Perspectives in Professional Education
Serving Society First: a Time for Change in Veterinary Medicine
Peter Eyre, BVMS, PhD; N. Ole Nielsen, DVM, PhD, DACVP; and James E. C. Bellamy, DVM, PhD
The educational and licensing processes in veterinary medicine are too rigid. They are crippling the profession’s ability to accommodate the changing needs of society. Specifically, agriculture, public health, ecosystem health, and biomedical science are progressively more poorly served by our profession. This situation is inconsistent with the veterinarian’s oath wherein veterinarians solemnly swear to act for “the protection of animal health, the relief of animal suffering, the conservation of animal resources, the promotion of public health, and the advancement of medical knowledge” for the benefit of society.Identifying the Problems
Members of our profession appear to realize there is a problem.1-4 However, the profession as a whole lacks the determination to take the bold steps necessary to respond to society’s high priority needs, and our present culture and practices are inadequate for this challenge. This is no time for more Band-Aids!
The principal elements of the problem are both external and internal to the profession. External elements include the following:
- The broad scope of society’s needs for veterinary medicine.
- Continuing explosive growth in knowledge and technology.
- Declining ecosystem health and consequent threat to the health, or even to the survival, of vertebrate species whose welfare we profess to protect.
- Increasing importance of zoonoses and food safety in public health, attending globalization, and a heightened level of public concern.
- Increasing risk of foreign animal diseases associated with globalization.
- The potential threat of bioterrorism.
- Much higher stakes vested in domestic animals by owners.
- Competition from other professions in the health related fields.
- Chronic, insufficient attention to society’s needs.
- An academic environment and curricula that motivate most students to opt for careers in small animal practice to the detriment of other fields.
- A paucity of new graduates to meet the nation’s needs in food animal practice, public health, ecosystem health, and biomedical science.
- An inefficient system for specialization.
- Weak contribution of the profession to biological and biomedical science, despite its unique opportunities in comparative medicine.
- A veterinary educational establishment that has seemingly exhausted educational opportunities for flexibility under the present licensing system.
The Pew National Veterinary Education Program identified many of these elements 15 years ago, but its vision has not been realized. The task remains for the veterinary profession to change its present education and licensing system, indeed its culture, to meet the new needs of society. If it does not do so quickly, it is doomed to become a minor player in the health and biological sciences. This would be a tragedy given its great potential to flourish. Veterinary medicine, by drawing on its unique strength in comparative medicine, can deal with a much broader range of the health-related issues that bedevil society.
The time has come to develop substantive diversity within the veterinary curriculum. It is no longer realistic to continue trying to provide each veterinary graduate with acceptable entry-level competence in each of the various fields of veterinary medicine. We have paid lip service to our diversity for years. In reality, the net effect of our educational and licensing systems has been to increasingly funnel the profession’s attention on animals with sufficient emotional value to their owners so that we can apply the practices of human medicine. Without losing the benefits of this development, we need to revise the system to allow other veterinary fields to flourish.
Contrary to some views, current veterinarians can no longer be considered veterinary medical generalists. Curricula do not provide sufficient exposure to the growing body of knowledge and clinical science in public health, ecosystem health, biomedical science, and many aspects of food animal practice to warrant this appellation. Present curricula and the veterinary teaching hospitals in our colleges prepare students acceptably well for companion and mixed animal practice. Even in these cases, there may be some who believe a year of compulsory internship is warranted.
The truly general veterinary education must be based on comparative medicine and structured to support all branches of veterinary medicine. The skills and knowledge required to provide competent professional veterinary service in small animals, equids, various species of food animals, public health, ecosystem health (including wildlife), zoo animals, laboratory animals, and biomedical science (industrial, governmental, and academic) are so distinct and complex that it is no longer rational to educate and license veterinarians by present practices.Finding the Solution
Emulating the human medical model of education and licensing has served the veterinary profession reasonably well in the past, but it now severely constrains the profession’s ability to respond to societal needs. The potential future of the profession to serve in its many fields is being progressively compromised. Postgraduate specialization is not a practical solution to this problem. Economic factors alone rule out this option.
Fortunately, a proven model for reforming the veterinary profession is at hand.1,4 We can adopt those elements of the engineering model of education and licensing that suit our situation. The engineering profession has been spectacularly successful.
We can adopt those elements of the engineering model of education and licensing that suit our situation. The engineering profession has been spectacularly successful this model could not be applied to veterinary medical education. This system will allow the various fields of the profession to flourish rather than have all but a few atrophy or never get off the ground from lack of attention, as is happening now.
Some institutions like the Virginia-Maryland Regional College of Veterinary Medicine and the School of Veterinary Medicine at the University of California, Davis, have already moved toward the engineering model in their tracking programs by allotting approximately a third of the curriculum to electives. However, curricula need to be closer to half elective, and possibly combined with program quotas, to ensure reasonable numbers of competent graduates in each of the major fields of veterinary medicine. Opportunities for tracking in the absence of quotas would still lead to a disproportionately large number of students electing small animal practice to the detriment of other fields.
Certainly, we are not advocating the abandonment of a core curriculum that defines a veterinary education and hence a veterinarian. Indeed, the core must be biomedical science and comparative medicine in the same way mathematics, physics, and engineering principles are core to an engineering education. Elective tracks that build on the core would accommodate the major fields of veterinary medicine and provide for a much higher entry-level competence in the chosen track. There is no reason for not continuing to offer a general track for those students who intend to enter general or mixed animal practice, but it seems foolish to let this career choice constrain the education of those who wish to focus and excel in other fields.The Immediate Crises in Food Animal Practice and Public Health
It may be no exaggeration to say that food animal practice is facing a crisis brought on by declining student interest in the field, the need for more sophisticated skills and knowledge to deal with large commercial livestock enterprises (including poultry and fish), and the increased societal concern about related public health and environmental issues. The threat of bioterrorism, experience with foot-and-mouth disease in the United Kingdom and elsewhere, bovine spongiform encephalopathy, avian influenza, Newcastle disease, and outbreaks of exotic fish diseases in aquaculture have underlined the urgency of the problem.
Similarly, the immediate societal need for expertise in veterinary public health has been thwarted by lack of student interest and appropriate curricula to develop competence commensurate with the challenge facing the profession. It is gratifying to see that this problem has been recognized and modest remedial initiatives launched. For example, the AVMA recently endorsed a model veterinary public health/preventive medicine curriculum developed by the American College of Veterinary Preventive Medicine. The entire required program includes 165 hours of lectures and laboratories, with 48 hours of options/electives. It is obvious that this initiative, however laudable, cannot be incorporated into the already overcrowded four-year veterinary curriculum. Despite this limitation, it is a powerful argument in favor of tracking, which is the only way that specific areas of concentration can be implemented. As a first step, it should be immediately possible for most colleges to provide sufficient elective slots that would constitute a form of tracking (streaming). As part of this step, quotas for food animal and public health students would provide a much higher level of competence than is presently possible. Such action might further serve to drive fundamental reform in the culture of our profession.The First Steps to Change
Effective reform will require a dynamic partnership between the profession and the academic community. In the final analysis, an organized profession dictates the essential characteristics of a veterinarian through its accreditation, examination, and licensing procedures. The profession cannot in good conscience ignore the present situation. The academic community cannot execute the necessary changes to our profession on its own. We will not be successful unless the profession is unified on this issue; thus, we urge the establishment of an organizational structure that brings together the representatives of the AVMA, Canadian Veterinary Medical Association, state and provincial licensing authorities, and the Association of American Veterinary Medical Colleges. Such a group can begin laying the groundwork for a future in which the profession is always guided by societal need and, in so doing, ensures its ongoing strength and vigor.References
- Eyre P. Engineering veterinary education. J Vet Med Educ 2002;29:195–200.
- Hird D, King LJ, Salman MD, et al. Crisis of lost opportunity—results of a symposium on challenges for animal population health education, Davis, California, May 9–11, 2002. J Vet Med Educ 2002;29:205–209.
- Walsh D, ed. Agenda for action. J Vet Med Educ 2003;30:92–190.
- Nielsen NO. Will the veterinary profession flourish in the future? J Vet Med Educ 2003;30:301–307.