Rethinking veterinary education: Focusing on the profession and society

Editor's note: This commentary is the second in a two-part series by these authors on rethinking the future of veterinary education. For part one, see dvm360.com/rethinking1.

In part one of this commentary series on taking a new approach to veterinary education, we addressed issues that affect, primarily, the individual veterinarian. Here in part two we direct our attention more toward the profession as a whole and the society it serves. We also suggest a strategy for supporting innovation and entrepreneurship.

Establish a culture of One Health

One Health is an excellent framework for veterinary education; however, it will not happen merely through the addition of new courses with catchy titles. A major paradigm shift is needed: from departmental silos and individual animal medicine to cross-disciplinary, holistic learning. All veterinary graduates should be well-versed in interrelated health and disease in animals, people and the environment, irrespective of their area of employment-veterinarians of the future will have to be true One Health scientists. Additionally, veterinary colleges should offer more transdisciplinary master's and doctoral programs (including dual DVM-PhD degrees) that train veterinarians in One Health research.

Emphasize professionalism

Swearing the Veterinarian's Oath is a time-honored tradition at graduation. This is much more than a colorful ceremony, however; it is a pledge of allegiance-a publicly witnessed, formal acceptance of the unique responsibilities of being a veterinarian. The Veterinarian's Oath, the Code of Veterinary Medical Ethics and the Model Veterinary Practice Act are published in the American Veterinary Medical Association (AVMA) directory accessible at www.avma.org. Veterinary students should be thoroughly acquainted with these principles early in their education, not merely at graduation.

For generations, veterinary colleges have provided course work in law, ethics and professionalism. In the present time of eroding societal standards, even greater attention must be paid to professional conduct throughout the curriculum. However, structured education is just one part of a student's experience. We must concede that professionalism is learned from the ethical and moral demeanor of teachers in classrooms and clinics and veterinarians in the workplace. Examples set by mentors (good and bad) endure for a lifetime, long after the so-called facts of science and medicine have become obsolete or forgotten.

Carefully weigh political, social and economic factors

Federal and state governments are unable to fund higher education at adequate levels as their budgets no longer generate sufficient tax revenue to support all public services. Consequently, colleges and universities are faltering as operating costs outpace revenues. The term “public” is rapidly fading from public universities, which are beginning to behave more like private schools. All U.S. veterinary colleges have decided to repair their tattered balance-sheets by increasing enrollment and charging higher tuition.1 This does not seem to be in the best long-term professional or public interest. Furthermore, these rich pickings could soon dry up if students reject the extreme costs of borrowing to finance a veterinary degree and the high-quality applicant pool shrinks. As mentioned above, resources shared among institutions will be vitally important in the future.

An unintended consequence of excessive tuition is that it places a disproportionate financial burden on lower-income students, who spend a greater percentage of their personal finances on college costs than their better-off classmates. They are at risk of being forced out by prices they cannot afford. This factor threatens professional diversity: Veterinarians who can make important future contributions to society will not all come from affluent families.

Deans must take their fair share of responsibility for this situation and take an active role in finding solutions. Some are already doing so-and it is far from easy. Reducing enrollment and freezing tuition are fiscally painful options that might be inevitable if the job market remains stagnant or worse. Colleges need to be more businesslike: finding greater cost efficiency by curbing operating expenditures, reducing administrative overhead, improving productivity and generating new sources of income through corporate sponsorship, federal research grants and private money. Considerable effort already goes into these areas, yet they remain important ways of further reducing the price of education. Fostering strong relationships with financially successful veterinarians will likely generate philanthropic support.

Support accreditation that evolves with time

Conferring a licensable professional degree carries legal responsibilities, and veterinary education is rightly subject to rigorous scrutiny by a credentialing authority. The AVMA Council on Education (COE) is authorized by the U.S. Department of Education to accredit all veterinary medical degrees in the United States, ideally ensuring that each veterinary college meets high educational and professional standards and serves society well.

Accreditation of most professional degrees tends to be conservative, with adherence to rigid criteria. This makes transformative changes in professional education challenging because, by definition, these changes do not conform to prescribed “norms.”

Veterinary medicine's accrediting authorities must continue to recognize that many different educational models can potentially meet the standards for graduating well-qualified entry-level veterinarians, and should grant the colleges freedom to implement curricular changes that enhance education and training. Innovation and entrepreneurship are essential for the profession's continued success; therefore curricular flexibility is vital.

Moving from words to actions

We are at the crux of some important decisions that could significantly enhance or diminish the profession, depending on the choices we make. Coercion cannot work; we need practical, collaborative strategies and tactics for moving forward. We offer the following proposals:

1. A new organization. The academic community should not undertake sweeping educational changes without authentic, profession-wide input. In most cases there will be more than one option and no clear best choice. Different areas of the profession do not need to think alike, but they surely must think together and act together, with each sector confident that its opinions have been properly considered. There needs to be an official process for collaborative deliberation and transparent decision-making that leads to a course of action by consensus. This could be achieved with the creation of a permanent visioning organization shared by the AVMA and the Association of American Veterinary Medical Colleges (AAVMC) and including relevant stakeholders and consumers. This entity-the “AVMA-AAVMC Education Consortium”-would set priorities and recommend actions for change that were always guided by societal need.2

2. Proper incentives. It will take strong inducement to overcome the conservative veterinary college culture. We propose a national program that would recognize innovation by awarding generous monetary grants to faculty teams that invent something capable of solving one or more of veterinary education's urgent problems. We anticipate proposals from more than one veterinary college, as well as collaborations with colleges of agriculture, medicine, business and engineering. The program should be given a prominent title, such as the Veterinary Education Innovation Award, and widely advertised.

3. A path to implementation. We suggest that the Innovation Award have two parts:

Part A would be an incentive prize: a cash reward of $2,000 for each member of the winning faculty team (or a maximum of $10,000 divided among the team members) for the exclusive use of awardees in support of personal professional development.

Part B would be an implementation grant of up to $100,000 awarded to the winning team's home college or colleges. Funding could be spread over several fiscal years. A condition for receiving the grant would be that the winners' college or colleges provide a matching grant of at least 50 percent (in cash or in kind) and a written guarantee that the college will provide fiscal support for the project for at least two years beyond the time period of the grant. This prerequisite commits the dean or deans to supporting and sustaining the project, which would greatly increase the likelihood of success.

What are the possible sources of funding? The AVMA and AAVMC could commit some of their budgetary resources, and contributions would be obtainable from other groups such as federal government organizations, the American Animal Hospital Association, state veterinary medical associations, industry and private donors.

Endnote

We agree with Hollier and co-authors that veterinary medicine is in danger of failing to preserve its professional values and meet its obligations to society.3 The profession must respond decisively and expeditiously, not wait for external circumstances to overwhelm. Now is the time to address-in a collaborative, nonpartisan way-the challenges created by the multiple issues of market demand, veterinarian supply, educational expense-and the prevailing conservative mindset of our profession. We welcome your opinions at dvmnews@advanstar.com and cvmpxe@vt.edu.

References

1. Larkin M. Will veterinary education hit a tipping point? J Am Vet Med Assoc 2011;238:256-261.

2. Eyre P, Nielsen NO, Bellamy JEC. Serving society first. A time for change in veterinary medicine. J Am Vet Med Assoc 2004;225:40-41.

3. Hollier PJ, Fathke RL, Brown, CC. The veterinary profession and precarious values. J Am Vet Med Assoc 2014; 244:1130-1132.

Peter Eyre, DVM&S, BSc, BVMS, PhD

Professor-and-dean emeritus,

Virginia-Maryland College of Veterinary Medicine

Blacksburg, Virginia

Robert C. Brown, DVM

Interact

Herndon, Virginia

Charles J. Wayner, DVM

Veterinary Vitality

Topeka, Kansas

Richard M. DeBowes, DVM, MS, DACVS

Inner Compass Leaders

Pullman, Washington

James F. Wilson, DVM, JD

Priority Veterinary Management Consultants

Yardley, Pennsylvania