"I enjoy problem-solving. But beyond that, helping people with their pets when they have no idea what's wrong with their animal is incredibly rewarding"

- James McMurrough, advanced practioner in internal medicine and cardiology
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Could you tell us about yourself and your role?

I currently work as an advanced practitioner in veterinary cardiology and small animal medicine at Vets Now in Manchester. I earned my qualifications before joining this practice, which offers referral services and a large out-of-hours service in the Manchester region.

I grew up in the Manchester area, went to university, and returned here for work! I work exclusively in the fields of cardiology and internal medicine, and I serve as a referral clinician in both disciplines here at Vets Now Manchester.

You’re an AP in internal medicine and cardiology. What excites you about working in these areas and disciplines?

I'm genuinely passionate about what I do, and I’m lucky that I wake up feeling excited to come to work. That’s because no two cases are ever the same and it's incredibly interesting work. I enjoy the clinical aspect, meeting new clients, and getting to know their pets while diagnosing new disorders in these patients. There's a sense of making a difference in the community as well. But honestly, deep down, I think I'm just a big science nerd! I can't imagine doing any other kind of work.

If someone was reading this and thinking of progressing their career into a similar area, what advice would you give them based on your experiences?

I would definitely recommend pursuing the advanced practitioner qualification. It's a robust training program with excellent accreditation, setting you up well for your future career. It opens up numerous opportunities and is an enjoyable journey that helps you become a better clinician in your field of interest.

If you're considering this qualification, I'd recommend speaking to others who have gone through it for advice. Additionally, consult with specialists to explore other options and reach out to universities, which usually offer the course, to understand its ins and outs. The beauty of the CertAVP qualification, unlike the diploma which helps you specialise, is that it's more flexible and can be completed over a more extended period while working in primary care or referral practice. You also don't need to focus solely on the qualification all the time, which is different from the diploma. While it is not to the same level as a specialist course, it provides a great deal of experience and valuable training.

How did you decide on your career path and determine that it was the right thing for you, focusing on cardiology and internal medicine?

After qualifying, my initial goal was to become a competent general practitioner and master the basics, which I achieved quickly in a practice supported by many certificate holders. I observed colleagues in their special areas of interest and realized I had my own areas of interest that I wanted to explore further.

I developed a keen interest in medicine cases and worked with advanced practitioners in cardiology and internal medicine on these cases which convinced me to enrol on my internal medicine certificate. Given my particular interest in cardiorespiratory cases, I decided to complete a second certificate in cardiology which synergised nicely with the medicine certificate. This has allowed me to offer a more complete service investigating and managing cardiorespiratory cases. The great thing about the advanced practitioner qualifications is that you can qualify in two areas, as I’ve done, and be an advanced practitioner in both. In contrast, a specialist can only specialise in one area, so it provides more flexibility and the ability to use the qualification in a primary care setting.

Working with Vets Now combines emergency and referral services. What about this style of practice interests you?

I absolutely love working alongside the emergency caseload. My previous practice had a similar setup, and I dealt with a lot of acute medicine there. Here, we have a dedicated team of ECC (Emergency and Critical Care) vets who handle the most acute and emergent cases. But there's still an acute aspect to the medicine and cardiology cases here, and I really appreciate the in-hospital care, tending to complicated cases that can change at any moment, for better or worse. These cases have numerous needs that we must consider to achieve the best outcome.

Working in an emergency setting suits me, but it's not for everyone. Some veterinarians prefer the chronic, outpatient approach. With the advanced practitioner qualification, you have the flexibility to choose either path, but this style of working aligns with my interests. Having an emergency clinic means that every day I walk in, I have no idea what challenges we'll be facing. We also have a consistent flow of outpatient referrals at the hospital, which is great. You can plan in advance for those cases, but when it comes to emergencies, you never know what's going to happen.

You’ve done a lot of teaching as well, is knowledge sharing with other professionals something that’s important to you?

Absolutely, I really enjoy the teaching aspects of my role too. I've been doing it for a while, initially lecturing to nurses and later expanding to include vets as I gained more experience and qualifications. I occasionally lecture in person, but more frequently, I do it online through platforms like webinars. It's a significant aspect of what I enjoy about my job. Teaching allows me to give something back to the profession and help those who may learn better in a lecture format rather than solely relying on written materials. It's essential to offer this service to others in the profession, share information on the latest developments in the field, and increase awareness regarding various career options. Hopefully, it also inspires some to pursue further qualifications, which is always a positive outcome. I genuinely enjoy it and wish I had more time to do it.

What are you proudest of so far in your career?

I think what makes me most proud is coming to work as a referral clinician in an environment where most people are specialists, and the highest level of care is expected. When I started at Vets Now Manchester as an advanced practitioner, I hoped to fill some rather large shoes. Over the past five years, I've been able to establish and manage a service in my discipline. I've handled a significant caseload during this time and believe I've done a decent job. Additionally, I've had the opportunity to work with some wonderful nurses, two of whom I’ve helped complete their further qualifications and specialize as VTSs in internal medicine, which is like the nursing equivalent of a diploma. That's been really rewarding too.

Do you have any specific goals or aspirations for the future?

I'm currently working on a couple of papers that I would like to get published. I also hope that the opportunity arises for me to complete a complete a residency training programme at Vets Now Manchester, to specialise in internal medicine.

What do you enjoy most about the work you do?

Fundamentally, I enjoy problem-solving. But beyond that, helping people with their pets when they have no idea what's wrong with their animal is incredibly rewarding. In those cases where I can diagnose the issue and offer a treatment plan, you see the look of relief and joy on the owner's face, and that's truly powerful. You genuinely build strong relationships with your patients and their owners, there are real bonds formed sometimes over several years of ongoing treatment.

Outside of work, how do you like to relax, and do you have any hobbies?

I'm in a couple of bands, and we do a lot of gigs around the UK and occasionally in Europe. It involves a lot of travel and hard work but it's quite a different experience compared to my veterinary work. I completely switch off from work when I'm on the road (except for occasionally checking work emails during long journey on the tour bus!). Many of the skills needed in music, like dedication and hard work, are similar to those in my veterinary career. It's a great way to unwind and detach from a busy day's work.

Another way is spending quality time eating, drinking, and cooking with my family and friends. I have two little boys who take up a lot of my time, and they're awesome.

If you could give your younger self one piece of advice, what would it be?

I think I’d tell my younger self to work a little less hard. I think it's a good piece of advice because, as a referral clinician, you often work long hours, attend conferences, take work home, read journals, write lecture and articles, and regularly feel like you're not up to speed with all your commitments. So, taking some time for relaxation and a work-life balance is essential.