AVMA Forecasts Veterinary Ed Struggles

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I think it can be argued logically pretty easily: "We have decided to strengthen our criteria for a school to become or remain accredited. These changes will include x, y and z. We feel that making these changes will provide our veterinary students the best possible environment for becoming an able veterinarian." Nevermind the fact that it would relieve the burden on schools (and their students) who have a teaching hospital and have to absorb all these other students.

There is no rule that things must remain as they are indefinitely.

Sure. And then after they say they've decided to strengthen their criteria, every school that doesn't meet it will get together and cooperatively hire a law firm and start threatening litigation, and the AVMA (or more correctly the COE, I suppose, never mind that behind the scenes they are basically the same thing) will roll over. Again.

Or worse yet, they spend the money to fight it and lose ....... then what do you do?

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I have a meeting with my faculty mentor today that is involved in regulatory stuff. I will ask how all that works.

I'd be interested to know because I just have to wonder how they would check up on a regulate all this stuff. I'm not opposed to the general idea of fourth year students rotating in practices - in fact there could definitely be some benefits because so much of what we see in referral/teaching hospitals is beyond the scope of the average practitioner. I would just be very concerned as to the monitoring of quality/consistency and the lack of teaching experience that most clinical veterinarians have outside of mentoring the occasional individual associate or tech - a fourth year student is going to need more attention than that. Effective teaching is a learned skill.
 
Sure. And then after they say they've decided to strengthen their criteria, every school that doesn't meet it will get together and cooperatively hire a law firm and start threatening litigation, and the AVMA (or more correctly the COE, I suppose, never mind that behind the scenes they are basically the same thing) will roll over. Again.

Or worse yet, they spend the money to fight it and lose ....... then what do you do?

If it were a foolproof plan I would hope someone would have implemented it by now. I'm sure the COE/AVMA would roll over again, repeatedly. My thought was that if they were to be so bold as to start cracking down on these things, someone would presumably have grown a pair and would be willing to stand up to the litigation. I recognize that the likelihood of that happening anytime soon is slim to none. But something big is going to have to happen at some point in the future.
 
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I'd be interested to know because I just have to wonder how they would check up on a regulate all this stuff. I'm not opposed to the general idea of fourth year students rotating in practices - in fact there could definitely be some benefits because so much of what we see in referral/teaching hospitals is beyond the scope of the average practitioner. I would just be very concerned as to the monitoring of quality/consistency and the lack of teaching experience that most clinical veterinarians have outside of mentoring the occasional individual associate or tech - a fourth year student is going to need more attention than that. Effective teaching is a learned skill.

Isn't that the whole point of externships? I mean, I did 5 of them..... one in a high vol spay/neuter, one in a 24-hr ER practice, and 3 in GPs. So that's 6 weeks in private GP practices, which seems pretty reasonable in the grand scheme of things for fourth year.

Of course, that's not a standard. I think UMN required you to do a minimum of 1 rotation (2 weeks) in a for-profit private practice, but that was about it. I just did 3 because of my career plans.

I agree with you.
 
If it were a foolproof plan I would hope someone would have implemented it by now. I'm sure the COE/AVMA would roll over again, repeatedly. My thought was that if they were to be so bold as to start cracking down on these things, someone would presumably have grown a pair and would be willing to stand up to the litigation. I recognize that the likelihood of that happening anytime soon is slim to none. But something big is going to have to happen at some point in the future.

I don't disagree with you! I'm just cynical about the whole thing. I feel like the problems are big, the options are few, and the leadership overall SUCKS and is extremely biased toward practice owners. I wouldn't even bother spending money to be an AVMA money if it weren't for my practice paying for AVMA PLIT.

So ... I don't feel very hopeful for smart management of the industry; I think it's more likely it's just going to have to be dictated by the market, which will hurt.
 
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Isn't that the whole point of externships? I mean, I did 5 of them..... one in a high vol spay/neuter, one in a 24-hr ER practice, and 3 in GPs. So that's 6 weeks in private GP practices, which seems pretty reasonable in the grand scheme of things for fourth year.

Of course, that's not a standard. I think UMN required you to do a minimum of 1 rotation (2 weeks) in a for-profit private practice, but that was about it. I just did 3 because of my career plans.

I agree with you.

I think so. I do think spending all of their time in the teaching hospital isn't the best idea - you can absolutely learn a lot from practices. I was talking about rotating at individual practices exclusively (I think you knew that, just wanted to clarify).
 
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Isn't that the whole point of externships? I mean, I did 5 of them..... one in a high vol spay/neuter, one in a 24-hr ER practice, and 3 in GPs. So that's 6 weeks in private GP practices, which seems pretty reasonable in the grand scheme of things for fourth year.

Of course, that's not a standard. I think UMN required you to do a minimum of 1 rotation (2 weeks) in a for-profit private practice, but that was about it. I just did 3 because of my career plans.

I agree with you.

On the flip side, people often use their externships here for specialties that they might not get to rotate through (whether that is due to limited spots, there isn't a specialist in the area (which is more rare)) and are particularly interested in.

ETA: That's what I've heard from those in 4th yr that aren't planning on pursuing internships, anyway.
 
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I think so. I do think spending all of their time in the teaching hospital isn't the best idea - you can absolutely learn a lot from practices. I was talking about rotating at individual practices exclusively (I think you knew that, just wanted to clarify).

I agree. The advantage of the VTH is that rotations typically have syllabi to help ensure a consistent body of knowledge is covered during rotations. I mean, my ophtho rotation had highly structured teaching rounds every day designed to cover the typical ophtho problems you encounter, in addition to getting to see appointments like you would out in practice. How do you ensure you get that if your students are rotating out at multiple ophtho specialties? They'll certainly see great cases, but ..... how do you manage the consistency?

On the flip side, people often use their externships here for specialties that they might not get to rotate through (whether that is due to limited spots, there isn't a specialist in the area (which is more rare)) and are particularly interested in.

ETA: That's what I've heard from those in 4th yr that aren't planning on pursuing internships, anyway.

Right. People certainly did the same thing here - some people did a bunch of GPs, some people did a bunch of specialties in their area of interest, some people used externships to internship-shop, some to job-shop, etc. There are all sorts of ways people approach it. But if you wanted to (as a school), you could certainly implement requirements to get people into non-specialty practices if the perception is that it is important. There are other solutions, too. At UMN, there is a GP service in the hospital - and it is in the middle of (or maybe finished by now?) a major expansion ... to the point that it almost is a self-contained practice within the hospital. They intentionally designed it to function and resemble a 'private practice'. Even before they did that, when I took the rotation it reflected the realities of private practice pretty well - and it had advantages like video recording your interactions with clients and reviewing those videos with a clinician. I imagine that rotation has only gotten better since I finished up.
 
I agree. The advantage of the VTH is that rotations typically have syllabi to help ensure a consistent body of knowledge is covered during rotations. I mean, my ophtho rotation had highly structured teaching rounds every day designed to cover the typical ophtho problems you encounter, in addition to getting to see appointments like you would out in practice. How do you ensure you get that if your students are rotating out at multiple ophtho specialties? They'll certainly see great cases, but ..... how do you manage the consistency?

Just as a comment, I think that would depend on the size of the teaching community the school is associated with and how much they incorporate teaching community specialists into their curriculum. Taking your example for optho, there are two optho specialists in this city, one of which provides optho rotations in 4th yr. The optho specialist often comes and teaches optho topics within courses and optho clinical labs. For many of the specialties there are clinicians that work partly in private practice through their referral center and partly with the university teaching the students (notable ones that come to mind are optho, neuro, IM, surgery, dentistry). Hopefully I can find out more on the regulation side, but there is most often a real teaching job associated with those that run some of the rotations.

Right. People certainly did the same thing here - some people did a bunch of GPs, some people did a bunch of specialties in their area of interest, some people used externships to internship-shop, some to job-shop, etc. There are all sorts of ways people approach it. But if you wanted to (as a school), you could certainly implement requirements to get people into non-specialty practices if the perception is that it is important. There are other solutions, too. At UMN, there is a GP service in the hospital - and it is in the middle of (or maybe finished by now?) a major expansion ... to the point that it almost is a self-contained practice within the hospital. They intentionally designed it to function and resemble a 'private practice'. Even before they did that, when I took the rotation it reflected the realities of private practice pretty well - and it had advantages like video recording your interactions with clients and reviewing those videos with a clinician. I imagine that rotation has only gotten better since I finished up.

I know a main concern regarding building a teaching hospital at the place I'm at is the competition with the veterinary community. They wanted the veterinary community's support for the school and didn't want to compete with surrounding practices for clients. Continuing to expand a teaching hospital in places not as large as the twin cities may not be received well in some cases.
 
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I know a main concern regarding building a teaching hospital at the place I'm at is the competition with the veterinary community. They wanted the veterinary community's support for the school and didn't want to compete with surrounding practices for clients. Continuing to expand a teaching hospital in places not as large as the twin cities may not be received well in some cases.
Just as a data point, AVC runs a community practice service that operates like a private practice and as far as I know, it doesn't hugely impact the private clinics in the area (including the one across the street). I would think if somewhere as small and as economically depressed as Charlottetown can manage this, just about anywhere could.
 
Just as a data point, AVC runs a community practice service that operates like a private practice and as far as I know, it doesn't hugely impact the private clinics in the area (including the one across the street). I would think if somewhere as small and as economically depressed as Charlottetown can manage this, just about anywhere could.

Stillwater's OSU has a community practice program, and there are *pauses to think* eight clinics (I think) that also do small animal service in town, one of which just opened last year. So that's a town with 44k people, counting the college students that cycle in and out (and probably don't have nearly as many pets as the general population). So I'd say it doesn't impact the totals as much as one would think.
 
Just as a data point, AVC runs a community practice service that operates like a private practice and as far as I know, it doesn't hugely impact the private clinics in the area (including the one across the street). I would think if somewhere as small and as economically depressed as Charlottetown can manage this, just about anywhere could.

Stillwater's OSU has a community practice program, and there are *pauses to think* eight clinics (I think) that also do small animal service in town, one of which just opened last year. So that's a town with 44k people, counting the college students that cycle in and out (and probably don't have nearly as many pets as the general population). So I'd say it doesn't impact the totals as much as one would think.

Sure the place can support it. But would they want to if they didn't have to? That's the point.

I think it's more nuanced than whether a place can economically support a certain number of practices and goes more to the effect on that clinic (and their bottom line). The city is large enough that I think it would be able to handle it, however they wanted the community's buy-in and when it was first debated, the veterinary community didn't want to compete with a teaching hospital, whether that was for primary care or referral. A teaching hospital would affect their businesses, some more than others. We have a strong equine community here as well with many, many specialty equine clinics for example. I don't necessarily believe the community felt as though the city couldn't handle it, but that they would be impacted by it and it would likely affect their bottom line, particularly those in referral practice, and would better get behind a school where this was not a factor. I don't believe this to be the sole factor in deciding to build a veterinary school with this teaching model, but it was a major one. Another strong belief held was that they wanted students exposed to a higher caseload and more everyday cases and fewer zebras. I believe the philosophy behind every place that has built a non-traditional school will be different.

In regards to AVC and OSU, they were established many years ago before this model was a consideration and there was only 1 correct way to build a veterinary school. If they were establishing them now, would both models have been considered?

Also I feel like that many clinics in Stillwater is an oversaturation of the SA market for a town of 44,000. But what place isn't oversaturated with SA clinics nowadays? :laugh:

I feel like this model has merit when done properly and I was given this confidence from my professors that all graduated from a teaching hospital school. Of course, we all have biases based on where we attended, but I don't think this is a question of which one is better (which I'm not trying to argue, I think both have drawbacks) or whether a teaching hospital should have been built (I support the innovation in veterinary education - if it works), but whether this model can deliver an equal level of quality of veterinary education.

Hopefully I can get some answers on inspection, but I don't see shutting down a veterinary school based on its possession of a teaching hospital on grounds of quality to be an honest endeavour.
 
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Sure the place can support it. But would they want to if they didn't have to? That's the point.

I think it's more nuanced than whether a place can economically support a certain number of practices and goes more to the effect on that clinic (and their bottom line).

Keep in mind I'm not really "disagreeing" with you.

I don't personally really know whether I think a vet school ought to have a VTH or not. I do agree with the concern WTF highlighted about ensuring a consistent delivery of fundamental knowledge, but I'm not saying it <can't> be done at a non-traditional environment. I do wonder how it is being ensured. The fact that people have graduated and are out in practice isn't, in my mind, 'proof' that it works. Unless you believe that NAVLE is a great exam for actually testing comprehensive knowledge (I don't).

So with that caveat .... I think it's a red herring to imply that because a place can't support a VTH (for whatever reason) that it means it's ok to plop a vet school there. The question should be: "Should a vet school have a VTH," not "Should a vet school have a VTH if the region can support it?"

Either it is necessary or it isn't. And I don't know that answer. I do know that it used to be required and that the AVMA/COE gave up that requirement because of legal pressure, NOT because they actually concurred that it wasn't necessary. That ticks me off because the decision was made not because they really decided it was better to relax the standards - they just didn't have the balls to fight the legal attack. Had they said "we really actually think that the standards should be relaxed" I'd feel differently. I think it would be a lot better to come up with a rational answer to that question rather than just cave to legal pressure because some schools want to open up and make money or serve a particular locale.

I also think it's a discussion that is almost impossible to have on a rational basis because of the stakeholders. I mean, there's no way that current students or graduates of the schools without a VTH are going to even entertain the idea that maybe a vet school should have a VTH - they've got too much investment in their own path to be able to set that aside and consider it rationally. To some extent I think that's true of people in traditional schools, too - although I think they have somewhat less of a defensive position so maybe could consider the issue slightly more objectively. But in the end, it's pretty damn hard for people to be objective about it.

So it is probably water under the bridge at this point.
 
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Keep in mind I'm not really "disagreeing" with you.

I don't personally really know whether I think a vet school ought to have a VTH or not. I do agree with the concern WTF highlighted about ensuring a consistent delivery of fundamental knowledge, but I'm not saying it <can't> be done at a non-traditional environment. I do wonder how it is being ensured. The fact that people have graduated and are out in practice isn't, in my mind, 'proof' that it works. Unless you believe that NAVLE is a great exam for actually testing comprehensive knowledge (I don't).

So with that caveat .... I think it's a red herring to imply that because a place can't support a VTH (for whatever reason) that it means it's ok to plop a vet school there. The question should be: "Should a vet school have a VTH," not "Should a vet school have a VTH if the region can support it?"

Oh absolutely. I don't disagree in the slightest with the bolded. I wasn't trying to imply that at all. A school should be built because there is a need for more schools and I wouldn't have it any other way. I was just stating that when it is decided that a vet school is needed, as was the case when my school was built, that the impact on the surrounding community should be considered and that is how they started to more seriously consider a different path.


Either it is necessary or it isn't. And I don't know that answer. I do know that it used to be required and that the AVMA/COE gave up that requirement because of legal pressure, NOT because they actually concurred that it wasn't necessary. That ticks me off because the decision was made not because they really decided it was better to relax the standards - they just didn't have the balls to fight the legal attack. Had they said "we really actually think that the standards should be relaxed" I'd feel differently. I think it would be a lot better to come up with a rational answer to that question rather than just cave to legal pressure because some schools want to open up and make money or serve a particular locale.

I also think it's a discussion that is almost impossible to have on a rational basis because of the stakeholders. I mean, there's no way that current students or graduates of the schools without a VTH are going to even entertain the idea that maybe a vet school should have a VTH - they've got too much investment in their own path to be able to set that aside and consider it rationally. To some extent I think that's true of people in traditional schools, too - although I think they have somewhat less of a defensive position so maybe could consider the issue slightly more objectively. But in the end, it's pretty damn hard for people to be objective about it.

So it is probably water under the bridge at this point.

It's really frustrating on my end and maybe that shows through as too large of a defensive front, I just really believe in what I have the opportunity to do and thus probably react more strongly than I need to (I also feel as though no one else seems to represent this side of things, so I might as well take that up). As you said, the Western debacle really did nothing to help a legitimate path in education innovation and only hurt it. In the end, I am slightly more sheltered from the ****storm that is veterinary medical education in the U.S. due to provincial subsidy, there just aren't schools popping up left and right like what you're having to deal with. I also only have a class of 30, so the logistics are also vastly different.

I don't have an answer as to how to objectively determine the quality of graduates that are produced. We can only rely on the community in which these graduates are entering to provide feedback on their performance at this point, in my opinion. Which as far as I've heard, has been positive (here and from Western). Students are entering internships, residencies, etc. I'm not sure how else it could be determined.
 
I don't disagree with you! I'm just cynical about the whole thing. I feel like the problems are big, the options are few, and the leadership overall SUCKS and is extremely biased toward practice owners. I wouldn't even bother spending money to be an AVMA money if it weren't for my practice paying for AVMA PLIT.

So ... I don't feel very hopeful for smart management of the industry; I think it's more likely it's just going to have to be dictated by the market, which will hurt.

I'm with you on the good ship Cynical; it's so disheartening to even think about these things. I think you're right in that the market will have to dictate, but it seems like it should already be dictating and here we are. Glad that I'm out of school and have a job at this point...
 
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I feel like I'm probably unnecessarily defending this model because of my location. This school wasn't built with for-profit goals like so many that are popping up now and the students aren't relying on federal loans in the hundreds of thousands range (due to government subsidization). I pay $10,000 a year and I'm not facing crippling debt with lower and lower starting salaries in the marketplace.

So I feel like where I'm at is being caught in the crossfire and really has nothing more in common with the other schools that are popping up than the model.

And I felt the need to defend it. :shrug:
 
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I don't have an answer as to how to objectively determine the quality of graduates that are produced. We can only rely on the community in which these graduates are entering to provide feedback on their performance at this point, in my opinion. Which as far as I've heard, has been positive (here and from Western). Students are entering internships, residencies, etc. I'm not sure how else it could be determined.

I think it says a lot that PBL is taking off and being incorporated in schools with a more traditional format. (That said, I'm also suspicious that it's a fad thing ... schools are always under pressure to come up with the latest greatest way to 'do' education. And then they manage to magically produce research showing how - surprise, surprise - the latest, greatest thing is better.)

And I know that in my tiny little bit of experience I felt like the people on 4th year with me from other schools (by definition without teaching hospitals of their own) were just great.

So my gripe is really with the industry leadership. The AVMA/COE made that change for all the wrong reasons. So I don't trust the AVMA/COE to make <other> decisions for good reasons that reflect the best interests of ALL veterinarians. And so far, I have seen the AVMA/COE do absolutely nothing to change my opinion. Their committee ... and recent reports ... dollar short and a day late.

And honestly, they still aren't actually DOING anything - just making noise and pushing paper around and having committee meetings and trying to make it look like they are still relevant and important. But I'm hard pressed to think of any substantive action they've taken, or any meaningful effort at lobbying at the federal level, that would help the majority of veterinarians (with regard to the issues we're talking about here).

I didn't mean to imply you were being unreasonably defensive. I apologize if I sounded that way. I think it's hard for ALL of us to have a very objective discussion about it.
 
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I feel like I'm probably unnecessarily defending this model because of my location. This school wasn't built with for-profit goals like so many that are popping up now and the students aren't relying on federal loans in the hundreds of thousands range (due to government subsidization). I pay $10,000 a year and I'm not facing crippling debt with lower and lower starting salaries in the marketplace.

So I feel like where I'm at is being caught in the crossfire and really has nothing more in common with the other schools that are popping up than the model.

And I felt the need to defend it. :shrug:

It's a tough comparison because Canada is very different in many ways from the US in regards to veterinary education. I don't think you're being unfairly defensive, but I think your arguments for your program versus a US program with no VTH won't always translate if only because of the difference in the economics of things.
 
It's a tough comparison because Canada is very different in many ways from the US in regards to veterinary education. I don't think you're being unfairly defensive, but I think your arguments for your program versus a US program with no VTH won't always translate if only because of the difference in the economics of things.

Yeah, I think you're right. *sigh*
 
I pay $10,000 a year and I'm not facing crippling debt with lower and lower starting salaries in the marketplace.

That must be awesome. I can't even dream of a tuition that low.
 
I feel like I'm probably unnecessarily defending this model because of my location. This school wasn't built with for-profit goals like so many that are popping up now and the students aren't relying on federal loans in the hundreds of thousands range (due to government subsidization). I pay $10,000 a year and I'm not facing crippling debt with lower and lower starting salaries in the marketplace.

So I feel like where I'm at is being caught in the crossfire and really has nothing more in common with the other schools that are popping up than the model.

And I felt the need to defend it. :shrug:

No one is demeaning the schools or their graduates, we've simply said that we feel that more research into the distributed models is needed. And I don't even think that anyone is blaming the individual schools. It's more like we're just saying that the advent of schools without a VTH has substantially opened the market to new schools and thus, more graduates. Staffing and building a VTH is a huge financial and logistical hurdle to starting a vet school so Western and the COE basically allowed the floodgates to open.

I also think UCVM worries some Canadians because they see the ****storm in the USA and worry that UCVM might trigger a bunch of similar schools, even though UCVM is non-profit.

Did any of that make sense?
 
At what point do you guys think the price of tuition will deter a larger portion of applicants? For me, if I didn't have a dead relative's money, I probably wouldn't have tried. We see some of that now with the "HOW DO YOU ALL HANDLE THE DEBT?!?!" threads, but it doesn't sound like it's deterring a lot of people outright.
 
I think a lot of students really don't understand the debt. I'm at $100,000 in debt and set to pay it off in 7-8 years given my current salary. Anything more and I would have seriously tried to get into med school. I think SDNers are better informed but I think the majority of students have no idea exactly how much debt they'll have and how long it will take to pay it off.
 
"I have bet my finances on a recession happening in early 2017."

..... GRRREEAT, right when my class graduates....:boom::wtf:
 
One of my big concerns about farming out to the local community is topic rounding. Yeah, many cases (for me) were under interns/residents and they weren't always interested in teaching. But even then, the clinicians were very involved in going through the cases. But a bigger point was the topics we rounded on with a board certified specialist. When we had "dead" time, we rounded. On specific topics to those specialties (but were still relevant to clinical practice) and I think that it was super valuable. I just don't see that happening in as many local clinics. So I'd be curious to see how Canada does it because I'm not sure I buy that it's all equal in the end. That being said, it's kind of apples and oranges - does seeing more cases help retain more? Because private practices typically see more and that would be an advantage. Do we overtrain to a degree? And so it doesn't really matter in that sense anyway? Interesting to see some direct comparisons.

I, personally, would not have done as well in that kind of environment. The teaching hospital was a huge benefit to me but that doesn't mean it negates your (@Caia ) education in any way.
 
In a kind of related note, we will be having a meeting with people from the Dean's Office about increasing the class size here at A&M. I'm fairly certain it's already been decided, but I plan on giving them (respectful) hell. The new school that's being built is designed to accommodate a class size of 200 students...I pray that maximum capacity is never reached. :dead:
 
In a kind of related note, we will be having a meeting with people from the Dean's Office about increasing the class size here at A&M. I'm fairly certain it's already been decided, but I plan on giving them (respectful) hell. The new school that's being built is designed to accommodate a class size of 200 students...I pray that maximum capacity is never reached. :dead:

"Oh, but we have to increase class size to accommodate the need for more rural vets in Texas."

I can hear it now.
 
"Oh, but we have to increase class size to accommodate the need for more rural vets in Texas."

I can hear it now.

The rumors I've heard is that in order to receive state funding for the new school, A&M agreed to increase class size to meet said "shortage" of rural vets. No idea if there is any truth to this or not. Our academic liaisons sent out an anonymous form for us to fill out last year and every single response to "Should we increase class size?" was a resounding NO. But what say do we really have? Very frustrating. :(
 
No one is demeaning the schools or their graduates, we've simply said that we feel that more research into the distributed models is needed. And I don't even think that anyone is blaming the individual schools. It's more like we're just saying that the advent of schools without a VTH has substantially opened the market to new schools and thus, more graduates. Staffing and building a VTH is a huge financial and logistical hurdle to starting a vet school so Western and the COE basically allowed the floodgates to open.

I also think UCVM worries some Canadians because they see the ****storm in the USA and worry that UCVM might trigger a bunch of similar schools, even though UCVM is non-profit.

Did any of that make sense?

Yeah, I understand what you're saying. I guess I never really had the worry that we would see what is going on in the US because of the funding structure. Having unlimited loans for COA really opens that up, which is something we don't have. I think so long as governments are supporting schools through this degree of funding, we won't see that kind of flood because they simply can't afford it and there isn't the means to get the cash to go private like there is south of the border, so I don't see a private expansion really either. Unless another province can also start affording a school, I don't see further expansion.

One of my big concerns about farming out to the local community is topic rounding. Yeah, many cases (for me) were under interns/residents and they weren't always interested in teaching. But even then, the clinicians were very involved in going through the cases. But a bigger point was the topics we rounded on with a board certified specialist. When we had "dead" time, we rounded. On specific topics to those specialties (but were still relevant to clinical practice) and I think that it was super valuable. I just don't see that happening in as many local clinics. So I'd be curious to see how Canada does it because I'm not sure I buy that it's all equal in the end. That being said, it's kind of apples and oranges - does seeing more cases help retain more? Because private practices typically see more and that would be an advantage. Do we overtrain to a degree? And so it doesn't really matter in that sense anyway? Interesting to see some direct comparisons.

I, personally, would not have done as well in that kind of environment. The teaching hospital was a huge benefit to me but that doesn't mean it negates your (@Caia ) education in any way.

I can't answer any of that even though I wish I had the experience to share on it. Hopefully once I'm in that realm I can relate some first hand experience because I feel like that is seriously lacking and we're just kinda guessing about what goes and what doesn't.
 
I unfortunately was only able to ask a brief question at the end of class because he had to cancel on me, but what I got was that the COE inspected every site and "really quite inspected the hell out of this place" so I guess I'll have to wait until our meeting to further probe into that.
 
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