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Making public health exciting
  1. Pia Gjertsen Prestmo

Abstract

As a resident in veterinary public health at Bristol, Pia Gjertsen Prestmo helps introduce final-year students to ante- and postmortem inspection in the abattoir

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EVERY week I meet a new group of vet students on the veterinary public health (VPH) rotation in our small on-site abattoir, and I often get asked ‘How did you end up here? (with the emphasis on ‘here’). Perhaps students, and vets too, see public health as an area of veterinary medicine where one ‘ends up’, not something to deliberately pursue. This is sort of true for me, but then so many things in life happen at random.

Growing up in Norway, I had always wanted to be a vet, although I also considered becoming a doctor, lawyer and architect. I chose to go to agricultural school instead of the standard upper secondary school, and over two years I learnt how to drive a tractor, milk a cow, recognise wild plants and animals, make hay, grow vegetables, weld two pieces of metal together and more. I loved being outside, learning about animals and how food was produced, but did not get the best marks. (I blame it on the tractor-driving exam, where we had to reverse up a barn ramp with a trailer. It did not go well.) Entering Norway's only vet school was therefore not possible, and I went to study on the English-language veterinary programme at Szent István University in Budapest, Hungary. After graduation, I returned home to Norway to find a challenging job market for new graduates. While looking for a job, I worked for a few months as a primary school teacher, which I enjoyed immensely. Eventually, though, I was offered a six-month position in a small animal practice to cover maternity leave, and there I gained my first experience of being a veterinary surgeon.

Because I had initially applied for every remotely relevant job there was, my CV was stored in the Norwegian Food Safety Authority's database, and one day I was called and asked if I would work in an abattoir as an Official Veterinarian (OV). I accepted and moved to the countryside. The job was great and I enjoyed my new role, working in a team of colleagues who were covering animal health on farm and in transport, restaurant hygiene, water quality, sewage treatment, and so on.

‘I enjoy seeing students go from seeming rather uninspired and disinterested when they first arrive, to asking lots of questions and making confident decisions in just a few hours.’

Learning how meat is produced fuelled my interest in food safety, disease control and, to my surprise, legislation. However, the Norwegian countryside is tough, with towering mountains, cold and dark winters, an hour to the nearest town, and no pubs. I decided to move to the UK to gain some international experience in public health, by working as an OV. Arriving in the UK I was required to attend an OV course at Bristol university (this was not a requirement in Norway), where I met my now supervisors. They told me about an upcoming residency position and suggested that I apply. Seven months later, I started my European College of Veterinary Public Health residency at the vet school.

My position here involves teaching students on final-year rotation, as well as research and studying for my board examinations. The on-site abattoir has for many years provided slaughter and butchery of sheep, cattle and pigs for local farmers as well as experience for final-year students. The abattoir staff and animal welfare officer are active in teaching, along with the academic staff who guide the students in postmortem examination of rejected materials, and auditing of the abattoir. International students, researchers and other visitors to the university frequently take part in the rotation as well.

Last year we introduced farmer feedback as an assignment, and students now perform ante- and postmortem inspection and welfare assessment of one batch of animals each. The students arrive at 7 am, when I am sure their expectations are relatively low. They soon rise to the challenge of making decisions based on the findings of their inspection. Previously, the rotation consisted mostly of observation, but by introducing more active participation we are seeing a change in students' attitudes towards the subject. Their findings are written up in a report, with advice for the farmer on the conditions found, which are usually mild parasitic lesions or subclinical lung disease. We send this advice by post, and one of our research projects this year investigated how this advice is used by the farmers. We have also been asking students how useful the exercise was as a learning experience, and are very happy with the results so far.

Pia visiting the World Organisation for Animal Health in Paris

The farmers who receive feedback letters report that they do use them, and appreciate them as a tool for herd health management. The students appreciate that they are able to make decisions on what to reject for human consumption, what to include in the feedback letter and how to phrase their advice, with some guidance. They have also said that knowing the output from this assignment is used to benefit the animals on farm, the farm vet in their work and the abattoir as a service provider, motivates them in their learning.

I enjoy seeing students go from seeming rather uninspired and disinterested when they first arrive, to asking lots of questions and making confident decisions in just a few hours. Some of our students have also chosen to attend the OV course, entering the meat industry as qualified OVs directly after graduating, and we are seeing increased undergraduate interest in this course.

During breaks, the discussion often revolves around the future of the veterinary profession, and career prospects after graduation in particular, as well as my own story and how I came to work at the vet school. Sometimes students express feelings of worry as they talk about their hopes for the future – many have been disappointed with their experiences so far, saying being a vet was not what they had imagined. Some have heard from previous graduates that finding a job is not as easy as it has been in the past. We try to encourage them, emphasising that there are many career options for someone with a veterinary degree. Many jobs in public health, for example, are not advertised through the usual channels, so knowing people in the right places is useful. Through our teaching team's international network of contacts we are often able to guide students who are interested in public health towards exciting work experiences (and possible future employers) both in the UK and abroad.

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We are fortunate to get a broad education at the foundation of our careers, which enables us to work in many different fields and have a good understanding of the bigger picture. It is not necessary to have a career path staked out on graduation day. If the work is interesting, challenging and appreciated, the basic foundation is there no matter what the subject. The most important thing is having a solid team of colleagues who mentor and support you and who have the ability to have a good laugh with you over a cup of coffee. At my interview, my supervisor asked me how we could make public health more exciting. A few years later, I'm thinking we don't need to make it exciting – it already is! I have learnt that in public health one's work can really have an impact on a large number of people and animals. In this interdisciplinary field, we must work internationally and strive to understand the world and its inhabitants as a whole. I hope that my future in public health will lead me to know many exciting new places, cultures, animals and people.

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