienced member of the profession is, is quite sobering really. You know, it does make you realize how challenging it can be. But I think that support as a new grad, the trust and the support, both of them together are so important.

Megan Sprinkle: Yeah, you mentioned that you feel like you're a person that may get bored easily if you don't probably pursue new things. You talked about learning different skill sets, like ultrasound , so I mean, you're, you're starting and it's mixed, but it's a general practice setting.

And then you said that you actually ended up going into an internship for being an internal medicine specialist. So how did you decide to specialize? 

Sheena Warman: so early on I was literally doing all of it and, and doing whatever was was available in terms of species. I think it was the equine side of it that I dropped. First, to focus a bit more on small animal medicine and to create a bit [00:07:00] more space. I registered, so in the UK we've got, certificate level qualifications, which people tend to do sort of two or three years after qualifying.

And, when I didn't get the Exotics and Wildlife residency, I thought, okay, right, let's recalibrate and focused in a thought. What attracted me to medicine was, especially in a GP setting with surgery, it's quite obvious if something goes well or goes badly. you know, it either gets better or it doesn't because of what you've done. With medicine, it's much easier to kid yourself. You never really know whether it is time or luck or what you did or what you didn't do that has made a difference or, or made a patient worse or, or better hopefully. And I, I was really interested to learn a bit more and, just have more confidence. In my own decision making and, and my rationale for the decisions I was making.

So that's when I started, I started on my certificate in small animal medicine from general practice. So to create time for that, I stopped doing the equine work. Kept on a little bit of farm work 'cause I was very reluctant to [00:08:00] let that go. Kept up doing some of the exotics. And then an opportunity came up to do a residency.

So this is back in the day where internships weren't necessarily required. There weren't that many available and had three and a half years of practice experience. So I got a residency at, at Bristol, in small animal medicine and intensive care, and learned loads there. I mean, that was a, a fantastic training, and a wide range of, skillset, you know, that it was the medicine, but with a bit of emergency and critical care before that was really a specialty in its own right in the uk. and again, I got to do a bit of cardiology. We were without a cardiologist for a little while, and I picked up some of that caseload at the appropriate level.

So it, again, it appealed to my, it turns out with hindsight, I just, I love learning and I love the range of stuff that we can do as veterinary surgeons.

Megan Sprinkle: Got it. So it still allowed you to do still a lot of generalization. Just dive in a little bit deeper into all of it.

Sheena Warman: And, [00:09:00] and it's interesting 'cause I think one of the reasons I ended up stepping back from specialty is that as the specialties got more specialized. Such that you have cardiologists, you have ECC people, you have oncologists, w e were almost as internal medics starting to do a little bit less and, opportunities came up for education leadership roles, and I couldn't, I just couldn't keep all the balls juggling. So I ended up very reluctantly. It was, well, it was the right thing to do, but it wasn't an easy shift to step back from the clinical work. 'cause I love the clinical work, I love the clients, I love the pets, I love the students. You know that in the moment. Light bulb moment that you see the students have when you finally manage to help them understand something in a way that creates meaning for them.

And you see that moment of, dawning on them often over something really tiny. But that's so rewarding as a teacher. And you don't get to see that every day in leadership roles. So I do miss that side of it as well.

Megan Sprinkle: Yeah. Now I may have the [00:10:00] timing wrong, so feel free to correct me. But you know, before you stepped back from clinics, you wrote a really wonderful book, and this was in 2011, where you co-authored 100 top consultations in small animal medicine. And you know, I thinking now we talk about, spectrum of care.

Yeah. And a lot now, but to me, like thinking back to T 2011, this was, this is amazing.

Sheena Warman: Yeah.

Megan Sprinkle: I mean, still amazing, but like, you know, this is an, a really wonderful resource. So do you mind sharing a little bit about how you came to start writing this and, and the whole journey there?

Sheena Warman: Uh, do you know, it's one of the projects that I'm proudest of over all the things that I've done. So Peter Hill, dermatologist, who is the, the lead editor and an author on it, had an office about three doors down from me. And I, I don't remember the moment he came and [00:11:00] said, you know, do you think you'd be interested?

But I loved it. I really jumped to the chance. I wrote a lot of the internal medicine chapters. I edited a lot of the chapters that came in from other people. I think I was about eight months pregnant when we were reviewing the final proofs. So I've done. And as I wrote it, I wanted the chapters that, that I was editing and writing.

I sort of had a rule with myself. I couldn't look up a book. It needed to be stuff that I could imagine a really good final year student saying to me in a, in rounds or in a. Back in the day, we still had five exams and things, so I wanted it to be pitched at the level that was just what you need at that point of transition into practice. And we were very clear that every chapter needed to include something on what to do if it doesn't get better, what the low cost options are, when to refer, if referral's an option for you in a way that encourage people to. To fulfill as much of the scope of general practice as they could. Our, our third [00:12:00] editor was, uh, a very experienced general practitioner, so he brought a different perspective to, it kept Peter and me on the straight and narrow and kept our feet firmly grounded. and , it was just a really cool project to be part of. And I still see the students reading the books. I had a text from an old college friend of mine saying that one of her new graduates was using it and was singing its praises. So, you know, it is a wee bit outta date now, but the basics don't really change and, and it still brings me joy, that book.

Megan Sprinkle: , I admit, , I had not heard of it. I wish I had. I did an internship and a lot of it was emergency and critical care. And there was a similar course that tried to do that. they called it getting through the Night. And it, it was for, , new grads that were working emergency. And it really did, it had the very practical things that it, it did get us through the night. So like having those types of resources are, are invaluable. Uh, so I, I think that's. A neat opportunity already to start with bringing in [00:13:00] those different perspectives.

You had the general practitioner, you had the internal medicine specialist as well. , And the other thing is it, you had mentioned that the education in the UK there is a lot of focus on giving general practice experience I think you said that there's like 26 weeks of.

Focused on general practice, education. And so was that also kind of a motivation for this resource was that there was such a focus on making sure that we are setting up our graduates for success, , when they go out into practice.

Sheena Warman: I think for me as a, as a teacher, that has always been my focus. I think having come from three and a half years in primary care into a residency, the skillset I was able to bring to the teaching as a resident was very much, well, what would you do in practice? What would you do if, and we'd have long conversations about, , how you would handle these cases.

And I, [00:14:00] was able to do that very authentically. 'cause I'd literally just come from that world. Um. in the uk all of our graduates, for as, as long as I, as I've been, um, been a vet, and I dunno when it started, they've all had to do what's called extramural studies. So there's EMS, which is on top of their curriculum requirements. So it used to be 12 weeks of animal husbandry and 26 weeks of clinical over the course of our five year programs, it's now 10 weeks and 20 weeks. So a little bit less and it's, it's a big cost for the students. The vets aren't paid to take the students. it's sort of an altruistic thing that the profession in the UK is very proud of. and as a profession, we've held on very strongly to belief that this EMS is really important. It gives the students a wider range of perspectives and they can pick and choose a lot of the different contexts that they want to go and work in, but over and beyond that, so that's always been there. Even beyond that, when the Royal College of [00:15:00] Veterinary Surgeons who are accrediting body and they updated the standards. , oh, three years ago now, what, I think it's three years ago, , introduced a new requirement that, , for clinical training, so clinical caseload, clinical teaching, that a majority of it had to be within a general practice context, and they defined majority as over 70%. , And you know, it doesn't necessarily have to be in a general practice setting. You can be teaching some anesthesia or some imaging. day one level with a focus on general practice type cases in, in a referral setting. It's, you know, you have to be able to justify that and explain it, but it really has made us all recognize that that is what the profession needs of us.

You know, we've always been training, I think we've always been very clear that we're training people, the majority of whom are gonna go into primary care practice. And most people wouldn't do an internship in the UK straight from vet school. Most of them would go into practice for a year or two first, and then think about [00:16:00] internships.

So we've always known that , that's our transition. That's what we're preparing graduates for, and that's the transition they're gonna make. So it is a big. Focus and, and then by definition, most UK veterinary teachers will have spent significant amount of time in, in primary care, whether as an undergraduate student or subsequently in the early stages of their, their career.

So it's just part of our culture. It's part of what we do, but we don't get it right all the time. And that's why, you know, the spectrum of care stuff has been so interesting for me working with mainly North American team, but, but folks from other places as well. and the parallel in the UK is the language around context care, which has really gained traction in the last. Couple of years. and if you speak to vets my age, we're like, oh, why is it a thing? It's just called being a vet, isn't it? It's just what we do. We use our knowledge and we apply it to the animal and the people in front of us, but somehow education and early careers [00:17:00] of vets has somehow transitioned in a way that this, in my opinion, far too much emphasis on the gold standard and it's kind of gold standard or bust. And we've just gotta recalibrate and make sure that our graduates are feeling empowered to, to do, you know, normal vetting, , look at the patient, look at the family, attached to the patient, and have a very shared, collaborative discussion about what's, possible and what's acceptable and what's okay.

Megan Sprinkle: Yeah. And since you were in the place of education, , you had mentioned that very reluctantly, , you stepped back from clinic. Because that there was a need for more leadership roles. So , what were they recognizing the need was for leadership and how did that evolve for you as, as your career started to progress?

Because I know it inspired , a doctorate and

Sheena Warman: Yes.

Megan Sprinkle: of other things. So what was that journey for you [00:18:00] personally?

Sheena Warman: So when I stepped back from clinics, at that point I was deputy director for the program. , And they asked me to step into the program director and had a teaching role for the school. , And part of my ask was to make sure I was, , doing a lot of work with our veterinary nursing, so vet technician degree as well. so again, broadening my horizons, which seems to be the recurrent theme in my career. The head of school at that point as well was very keen, and this is before the Royal College required us to do this, was very keen that we refocus a bit on primary care. So I had the huge privilege of getting the green light to recruit some primary care educators. So we called them veterinary clinical demonstrators. We started with five. We've now got about 12 full-time equivalents. We've published their experiences and how they settled in. and they're just the most amazing team of people, and they're very much people that are. Being pulled into education rather than feeling pushed out by their experiences [00:19:00] as a practice.

, That's really critical for me at interview was gotta have people that can absolutely sing, the joys of, of primary care, but are really keen to teach and we've got incredible people. So initially their role was to emphasize and reinforce the day one relevance of referral practice. So they were embedded within clinics in the referral hospitals, and they co-created their role with a specialist that led those rotations. , And just did an amazing job that I just turned the experience the final year around. Built up fabulous relationships with the specialists. Just, they're just amazing. And now those roles have evolved. Some of them have been promoted up into lectureships and they're teaching. So they're teaching internal medicine, they're teaching some surgery, they're teaching wellbeing, , they're teaching all sorts of different things and, they're just the right people for it.

They're really talented. Lots of them have got [00:20:00] loads of primary care experience. Some of them have got further qualifications from a primary care background. So there's sort of mid-level qualification. I was talking about the certificates. they are the most skilled educators and communicators that I know. , They're just brilliant. And for me, that collaborative approach of having the specialists and the primary care people working together, empowering the primary care people to deliver content that historically might have been specialist led, but they've got a specialist colleague they can go to if they've got tricky questions or if they just want to fact check something. It just works. It works so well.

Megan Sprinkle: ​​, you said that it.

Completely turned around the students by the time that they were ready to, uh, qualify or graduate, what were you measuring? , What was the measure that you could say, oh wow, like, now we see a difference, if that makes sense. , How were you assessing, , the before and after of bringing in the general practitioners?

Sheena Warman: [00:21:00] So a lot of it was around student experience. So we have a survey in the UK called a national student survey that every final year student fills in. And you know, correlation is not causation, but the year that the clinical demonstrators started satisfaction with the program really increased the feedback on rotations really increased. We ran a, project that we've published evaluating student and staff perspectives of the role and the findings from that were overwhelmingly positive. So, you know, there is a bit of quantitative data in there, albeit kind of experience rather than outcomes based. It's very hard to measure.

Did we produce better graduates? I don't, I dunno. , We're going through a big curriculum review at the moment, and, and we do now have data that comes in from the graduates. So the Royal College runs a survey, about three to five months after the students graduate that every veterinary graduate in the UK and their [00:22:00] mentor. So every graduate has to have a mentor in their first job.

It's called the veterinary graduate Development phase. It's, there's a lot of training involved. There's lot of paperwork involved. It's a, it's a big thing. But every pair of graduate and mentor fills in this survey and that, that's highlighted things to us. Like they struggle with uncertainty. They struggle with incomplete information, which is part of the human condition, isn't it?

Like we'd all rather things, we crystal clear and we have enough data. But those are things that are helping inform our curriculum design in our, our curriculum review. And we'll be able to track that year on year and we'll, we'll get a sense. Again, it's very hard to put one intervention and say that this is what's caused a difference because it's such a holistic assessment, but we will have access to that data going forward to see whether in the whole, what we're doing is making a difference to outcomes.

Megan Sprinkle: , I don't think we need to, uh, belittle surveys on this one because I, I think, I [00:23:00] mean, it's not a hundred percent, but a lot of, confidence comes from competence. And so if you feel like you're competent in something, you feel a little bit more, comfortable and like you are prepared. So I think that is a huge.

Measure, uh, because I, I think that is some of the things that other surveys are finding is that new grads are not feeling like they are prepared for whatever they are getting into when they get into practice. So I think that's, that does speak volumes. And because you already had those surveys lined up, you were able to kind of see where the change was.

, So I think that's a, a great answer. I, I think that's really good data from my perspective. And, , I think this is such a good setup, everything from also having a mentor afterwards. I've heard people say that too. It's like, you know, they, they graduate and we're like. Bye. And we just leave them to their own devices.

Uh, so having that follow [00:24:00] up, So that's, uh, also a, another good thing that you've done. , You also are coming from the position of a specialist, so we're, we're trying to support.

Veterinarians to be able to be good general practitioners and you're a specialist . You are able to see both sides of that and you know, I'm. So curious, like how general practitioners came into the academic environment and how they were able to find their home and how they were able to work so well with other specialists.

Because I, I think it could be very intimidating to be a general practitioner coming into that academic environment. I think we have a lot of people, and I say this because I hear people say it, I'm just a. General practitioner. I'm just fill in the blank. It breaks my heart every time. I, I, I hear it. Um, so what are your [00:25:00] thoughts on the best way to come together?

To ultimately what I, I hope we all came to veterinary medicine for, and that that is to do the best. For that individual patient that's in front of us. So what is your experience? What are your thoughts around just like everybody coming together to make this all work?

Sheena Warman: Yeah, it's interesting. , It's one of the hardest branches of. practice, isn't it? Because you are constantly dealing with uncertainty or you've got a, infinitely wide range of client expectations and client resources and it, it's a different job.

It's a different job from being a specialist. I think, I think the key thing is a culture of non-judgment. And that that can be difficult and it can be very easy to slide within a team or within the practice, within a hospital into a culture of being a bit judgy about referrals that come in about things other people have done. And it's [00:26:00] just calling that out when you see it and making that not okay. we had one particular very experienced professor. students kept saying, oh, there's too much content, there's too much content. We don't need all this. It's too hard. We can't handle it. You know, their notes were this hard kind of thing, and I, I said, look, would you be open to a conversation with one of our clinical demonstrators?

They've got a couple of years experience in your area of practice. Would you just. Let them go through your lecture notes and then sit down with you and have a chat about what should and shouldn't stay in. And they're like, okay, maybe. I sat in on that first meeting and it was just brilliant. I sat, I went just in case, just in case it was awkward. and it was just amazing to watch. It was just this very collaborative. Conversation, conversation. Gentle challenge in both directions. Lots of red pens, scoring out lots of stuff that was very interesting but not necessary. and ended up with a much better, you know, product for the [00:27:00] students. And it, and it was co-created. And it requires humility. , It requires an openness. . It requires a willingness to be guided by people who have had different experience or more recent experience from what you have. And you know, I think it's a huge ask, isn't it? To ask a specialist who's gone from. Undergrad to vet school, to internship, to residency, perhaps even in the same hospital. Not done significant primary care work where they've had to juggle their own caseload and their own outta hours , and have very difficult conversations about money and about expectations and about what social media says compared to what you're actually to do. And create training that is appropriate for your students. 70, 80% of whom are going to go into primary care. You are being asked to prepare them for something you've not done yourself. And that's a really difficult ask. So I think the first thing is recognizing that there's a gap. And even if you have done it yourself, you may not have done it for 20 [00:28:00] years and the world has clearly moved on. , So it's identifying that there is a gap in, in our knowledge there as specialists. And figuring out, well, what's the best way to fill that gap? Oh, I know. Let me talk to my general practitioner friends and let's do this together. I think I've had a few, a couple of conversations with my specialist colleagues and know, there was absolutely nervousness around us hiring primary care people to do some of the teaching roles that might have been specialist led previously, but actually the proof's in the pudding. You know, they have created amazing resources. They have reached out to specialists for a sort of quality check where needed. It's not always needed. and it's getting, getting the specialist teams to realize that. They have a slightly warped sense of general practice because they see a disproportionate amount of stuff that hasn't gone terribly well. And what they're not seeing is the [00:29:00] 95% of stuff that is just happening every day and is fine and is great practice and everyone's happy. 'cause you just don't see that, do you? You don't see it coming in. And I remember, and this made me really sad actually, I remember a conversation with a colleague who, a specialist who was probably 15 years graduate, 10, 15 years graduated,

And I said, well, you know, look around your peers who are in primary care. Surely you'd be really happy for your mum's dog to go and see them. You know, you trust them, they're your friends, you've seen them, you know, grow into their roles as primary care practitioners. 'cause that's my experience. You know, most of my friends are still in primary care practice. Um, and she said, well, no, they're not in practice anymore. They've all left. And I just thought, oh. Okay. A, that's really sad, you know, where have we gone wrong as a profession, and B, where's the mentorship gone? Where has that person in your practice who was 10 or 15 years qualified and had enough kind of veterinary pragmatism and common sense to problem solve with you?

Where have they [00:30:00] gone? so that was a bit, you know, that's just an anecdotal story, but it's. It's one of those things that I worry about. , It's not just the, the students that we want to support to develop this understanding of spectrum of care and contextualized care. It's the recent graduates as well.

We, within the Spectrum Care community, we coined the term the gold standard generation, slightly flippantly, but it felt like it had, credibility in that there is just this generation of graduates who have come out thinking, well, if I don't do what the textbook says, I'm a bad vet. And that's not what being a vet is. The textbook is one way, that's only the right way if you've got the resources and everything else around you to make that happen. Being a good vet is serving the pet and the family as a unit coming up with the best solution you can for them at the time. Which might look quite different from what the textbook says.

So long as it's welfare acceptable and not bad practice, then go [00:31:00] for it. And it is about empowering those graduates to feel they can do that and to feel they've got permission to do that, and to feel that that is actively celebrated.

Megan Sprinkle: So are you. Thinking that this veterinarian who said who she's been out 10, 15 years and all of her colleagues have left general practice, that the mindset around the standard of care bust is one of the reasons that pe that that generation is not there anymore.

Sheena Warman: Oh, I'm, you know, I'm sure other people understand far more about retention than I do, but it's a very, it's a difficult job, isn't it? And if you can't find your joy from problem solving the problem in front of you, rather than feeling frustrated 'cause you can't do what you think the textbook or your professors would want you to do. I really love Liz Chan's work. She talks, and I think Kristen talked about this in her podcast with you as well. , The [00:32:00] difference between a diagnosis or academic-focused identity and a relationship or challenge focused identity, where the academic/ diagnosis focus people find their joy from getting to the right, the right answer as per the textbook, and delivering what the textbook says in terms of care. And maybe it may be they're more naturally attracted into specialty roles where that's an option for them versus the relationship focused people 

Who love the challenge of improvising and being creative and working very much in a relationship centered way with shared decision making. and that mindset, that professional identity does feel like a much better fit to flourish in general practice. So as educators, it's then on us to call that out to students.

You know, we're not gonna tell them what sort of identity to develop. That's, that's up to them. That's a personal thing, but highlighting to them that there is a range and maybe, you know, they're both okay. They're both right. You know, one isn't a good vet and one's not a bad vet. They are both [00:33:00] absolutely being a veterinarian, but in different ways. And your identity doesn't match the environment you're in, you're setting yourself up for sadness. So, yeah, you've gotta take some personal control over that is what we try. Just encourage the students to think about their identity development and what sort of vet they want to be and celebrate the general practice role.

Have role models for them, put them in. So the, the other, the other conversation I have with the specialists as well is our specialists are amazing, you know, and they're constantly stepping out of the role and going. Or what if the client only had a hundred pounds? Or what if they hadn't been able to refer?

What would you have done? And they ha, I know they have those conversations all the time, but there's something very different between an amazing specialist having that conversation, but then going ahead and doing all the fantasy stuff. The student walks away remembering the fancy stuff and that that's what you should be doing. Versus somebody in primary care who's saying, well, we could refer, but we can't. So what [00:34:00] are we gonna do? And then doing that and getting a good outcome. And then the student remembers and values that process and learning. So context is really important. And I think, you know, I know we've had the sort of, the, the stick, I suppose of our accreditor saying you need to be 70%, in a general practice context, but actually physically putting the students in primary care for a significant chunk of their learning balanced by the different expertise that you get in specialist practice as they know what's possible and they're still getting inspired to, if that's a tribe, they can find their tribe, through those exposures and, and learn from those amazing skillset. But they're also learning from the amazing skillset in primary care. So we've now got about 55 practices that we work with, as well as our hospital. So our students spend about half their time in final year now out in primary care, small animal, equine farm. So it's very different from how it was 10 years ago.

Megan Sprinkle: [00:35:00] Yes. Well, and I was very drawn to the idea around the identity piece because I, I don't know if we talk about that a whole lot is reflecting on who we are. I mean, this is one of the things I try to encourage people to do, but when you're going through vet school, you, you're just thinking about taking the test and, you know, getting to the next step.

You're not necessarily thinking about, oh. Well, , how do I like practice? , How does this fit with me? And, and just starting to check in with yourself on this. Yes. You're, you're soaking it in and you're all of it, like you're, you're experiencing it all. 'cause I think that's important to know , how you work best.

 Like how do you encourage the students. To reflect on that, 'cause you said you're, you're not trying to push a particular identity on anyone. So how do you balance the, that presentation? With also encouraging them to do some self-reflection?

Sheena Warman: So we build quite a [00:36:00] lot of reflection and professional identity work into the curriculum. , And it's supported in a range of ways. They do some reflective writing, they review one-to-one with their personal tutors. They do very early on. They do what makes a good vet as a sort of creative project within a group.

And, that's an idea we borrowed from a vetted presentation where they had this modeling with craft materials, what makes a good vet? You know, and it, but, and it, the students like, hang on a minute, I'm doing this amazing science based degree. Why am I fiddling around with coloring pens and, and um, what do you call this furry pipe wire cleaner

Megan Sprinkle: Oh, pipe cleaners or.

Sheena Warman: That's it. But it gets people talking and it gets 'em talking about really important stuff. Um, and they reflect on the development as they go up through the course. But we also do a lot of case-based learning and we're quite conscious. Our case-based learning is overseen by one of our first intake of clinical demonstrators, who's a very PRI primary care [00:37:00] practitioner. and she makes sure that our cases represent real life. You know, they don't all have everything done to them. They all come with different human stories attached to them. So the students are kind of normalizing that right from very early on in first year of their degree that that is part of the conversation.

It's not just about the science, and the animals. It's very much about the people as well, and, and you as a person as well.

Megan Sprinkle: Fascinating. Now going back to more on you and your career journey, what have been some of the, you mentioned, you know, you have to find your joy. What has been that for you as it sounds like your path has been a little unpredictable as you've gone, but kind of reflecting back, what are some of the, .

Big moments , where you are today and, and how you've discovered what really fit you and what you were enjoying.

Sheena Warman: Oh, gosh, that's a huge question. [00:38:00] I mean, the, the, the book, the book, , that still gives me little moments of joy whenever, you know, a friend or I get a message from an ex student saying they, they find it helpful. Um. My doctorate. I really enjoyed that. That was really transformative for me.

So I did it part-time alongside almost a full-time job with two small children. That is not a recommended approach. , It was pretty exhausting. , But I was exploring the experiences of recent graduates with how they reflect. So this was in the, before we had , the vet graduate development phase, which the Royal College organizes, , we had the, , what was it called?

PDP, professional Development Phase. And it was quite tick boxy. You didn't have a mentor in your practice. You kind of liaised through a very clunky computer system where somebody quite remote. so there was this kind of narrative around, well, you need to reflect, but then it wasn't really set up to help you do so. So I, I spoke to. , A bunch of people, a bunch of recent graduates about their experiences with it, and it [00:39:00] really brought home to me the contrasting experiences people could have. So I suppose that acted as a big incentive to me to try and just prepare our students better, but I still get absolute joy from cuddling my cat, visiting my neighbor's puppies. You know, all the stuff that attracts you to vet in the first place. , Chatting to high school kids that think they want to be veterinary surgeons. One of my favorite bits of my role, so I, they, I still do bits of teaching and I fill in gaps quite a lot. But, , I'm still very much a, a personal tutor.

So I have 15 tutees and I've just seen, my 15 from last year all graduate. So now I'm back in with the first years again. and people that you get know over five years. Feel you play this tiny role in, in supporting them as they go through vet school and, and as they evolve. You know, seeing firsthand that transition from excited first year [00:40:00] into excited about to be professional.

I just, I just love being part of that journey with them.

Megan Sprinkle: There is something about veterinary students. They have this energy. Uh, about them, the enthusiasm for the profession that is so refreshing to keep like, oh yeah, we, we do cool things. Uh, it's really good to be around them, so that, that's a really neat experience. And also to follow them through their entire journey.

You kind of have your little cohort that I think that's a really unique experience for sure. Well, and then all of your work too has really been able to connect you on a global level. Uh, uh, how I I met you is through, , a group in the United States. 'cause you're helping, um, US do some unique things around, , education and how we can better prepare students for, , going out into practice.

So, do you mind sharing some of the, the recent projects that you're working on and, and anything you. We wanna make sure [00:41:00] that we, share with people.

Sheena Warman: Yeah, so the Spectrum of Care initiative has been a huge part of what I do the last few years, and they're an I'm so lucky. Everything I do, I work with amazing people. It's just our profession, isn't it? but getting to know the team at AAVMC and the Spectrum Care Task Force, , it's been really fulfilling.

So I've been able to bring a slightly different perspective from the UK and a real passion for that transition, , for our graduates into effective, you know, happy, flourishing veterinary surgeons. we've done some great stuff, so I think Kristen mentioned this, but we've got our implementation strategies guide now, which is.

Quite a bulky document. I don't think many of us will have sat down and read it from cover to cover, but if you scan the contents page. You're quite likely to find something that's, that's helpful and useful for you. and there's, guidance on, , different spectrum care approaches to some common conditions and those sorts of things are popping out all the time. , There's a really good article in, the [00:42:00] uk, publication and practice just last. Week around, , a spectrum of care approach to managing diabetes mellitus in dogs. So, you know, the stuff popping out is becoming part of our language, and I think it is refocusing us as a profession on, let's just celebrate the basics.

Let's, well, it's. Basics isn't even the right word. 'cause it's often the most complicated stuff to actually navigate and decide on. But, you know, let's get it right in a resource sensible way, for the person in front of us. And, and there's so many more publications. Like five years ago we didn't talk about Spectrum of Care.

We didn't talk about contextualized care. and now there's publications, conferences. People know the words. They might go, we don't need these words, but the fact that we need these words for some people is really interesting in itself. How the profession has evolved, but is a sign it needs air space and it needs attention and. [00:43:00] Veterinary schools are doing tons. They really are. We're, we're gonna be starting some work looking at what's happening in each schools that want to share with us. , I'm working on a project that is funded again by the Stan Foundation who funded a lot of the spectrum of care work, , looking at co-creating, mitral valve disease guidelines based on the, the published, , A-C-V-I-M ones, but co-creating a version with general practitioners. So there's a lot going on, and what I love about it is this collaboration is opening up normalizing conversations between specialists and, and primary care people valuing one another's skillset, creating things that work for, for everybody. It's an exciting, exciting, I mean, you look back and it seems mad that that's not what has always happened, but we are where we are and um, if we're starting to integrate and collaborate more, that's got be a good thing.

Megan Sprinkle: I think if, if I [00:44:00] may wonder part of it being this surge of technology and our ability to. Understand science and and biology, and that's very exciting and I think we're just. Getting more into being able to have more resources and tools. And so it's always, you know, life, sometimes you have to check in and it's like, yes, we're learning this.

That's not a bad thing. We just need to make sure we all bring it back to why we're all here. And it's, and it's the pet and, um, kind of yeah. Centering again. And, and so it, it's. It's a good opportunity. 'cause again, I think we're just going to learn more, get more tools and a, as we continue to get better in medicine and everything.

But to continue to bring this collaborative approach back is so exciting. 'cause then if we can get that down, then we can [00:45:00] all go together

Sheena Warman: Yeah.

Megan Sprinkle: the future of learning more, , and being able to apply that. In the best way possible to support pets and their families. So I think it's a, a great opportunity to just bring it all together.

Sheena Warman: And, and the tools and technology, they'll help everybody, right? There will be some fancy, highly technical, highly expensive stuff that will work for those that can afford it and want to access the real fancy stuff for their pets, but. With AI and, and that side of technology, there will be developments, I'm sure that will help all of us make decisions more easily.

and, you know, we'll, we'll change how we're able to interact between primary care and specialists as well. So, I, you know, 10 years time is gonna look completely different. Again, isn't it? And, and, and the research that we do as well, we've now got the scope to do much more big data research and so much of veterinary research.

When I was a resident, lots of what was published in, in the specialist journals [00:46:00] was around small numbers of referral hospital cases. And you go, well, that's all very interesting, but. But does it really matter in the, in the bigger world, , including stuff I've published, you know, look back and go, I thought that was so cool at the time, but, you know, , but now we've got, so in the UK we've got Vet Compass and we've got SAVSNET who are a couple of, groups working with massive databases of clinical records from primary care.

And so the stuff they can access is at a different level in terms of volume and , and it can answer different questions. You know, all these questions are important, the work everyone does is important. , But as you said, it's that pulling together and understanding one another a bit better.

Megan Sprinkle: Yeah, that's how we find the better solutions, uh, is. Being all there together with the different perspectives. Well, we are almost outta time and I, I love to end on this question and I think you were already starting to bring it in a little bit, but when I say ask about gratitude, what is something you're really grateful [00:47:00] for?

What comes to your mind? I.

Sheena Warman: Oh, well, family, family and, and Toby the cat. He has a very long story, Toby, the cat, but it's, it's, know, personally, absolutely. Family bring me joy every day. Professionally. It's feeling like I'm part of something. A very small part of a, movement probably too strong a word, but an initiative, a drive for a direction of travel that feels really important for, you know, for our clients, for our animals.

But as importantly, for our colleagues, for our new graduates, um, know, really matters to me that they flourish. And stay in the profession. It makes me very sad when you, people talk about the, the challenges with retention. And I just think we need to find pathways to making it better for, for all of us. 

Megan Sprinkle: I always love when a guest connects so many threads that we've been exploring here on the podcast. Dr. Warman's work [00:48:00] Helping Shape veterinary education blends academic insights with real world practicality, which is such a powerful example of how our profession continues to evolve. A big thank you to Dr.

Sheena Warman for sharing her story and her leadership in shaping the next generation of veterinarians. I also wanna thank Dr. Kelly Cooper, who's ongoing support of the. The podcast makes this possible. And if you enjoyed the podcast, please make sure you take a moment to hit that follow or subscribe and share it with a colleague or a friend who might benefit from listening to some of these episodes.

And as always, let's keep re-imagining what's possible in veterinary life.