NC State Residency a Knockout Opportunity for Anesthesiologist-in-Training
If Dr. Jerome Joseph does his job well, NC State Veterinary Hospital clients never know the anesthesiology resident has been involved in their pet’s care. He prefers it that way and excels behind the scenes.
Dr. Jerome Joseph’s surgery prep begins well before he even thinks about inserting an IV near a patient’s paw, hoof or fin.
Anesthetizing an animal is careful and detailed work that requires precise knowledge of disease and drug processes in addition to understanding the animal’s health status and history. It also involves many calculations around body mass — and since the NC State Veterinary Hospital’s anesthesiology service deals with small, large and exotic animals, second-year resident Joseph has to be prepared to treat patients that could fit in his hand or dwarf him by thousands of pounds.
“We put a lot more front-end work into anesthetizing a single patient than a client would probably be aware of,” he says. “A lot of this job is anticipating what could go wrong and having a plan in place so that if it does happen, then we’re prepared to deal with it.”
That responsibility means his work isn’t done after the IV is in and the animal is asleep. Along with a team of anesthesiology faculty and technicians, Joseph monitors patients during and after procedures to ensure they recover safely and smoothly. Anesthesiologists are also consulted for medication decisions hospital-wide, including when patients in intensive care need to be weaned off systemic pain drugs.
As critical as this role is, it’s also underrecognized. Pet owners often meet their animal’s specialist or surgeon during the treatment process but never learn the names of their pet’s anesthesiologists. Joseph, an admitted introvert, prefers working in this relative obscurity.
“If I’m doing my job well, a client doesn’t know that we’ve been involved — and I don’t mind that,” Joseph says.
He may not seek recognition for it, but Joseph excels at this behind-the-scenes work. Thriving in a fast-paced hospital setting requires both competence and confidence, and Joseph says he has gained both in spades during his NC State training.
Canada, California, Champaign and Carolina
Joseph grew up immersed in veterinary medicine thanks to his father, a general practice veterinarian in Toronto, Canada. Though Joseph knew from a young age that he wanted to join the medical profession, it wasn’t until high school that he chose the veterinary field over human practice.
He worked his way up from cleaning kennels at his dad’s clinic during elementary school to serving as a veterinary assistant at a different general practice clinic and a veterinary ER by the end of high school. Joseph went on to earn his bachelor of medical science in physiology and pharmacology from the University of Western Ontario in 2018.
When applying to veterinary school, he looked to the United States for broader options and was admitted to the University of California, Davis’ DVM Class of 2022. Moving to California was more of a climatic adjustment than a cultural one, he says, since he grew up close to the U.S. border.
Joseph figured he would follow in his father’s footsteps by studying small animal medicine to eventually start his own general practice clinic. Then he learned more about anesthesiology and found in his second year of veterinary school that he had stumbled onto another path.
“I realized that anesthesiology fits in really well with the things I like: pharmacology, physiology and disease pathophysiology,” Joseph says. “I also really like acute medicine and prefer managing issues in an immediate setting to dealing with long-term care. Anesthesiology checked a lot of boxes of things I was looking for in a future career.”
During his clinical year, Joseph completed rotations in both small and large animal anesthesia at UC-Davis. He also finished two externships at private practice clinics in California and another at the University of Georgia’s Veterinary Teaching Hospital.
Like most trainees aiming for a specialized residency, Joseph first sought a rotating internship after earning his DVM. He matched into a small animal medicine program at the University of Illinois Urbana-Champaign and completed his year-long training there in 2023.
“There were times where it felt like I was drinking from a fire hose, but it definitely taught me how to function as an efficient doctor,” he says of the experience, which included an anesthesiology rotation.
For his residency, Joseph searched for programs at busy hospitals that would challenge and expand his existing skill set. He found his match at NC State, where the Veterinary Hospital’s anesthesiology service sees over 4,000 patients of all species and diagnoses annually.
‘Breaking the Boundaries’
Veterinary anesthesiology is a job for multitaskers who are quick on their feet and able to handle busy hospital caseloads and the many steps involved in anesthesia and analgesia, the practice of administering pain relief, with aplomb. Having a supportive and cohesive community is essential.
“Our service works really well as a team, and that type of teamwork is something that I’m going to prioritize in my career going forward,” Joseph says. “One of my biggest takeaways from working at NC State is that having open communication and coordination in a large hospital setting, with multiple doctors and services, is very important.”
Joseph’s dedication and collaborative spirit are two of many qualities that make him an asset to the service and hospital, says Dr. Kelley Varner, associate professor of anesthesia and analgesia.
“We are incredibly lucky to have such a promising and dedicated individual contributing to our department, and Dr. Joseph undoubtedly has a bright future in anesthesiology,” she says. “His commitment to both excellence and teamwork greatly benefits our patients and our working environment.”
Varner’s mentorship of Joseph extends beyond the clinic. The two have joined forces on a research project studying the effect of the sedative trazodone on horses’ post-anesthesia recovery times. Horses face more difficulties recovering from anesthesia than many other species due to their size, physiology and temperament, and Joseph and Varner’s research suggests that giving horses trazodone before anesthesia could ease the recovery process.
As he starts the last year of his residency this summer, Joseph is looking ahead for opportunities in small animal private practice or a teaching hospital at a veterinary school. Working at NC State has shown him what’s possible within an anesthesiology career, he says.
“Our vast resources and our ability to work with more critical patients set NC State apart,” Joseph says. “We’re breaking the boundaries on what we can do within veterinary medicine.”
