I spent March 30-April 10, 2015, in the surgery department of the veterinary hospital at the University of Sao Paulo in Sao Paulo, Brazil. Here I was immersed in another culture, another language, and another viewpoint of veterinary medicine. The clinic here is lower cost than private practice and is located centrally in the city so has a very high volume of cases. Common orthopedic cases seen included torn cranial cruciate ligaments and trauma. Common orthopedic surgeries included femoral head osteotomy, tibial plateau leveling osteotomy, and fracture plating. Soft tissue cases seen included many hit by car cases, a rectal prolapse I was able to assist in reducing, cats with urinary blockage, mass removal, and a cryptorchid and umbilical herniation surgery. While I was there I went in on many appointments as well as watched/assisted with many surgeries.
Although there were differences in the way cases were handled, the level of care was still very high. One of the differences in case handling included post-operative care. At the hospital, only four overnight/intensive care cages are available, so the vast majority of surgical cases go home that afternoon. This means there is an extensive number of recheck appointments, contributing to their busy schedule as surgical patients return the next day and continue coming back regularly.
Another difference was the intake of cases. When a new patient comes to the hospital, they go to a separate area of the hospital- “triage”. Veterinary residents (similar to veterinary interns in the US) in the triage region are responsible for examining all animals entering the hospital to decide the department they need to see and if they will be seen that day. Certain departments only accept certain types of cases relevant to current research and teaching, although the surgery department was able to accept most cases. If you are accepted to be seen that day, you place your blue card with the proper department and wait in a large open-air lobby to be seen.
The third difference I noted was the handling of the patient during examination and the owner presence. The owner stays with the patient throughout the exam and immediately pre- and post-operatively. On surgery day, the owner spends the day at the hospital and is there to hold the patient as they recover and for post-operative radiographs. During a regular exam, the owner is responsible for holding the pet’s head to comfort them and making sure the pet does not move up front as the doctor does the exam and bandage changes.
Overall, I really enjoyed my time at the hospital. The doctors were very friendly and loved to joke around. Most everyone tried to speak some English during my stay and many people were fluent. Every day they would make sure we had time to sit down together for lunch and the doctors introduced me to many restaurants with native Brazilian food! I took public transportation across the city and had no problems. My only regret while studying at the university was not knowing more Portuguese so I could better communicate with clients directly. My Portuguese definitely improved while I was there but studying more before going would have been useful. While I was at the University of Sao Paulo, with the high caseload I saw many types of cases I will see in private practice, as well as surgeries I will be expected to perform. I had a very enjoyable time getting to know the doctors and would recommend the experience to others, but would say knowing more Portuguese would be helpful although not necessary. I am very grateful I was able to have this opportunity!