星期六, 1月 28, 2006

Mission almost impossible

http://www.avma.org/education/ecfvg/default.asp#steps

Step 1 1000 usd... passed

Step 2 TOEFL or IELTS

For ECFVG program purposes, the passing score on the computer-based TOEFL is 213 with at least 25 points in listening comprehension (section 1); the passing score on the TWE (TOEFL essay section) is 4.0; and the passing score on the TSE is 50. The passing score on the new internet-based TOEFL is 80 overall, with at least a 26 in listening, a 17 in writing, and a 26 in speaking;

For ECFVG program purposes, candidates choosing to take the IELTS MUST take the academic IELTS. The passing score on the academic IELTS is 6.5 (overall band score), with at least a 6.5 in the listening band, a 6.0 in the writing band, and a 7.0 in the speaking band


Step 3 NAVLE www.nbvme.org

candidates must provide proof of attaining a passing score on the North American Veterinary Licensing Examination (NAVLE)

the ECFVG will consider Step 3 complete only on receipt of a score report from VIVA.

Step 4 Clinical Proficiency Examination

Please note that as of July 1, 2007, only the CPE will meet the requirements for assessment of hands-on clinical skills.

CPE format—The CPE is a 3.5-day, 7-section, hands-on clinical skills examination, administered by the faculty of a college of veterinary medicine or other authorized testing institution. The skill level expected for a passing grade on each of the 7 sections of the CPE is that of an entry-level graduate of an accredited veterinary college. Only well-prepared candidates will be able to pass the CPE.

The 7 sections of the CPE include: anesthesia, clinical and anatomic pathology, equine practice, food animal practice, small animal practice, radiology, and surgery.

The CPE Manual of Administration whats this?

The full CPE fee is $5,000 for ECFVG candidates initially registered in the certification program on and after January 1, 2006 and who have paid a one-time ECFVG QAP on program registration.

太難了吧 .... Since the inception of the current certification program (January 1, 1973) through December 31, 2004, the ECFVG has awarded 3,034 certificates

三十年才有 3034人....真恐怖....

星期五, 1月 27, 2006

Balloon dilatation

Balloon dilation Leib MS JVIM 2001 547-552

1. Esophagitis diagnosed by granular hyperemic eroded or mucosal hemorrhage

2. fibrosis pink to grey color mucosal

3. Rigiflex microinvasive 6, 8,12,18mm

4. inflat balloon diameter 4mm larger than stricture

5. 1-1.5 min

6. 沒擴大到3mm就作第二次

7. 換到18-20mm除非傷害已經太大

8. adequate diameter: 10mm

9. 64% 跟麻醉有關


10. stricture diameter 5, 1-12mm length 1cm, 1-10cm length

11. some animal develop esophagitis away from primary stricture

星期四, 1月 26, 2006

Balloon dilator BH Harai, et al JVIM 1995 pp332-335

boston scientific 0917 938986 27477278 胡經理 37662148

staet with 10 mm balloon dilator

pressure to 45mmhg to 50 mmhg

45-60 sec

repeat when esophageal damage is limited

med: antibiotic sucealfate meto h2 blocker antacid

food within 24 hrs


result 1/13 die

cat severe tear hemorrage trauma pneumothorax/mediastinum

安樂死

3 die

1 unrelated

1 no improvement and cost 安樂死

1 噎到隔天猝死 無屍解

46.2% 麻醉造成食道狹窄

endoscopic economical and practical

complication

bleeding => not severe

perforation

tear

small stricture cause perforation

心得

利用balloon dilation是治療 esophageal stricture的好方法

但是昂貴的價格可能讓主人卻步

一個尺寸的管子就要15000

還沒有包括壓力計... ><

淒慘喔

星期四, 1月 19, 2006

天作孽,由可違 自作孽,不可活,那主人造孽呢?

這禮拜處理兩個很無力的case

讓人覺得動物著實無辜

被一個腦子裝大便的主人餵養,是多無辜的事情



備蛇咬的冬冬

已經瀕臨敗血主人還是堅持要帶回家

不吃抗生素

想要用"傳統療法治療"

what can i say

現再只能希望他的動物本能幫助她熬過這一切..

星期一, 1月 02, 2006

Good doctors and bad

Recently i read a interesting saying about good doctors and bad, Dr. WB Morrison adopted from Dr. Fuller Albright, in the perface of Dr. Morrison's book "Cancer in Dogs and Cat" Which is definitely a bible for all veterinary oncologist



" One cannot possibly practice good medicine and not understanding the foundamentals underlying therapy"

"There are those who advocate medical schools who turn out practical physicians rather than theorist. But they end by turning out a poorer grade of doctor."

I thinked a lot. Veterinarians in taiwan relies too much in there own "experiences" which are, probably no, or few, scientific theory based medicine. Or i should say "Evidence based medicine", A concept which has already been widely accepted in human medicine, but not in Veterinary medicine, espeicially in taiwan.

We are heading into a very dangerous situation since most veterinarians refuse to do any change when the overwhelmed evidence showing what they have been doing for decades are wrong. This really makes me worry.