Interview with Amy Randall, DVM, MS, Diplomate ACDV about the meaning and importance of working with veterinary specialists and the significance of Board Certification
- Please tell us about your background and training.
After receiving my doctorate of veterinary medicine from North Caroline State University, I practiced general veterinary medicine for a year in Fredericksburg, Virginia. With a deep desire to continue my education, I then completed a two-year internship in veterinary medicine and surgery at Mississippi State University. Because I wanted to continue the learning process, I then spend a term as a clinical instructor of veterinary internal medicine and dermatology. As part of the process of getting a Master of Science degree, specializing in dermatology, I did my residency at Ohio State University in Columbus, Ohio. I am one of fewer than 300 veterinarians board-certified by the American College of Veterinary Dermatology.
I currently practice out of two clinics, one in Beaverton, Oregon and the other in Greensboro, North Carolina, which I travel to once a month to provide dermatological veterinary care in a community which did not previously have access to that type of care.
I have also formulated, tested, and produced a line of pet treats and pill wraps designed for dogs with food sensitivities. The line is limited ingredient, all natural, and made in the United States at a bakery that is attached to my Beaverton clinic. To learn more about the products, you can visit www.serenegy.com.
- Why veterinary dermatology as opposed to another specialty?
I chose dermatology as my specialty due to my desire to have all my patients’ home at night instead of in the hospital. During my internship at the Mississippi State University Internal Medicine Department many of my patients were very sick and died despite all our efforts. I attended to my patients and their pet parents to such an extent that it left me with little time for anything else. These experiences provided me with the basis for my decision to specialize in dermatology.
- What does Board Certification by the American College of Veterinary Dermatology entail and what does it mean?
Board Certification means an individual has completed a very rigorous set of requirements and training and passed a 2-day examination which includes essay questions, reading histopathology slides, multiple choice questions and diagnosing diseases with a slide show. All of these exemplify and test the candidate’s training and knowledge to be qualified for Board certification.
An individual must have a degree in veterinary medicine which is an 8-year process. Then they must get matched into an internship program which a one-year post DVM program for extended training in veterinary medicine. This training consists of acting as the primary veterinarian seeing patients but under the guidance of a Board certified veterinarian in the fields of internal medicine, surgery, neurology, cardiology, anesthesia, dermatology and oncology. After completing this program the candidate then applies for residencies which are 2 to 3-year programs focused on dermatologic training. This training is under the guidance and supervision of Board certified veterinary dermatologists. There are 50 – 75 residency programs available throughout the United States, most only accepting 1 individual annually or every few years. The candidate must rank at the top of the pool of candidates to be selected and the pool of candidates may include several hundred individuals. In these programs the candidate takes on the responsibility of the primary veterinarian seeing patients and training senior students if they are working at a university. The 2 to 3-year training is a comprehensive training which is focused on veterinary dermatology but also comparative human dermatology. Residents need to understand human aspects of dermatology and apply this to veterinary dermatology and then compare and contrast the difference. We also are trained to read biopsy samples and interpret histopathology reports for diagnostic purposes to identify different diseases. Some residencies require you to also obtain a Master of Science degree during your dermatologic training. This training encompasses case reports which are reviewed and passed by the ACVD certification board, conducting research to advance veterinary dermatology which research needs to be published in a respected journal, journal club hours (sitting down with your mentors and discussing research articles about dermatology) and book club (guided by the mentor, reading both human and veterinary dermatology books about diseases and the comparative pathophysiology of diseases). After successfully completing the residency, which is also tied to fulfilling all your requirements to sit for the Board certification test, the resident is ready to sit for the boards. Once you pass this extensive comprehensive test, the candidate receives a certificate of acknowledgement by the ACVD. This allows that individual to say they are Board certified in dermatology which is the highest ranking in that field.
- What is your practice/clinical philosophy?
My clinical philosophy is to offer the best of care and top of the line treatment options for the patient and then, as a team, the client and I can come up with a treatment option that is best suited for the patient and his or her family.
- How important do you think it is for pet parents to work with veterinary specialists instead of generalists?
I think it is very important that pet parents are educated about veterinary specialists and the additional training and expertise they have. As specialists we each devote our life and career to one aspect of veterinary medicine; thus we understand disease processes much better and to a much greater degree. We provide the very best in the specialized field. I feel the general veterinary practitioner is akin to a GP for people. They understand a little bit about everything and can handle many different issues but once the clinical condition does not respond to a few treatments and starts to get complicated, the pet parent should be encouraged to go to a specialist for further evaluation and diagnostics.
- Do you treat both dogs and cats and, if so, how are those practices different?
Yes, we treat both dogs and cats. Cats are harder to treat and examine due to their personalities and sensitivities to clinic environments. At our clinic we have provided our patients with big exam rooms and numerous windows which help to reduce the stress level and anxiety. The windows also have a ledge large enough for cats to sit on and watch the squirrels and bugs outside on the fence and grass. They no longer feel boxed in and confined.
- What sorts of symptoms should cause a pet parent to seek the advice of a veterinary dermatologist?
- Any hair coat or skin condition such as hair loss, changes in hair coat texture, thickness, feel.
- Demonstration of excessive licking, chewing, scratching, biting which causes trauma to the skin and haircoat (hot spots, hair loss, redness, oozing and wetness on the skin).
- Ear infections or frequently scratching and shaking the head
- Nailbed and footpad problems
- Pigment loss on the nose
- How do you work with other veterinarians who may also be caring for some of your patients? (i.e. coordination of care)
Since I only provide care for conditions like allergies, autoimmune diseases or other dermatologic problems, the owners need to rely on their primary veterinarian for all other forms of care and management. We do not perform daily routine vaccinations or other services which would be better provided by a general practitioner. I chose to become a specialist with a focus on one aspect of veterinary medicine which would then allow me to provide the best care and most up to date information to my clients.
- What should a pet parent look for in deciding which veterinarian to take their animal companions to?
The general practitioner should be able to provide good overall health care and educate the client on their treatment options for simple medical conditions. They should also be comfortable telling the client when they do not know what the problem is or how to treat the pet’s medical issues. They should feel very comfortable providing the client a referral to a specialist for further advanced treatments and diagnostics. Most of the time specialists are able to identify the problem very quickly and provide the best and most up to date treatment options, helping to get the pet healthier sooner. The goal for every veterinarian should be providing the pet with the best and quickest recovery from illness without an ego attached.
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