Humane Alliance

4-6 million dogs and cats euthanized in U.S. shelters each year

Extern Plus Syllabus

The Extern Plus program is available to students who have completed the 2-week Extern program program. The week-long syllabus (and extra five business days) is customized daily to your needs and desires.

Our goal is two-fold: to polish your surgical skills, with emphasis on sterilization procedures (the high-quality piece); and to enhance your organizational skills to make the most efficient use of time (the high-volume piece). The Extern Plus syllabus may include, but is not limited to, the following:



  • Patient selection and identification of appropriate low-risk surgical candidates
  • Patient flow management
  • Drug/anesthetic protocols
  • Support staff coordination

  • Recognition of surgical pack contents and the value of minimizing the same
  • Maintenance of sterile surgical technique in a high-volume situation
  • Review of anatomy as it applies to the efficient and successful completion of the sterilization procedure
  • Review of instrument and tissue-handling skills
  • HVHQ-specific surgical techniques
    • Pedicle tie
    • Overhand knot
    • Incision placement
  • Efficiency of motion/movement
  • Body mechanics

  • Identification of complications
  • Management of complications
  • Pain management