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Extra-mural studies (EMS)
What is EMS?
EMS stands for extra-mural studies. Extra-mural placements are an essential element of undergraduate veterinary education. Students must complete a minimum of 38 weeks EMS during their course, which should normally consist of 12 weeks pre-clinical and 26 weeks of clinical placements.
EMS provides students with an unrivalled opportunity to gain real-life work experience that enhances their university-based studies.
Whilst the universities are responsible for teaching the skills that the student needs to practise when they first graduate (the 'day-one competences'), it is on EMS placements that students can further practise the animal-handling and clinical skills that they first learn at university, as well as build up their experience of dealing with clients and with members of the veterinary team.
New graduates are therefore able to 'hit the ground running' having developed their day-one competences whilst on EMS placements during their degree course.
EMS helps students to prepare for work, and introduces them to the important concept of lifelong learning and reflective practice which then continues after graduation through the Professional Development Phase (PDP) and continuing professional development (CPD).
As the veterinary degree is a professional qualification, EMS constitutes an important component that helps to distinguish the qualification from other academic science degrees.
EMS is made up of:
the ‘pre-clinical’ or animal husbandry phase, which comprises a total of 12 weeks, and
clinical EMS, which should be seen as comprising two phases:
- Preparatory EMS of about 6 weeks, to be undertaken when pre-clinical EMS has been completed. It is suggested that students should undertake at least three different types of placements to experience a range of veterinary work.
- Practical EMS should then follow on from this preparatory EMS phase, and should comprise the remaining 20 weeks, to be undertaken during the later clinical years.
The EMS Recommendations, Policy & Guidance agreed by Council in November 2009 sets out the RCVS's recommendations about EMS for universities, placement providers and students. This can be found in the 'Related documents' box.
In 2014, recent graduates were asked to take part in a survey on EMS. Download the report of the survey.
The aim of EMS
The aim of EMS is to enable students to gain practical experience in as many aspects of veterinary work as possible, including the handling of animals, to achieve proficiency in routine techniques, and give students first hand experience which will help them to develop as professionals. Specifically, EMS should enable students to:
develop their animal handling skills across a range of common domestic species
develop their understanding of the practice and economics of animal management systems and animal industries
appreciate the importance of herd health and the epidemiological approach to production animal work
develop their understanding of practice economics and practice management
develop their understanding and gain further experience of medical and surgical treatments in a variety of species
develop communication skills for all aspects of veterinary work
expand their experience to those disciplines and species not fully covered within the university
appreciate the importance of animal welfare in animal production and in the practice of veterinary medicine
gain experience to help them appreciate the ethical and legal responsibilities of the veterinary surgeon in relation to individual clients, animals, the community and society
gain experience of a variety of veterinary working environments
Guidance for clinical EMS placement providers
We recommend that an introductory, or 'preparatory', phase of clinical EMS should be undertaken by students at the beginning of their clinical placements. This should last around six weeks and could be achieved with three two-week placements. This phase will give students an opportunity to think about the areas of practice they may wish to return to in the later practical phase of EMS.
Recognising that most students will have had little clinical experience at this point in their course and that their practical skills may therefore be limited, the emphasis should be on introducing students to aspects of practice such as record keeping, nurse communication, stock taking and basic equipment preparation, and giving them the opportunity to see how a practice operates generally.
Students shouldn't necessarily be excluded from helping out with clinical cases, but practices should be alert to the limits of their practical skills and clinical competence at this stage.
The next, "practical" phase of EMS of around 20 weeks allows students to spend longer periods on placements and we recommend that students select a 'base' practice to which they can return at different points during the later years of their course.
We do not define the number of weeks that must be spent on different types of placements or with different species: it is up to the university and the student to plan a programme of placement the best suits the student's learning needs and complements the 'intra-mural' curriculum at the veterinary school.
The use of a 'base' practice enables the placement provider and the student to get to know each other over a longer period. Practices that operate as a 'base' practice for a student should be able to expect more of them over time; towards the end of the degree course, a student should be close to becoming a useful member of the practice team.
The practitioner's contribution to EMS is of vital importance. It is recommended that practices identify named individual(s) to act as EMS contact for students and the university, and that some time is set aside for entry and exit interviews with the students at the beginning and end of each placement.
It is recognised that this can sometimes be difficult given the pressures of practice life, but a few minutes preparation and induction at the outset will help to make the placement more productive for the practice and the student.
The practitioner’s aims should be to:
maintain and improve, where possible, students’ present knowledge and level of training
encourage students to become familiar with the use of simple instruments and with drug compounds, their trade names and applications
provide experience under practice conditions of as wide a range of medical and surgical conditions as possible
provide experience in handling routine consultations and procedures
encourage students to relate to and communicate with clients where appropriate
teach students about the non-clinical aspects of practice: interaction with clients, employers/employees and lay staff; care of practice property; the limitations that may be placed on clinical work in a commercial situation
teach students the importance of the above in relation to professional behaviour and practice income by illustrating, for example: how practice fees are calculated; how bad debts are dealt with; how practice is structured and financed
ensure students see the Practice Health and Safety Policy and appreciate how it applies to individuals.
Practices should not be inhibited from providing honest feedback to and about the student, and should contact the university's EMS coordinator if they want to discuss a particular student in more detail.
For a list of EMS coordinators at each school, please see the contacts list at the bottom of the page.
Guidance on supporting student learning
Before the placement:
Practitioners should discuss a proposed placement with the student, either by interview or by telephone, in order to ensure mutual compatibility at the start.
Each student should arrive at the placement with a set of objectives they're hoping to meet, and it will save time and make the placement more productive for both parties if these can be briefly discussed with the student at the outset.
It is helpful to explain any ‘rules’ relating to conduct in the practice, the relationship with practice personnel and clients, standards of dress, health and safety etc.
Practices should check they have access to the latest guidance on EMS. The student should be able to give them a copy or point them to online guidance if necessary.
During the placement:
The extent of supervision that individual students require to achieve competence will only become apparent with time. An adequate level of competence cannot be assumed from the outset. The animal’s health and welfare must always be of prime concern and the supervision should reflect this.
If the student is unknown to the practice, it is worth spending a short time to determine his/her current knowledge and experience.
You can view the outline curricula of the clinical courses for each of the seven UK schools in the EMS summaries for individual schools.
The summary of clinical objectives (PDF 53Kb) provides a general indication of the experience students should be acquiring in each clinical year.
The RCVS ‘Day One’ Competences (PDF 101Kb) outline the knowledge, skills and competences that the veterinary student must achieve at graduation.
The overall objective is that in the first two clinical years the student becomes so competent at everyday procedures that they become part of the job, rather than the job itself.
At that stage, he/she should also be developing skills in recognising clinical signs and determining diagnoses and treatments, until by the end of in the final year he/she should be able to carry out a practitioner’s routine work under supervision. At graduation he/she should be capable of becoming a useful member of a practice team.
There may be slight variations in the way that each school manages its EMS and reviews its students’ progress on EMS; see the EMS summaries for individual schools for further details.
Other EMS guidance
BVA - Making the most of EMS (guides available to BVA members only)
EMS Driving Licence - guidance for students before they start EMS
The Animal Management and Husbandry Online Placement Tool - guidance for students on preparing for their first EMS placement
- AVS Pre-Clinical EMS Guide
- AVS Clinical EMS Guide
Practice by students – regulations
As veterinary students are required to undertake acts of veterinary surgery as part of their clinical training, the acts that they can undertake are set down in the “Veterinary Surgeons (Practice by Students) (Amendment) Regulations 1993”.
The Regulations provide that students may:
examine animals, carry out diagnostic tests under the direction of a registered veterinary surgeon,
administer treatment under the supervision of a registered veterinary surgeon and
perform surgical operations under the direct and continuous supervision of a registered veterinary surgeon.
We have interpreted these as follows:
'direction' means that the veterinary surgeon instructs the student as to the tests to be administered but is not necessarily present,
'supervision' means that the veterinary surgeon is present on the premises and able to respond to a request for assistance if needed and,
'direct and continuous supervision' means that the veterinary surgeon is present and giving the student his/her undivided personal attention.
Feedback to the student
Each school provides a student EMS feedback form (PDF 52Kb) for completion by the placement provider at the end of the placement. This information helps schools in their assessment of individual students and also helps to identify deficits in undergraduate education.
The return of these forms, combined with a short time spent in discussion with the student at the end of the placement, enables the student to review their progress prior to the next placement.
Schools also normally require an attendance certificate to be completed. It is the student's responsibility to bring and present the certificate for signature by the EMS contact at the placement.
Student review of the placement
Students may be asked by their school to complete an EMS placement feedback form (PDF 23Kb). This enables each school to evaluate its EMS programme and provides information for feedback to practices.
Health and safety
Students are expected to adhere to the Health and Safety Policy of the practice in which they work and their attention should be drawn to this at the start of the placement.
In addition, the schools have a legal obligation to safeguard the students’ safety at work placements. These health and safety guidelines (PDF 58Kb) are representative of those given to students at each of the schools.
All the schools recommend that their students take BVA student membership which automatically provides students with free personal accident and personal liability insurance. For details of each school’s cover, please refer to the EMS summaries for individual schools.
Further details about BVA student insurance can be found on the BVA website. The student insurance policy does not include professional liability as students should be covered by their employers’ professional liability insurance.
The RCVS Code of Professional Conduct for Veterinary Surgeons requires all veterinary surgeons to ensure that their professional activities are covered by professional indemnity insurance or equivalent arrangements. Such cover may be held individually or through an employer.
EMS summaries for individual schools
Click on a link in the list below to view information for each school about their outline curriculum, an overview of the management of EMS at the school and a summary of insurance cover provided by the university.
- EMS at Bristol University (PDF 25Kb)
- EMS at Cambridge University (PDF 52Kb)
- EMS at Edinburgh University (PDF 51Kb)
- EMS at Liverpool University (PDF 58Kb)
- EMS at Nottingham University (PDF 15Kb)
- EMS at the Royal Veterinary College (PDF 34Kb)
The contact details for EMS Co-ordinators at individuals schools are detailed below:
Miss Veronica Roberts
Dr Penny Watson
Mr Andrew Gardiner
For attendance and feedback forms
Dr Philippa Yam
Dr Liz Bode
Royal Veterinary College (RVC)
Dr Karla Lee
Mr Stephen Brogden
For admin/general enquiries
Royal Veterinary College (RVC)
Dr Karla Lee
Dr Sharmini Paramasivam
We facilitate meetings of the schools’ EMS Co-ordinators and can answer enquiries about our EMS requirements and policy, but not matters relating to individual students.
You can contact the Chairman of our EMS Coordinators Liaison Group, via our Education Department, by email on firstname.lastname@example.org or telephone 020 7202 0704.