William R. Pritchard Veterinary Medical Teaching Hospital

Shelter Medicine

Shelter Medicine Residency Program

Overview:
The Shelter Medicine Residency is designed to teach residents skills relevant to major problems in animal shelters, including infectious disease prevention and management; basic principles of epidemiology; maintenance of behavioral wellness and principles of behavior evaluation; shelter design as it relates to the prevention and management of disease and behavioral problems; development and implementation of high volume/high quality spay neuter strategies and other methods of pet overpopulation control; policy and legal issues that affect shelter veterinarians; and principles of pet management in disaster response. Residents will gain experience in reviewing the scientific literature and other resources; developing and implementing a clinical research project; preparing a paper for publication; providing clinical training for veterinary students; and writing and presenting continuing education material for veterinarians and shelter professionals.

Justification
Shelter medicine is a rapidly developing specialty. Expectations for quality care of animals in shelters have greatly increased, and more animal shelters integrate veterinary care into routine management. There is a need for veterinarians trained specifically in shelter medicine to promote the highest standards of care for shelter animals, serve as consultants, conduct research, and train others. Many public and private shelters employ full-time veterinarians, while smaller facilities and rescue groups increasingly retain contract providers of specialized shelter medicine services in addition to seeking care from local community practitioners. Veterinarians also act as shelter directors and provide leadership in the field of animal sheltering. In order to work effectively with shelter populations, veterinarians must be trained in principles of population medicine, infectious disease management and behavioral care of densely housed dogs and cats. Additional requirements include familiarity with shelter facility design, public health considerations, and legal and ethical issues affecting shelter animal care. Many of these skills are also applicable to breeding, boarding, and service animal training facilities.

Several universities, including UC Davis, Cornell, Florida, Iowa, and Ohio currently offer undergraduate veterinary student training in shelter medicine, and textbooks on shelter medicine have recently been published (Shelter medicine for veterinarians and staff, Second edition, Blackwell Press, Iowa, 2012, and Infectious Disease Management in Animal Shelters, Wiley-Blackwell, Iowa, 2009). Shelter medicine tracks are now included at most major and numerous regional veterinary and shelter conferences, including the North American Veterinary Conference, Midwest Veterinary Conference, Western States Veterinary Conference, Humane Society of the United States Expo, and others. Introductory and intermediate courses in shelter medicine have been offered through the Veterinary Information Network. Research conducted within shelters is seen in the literature with increasing frequency. A petition for a boarded specialty in shelter medicine under the umbrella of the American Board of Veterinary Practitioners was accepted for consideration by the American Board of Veterinary Specialties (ABVS) in 2012, with a decision expected in 2014.

At UC Davis, the residency is facilitated by working relationships with a number of shelters, including Yolo County Animal Services and SPCA, Sacramento City Animal Control, Sacramento SPCA, Marin Humane Society, San Francisco SPCA, Tony La Russa's Animal Rescue Foundation (Walnut Creek), Peninsula Humane Society (San Mateo), Oakland Animal Control, Berkeley East Bay Humane Society, and San Diego Humane Society. Direct contractual relationships for veterinary services exist between the UC Davis Shelter Medicine Program and two shelters, Yolo County Animal Services and Marin Humane Society. These close relationships provide opportunities for in depth clinical experience and practical research.

Oversight
The shelter medicine residency is a program of the Center for Companion Animal Health (CCAH). Therefore, direct oversight is provided by the Director of the Shelter Medicine Program, with additional advice and guidance from the Director of the CCAH.

Mechanics and schedule
Minimum qualifications for acceptance to the residency are one-year practice or internship experience and demonstrated interest in shelter medicine. Candidates for the animal shelter residency will be chosen by shelter medicine faculty. There will be two residents in the program each year, with staggered starting dates, such that there will always be a junior and a senior resident, with completion of the program in three years. The shelter medicine program director will be responsible for performing an initial six month and then annual reviews to ensure that residents are making satisfactory progress towards completion of the program. Residents with poor performance will not be allowed to continue in the program. Shelter medicine residents will not have emergency duty in the VMTH, except to answer calls from shelters. Staff support will include 1 full-time SRA (Staff Research Associate).

Required clinical rotations as described below will be completed within the first two years. In addition to the required clinical rotations, a minimum of 84 weeks will be spent on the shelter medicine service under supervision by the program director or faculty, engaged in remote and on-site shelter consultations and other activities of the shelter medicine program (this includes 20 weeks of primary shelter experience). 8 weeks will be allocated for completion of a research project, including preparation for publication. Additional time will be spent on required activities including animal cruelty investigations, participation in high volume spay/neuter services, and student training. Additional optional rotations may be selected in other specialty services within the teaching hospital; in conjunction with other shelters or animal welfare programs; and/or other university based shelter medicine programs provided adequate supervision is available. Residents receive 4 weeks of vacation annually.

Required rotations

Requirement

Dermatology 

2 weeks

Ophthalmology 

1 week

Behavior service

2 weeks

Exotics / Zoo

2 weeks

Internal medicine 

2 weeks

Clinical pathology

1 week

Pathology/necropsy

1 week

Community practice 

1 week

While in the VMTH, residents will see cases in association with medicine residents (shelter residents will not have primary case responsibility) and will participate in all related activities, including assisting technicians and students, communicating with faculty, owners, and referring veterinarians, and attending rounds and lectures. Residents will be responsible for answering shelter phone and email consults during VMTH rotations.

Specific objectives

Specific objectives of shelter medicine residency programs have been defined. A full set of objectives was produced by a committee comprising shelter medicine faculty representing 11 veterinary schools. These are as follows.

Shelter visits

Objectives:
Residents are expected to become knowledgeable about a wide variety of sheltering models representing a range of sizes, budgets, species, philosophies, regions, facility styles and programs.

Required training experiences:
Residents must visit at least 50 different animal shelters in at least 3 of the following 5 regions: western United States; mid western United States; northeastern United States; southern United States, international. Visits should include both municipal and private shelters including both open and limited admission facilities. The content or type of visit may range from an informal tour to a comprehensive site consultation. The term animal shelter is meant to include any traditional open-admission shelters; limited or planned admission shelters; no-kill or adoption guarantee shelters; care-for-life sanctuaries; home-based rescue and foster-care networks; animal transport programs; and other permutations of these various approaches. Visitation of a wide variety of organizations is strongly encouraged.

Shelter Practice

Objectives:
Residents are expected to hone their clinical skills in the day-to-day practice of shelter medicine in animal shelter(s).

Required training experiences:
Residents must spend the equivalent of at least 20 training weeks in shelter practice.

Shelter consultations

Objectives:
Residents are expected to develop the ability to systematically gather data, perform observations, communicate findings and provide resources regarding management, medical and husbandry practices and facility use at shelters as related to physical and mental animal health, as well as within HQHVSN programs.

Major consultation areas include: Shelter Management and Record Keeping; Facility Design and Environment; Population Management; Sanitation; Medical Health and Physical Well-being, including animal transport programs when applicable; Behavioral Health and Mental Well-being, including group housing and animal handling; Euthanasia; Shelter Animal Spay/Neuter; Public Health; Management of Specific Infectious Diseases (e.g. respiratory disease, diarrhea, dermatophytosis, canine or feline parvovirus); and HQHVSN programs (shelter associated or non-shelter associated programs).

It is expected that applied knowledge of veterinary medical regulations, euthanasia regulations, shelter regulations, zoonotic disease regulations, DEA, OSHA and other regulatory matters, as well as best practices for animal sheltering will be reflected/addressed during the course of shelter consultations.

Required training experiences:

Comprehensive site consultations:
Residents are required to participate in three (3) on site comprehensive consultations covering the areas listed above. Primary responsibility for information gathering and communication is required for at least one (1) section on each comprehensive consultation; overall responsibility is required for at least one (1) comprehensive consultation.

Targeted site consultations and protocol development:
Residents are required to participate in at least nine (9) on site targeted consultations, including at least one (1) consultation in each of the above listed major consultation areas unless covered as section leader in the course of a comprehensive consultation. A maximum of three (3) targeted consultations at any single facility may be counted towards this requirement.

Residents must design a protocol for a specific shelter on at least five (5) of the above listed major consultation areas, including at least one on management of an infectious disease. Residents must implement at least one (1) of these protocols, including staff training and initial follow up.

Written Telephone/email consultations:
Residents must respond to at least sixty (60) telephone/email consultation requests covering a wide variety of questions from the field pertaining to shelter, rescue and foster animal health; and public health including rabies prevention, control, and management.

Outbreak investigations

Objectives:
Residents are expected to learn to recognize and diagnose infectious disease outbreaks; utilize CDC approach to outbreak investigation including risk factor analysis; make recommendations for outbreak control, including: titer analysis, quarantine, isolation, treatment, communication and facility decontamination; and make recommendations for prevention of future outbreaks.

Required training experiences:
Residents must advise on at least nine (9) outbreaks, including at least three (3) site visits and outbreaks involving at least three (3) of the following diseases: dermatophytosis, canine distemper virus, canine parvovirus, feline parvovirus, or one “unknown” cause outbreak or mock/table top exercise involving a different pathogen.

High quality, high volume spay-neuter (HQHVSN) program visits and surgical experience

Objectives:
Residents are expected to become knowledgeable about different models of HQHVSN programs and develop skills in efficient surgical techniques for spaying and neutering cats and dogs.

Required training experiences:

High volume spay-neuter program visits:
Residents must visit at least 5 different high volume spay-neuter programs of at least 3 of the following different types: stationary, mobile, MASH, non-surgical or other. The content or type of visit may range from an informal tour to hands on participation. Visitation of a wide variety of organizations is strongly encouraged.

HQHVSN surgical experience:
The resident must spend the equivalent of at least four (4) training weeks directly supervised by an approved supervisor actively participating in HQHVSN practice. Training should emphasize developing skill in performing HQHVSN techniques and developing awareness of differing management styles for operating HQHVSN clinics. Note: The term HQHVSN program refers to an efficient surgical initiative that meets or exceeds veterinary medical standards of care in providing accessible, targeted sterilization of large numbers of cats and dogs in order to reduce their overpopulation.

Cruelty Investigations

Objectives:
Residents are expected to develop a thorough understanding of the spectrum of cruelty cases (including abuse and neglect), the types of cases that are commonly seen in shelters, the types of assets and logistics required for investigating multi-animal events (e.g. management of large scale seizure and temporary sheltering), and knowledge of the agencies engaged in the reporting, investigation, intervention, prosecution, enforcement, and follow-up of cruelty cases. Residents must develop an understanding of the forensic physical examination, methods for gathering evidence, and protocols for maintaining the chain of evidence in a case. Specifically, residents must perform live animal exams, forensic exams, participate in collection of physical evidence, prepare and present testimony, maintain contact with legal authorities, understand application of state statutes in specific cruelty cases, maintain chain of evidence, and comply with chain of authority.

Note: Although field experience is ideal for cruelty case training, it is recognized that opportunities may be lacking for certain case types or activities that require expert level input (e.g. a resident in training may be unlikely to be asked to testify in a major cruelty case). As noted below in some cases training requirements can be met through wet lab experiences.

Required training experiences:
Residents must participate in the investigation of at least two (2) single animal cases and at least one (1) multi-animal case involving alleged criminal abuse or neglect. Residents must perform at least two (2) detailed live exams under field conditions and at least one (1) forensic necropsy (can be wet lab) with appropriate documentation and record keeping. Residents must participate in physical evidence collection for at least one (1) case (can be wet lab).

Disaster preparedness and response

Objectives:
Residents are expected to develop an understanding of the issues involved in response to a disaster involving companion animals, including response, reporting and coordination; methods of safe transport; measures to control infectious/zoonotic disease and other risks in a temporary shelter; and animal-owner reunification. Residents are expected to gain experience in the practical and logistical issues involved in a disaster response including rescue, transport and sheltering of companion animals.

Note: As with cruelty investigations, field experience is ideal but it is recognized that the opportunity to participate in a disaster response may not occur during every residency, therefore simulation or wet lab is an acceptable substitute.

Required training experiences:
Residents must participate in response to one (1) natural or other disaster (field conditions, simulation or wet lab). Residents must complete a basic credentialing course for participation in disaster response.

Required Rotations Outside of the Primary Field of Study (minimum 16 weeks)

Dermatology: The resident must spend the equivalent of at least two (2) training weeks directly supervised by a Board-certified veterinary dermatologist actively participating in the management of dermatologic cases, including selection, performance and interpretation of diagnostic tests (eg. DTM, cytology of skin preparations); patient management and decision-making; client communication; and appropriate follow-up. This training should emphasize the approach to diagnosis and treatment of common dermatological diseases with emphasis on those of most importance in shelters (e.g. dermatophytosis, parasitic dermatopathies).

Ophthalmology: The resident must spend the equivalent of at least one (1) training week directly supervised by a Board-certified veterinary ophthalmologist actively participating in the management of ophthalmologic cases, including selection, performance and interpretation of diagnostic tests; patient management and decision-making; client communication and appropriate follow-up. This training should emphasize understanding all aspects of the ophthalmologic examination, including diagnosis and treatment of infectious diseases and other common diseases of the eye with emphasis on those seen commonly in shelters (e.g. FHV-1, prolapsed gland of the third eyelid, entropion, ectropion).

Behavior: The resident must spend the equivalent of at least two (2) training weeks directly supervised by a Board-certified veterinary behaviorist actively participating in the management of behavior cases, including patient evaluation and decision-making; client communication and appropriate follow-up. This training should emphasize behavioral history taking and behavioral examination of owned animals and enable the resident to become familiar with evaluation, treatment and prognosis of behavior problems commonly associated with pet relinquishment (eg. aggression, inappropriate elimination, separation anxiety).

In addition, the resident must spend the equivalent of at least four (4) training weeks directly supervised by an approved supervisor actively participating in the behavioral evaluation and management of dogs and cats in a shelter setting.

Avian/exotics/zoological medicine: The resident must spend the equivalent of at least two (2) training weeks directly supervised by a Board-certified avian,exotics or zoological medicine specialist actively participating in the management of cases, including selection, performance and interpretation of diagnostic tests; patient management and decision-making; client communication and appropriate follow-up. This training should emphasize physical examination and husbandry of rabbits, other small mammals, birds and reptiles commonly encountered in shelters, as well as the approach to diagnosis and treatment of diseases common to these species.

Internal Medicine: The resident must spend the equivalent of at least two (2) training weeks directly supervised by a Board-certified small animal internist actively participating in the management of internal medicine cases, including selection, performance and interpretation of diagnostic tests; patient management and decision-making; client communication and appropriate follow-up. This training should emphasize developing skill in the problem-based approach to diagnosis and treatment of medical cases including integration of evidence-based medical concepts.

Clinical pathology: The resident must spend the equivalent of at least one (1) training week directly supervised by a Board-certified veterinary clinical pathologist actively participating in evaluation of clinical pathologic findings and reviewing cytologies. This training should emphasize development of proficiency in cytologic interpretation of blood smears, tissue exudates, mass aspirates and other samples that are likely to be encountered in shelter practice.

Necropsy: The resident must spend the equivalent of at least one (1) training week directly supervised by a Board-certified veterinary pathologist performing necropsies and evaluating pathologic findings. This training should emphasize developing skill in performance of a systematic necropsy, including sample collection from every organ system, special considerations for infectious disease detection (e.g. collection of smears and samples for virology, bacteriology, molecular biology), and experience in documentation of findings for medical records and sample submission.

Community practice: The resident must spend the equivalent of at least one (1) training week directly supervised by an approved supervisor actively participating in the management of outpatient cases, including selection, performance and interpretation of diagnostic tests; patient management and decision-making; client communication and appropriate follow-up. This training should emphasize experience in application/communication of current guidelines for quality preventive care for individually owned pets (e.g. heartworm, parasite control, vaccination, spay/neuter, retrovirus management, zoonotic diseases, nutrition, behavioral wellness, pet identification).

Education and Other Scholarly Activities

Clinical rounds: Residents must attend and participate in clinical rounds on a daily basis during the clinical training period. The resident should periodically lead rounds discussions an average of once every other week.

Journal clubs and Formal Conferences: Residents must attend formal conferences such as journal clubs or seminars in shelter medicine and related disciplines on a regular basis. A minimum of 60 hours in attendance is required. The resident must give a formal presentation at such a conference at least once per year.

Continuing Education Meetings: The resident must attend at least one major veterinary medical meeting with a dedicated shelter medicine track and one national or regional animal sheltering professional conference during the previous 5 years.

Presentations to professional audiences and shelter staff
The resident must give at least six (6) formal presentations to professional audiences and/or shelter staff during the course of the residency program. Conferences given within a veterinary practice or hospital; at a medical school or medical teaching hospital; at an animal shelter; or at a regional, state or national meeting are acceptable. At least one presentation must be delivered to a primarily veterinary audience and at least one must be delivered to a primarily shelter audience. Journal club presentation and presentation of resident research does not count towards this requirement.

Communication training
The resident must complete a minimum of six (6) hours of formal instruction in communication (including didactic and structured interaction) emphasizing understanding and developing skills necessary for successful communication, negotiation and conflict resolution.

VI.) Certification
Successful completion of the residency will be certified when the resident achieves the specific goals described in Appendix I. Upon completion of the residency, residents will receive UC Davis VMTH certification of expertise in shelter medicine. It is anticipated the a boarded specialty in Shelter Practice through the American Board of Veterinary Practitioners will be available as early as 2014. The current residency program at UC Davis meets all pre-requisites for exam qualification; if the specialty is approved, graduates of the residency will be qualified to sit for the specialty exam (assuming all materials, including submission of all required forms and case reports, are completed).

Shelter Medicine Residency Requirements Summary

  Months in Program 0 6 12 18 24 30 36 Completed (X)
A. Initial orientation and resource review to be completed in first month                
1 Receive and review Shelter Medicine residency requirements, activity logs and progress checklist with Resident Advisor                
2 Establish UC Davis email and outlook web exchange account, gain access to shared Shelter Medicine calendar, shared drive                
3 Phone set-up, voice mail, VMTH phone lists                
4 Order business cards                
5 Establish VMACS access including VOLES                
6 Establish password and login for www.sheltermedicine.com                
7 Receive and review residency resource e-folder (including team and shelter contact list, web based resources, reading list, journal review guidelines), print materials as needed                
8 Join Smartsite group for rounds notification                
9 Join Association of Shelter Veterinarians and subscribe to email list (job requirement; paid for by KSMP)                
10 Receive and review sample consult reports and consultation overview                
11 Become familiar with online scientific research tools; appointment with reference librarian                
12 Set up journal notification for required journals available onlinewww.sciencedirect.com, Elsevier infectious disease gateway, others per resident interest                
13 Working with shelter program director and coordinator, develop schedule for first year of program                
14 Contemplate Getting Things Done                
15 Develop list of self-study goals                
B. Intensive Clinical Traininag in the Specialty of Shelter Medicine                
1 Minimum 84 Weeks of Clinical Training in Shelter Medicine[Indicate no. of weeks and level of supervision: Direct (D) or Indirect (I)]                
2 Visit at least 50 animal shelters in at least 3 regions of the following 5 regions: western United States; mid western United States; northeastern United States; southern United States, international (maintain activity log)                
3 Participate in shelter practice for at least 20 training weeks (maintain activity log of all clinical rotations including shelter practice)                
4 Participate in at least 3 comprehensive shelter consultations with primary responsibility for at least 1 section of each and overall responsibility for at least 1 comprehensive consultation (maintain activity log)                
5 Participate in at least 9 targeted shelter consultations including all major areas of consultation as defined in section V of the clinical requirements (maintain activity log)                
6 Design at least 5 shelter protocols, including at least 1 infectious disease protocol; implement at least 1 of these protocols at a shelter                
7 Respond to at least 60 telephone/email consultation requests (maintain activity log)                
8 Advise on at least 9 disease outbreaks, including at least 3 site visits and at least 1 outbreak of at least 3 of the following: dermatophytosis, canine distemper virus, canine parvovirus, feline parvovirus, and one “unknown” cause outbreak (maintain activity log)                
9 Visit at least 5 different HQHVSN programs of at least 3 of the following different types: stationary, mobile, MASH, non-surgical or other (maintain activity log)                
10 Participate in HQHVSN practice under direct supervision for at least 4 weeks                
11 Participate in the investigation of at least 2 single animal cases involving alleged criminal abuse or neglect including live animal examination for documentation (maintain activity log)                
12 Participate in the investigation of at least 1 multi-animal case involving alleged criminal abuse or neglect (maintain activity log)                
13 Perform at least 1 forensic necropsy (can be wet lab) (maintain activity log)                
14 Participate in response to 1 natural or other disaster (field conditions, simulation or wet lab)                
15 Complete a basic credentialing course for participation in disaster response                
C. Other Required Clinical Rotations
(maintain activity log of all clinical rotations)
               
1 At least 2 weeks-Dermatology                
2 At least 1 week-Ophthalmology                
3 At least 2 weeks-Behavior practice with boarded behaviorist                
4 At least 4 weeks-Behavior shelter with approved supervisor                
5 At least 2 weeks-Avian/exotics/zoological medicine                
6 At least 2 weeks-Small animal internal medicine                
7 At least 1 week-Clinical Pathology                
8 At least 1 week-Necropsy                
9 At least 1 week-Community Practice                
D. Education and Other Scholarly Activities                
1 Attend/participate in clinical rounds on a daily basis during the clinical training period; periodically lead rounds discussions an average of once every other week                
2 Attend at least 60 hours of formal conferences (e.g. journal clubs or seminars in shelter medicine) on a regular basis                
3 Deliver a formal presentation at journal club or seminar at least once per year                
4 Attend at least 1 major veterinary medical meeting with a dedicated shelter medicine track (maintain activity log)                
5 Attend at least 1 national animal sheltering professional conference (maintain activity log)                
6 Deliver at least 6 formal presentations to professional audiences and/or shelter staff; at least 1 presentation must be delivered to a primarily veterinary audience and at least 1 must be delivered to a primarily shelter audience (excluding journal club and resident research presentations)                
7 Complete a minimum of 6 hours of formal instruction in communication (including didactic and structured interaction)                
E. Research Requirements                
1 Complete at least 1 graduate level course (with a minimum of 10 hours of instruction) in epidemiologic study design                
2 Complete at least 1 graduate level course (with a minimum of 15 hours of instruction) in basic statistics                
3 Write at least 1 grant proposal (may be for research or other project, e.g. spay/neuter, program activities ) and submit for review                
4 Conduct at least 1 research project (prospective or retrospective) pertinent to shelter medicine)                
5 Present resident research (oral or poster) at a local or national meeting                
6 Prepare at least 1 first author publication relevant to shelter medicine in a peer reviewed journal                
7 Prepare at least 1 first author article related to shelter medicine for a lay audience                

The University of California, Davis, and the Veterinary Medical Teaching Hospital are interested in candidates who are committed to the highest standards of scholarship and professional activities, and to the development of a campus climate that supports equality and diversity.