Spectrum of Care - E. Czerwinski

September 21, 2025

Emily Czerwinski, AVC 2026, travelled to Hopedale and Sheshatshiu as one of the student participants on the Chinook Project. As part of the experience, the students craft various pieces of writing.

The gold standard of care asks veterinarians to recommend all available services to maximize diagnostic accuracy in our patients. It is what we are taught throughout our four years of vet school. We are taught about the advancements in diagnostics and treatment options, the lengths we can go to provide better treatment outcomes and rarely do we focus on our ability to diagnose without advanced diagnostics. It is the gold standard of care that is underlined and bolded as the standard of care we should be offering to our clients and providing to our patients on a daily basis.

Learning at a referral hospital, the gold standard of care is easy to access and uphold. We have access to advanced bloodwork, a CT scan, an MRI machine and a full in house diagnostic lab. But that environment creates a bubble, where it is easy to forget that most of the world doesn’t have access to these technologies, and many clients cannot afford such extensive care. For me, it became clear that the relationship between advancements in veterinary medicine and our ability to meet clients where they are is often overlooked.

Setting up clinic in Hopedale

Travelling with the Chinook project was exactly the reminder that I needed as a student to focus more on my diagnostic abilities, the people and their animals versus focusing on advanced diagnostics. When travelling to provide veterinary care to remote communities like Hopedale and Shetshushi, there is only so much we could bring for diagnostics. We have to leave all of the fancy bloodwork machines at home. Not to mention a CT scan isn’t really portable on a twin otter aircraft. So for the most part diagnostics are limited to physical exam skills and handheld veterinary equipment. This provided me with the unique opportunity as a student to hone in on my abilities to identify, diagnose and treat both dogs and cats without the benefit or added cost to owners of advanced diagnostics.

Emily with recovering patient

I was once told by a veterinarian that you “miss more for not looking” and truthfully, I don’t think that we are really given the opportunity throughout vet school to practice “looking”. On the Chinook Project, most of what we did was look. As students we watched dogs and cats come into the clinic, examined how they interacted with their surroundings, meticulously checked them for any problem big or small. I had the opportunity to identify heart murmurs, address owners' concerns over cloudy eyes, and look in many dogs' ears to make sure there was no underlying infection. All of these, common parts of a routine physical exam. When I did identify these abnormalities, I then got to practice discussing with owners how to manage their pet’s health with limited access to advanced care and I was able to reassure them that even without advanced diagnostics, we could still provide their pet with the best quality of life possible.

This remote veterinary opportunity has played a part in building my confidence as a young veterinarian, particularly in my ability to independently assess cases and make treatment decisions across a range of diseases. I now feel more equipped to have meaningful conversations with pet owners, addressing their concerns and tailoring diagnostic and treatment plans to meet them where they are. Through the Chinook Project, I developed a deeper understanding of the importance of offering a spectrum of care, ensuring that all clients and their animals have accessible veterinary care options.