‘We just didn’t eat’: VetMed students speak out about working conditions


Jack McClellan

The Lloyd Veterinary Medical Center is a teaching hospital used to expose students to clinical environments as well as treat animals. The hospital is primarily made up of the Hixson-Lied Small Animal Hospital and the Equine and Farm Animal Hospital.

Madison Esker, a year four veterinary medicine student, said during a rotation in the large animal ICU she found herself constantly working from 5:30 a.m. to midnight, violating a policy that requires students to be allowed a minimum eight hour rest period after spending 18 out of 24 hours in the clinics.

Students say the fourth year consists primarily of duties within Iowa State’s teaching hospital, whereas veterinary students spend the first three years of their curriculum in typical classroom settings. During their fourth year, students’ clinical duties are made up of two-week rotations in which they receive and treat patients. On top of that, many students have in-house duties during which they provide after-hours service and care.

Many students experience similarly long days when assigned to the college’s more strenuous rotations. Not all rotations are so taxing, but many students have pointed out that the high workload takes a toll on their well-being.

To prevent students from being over-scheduled and overworked, the university implemented a duty-hours policy in 2019. The policy limits the time a student is required to spend in the clinics to 80 hours a week and requires students to take a day away from clinical responsibilities every week, among other guidelines.

Esker said she experienced a number of violations in the large animal clinic. In one rotation, which took place shortly after Christmas, Esker said she and her peers were scheduled to work every day of the week and weekend, despite the duty-hours policy requiring students to have at least one in seven days away from clinical duties.

Senior Associate Dean in Veterinary Medicine Administration Jared Danielson oversees the duty hours policy and addresses violations of it. He said when students look ahead in their schedule and identify violations of the policy before they actually go through the rotation, he is able to resolve the schedule and prevent violations from taking place.

Danielson said if a student knows they have hit their 80-hour limit or have experienced other policy violations, they can go home, but said students often make the decision to stay to complete the day’s work.

“It’s hard, but they also see that if they leave, it’s going to be harder,” Danielson said. “So even though they could go to the faculty member and say ‘I hit my 80 hours,’ they don’t because they’re part of that team, and they see that they’re needed.”

He said he prefers when students are looking ahead and bring scheduling issues to his attention before working through them. Students sometimes instead report violations of the policy after they have occurred, in which case Danielson said there is not much he can do.

Danielson said scheduling the rotations in the clinic and assuring that every rotation is adequately staffed can be challenging. He said there are a lot of moving parts, and that it can get very complex.

“We’re there 95% of the time, but it can be really hard when we’re not,” Danielson said.

Esker said during a rotation in the large animal ICU she and her peers found themselves needing to arrive at the clinics around 5:30 a.m. to be ready for 8 a.m. rounds.

“So essentially, if I’m there at 5:30 a.m. and I work through the day, and to midnight, I’ve been there for more than 18 hours,” Esker said. “And now I have to be back at 5:30 a.m., which is five-and-a-half hours of rest– not eight.”

Esker said five-and-a-half hours of rest does not equate to five-and-a-half hours of sleep. She said she still would like to eat, do laundry and fulfill other necessities.

Brittany Albers-O’Brien, another year four veterinary medicine student, reported one rotation in which she worked 90 hours both weeks without having a day off. She also said there were instances of canceling or missing medical appointments in order to not miss any time in the clinics.

Albers-O’Brien said while students are supposed to receive 30 minutes for a lunch break, on some of her rotations, she never received one lunch break.

“Yeah, I lost 15 pounds on my month of ICU,” Albers-O’Brien said. “We just didn’t eat; you didn’t have time to eat.”

Albers-O’Brien said not all rotations make it so hard to get a meal in, with some rotations even allowing students to leave the clinic for lunch breaks of up to an hour.

Brandon Garrison, another year four veterinary medicine student, stated in an email with the Daily that the requirement that students get one day off within every seven is “a joke.” He stated he had a stint of 20 days without a day off from clinical duties, as well as several incidents of working more than seven.

“Twenty days straight of 10-12 hour days wears on you– especially as a student who is being bombarded with information, constant questioning and is mentally and physically exhausted,” Garrison stated. “Many struggle to keep their composure. Even more struggle to maintain the care of their patients while battling exhaustion and constant stress.”

Garrison described one instance in which he was the only student on a two-week-long canine rehabilitation rotation. He stated the rotation typically includes a minimum of two students but usually includes three or four.

He stated during the first week of the two-week rotation, not even the canine rehabilitation specialist was present as he was on vacation, leaving all the responsibilities of the clinic on himself and a canine technician. During the second week, Garrison stated the rehab specialist returned, but the technician then had his own absence.

“At first, I thought it was no big deal as canine rehab has a reputation of being a pretty chill and laid-back rotation,” Garrison stated in an email to the Daily. “It quickly became apparent that I was going to be used as a workhorse.”

Through the rotation, Garrison stated he was responsible for all of the patient care. In the evenings, Garrison stated he would have to return to the clinic to take patients out, medicate them, feed them, update their records and call owners with updates. During the weekends, he stated he would make three separate trips to the clinic throughout the day to fulfill similar responsibilities.

Garrison stated while he was not happy with the way the rotation went, he placed no fault on the clinician and technician he worked with. He stated throughout the rotation, they were sympathetic and worked to make the best of the situation.

Danielson said large quantities of patients, emergency situations and absences from rotations could put a larger workload on people on duty in the clinics. He said sometimes students will get sick or be unable to take part in a rotation to which they’ve been assigned.

“Every once in a while we have a situation where we just have our services overwhelmed by a sort of perfect storm of circumstances,” Danielson said.

Danielson said another issue that occasionally pops up is students can drop some rotations if they are not required for them to graduate. He said sometimes the clinic sets up a rotation so that it has enough students until a student drops off the rotation. Danielson said that would usually lead to the students and faculty remaining on the rotation having a tough two weeks.

“Now you had two students who are trying to do what three students would typically do,” Danielson said. “We do rely on our students to do work in the clinic. They’re a critical part of the health care team in the clinic.”

He said there are even times when it is not a student that gets sick or drops a rotation, but a faculty member or technician who gets sick or even quits.

Esker also said students are also asked to work certain hours and do certain tasks without consideration for the student’s time or the actual needs of the clinic.

“I sit there and stare at the wall awake when I could be sleeping because there’s so little to do,” Esker said. “They just have us there because they’re not paying us and it doesn’t matter to them.”

Danielson said the clinics try to avoid scheduling students for unnecessary shifts, but occasionally it does occur.

“A student reported it this year, and in that case, I reached out to the chair of the department and said, ‘Hey, this is happening,’” Danielson said. “And usually if faculty are aware of it, then they make adjustments to those kinds of things.”

Esker said the policy is set up in a way that its enforcement falls on the students to carry out.

“I emailed the [associate] dean when I was on this rotation to tell him about the overt lack of following of the policy,” Esker said. “The thing is, I believe that it’s a staffing issue. I don’t want to take it out on the clinicians, I don’t want to take it out on my patients, but I do believe change needs to be made.”

Esker said there had been times when the long work days and lack of sleep got in the way of completing readings and homework. Not only did she say she would sacrifice her educational duties because of the long hours at the clinics, but also her personal obligations to herself.

“I’m choosing to eat cookies instead of cooking, I’m eating whatever random food is in my house,” Esker said. “I don’t have time to go to the grocery store. You’re never not at school during the hours that anything is open.”

Esker said not every rotation is as busy as others, but even the lighter rotations are not ideal.

“If you were at a job and they were treating you like this, you could just go get a different job,” Esker said. “But as fourth-year vet students, you can’t really transfer, you can’t just say ‘screw you, I’m not going to do it’ because at this point, we’re six figures plus in debt and graduation is essentially required for life.”

Brennan Goodman, a year four veterinary medicine student, described experiences of veterinary students in various rotations in an email exchange with the Daily.

“I have only experienced a few violations except when I was on the ICU rotation in July-August,” Goodman stated. “I would eat my lunch while walking the hallways to get back there to help out. I lost 10 lbs in a month on that rotation.”

Goodman stated the duty-hours policy is written in a way that leaves the lunch policy up to students to organize, yet he stated students are not going to speak up for themselves when there is an emphasis on patient care, not student care.

“You feel guilty going on break on your 12-hour shift when there’s so much to do, but breaks also are an important part of staying mentally sharp and avoid making mistakes,” Goodman stated.

Goodman stated although there is potential to get schedules corrected to align with the duty-hours policy, students often just decide to roll with the punches. He stated because rotations only span two weeks and students only spend a year in the rotations, many students opt not to speak out.

“We’re hard workers in general, we care a lot about our patients, [but] we’re new and vulnerable,” Goodman stated. “There’s the thought of a poor grade if someone speaks up.”

Albers-O’Brien said going through the fourth year of a veterinary medicine degree is a taxing situation in general, but when paired with other health concerns, it begins to take a serious toll on students.

“It started to affect not only my physical health because I wasn’t getting enough sleep, but really my mental health too,” Albers-O’Brien said. “And I mean, a lot of us already have issues with depression and anxiety and other things, so it kind of sucks when you have the added pressure at this place that’s the only place you go all day long.”

The public entrance to the Hixson-Lied Small Animal Hospital, pictured on Feb. 17, 2023. (Jack McClellan)

Albers-O’Brien said it sometimes feels like she’s treated as much like an employee as a student. She said it is upsetting to think that she pays more than $20,000 per semester to be put to work on tasks to keep the clinics running, like cleaning up after patients and staying late to help with patient care.

“Sometimes they don’t even let us draw blood or place catheters,” Albers-O’Brien said. “It depends on the rotation and the clinician, but there’s been some of rotations where I didn’t do a single hands-on thing that made me feel any bit closer to being a doctor.”

Danielson said much of the patient care and bookkeeping are important aspects of the daily duties of a veterinarian. He said from the faculty perspective, many of these duties are critical for learning.

“What nobody wants to happen is for students to be just so tired, and have so much of a workload that they can’t think and that they can’t learn to function as a veterinarian,” Danielson said. “And absolutely, that’s not what we want.”

Albers-O’Brien said the pressures of working in the clinic and taking care of patients make it hard for students to take time for themselves despite the emphasis placed on self-care during the first three years of the veterinary program.

Garrison stated that overall his experience in the small animal hospital has been OK, but some rotations are much better in terms of education and experience than others.

“Clinical year is where we are supposed to practice our roles as clinicians,” Garrison stated. “We are supposed to get hands-on experience and gain clinical knowledge. We are supposed to be bringing the last several years of our education together to form diagnoses and treatment plans, we are supposed to be doctors in training.”

Garrison stated some rotations work hard at allowing students to step into the role of being a doctor while others simply have students carry out the “grunt work,” which he stated includes hours of paperwork, calling owners with appointment reminders and after-hours patient care.

“Some days it seems we do everything but be a doctor,” Garrison stated.

Garrison stated it is frustrating that the importance of making time for ones’ self and maintaining mental health is stressed through the first three years of veterinary school, only to be left behind in students’ fourth year.

He stated he has developed a strong bond with his peers, though the bond is more similar to that between “trauma victims” than colleagues.

Danielson said he is grateful that students can recognize the emphasis the university puts on mental health during the first three years of the veterinary curriculum, adding that the first three years of the veterinary medicine program are also quite demanding.

“We’re doing our best to make it as wellness-focused an experience as we can,” Danielson said. “And it’s a very inherently demanding profession, which we also try to communicate. And we’re trying to get better at both of those things, but that’s what they discover in the fourth year often.”

Danielson said staff members and faculty working in the clinic have similarly high workloads.

“What students don’t see is that the full faculty experience is much more than the time that they’re side by side, elbow to elbow [with the student] in a clinical setting,” Danielson said. “Faculty are also working individually with other learners, they’re answering email from students, they’re interacting by phone with referring veterinarians. It’s an awful lot that they’re managing, and they try when they’re with a student to be present with that student.”

Danielson said he is amazed by the work many of the veterinary professors do. He said he is consistently impressed with their ability to manage their various responsibilities and keep the clinic running.

“The faculty are the ones who are communicating with grieving clients, and they’re the ones who people are complaining to,” Danielson said. “They always just look like they just have everything under control, but they’ve usually got a variety of challenges just under the surface that the student isn’t aware of.”

Danielson said five years ago, the college did not have a duty hours policy. The expectation was that students would come in and work until the work was done. He said the creation of the current duty hours policy came out of concern for the types of situations students have brought up.

Danielson said an alternative that would ensure a more manageable workload for students would require limiting the number of patients the clinic admits. He said nobody wants to limit the amount of care the clinics are able to provide.

“This is a patient that needs the care, so we’re going to do what we have to do to provide it,” Danielson said. “That’s really the mentality of all of them– the faculty and the house officers and the students– really that’s what they’re all there for, but it still sometimes makes for a hard couple weeks.”

In regard to paying students for services in the clinic, Danielson said there is no argument on whether or not students bring value to the clinic.

“We’re grateful for our awesome students,” Danielson said. “However, part of the nature of a teaching hospital is that because our clinical faculty have students with them, the hospital moves at a much slower pace than it would if it were just a referral hospital.”

Danielson said it costs Iowa State more to educate students in the clinical setting than it would to simply operate as a typical hospital. He said most referral hospitals see many more patients much more quickly than at Iowa State’s teaching hospital. He said students are the clinics’ primary clients in that regard.

“What their tuition is getting them is access to that environment with those faculty who are teaching them and the other instructional staff who are helping them to learn at a speed that allows them to learn, because as fast as they feel like it is, it’s not compared to what it will be when they’re out and in the real world,” Danielson said.