The Vet Vault: Veterinary Career, Clinical Skills & Wellbeing

Am I a useless vet?

Sounds like a silly question that a new grad might ask, right? But imposter syndrome doesn't care about your credentials.

It whispers that you're a fraud, that you got lucky, that one day everyone will realise you don’t belong. 

Or maybe you don’t feel like an imposter - but you beat yourself up after a case goes wrong. You replay every missed diagnosis. You hold yourself to an impossible standard, and when you fall short (even slightly), the inner critic shows no mercy.

Sound familiar?

In veterinary medicine, where perfection often feels like the baseline and the emotional toll runs deep,  these patterns can be exhausting.

But here’s the truth: you’re not the only one who feels this way.

In this raw and honest conversation, we unpack:

• Why imposter syndrome isn’t just a new grad thing - it can resurface anytime you step into something new, no matter how experienced or accomplished you are (Just keep listening if you don’t believe me)
• What confidence really looks like - not knowing everything, but being willing to try, learn, and grow
• Why perfectionism is often at the root of imposter - and what to do about it
• Making peace with the inner-critic
• Why vulnerability matters 
• A simple mindset shift that can make all the difference
• And practical strategies to manage imposter feelings 

You’ll hear real stories, mindset tools, and the reminder that feeling “useless” says nothing about you. 

If you’ve ever questioned your abilities or felt like you're just pretending to hold it all together - this episode is your mirror.

You belong here. And it’s time you believed that too.

Our guests are: 

Dr Marie Holowaychuck - a board-certified emergency and critical care veterinarian and the founder of Reviving Vet Med, a global initiative dedicated to equipping veterinary professionals with practical tools for mental health, resilience, and work–life balance, and the author of A Compassionate Calling: What It Really Means to be a Veterinarian.

Check out her new book here. 

Dr Kerri Nelson: Experienced ER vet, mentor and former medical director. First time mom-to-be! (She has an epic blog about over-achieving - here.) 

Dr Rob Webster: Co-Chief Executive Officer of Animal Emergency Australia, the leading veterinary emergency-care group down under, where he oversees clinical standards and consults on complex emergency and critical-care cases. A board-certified specialist in emergency and critical care since 2014. Jiu-jitsu tragic. 

Check out our Advanced Surgery Podcast at ⁠⁠⁠⁠⁠⁠⁠⁠⁠cutabove.supercast.com⁠⁠⁠⁠⁠⁠⁠⁠⁠, or go all in on surgery with our collaboration with Sydney University's CVE Surgery Course.

Find out how we can help you build you in your vet career at ⁠⁠thevetvault.com⁠⁠.

Get case support from our team of specialists in our ⁠⁠⁠⁠⁠⁠⁠⁠Specialist Support Space⁠⁠⁠⁠⁠⁠⁠⁠.

⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠for Hubert's favourite clinical and non-clinical learnings from the week.

Join us in person for our epic adventure CE events at ⁠⁠⁠⁠⁠⁠Vets On Tour⁠⁠⁠⁠⁠⁠. (Next up: Japan snow conference!) 

Topics and Time stamps

04:28 You're not alone

09:56 What is a syndrome?

15:49   Defining Imposter Syndrome

19:44 Maybe It's Just Kinda Normal?

22:10 So What Can We Do About It?

27:22 The Eternal Internal Critic

30:22 Talk It Out

35:59 Vulnerability As A Weapon Against Imposter

39:03 This Is What Getting Better Feels Like

40:18 Perfectionism - The Root of Imposter

49:28 At Least You'er Not a Psychopath!

51:04 The Best People Are Filled With Self-Doubt

51:56 Mistakes Happen

Stop scrolling -  I know what you’re thinking: “I don’t want to listen to someone preaching to me about antimicrobial resistance  - it’s boring, and it just makes me feel guilty!”

Here's a promise: you'll find nothing boring or preachy here. What you will get is interesting science, practical tips, and zero guilt trips. 

Dr Kate Worthing is a senior lecturer in veterinary microbiology, practising clinician and passionate antibiotic resistance researcher, and she’s about to change how you prescribe.

Together we unpack why the way you use antibiotics in general practice is more than a clinical choice - it’s a responsibility that affects your patients, your team, and your future cases. From unseen pathways of resistance to pragmatic stewardship strategies you can implement this week, this is essential listening for all veterinarians. 

You’ll learn:

• Why antimicrobial resistance is not just a global issue - it’s personal, and it’s already in your consult room.
• How selection pressure works beyond the infection: across the microbiome, the patient, and the environment.
• Why MRSA isn't really the problem you should be worried about (and where you SHOULD point your attention).
• Where resistance risk is highest in small animal practice.
• What “good prescribing” looks like in real life
• How to find and apply trustworthy prescribing guidelines without slowing down your workflow.

Resources:

AMRVC

https://www.amrvetcollective.com/

https://www.amrvetcollective.com/home/guidelines/

WSAVA Infographics

https://wsava.org/committees/therapeutics-guidelines-group/

ISCAID

https://www.iscaid.org/guidelines

Understanding the mechanisms of resistance

Video

Visit thevetvault.com to join our Vet Vault Nerd community for more clinical confidence and better patient outcomes, get help with your tricky cases in our specialist‑support space, and subscribe to our newsletter for clinical gems and a bit more.

We scrutinise one of the most practical yet under‑examined advances in veterinary practice: AI‑based radiology interpretation tools. 

I sit down with veterinary radiologist and Vedi entrepreneur Dr  Steve Joslyn to unpack the rise of AI-powered radiology tools in general practice. But this isn’t just opinion: Steve reveals the findings from his team’s recent study that put 6 commercially available AI radiology softwares in the spotlight - or up on the light box - to assess whether they deliver on what they promise.

From how these systems are trained, to where they shine (and where they fail), this conversation gives a no-nonsense look at what AI can actually do for your diagnostic imaging workflow. 

What You’ll Learn:

• How these tools are built: Neural networks, down-sampling, and the truth behind “ground truth”.
• The data dilemma: Why most AI tools perform best in theory, not in general practice.
• Where they fall short: From image quality issues to breed bias and external validation gaps.
• New accuracy data: Insights from Dr Joslyn’s pilot study comparing six commercial AI tools.
• A decision-making playbook: When to trust AI, when to double-check, and when to avoid it entirely.
• Ethics and workflow impact: Who’s responsible? What do you tell clients? Can AI triage be trusted?
• How to stay future-ready: What’s coming next – and how to adapt without compromising care.

🎧 Listen now for the tools to ask better questions about AI in your clinic.

Find out how we can help you build you in your vet career at ⁠thevetvault.com⁠.

Check out our Advanced Surgery Podcast at ⁠⁠⁠⁠⁠⁠⁠cutabove.supercast.com⁠⁠⁠⁠⁠⁠⁠. 

Get case support from our team of specialists in our ⁠⁠⁠⁠⁠⁠⁠Specialist Support Space⁠⁠⁠⁠⁠⁠⁠.

⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠for Hubert's favourite clinical and non-clinical learnings from the week.

Join us in person for our epic adventure CE events at ⁠⁠⁠⁠⁠Vets On Tour⁠⁠⁠⁠⁠. (Next up: Japan snow conference!) 

Did you know that a brachycephalic dog with BOAS has a 433% higher anaesthetic risk than a dog with a normal nose?

Let me rephrase that: that Frenchie you’re spaying later this week is more than four times more likely to die on her surgery day than any of your other patients. 😳

Do we have your attention?!

Thanks mainly to the rising popularity of the French Bulldog, you’re probably anaesthetising these kinds of patients all the time.

So how do we reduce that risk? How do improve patient safety while decreeing your stress levels?!

At the Brachycephalic Care Unit, surgeon Dr Abbie Tipler and her team have polished brachycephalic anaesthesia down to a fine art, and in this episode, she shares all the gold.

From the days leading up to anaesthesia to selecting the safest mix of premed and anaesthesia agents, all the way to a calm, well-oxygenated recovery, this episode is the ultimate masterclass in brachycephalic anaesthesia.

Hit us up for the full show notes for this episode, as well as Dr Abbie’s brachycephalic pre-surgery history template, here. 

This episode is one of more than 600 from our subscriber-only clinical podcasts. If you like this style of learning, where I dig for all the pro tips and updates from some of the best specialists in the world, then you’ll love our clinical feed. Go check it out at thevetvault.com

Oh, and if you’d like to join me in Japan in February or the Maldives in April for the most fun you’ll ever have at a vet conference  - have a browse at vetsontour.com

Topics Covered:

Before the big day

• Structured history taking: airway, gastrointestinal, sleep, and anxiety indicators
• Understanding the link between upper airway obstruction and GI dysfunction
• Assessing regurgitation, silent reflux, and aspiration risk
• Pre-treatment protocols: omeprazole, metoclopramide, and diet adjustments
• Identifying when to delay elective procedures for optimisation
• Using C-reactive protein and radiographs to assess for aspiration pneumonia
• Managing anxiety pre-hospitalisation with trazodone

Plan for the day of surgery

• Fasting times and timing surgeries for optimal recovery monitoring
• Strategies for minimising stress in brachycephalic patients pre-op
• The role of early premedication and pain relief
• Drug choices: the “Goldilocks” approach to sedation
• Reducing regurgitation risk
• Your pre-op pro tips
• Extubation and recovery: positioning, monitoring, and oxygen weaning
• The impact of cage-side nursing and owner-assisted recovery

 “If you can’t afford a pet, you shouldn’t own one.” 

Ever said this line?

Once you’ve  been on the receiving of someone’s anger about the cost of their vet bill, it’s an easy thought to have. 

But it’s not the whole story, is it?

In this episode, I sit down with Dr. Paul Manktelow - a veterinary surgeon with 20+ years in UK animal charities and current Director of Veterinary Services at Blue Cross. Dr Paul shares lessons learned in not-for-profit vet care to help us untangle that tension between care, compassion, and commercial reality.

We cover:

• Trends from the front lines in the charity sector
• How “affordability” is shifting under rising cost of living
• Decision-making tools that balance optimal vs achievable care
• Business models that either enable or block access to care

• How vets can approach financial conversations with clarity, dignity, and trust

You’ll learn about:

💡 “Pragmatic care” as the antidote to chasing the mythical ‘gold standard’

💡 Cost-based vs value-based pricing models 

💡How to think in tiers of care—and where the limits lie

Because behind every clinical decision is a human one.

Find out how we can help you build you in your vet career at thevetvault.com.

Check out our Advanced Surgery Podcast at ⁠⁠⁠⁠⁠⁠cutabove.supercast.com⁠⁠⁠⁠⁠⁠. 

Get case support from our team of specialists in our ⁠⁠⁠⁠⁠⁠Specialist Support Space⁠⁠⁠⁠⁠⁠.

⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠for Hubert's favourite clinical and non-clinical learnings from the week.

Join us in person for our epic adventure CE events at ⁠⁠⁠⁠Vets On Tour⁠⁠⁠⁠. (Next up: Japan snow conference!) 

Topics and Time Stamps

03:11 Balancing Costs and Care in Veterinary Practice

06:45 Challenges and Changes in the Veterinary Profession

11:41 Client Expectations vs Financial Realities

16:32 The Impact of Economic Hardships on Pet Care

32:16 Blue Cross's Model

39:10 Individual Responsibility in Veterinary Practice

42:54 Getting Clear on Quality of Life and Prognosis

47:23 Cost-Based vs Value-Based Pricing Models

01:10:05 Pragmatic Care and Clinical Guidelines

01:16:54 The One Question

In episode 141, I shared my take on where AI fits into veterinary medicine - and where it might take us next. 

But I’m no expert.

So I brought one in.

In this episode, I sit down with Rohan Relan , Silicon Valley software engineer and founder of ScribbleVet ,an AI tool built for vets. We unpack the promise and pitfalls of AI in clinical practice and try to figure out how you can use it without losing sleep (or your license).

What we cover:

• Why AI is not just a "smarter Google”- and why that matters
• The risky shortcuts vets are already taking (and how to avoid them)
• How to increase trust and accuracy when using AI
• Where innovation collides with privacy, data, and consent
• DIY AI vs purpose-built tools 

If you're curious about AI but not sure what’s hype and what’s helpful, this one’s for you.

Come find out what W(asabi)TF Wednesday is all about at our Japan Snow Conference

Check out our podcast for business owners, and Dr Sam’s ‘How To Make A Hell Of a Profit And Still Go To Heaven’ workshop.

Join our community of Vet Vault Nerds to lift your clinical game and get your groove back with our up-to-date, easy-to-consume clinical episodes at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠vvn.supercast.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠.

Get help with your tricky cases in our ⁠⁠⁠⁠⁠⁠⁠⁠Specialist Support Space.⁠⁠⁠⁠⁠⁠⁠⁠

V⁠⁠isit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠thevetvault.com⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠for show notes and resources related to this episode.

⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠for Hubert's favourite clinical and non-clinical learnings from the week.

Topics and Timestamps

04:39 What I got wrong about AI

08:19 How models “know” things — next‐word prediction & reasoning

15:00 Grounding AI responses using external tools / search

19:19 Scribble Vet features

38:12 Privacy, ownership, and AI liability

51:00 Rohan’s podcast and AI tool recommendations

54:00 Key misconceptions & Caveats

Today’s bonus IVECCS live session wasn’t your average ‘clinical 101’. I had the absolute privilege of getting two brilliant minds on the yellow couch, and … wow. 

Apparently 1 + 1 = 🤯 !!

Clinical pathogist Dr Cynthia Lucidi joined me to unpack her talk on Diagnosing Ineffective Hematopoiesis.  If you’re a bit lost with that title - don’t worry, so was I!  So I brought backup: ECC legend Dr Claire Sharp joined me to ask the smart questions, and together, they cracked open a topic every GP and ECC vet needs to understand: PIMA – Precursor-Targeted Immune-Mediated Anaemia. (If you’ve ever managed an anaemia case that almost looked like IMHA but just didn’t quite fit, or just an anaemia that didn’t want to fit into ANY of the boxes, it was probably this!) 

This one started out GP-friendly, but with two minds like these-it escalated fast. Expect specialist-level gold. You’ll want to give this one your full attention. But I promise - it’s worth it!

What we cover:

• Defining ineffective haematopoiesis and how it differs from hypoplasia
• Diagnostic criteria and differentials for PIMA vs. IMHA
• Importance of timing and interpretation in persistent non-regenerative anaemia
• Why bone marrow aspiration is underused and how to perform it effectively
• Pathologist tips on identifying spherocytes and phagocytosis artefacts
• Challenges of diagnosing IMHA and PIMA in cats
• Role of transfusions and crossmatching in long-term PIMA management
• Timeframes for response and remission in PIMA treatment
• When to consider splenectomy for refractory cases
• Clinical significance of myelofibrosis in dogs with PIMA
• Educating clients and general practitioners on prognosis and referral timing

Click here⁠⁠ to access all of our clinical content at IVECCS special rates.

If you caught my conversation with Prof. Steve Epstein from IVECCS 2024, you already know this:

When it comes to septic patients, timing of antibiotics is everything. Ok, maybe not EVERYTHING, because in our follow-up discussion 1 year later at IVECCS 25, Prof Steve explored an idea that might just shift your ICU protocols: duration of administration matters. 

That’s the idea behind the concept is prolonged infusion - giving time-dependent antibiotics over extended periods for more sustained bacterial kill time. (Spoiler alert: it works. BUT...with a few caveats.)

Jump in to this one for a straight-forward data backed action you can take with your critical patients that will save more lives.

Topics We Unpacked:

• Time-dependent vs. concentration-dependent antibiotics
• Prolonged infusion vs. continuous rate infusion (CRI)
• Human evidence: findings from the BLING III trial
• Applicability of human data to veterinary patients
• Dosing challenges and pharmacokinetics in septic animals
• Practical recommendations for veterinary ICU settings
  

⁠Click here⁠⁠⁠ to access all of our clinical content at IVECCS special rates.

We’re live at IVECCS! For the next few days we’ll be sharing some highlights from our favourite recordings with the fabulous speakers, where we get to the best bits from their talks at IVECCS, the premier conference for emergency and critical care veterinarians, technicians, practice managers, and students. 

If you’ve worked in vet practice for more than a minute, you’ve seen it:A cat comes in, blocked and in pain.You know the treatment.The owner hears the estimate.And just like that — a treatable case turns into a heartbreaking goodbye.

But what if there’s a better way?

In this eye-opening talk, Dr. Corey Fisher breaks down practical, evidence-based protocols for managing feline urethral obstruction (iUO) without breaking the bank.
He draws on peer-reviewed research and ongoing clinical trials to bust some myths about fluids, catheters, and cost.

Most importantly?
He’ll show you how to tailor treatment to the client’s budget while still delivering acceptable clinical outcomes.

What You'll Learn:

• Recurrence rates and euthanasia risk in feline urethral obstruction
• The surprising data behind 8-hour catheter protocols
• To flush or not to flush
• Hyperkalemia management: hold the insulin!
• Should you perform decompressive cystocentesis? The evidence says...
• The most cost-effective pain relief 
• Fluid therapy without the fluff: shorter stays
• The meds we use that we shouldn’t
• The truth about urinalysis and prescription diets: essential or optional?

This isn’t just theory — it’s a mindset shift.Whether you're in a high-end clinic or resource-limited practice, you’ll walk away with real tools you can use today to improve care and protect your patients from unnecessary euthanasia.

Click here⁠ to access all of our clinical content  at IVECCS special rates.

We’re live at IVECCS! For the next few days we’ll be sharing some highlights from our favourite recordings with the fabulous IVECCS speakers, where we get to the best bits from their talks at IVECCS, the premier conference for emergency and critical care veterinarians, technicians, practice managers, and students. 

How much do you love intubating dogs with upper airway issues? You know that Frenchie or Pug needs an open airway - NOW - but you also know that intubating it is going to be hard. (And you REALLY would prefer not to do a tracheostomy!) We have good news…

In today’s highlight we hear from Dr Cassie Lux, Associate Professor of Surgery at University of Tennessee, to dig into her talk on upper airway emergencies. The conversation covers how to identify the likely location of airway obstructions, prepare for safe intubation, and apply temporary surgical techniques that stabilise patients without committing to high-risk interventions. From temporary palatopexies to laryngeal stents and novel uses for human piercing gear, Dr. Lux outlines tools and procedures that general practitioners and ECC clinicians can implement right away.

Topics Covered:

• Why definitive airway surgery during crisis leads to poorer outcomes
• Sound-based and visual cues to localise airway obstruction
• Equipment essentials for challenging intubations 
• Palatopexy as a temporary airway intervention
• Use of laryngeal stents in laryngeal paralysis and collapse
• Alternative temporary tracheostomy sites and techniques 
• Novel use of silicone “flesh tunnels” for airway access
• Managing airway swelling 
• When to delay tracheostomy and opt for prolonged intubation
• Tips for extubation and airway support during recovery

Click here⁠ to access all of our clinical content  at IVECCS special rates.