DISCUSS: News on Future veterinary schools

[battie]

I am of the camp where incoming students do not have enough experience, but for me it's the mental health side of things. If vet schools keep accepting 50% or more of the class still in/straight from undergrad with 100 hours of experience and a 4.0, you're ensuring that student will get through your program but you're not ensuring that student is fully understanding the realities of the job they're signing their life away for (debt-wise). It makes me nuts, because yes clinical rotations are super helpful but they also are not the reality for 80% of those students. I just wish more incoming students did have experiences, in the real world, with difficult clients and crappy cases. It's been a long time since I worked in GP (except a short stint at a Banfield in 2018), but I also felt the shadowing students were shielded from some of the struggles that the DVMs were dealing with (Dr. Smith, Tony Green called about his 18 year old laterally recumbent cat for the third time today and berated the CSR because he didn't want to bring it in). From client situations to cases that the owner elected to euthanize after refusing to surrender it (8 month old puppy femur fracture that the owner "didn't want anyone else owning her"). I just think that aspect of the job is missing for people until they're already in practice, and that sucks for the veterinarian.

But that's not the average matriculant. The average matriculant has 800+ hours both in animal and vet experience. The 100 hour matriculant is the person who worked predominantly in zoo med, lab med, research, etc. with those specific goals in mind, as an example. Likewise, those people are balanced out by the people who were techs for forever.

The average matriculant also doesn't have a 4.0 at the vast majority of the schools either.

Now is it a problem when those people don't advance in those rolls because the competitive nature? Absolutely. But the schools can only do so much too. The person with 100 hours of GP experience (but 5000 hours in lab animal med) should be allowed in because at least they'll try to go lab animal, a desperately needed demographic of doctor. That matriculant also should be aware of what their backup plan is if they never get to be a lab animal vet. I like open book interviews for this reason cause then an interviewer can force the students to look at that potential possibility.

The only alternative would be one of two routes: the AVMA require member vets to accept pre-vets shadows (fat chance) or vet schools require X number of hours per category from each student. I'm not adverse to either plan, tbh. If it was an AVMA requirement, I would do it in a heartbeat. As it is, I don't get to make the decision in any way. Likewise, if the school made it a requirement, it would cut down on the number of applicants depending on the categories and the amounts required. I don't see a high motivation for that either.

I see this statement predominantly from people who don't know the data behind the applications on a year in and year out basis. Everyone has said forever that vet med is more competitive than med school (as an example), when that wasnt true until the 2020 or 2021 cycle. The cycles I applied during, your chances of acceptance were something like 63% if you were dead average; for human med, it was <40%. When I post this on VIN, people who graduated in the 90s argue until I show the data. The average vet med person just doesn't understand how applications work any more.

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[TheDogFather]

These are the exact specialties that are ALREADY struggling to fill positions in academia, even without adding 14 new programs into the mix. There are several schools without radiologists (or at least there were fairly recently). Schools that used to have 3-4 clinical pathologist positions have often downsized to one or two. We had a whole discussion panel at ACVP conference in October literally titled “The Exodus of Pathologists from Academia”…let’s just say the discussion was pretty bleak and even aside from pay issues, the rampant mental and sexual abise, and lack of respect are also consistently mentioned “pain points”. Probably a more immediate issue we talked about at the panel was who is going to train residents in these specialties if there isn’t anyone left in academia, but who is going to teach students is the natural step after that.

What? Behind the ivy covered walls of these temples to diversity, inclusion, and equity lurk these concerns? They aren't quite the safe spaces they promote themselves to be? Mon Dieu! I need to reach for the smelling salts.

 

[TheDogFather]

Yes. The main premise as to why we don't have separate licensing is the "what if" we have a disease outbreak or bioterrorist attack that affects the majority of a production species. There aren't enough large/mixed animal vets between the private and public sectors to be able to handle that kind of scenario. So they would pull from the small animal pool like they did for mad cow in the UK.

I realize that, but I also think that that is a lame reason to dilute the (quite expensive) training we undergo. "Veterinary medicine is changing (veterinary cliche #47)" I am always told. The schooling needs to change with it. I've often raised this very point when I discuss with clients just why our supposed wide-ranging education precludes us from treating the conditions which most often ail your pets. There is "no time in the curriculum (veterinary cliche #66)" to teach stifle repair but I am supposedly qualified to sally forth from my small clinic to step in for production veterinarians, should they all be wiped out in some focused terrorist attack. I plead guilty to not keeping up with large animal literature and given the recent focus on boundaries, mental health, and work life balance I don't see large numbers of small animal vets having a large impact in any sort of food animal crisis. "Just because you can doesn't mean you should (veterinary cliche #27).

 

[DVMDream]

I am of the camp where incoming students do not have enough experience, but for me it's the mental health side of things. If vet schools keep accepting 50% or more of the class still in/straight from undergrad with 100 hours of experience and a 4.0, you're ensuring that student will get through your program but you're not ensuring that student is fully understanding the realities of the job they're signing their life away for (debt-wise). It makes me nuts, because yes clinical rotations are super helpful but they also are not the reality for 80% of those students. I just wish more incoming students did have experiences, in the real world, with difficult clients and crappy cases. It's been a long time since I worked in GP (except a short stint at a Banfield in 2018), but I also felt the shadowing students were shielded from some of the struggles that the DVMs were dealing with (Dr. Smith, Tony Green called about his 18 year old laterally recumbent cat for the third time today and berated the CSR because he didn't want to bring it in). From client situations to cases that the owner elected to euthanize after refusing to surrender it (8 month old puppy femur fracture that the owner "didn't want anyone else owning her"). I just think that aspect of the job is missing for people until they're already in practice, and that sucks for the veterinarian.

But this isn't an accurate representation of the incoming veterinary classes at all. Also, just because people have 4.0GPAs does not mean they will pass or do well in vet school. It is an indication they should likely handle it ok, but I have seen many struggle as well.

Also, you can have 32423423234 hours of experience in a veterinary clinic and you will NEVER be prepared for what it is actually like to be a vet. You can't accurately ever replicate what it feels like to be entirely responsible for that pet's life and well-being. You can't replicate being responsible for someone else's mistake (your vet assistant gives or send home the wrong medication for example). You can't replicate being responsible for managing a team of people at all times and making sure things in the clinic run smoothly and appropriately. You can't replicate the amount of training of other staff you will be doing. You can't replicate the stress of dropping a pedicle during a spay and watching the abdomen fill with blood. You can't replicate yourself making a mistake and having to call the owner to tell them. You can't replicate being the one responsible for that angry client and having to manage them to protect your staff. You can't replicate the debt and stress of that debt on day to day life. You can't replicate dealing with management, corporate policies (let's be honest, most vets will end up in a corporate practice) that you just are not exposed to as a tech, assistant, receptionist, etc.

I had 7 years of solid, small animal medicine experience before veterinary school and there was no way to really understand what you are really doing and dealing with day to day. Sure you see the angry clients, you even deal with them yourself as a tech, but you don't really deal, deal with them as the vet does. As a vet, I refuse to let any client be rude to staff, ever. If they have been rude to staff and become sweet as pie to me, I will still call them out, every single time. I don't care if it creates conflict, you will NOT be mean to the staff. Period. That is never something I did as an assistant. I just ignored the rude remarks and moved on.

Plus, veterinary medicine is not only about clinical medicine, there are other aspects of veterinary medicine that are important as well and need veterinarians. This is why veterinary medicine can't become focused on just a small animal track or just a large animal track or just an exotics track, because there are multiple, multiple areas in veterinary medicine that treat, manage, review medicine, etc on all species.

 

[TheGirlWithTheFernTattoo]

I’m a bit late to the party but I have some thoughts on teaching hospital vs distributed learning for students. This comes from my experience teaching students in a teaching hospital setting, and also teaching students at a private practice distributed learning facility. Full disclosure I went to a school with a teaching hospital, so I may have bias from that personal experience.

In a teaching hospital setting students have it grilled in to them the correct way to properly present a case, organize a problem list/ddx, and report diagnostics in that exact order we all learned during lecture. I’ve noticed pretty reliably that students coming through who aren’t coming from a teaching hospital school are not nearly as competent at this skill. I also notice that 90%+ of doctors in PP don’t sit there and insist they present in the classic taught format each time (instead they will get asked one off questions about their problem list and plan) which means they don’t ever get it beat into them the same way. It is semantics, but there is a lot of value in being able to present a case well and it helps you think about the case and not miss things.

Teaching hospitals are specifically set up and designed for students to be heavily involved in cases. When a client walked in the door at my teaching hospital, they were expecting 3 hours minimum and to have a student doing a large part of the history and client comms (potentially struggling to as well). Part of that inefficiency is the automatic requirement that students present to me, discuss the plan, and then do some general teaching about the case. In PP I don’t have that time, and my clients are not expecting or prepared for that time. I need to still clear a high caseload with the student doing parts or “along for the ride”. But I can’t let students who are struggling with client comms cringe through 45 minutes of talking for practice when I have too many cases to see and my clients are going to leave bad reviews because their expectation is a private practice hospital and not a teaching hospital. At the end of the day in private practice my first priority has to be my hospital and the company I produce revenue for because it is a for-profit business. I absolutely love teaching and working with students; ideally I would like them to see their own cases from start to finish with me giving them heavy supervision and support. Unfortunately, the private practice setting (at least for ER and specialty) does not allow that and I don’t feel the students get the experiences I would want them to have and was able to give them in academia.

As someone touched on earlier, I think in private practice you run a higher risk of being taught “what we do” vs “what is the most recent evidence-based approach”. Academia can also fall prey to this, but I think it is more prevalent in private practice.

Teaching hospitals are standardized. Each student is getting the same set of clinicians/approach/minimum standards of care. With distributed learning you are introducing large variation and the oversight is much more difficult to make sure all students are being given approach training in each core area. There’s a couple local hospitals that many students rotate through that I don’t feel should be an example to students of medicine to strive for.

I don’t necessarily think distributed learning is bad, there’s absolutely perks that you don’t get with academia training (hello real world medicine when clients can’t do everything, hello working efficiently). However, there is absolutely some gaps that exist in this type of training that we need to be aware of as we start making more and more schools this format.

 

[Trilt]

Also, you can have 32423423234 hours of experience in a veterinary clinic and you will NEVER be prepared for what it is actually like to be a vet. You can't accurately ever replicate what it feels like to be entirely responsible for that pet's life and well-being. You can't replicate being responsible for someone else's mistake (your vet assistant gives or send home the wrong medication for example). You can't replicate being responsible for managing a team of people at all times and making sure things in the clinic run smoothly and appropriately. You can't replicate the amount of training of other staff you will be doing. You can't replicate the stress of dropping a pedicle during a spay and watching the abdomen fill with blood. You can't replicate yourself making a mistake and having to call the owner to tell them. You can't replicate being the one responsible for that angry client and having to manage them to protect your staff. You can't replicate the debt and stress of that debt on day to day life. You can't replicate dealing with management, corporate policies (let's be honest, most vets will end up in a corporate practice) that you just are not exposed to as a tech, assistant, receptionist, etc.

I had 7 years of solid, small animal medicine experience before veterinary school and there was no way to really understand what you are really doing and dealing with day to day. Sure you see the angry clients, you even deal with them yourself as a tech, but you don't really deal, deal with them as the vet does. As a vet, I refuse to let any client be rude to staff, ever. If they have been rude to staff and become sweet as pie to me, I will still call them out, every single time. I don't care if it creates conflict, you will NOT be mean to the staff. Period. That is never something I did as an assistant. I just ignored the rude remarks and moved on.

Meanwhile I got my first paid job in vet med the same week I got my vet school acceptance.

And while I can't boast a 4.0, I had much closer to a couple hundred hours of experience vs. couple thousand - in a bunch of different areas. My biggest experience was actually in a research lab, which just taught me I don't like benchtop research lol.

And I'm very happy in my career eight years in, and I'm a good vet. A lot of my much more experienced classmates can't necessarily say that, or have changed careers completely.

We don't know what makes people successful. But working a bajillion hours in SA prior to school ain't the guarantee people like to portray it as.

 

[Kuckie92]

It was posted on a Ross parent site.

Where? I'm rather skeptical that Ross would post that information willingly.

 

[SV88]

Meanwhile I got my first paid job in vet med the same week I got my vet school acceptance.

And while I can't boast a 4.0, I had much closer to a couple hundred hours of experience vs. couple thousand - in a bunch of different areas. My biggest experience was actually in a research lab, which just taught me I don't like benchtop research lol.

And I'm very happy in my career eight years in, and I'm a good vet. A lot of my much more experienced classmates can't necessarily say that, or have changed careers completely.

We don't know what makes people successful. But working a bajillion hours in SA prior to school ain't the guarantee people like to portray it as.

I'm not saying every single student has to have 10,000 hours of experience. I'm not saying that students going into vet med after doing 3 years of undergrad with a 3.97 can't be amazing, capable, HAPPY veterinarians. I'm just saying that, in my experience, there are plenty of graduates who come out working ER without having spent much time in a true ER setting. That's a debilitating job at times, for ALL staff involved, REGARDLESS of how long you've been in the field. It can be that way with GP too. If our field is so targeted at improving mental health, maybe we need to go back to the start before the students are signing on for $300k, $400k of debt and are saying they're trapped on the NOMV Facebook page. You can't always predict it, but I just don't believe 100 hours of experience is sufficient. If people are going into six figures of debt for their career, I wish for the best chance for all to have longevity, happiness, and a good work/life balance. Just my $0.02.

 

[Rejected Med_Vet_Students]

Where? I'm rather skeptical that Ross would post that information willingly.

Like I said it was on a parent site. You are right Ross wouldn’t post it. That would damage a money maker for them. Parents may be finally getting tired of Ross’ tactics.

 

[battie]

You can't always predict it, but I just don't believe 100 hours of experience is sufficient.

I think Trilt, DVMD, and I are making the argument that the majority of vet school matriculants have much more than 100 hours though. Maybe not specifically in GP or ER, but overall, the average matriculant has spent substantial time in a veterinary setting. To a large extent, the schools are overall thinking ahead on a population level that the vast majority of matriculants have some sense of what being the average veterinarian is like. The students with 100 hours of veterinary experience are the exception, not the rule.

 

[supershorty]

You can't always predict it, but I just don't believe 100 hours of experience is sufficient.

I was involved with admissions for the last several years, and this is true - 100 hours isn't. But the students who are accepted with that little experience are few and far between. We advise applicants on here to have hundreds or thousands of hours, as diversely throughout the field as possible, to know what they're getting into. Those students who have only a handful of hours who matriculate have lots of experience in some other, more niche area of the field, usually - research, lab animal medicine, etc.

Getting admitted to veterinary school with few experience hours is the exception. More broadly, applicants need to have many hundreds of hours to be competitive, unless they are an outstanding applicant in other areas that are evaluated.
(Now, getting admitted to human medical school with 100 hours, as far as I can tell from creeping on the allo forums, is a different story).

 

[WhtsThFrequency]

I'm not saying every single student has to have 10,000 hours of experience. I'm not saying that students going into vet med after doing 3 years of undergrad with a 3.97 can't be amazing, capable, HAPPY veterinarians. I'm just saying that, in my experience, there are plenty of graduates who come out working ER without having spent much time in a true ER setting. That's a debilitating job at times, for ALL staff involved, REGARDLESS of how long you've been in the field. It can be that way with GP too. If our field is so targeted at improving mental health, maybe we need to go back to the start before the students are signing on for $300k, $400k of debt and are saying they're trapped on the NOMV Facebook page. You can't always predict it, but I just don't believe 100 hours of experience is sufficient. If people are going into six figures of debt for their career, I wish for the best chance for all to have longevity, happiness, and a good work/life balance. Just my $0.02.

I agree with the general gist of your posts, and how students are often thrown into the crucible after graduation, BUT.....

You can never predict what your chosen field is going to be like in ANY discipline, whether it be medicine, engineering, business, whatever. For the vast majority of students, the experience that you get pre-professional school is NOT going to be fully reflective of the realities of the job, because when you are there in a student position you are shielded from a lot of it simply because you are inexperienced, don't have the knowledge base, etc - just as @DVMDream said.

I'll use a hockey analogy. If I spent hours and hours at the rink at stick-and-pucks practicing, and going to scrimmages....sure, I might get good at the mechanics of hockey, gain decent positional awareness, get good cardio, and all those building blocks. But when I'm thrown into my first real competitive game with a win on the line - when its not longer a scrimmage and the speed and aggression is real - things are extremely different and it takes time to adjust the knowledge base to the new environment. However, it's a catch 22 - I can't become accustomed to a game environment unless I play in a game, and I can't be effective in a game unless I have skill and practice because no team would take me and put me in a position of responsibility without it. We ideally would want students to come in with a full experience of what a job in veterinary medicine is like...but its impossible to give them that because they literally can't do the job first without the training. They will always be shielded from a lot of it simply because they are not vets (yet).

So how to we address this and best prepare our new graduates? Personally, I think that the answer lies way more on the early career mentoring side than the pre-vet school experience. Because then, you have the knowledge base to actually perform the job and you are going to be put in those stressful positions that a pre-vet student never would be. And unfortunately, early career mentoring quality is not something that can be standardized given how our system is currently set up. So this is a very long and roundabout way of saying that as of right now, I don't think there is a easy solution or that expecting more "practice" hours from pre-veterinary students will solve the issue.

 

[WhtsThFrequency]

A second note about veterinary education (sorry but not sorry lol, I'm very passionate about education). I think we are coming to a point where we need to decide if we as field (heck, we as a society) want and need veterinarians to essentially be animal physicians and have a deep understanding of pathophysiology, or if we want veterinarians to be more limited diagnosticians and "fixers" of problems. And in all honesty, I'm not sure which camp I lie in at this point based on how wide the field has gotten and how overextended our DVM students are.

We struggle in vet med to really get our students to high levels on the Bloom's taxonomy framework, because of the crazy massive cognitive load and variety of knowledge inherent in vet school. When I'm on my DVM teaching weeks, I have fourth year students who, when I ask for the differential for a yellow cat with fluid in the abdomen and high blood pressure, they all immediately go "liver problems!" and then when I ask all right, if there is chronic liver disease, tell me exactly what is happening in this cat/dog/whatever, why it is yellow and how does that happen, why there is fluid there and how did the liver cause that, what other abnormalities in the bloodwork would you expect to see and WHY....and that's where they struggle.

Now, do they NEED to understand the specifics of bilirubin metabolism and the difference between prehepatic, hepatic, and posthepatic icterus, how liver disease affects albumin production related to ascites, why certain enzymes are elevated in cholestatic vs hepatocellular disease, exactly how portal hypertension occurs in cirrhosis, etc....OR do they just need to know that icterus and ascites means liver problems, and what drugs to prescribe/imaging to do/surgery to do? As a pathologist, I will of course admit my own bias - I want all students to really understand the WHYs of everything...because when you don't understand the WHYs and HOWs of pathophysiology, but instead just recognize a symptom and match it to a disease and match it to a treatment, are you really a doctor, or are you a diagnostician who just follows an internal algorith? And this applies to ALL medicine - I bang this into my MD students' heads just as hard. Our DVM and MD students are paying far too much in terms of money, blood, sweat, and tears to just memorize associations at the end of the day, even if that is what their job looks like on the outside.

HOWEVER, the above rant aside, I'm also extremely aware of the volume our DVM students are required to get through, and how difficult it is to get a complete understanding of pathophysiology when you are supposed to be doing it for six or seven species as opposed to one. I went through it myself. Perhaps there could be a combination of fixes - a more limited focus on species for those who are sure they want to work in those areas, but ALSO (and this is key) an increase in DEPTH of teaching. I don't think one could or should come without the other, because then again - we are limiting our students to simply being able to associate X or Y result with A or B disease, and now in an even more limited set of species, rather than actually being able to articulate and understand what is happening at a physiologic level. If you have a really deep understanding of pathophysiology (something that I think is lacking in vets schools right now because we spread everything way too thin), you can in general apply a LOT of the same principles to other species. Sure, you would have to learn about specific diseases and causes if you had to switch careers/species focus, but the basics are extremely similar.

However (another however), at the end of the day, if we decide that veterinarians do NOT need this depth of understanding of disease, and they should be much more on the diagnostician/"fixer" side.....than yes - vet school needs to be far more tailored, shorter, and far less expensive. I guess time will tell with rising tuition costs and how the field develops in the next 10-20 years.

 

[thenontraveler]

A second note about veterinary education (sorry but not sorry lol, I'm very passionate about education). I think we are coming to a point where we need to decide if we as field (heck, we as a society) want and need veterinarians to essentially be animal physicians and have a deep understanding of pathophysiology, or if we want veterinarians to be more limited diagnosticians and "fixers" of problems. And in all honesty, I'm not sure which camp I lie in at this point based on how wide the field has gotten and how overextended our DVM students are.

We struggle in vet med to really get our students to high levels on the Bloom's taxonomy framework, because of the crazy massive cognitive load and variety of knowledge inherent in vet school. When I'm on my DVM teaching weeks, I have fourth year students who, when I ask for the differential for a yellow cat with fluid in the abdomen and high blood pressure, they all immediately go "liver problems!" and then when I ask all right, if there is chronic liver disease, tell me exactly what is happening in this cat/dog/whatever, why it is yellow and how does that happen, why there is fluid there and how did the liver cause that, what other abnormalities in the bloodwork would you expect to see and WHY....and that's where they struggle.

Now, do they NEED to understand the specifics of bilirubin metabolism and the difference between prehepatic, hepatic, and posthepatic icterus, how liver disease affects albumin production related to ascites, why certain enzymes are elevated in cholestatic vs hepatocellular disease, exactly how portal hypertension occurs in cirrhosis, etc....OR do they just need to know that icterus and ascites means liver problems, and what drugs to prescribe/imaging to do/surgery to do? As a pathologist, I will of course admit my own bias - I want all students to really understand the WHYs of everything...because when you don't understand the WHYs and HOWs of pathophysiology, but instead just recognize a symptom and match it to a disease and match it to a treatment, are you really a doctor, or are you a diagnostician who just follows an internal algorith? And this applies to ALL medicine - I bang this into my MD students' heads just as hard. Our DVM and MD students are paying far too much in terms of money, blood, sweat, and tears to just memorize associations at the end of the day, even if that is what their job looks like on the outside.

HOWEVER, the above rant aside, I'm also extremely aware of the volume our DVM students are required to get through, and how difficult it is to get a complete understanding of pathophysiology when you are supposed to be doing it for six or seven species as opposed to one. I went through it myself. Perhaps there could be a combination of fixes - a more limited focus on species for those who are sure they want to work in those areas, but ALSO (and this is key) an increase in DEPTH of teaching. I don't think one could or should come without the other, because then again - we are limiting our students to simply being able to associate X or Y result with A or B disease, and now in an even more limited set of species, rather than actually being able to articulate and understand what is happening at a physiologic level. If you have a really deep understanding of pathophysiology (something that I think is lacking in vets schools right now because we spread everything way too thin), you can in general apply a LOT of the same principles to other species. Sure, you would have to learn about specific diseases and causes if you had to switch careers/species focus, but the basics are extremely similar.

However (another however), at the end of the day, if we decide that veterinarians do NOT need this depth of understanding of disease, and they should be much more on the diagnostician/"fixer" side.....than yes - vet school needs to be far more tailored, shorter, and far less expensive. I guess time will tell with rising tuition costs and how the field develops in the next 10-20 years.

What are your thoughts on having an intermediate job like a physicians assistant in Vet med? One that doesn't take as much schooling, but possibly could help bridge the gap between the technician and DVM in terms of being able to address and treat lower level concerns in most animals.
Less schooling, but still allowing some diagnostic ability would probably go a long way to addressing areas of true vet shortages maybe? Since with less schooling comes less debt and a better ability to live in a rural area and provide some basic services.

 

[WhtsThFrequency]

That's a really, really complex question and something that I definitely go back and forth with in my own head. You've started me on another stream of consciousness post, so I blame you (just kidding )

I think the intent behind the idea is good. I see how it could help certain areas in need of vet care (e.g. underserved areas just as you said), and allow vets to be able to focus on more complex cases...but here are my questions I ask myself:

1. Who decides when the case would be complex enough to send to a "real vet?" What limitations would be place on these midlevels in terms of their medicine/practice scope, and how would that be enforced? Practitioners who were trained in such a limited fashion would have to have very strict boundaries on what they would be able to do and not do. And you only have to look at the human side to see how those limitations have been stretched how contentious it has become.

2. What about clinic finances - primary care is the bread and butter of most practices, if that was taken over by midlevels, how would a DVM clinic be expected to survive, knowing that not all clients will be pursuing advanced diagnostics? Would higher level care or anything other than well visits and common sicknesses be then spread out even further, and made even less accessible to patients who need it? What would happen to the overall quality of vet med as a whole?

3. What about clients transitioning to seeking more "basic" care (basic is the best word I can come up with, I don't want to say "lower level" because that has a negative connotation and I do highly respect PAs, NPs, etc) because its cheaper than going to a "real vet"...and this could lead to insidious conditions or complex problems being missed. When you need to go to the doctor to get care, you don't go "well, it will be way cheaper if I go to this PA over here versus a doctor" and make a decision purely based on that. While in the vet world, I can absolutely see a client doing that.

However, as I said before, I do also see the potential value. Think about urgent care centers. When I have a UTI, I'm not going to try to make an appointment with a physician because I need care now and it will take a week or so to get an appointment at best. I'm going to swing by urgent care, get evaluated by a good PA or NP, and be on my way. In fact, I had to do that exact thing last week, lol. Sort of similar to vaccine clinics in vet med - get the animal in, cursory exam, pop a vax and get 'em out. Those services are definitely needed and I am SO thankful for the NPs and PAs who do this.

Problem is, this is where I believe human and vet med diverge a little bit in terms of midlevels ability to catch things - and when I say "ability" I do NOT mean that in an intrinsic ability way at all......more the fact that the patient in human medicine is, well, a human! If you are the patient, you feel what is wrong with you and you can communicate to the midlevel. Yeah I know I came in for XYZ but yeah this also kinda hurts, etc. It is easier (in my opinion) for NPs and PAs to ferret things out and realize if higher level care is needed because they are working with another literal person. In vet med, especially in the 1) fast paced and 2) limited diagnostics environment I imagine a midlevel provider center would be, when 3) you are relying on just what the client says they brought them in for and 4) the animal can't communicate that anything else is wrong (yeah mom brought me in for vaccines but also my tummy hurts) and 5) you are not trained in the more complex parts of medicine.....that is kinda dicey IMO. There is always another layer of investigation when it comes to vet med because we are going through an interpreter who doesn't even really speak the language (i.e. the client) while simultaneously working with a totally different species that us who can and do hide their problems until they become obvious and too late.

So after all that gobbedlygook I just wrote....I don't have an answer and I'm torn on it myself. Since I'm not a boots-on-the-ground GP vet, I very much defer to those who are because they would be much more able to speak to the issue than me.

 

[battie]

What are your thoughts on having an intermediate job like a physicians assistant in Vet med? One that doesn't take as much schooling, but possibly could help bridge the gap between the technician and DVM in terms of being able to address and treat lower level concerns in most animals.
Less schooling, but still allowing some diagnostic ability would probably go a long way to addressing areas of true vet shortages maybe? Since with less schooling comes less debt and a better ability to live in a rural area and provide some basic services.

Absolutely not. Mainly because of the following point:

primary care is the bread and butter of most practices,

In theory, these mid-level positions would be used for wellness visits or basic sick pet (lameness, ear infection, etc.) so that the doctors can do more complex cases. However, the average veterinarian *would not* have a high enough case load of "more complex cases" to justify their existence to a practice. More to the point, a lot of GP vets go into vet med as much for the wellness appointments as they do the complex cases. The wellness appointments are a great breather for a GP to be able to have a mental break between the hard cases.

Case in point of the urgent care cases: I work exclusively ER and I see a "true" ER case (HBC, GDV, emergent toxicity, FBO, etc.) probably a few times a week depending on which hospital I'm at (three hospital group with wildly different demographics). Otherwise, it's diarrhea, lameness, non-specific lethargy, etc. If a VPA position was made that did all those cases, I would lose my job.

Finally, there's the money aspect. There are definitely NPs and PAs that make more than I do. Hell, there are RNs that make more than I do. Some technician positions in human health care make slightly less than me (fetal ultrasound tech at my neighborhood hospital makes 55/hr, I make 75/hr). But then a human ER doctor is 250-350k+. There's a huge financial gap between RNs, NPs/PAs, and MD/DOs. That massive gap doesn't not exist in vet med. My techs are paid 30/hr (vs my 75). So I make doubleish a tech makes. Human doctors are making 5-10x other healthcare professionals. And, most importantly, there's money there for this due to human insurance. We don't have that luxury. A VPA making 80-90k a year (which was my base salary at graduation in 2021, btws) would not be saving a lot of money for a lot of folks despite coming out to around 40-45/hr.

And what about the techs? We already don't have enough support staff for the clinicians we do have. We certainly won't if we channel a ton of techs into VPAs. Techs are also grossly under utilized and under promoted. There are so many techs that would be great VTSs that never get that opportunity.

If VPAs became a thing, I would leave vet med and actively discourage others from pursuing it at the doctor level. The ROI now is already tenuous at best and downright non-existent for a lot of students. Introducing VPAs would make being a vet downright stupid.

 

[JaynaAli]

I agree with what WTF and Battie said.

But I wanted to touch on this a little more…

Since with less schooling comes less debt and a better ability to live in a rural area and provide some basic services.

In a true rural area, salaries for vets are much lower than those in cities. Sure, cost of living is also low but we also have other things that cost more like gas and travel time to reach services that are not available locally (like medical care). My friend works rural mixed out here and she started at 55k. I was offered a different rural mixed job for 50k. Nine years out my friend is now making 65k. An unlicensed tech might make 25-30k. There’s no real meat left on the bone for a mid level in that mix…it’s not a salary bump to be worth the cost schooling imo…even if it costs half to a third of what vet school costs that’s still over 100-150k for a mid level degree that in my area I bet would pay 40-45k. Who’s gonna want to do that when they can make 80 in a city (the same issue we have with recruiting vets to rural areas!). The closest ER/specialty/urgent care hospitals are over two hours away from where I live. If you replace a full rural vet with a mid level designed to do wellness and minor injury, that actually only makes rural people’s access to care worse because those midlevels may not have the training to deal with the seriously ill pets, especially the vast majority that that can’t/don’t refer. They’d have to “refer” to a full vet and I don’t see people doing that, and then a mid level gets in over their head trying to be a full vet for the area and trying to help pets when they don’t have the full vet training and knowledge.

 

[DVMDream]

What are your thoughts on having an intermediate job like a physicians assistant in Vet med? One that doesn't take as much schooling, but possibly could help bridge the gap between the technician and DVM in terms of being able to address and treat lower level concerns in most animals.
Less schooling, but still allowing some diagnostic ability would probably go a long way to addressing areas of true vet shortages maybe? Since with less schooling comes less debt and a better ability to live in a rural area and provide some basic services.

I will try to be brief because I have a lot of opinions on this.
First, it has been proven over and over that patients in human medicine have worse outcomes in care with PAs and NPs. I have met some amazing PAs and NPs, but the research overall shows an overall delay in care and decreased quality of care.

Regardless of that, I am strongly against a mid-level in veterinary medicine for many reasons:
1. Mid-levels are a corporate organization's wet dream, especially corporates that own GP clinics. The corporates are already heavily pushing for a mid-level, because again, this is an absolute wet dream for them. They can hire on a bunch of mid-level people to see "basic" cases, reduce the number of actual vets they have to hire AND still charge the same amount for the care provided to the pets. So they will reduce their employee overhead and increase their revenue which will go directly into CEO pockets.

2. The few vets that they do keep on board will be responsible for that mid-level. Everything a mid-level does will be that vet's responsibility. There is no current discussion about mid-level certification, liability, etc. The only discussion has been the vet "overseeing" their cases and being liable for them. No thank you. If someone wants to make medical decisions as a practitioner they need to put their own butt on the line and be responsible and liable for their actions.

3. Vets who get into GP do so because they want to build those long-lasting relationships with clients. They want to see the puppy/kitten and watch it grow through the years to old age. They want to see the healthy pets among the sick cases. Plus those healthy pets help to break up the schedule to allow the clinic to run more smoothly.

4. There aren't enough vet techs or assistants to have mid-levels. Plus we don't utilize vet techs (at least in GP) to their full potential. At one of my first jobs I allowed a tech to bandage a leg. Just a basic Robert Jones bandage, nothing fancy. I asked the tech if she was comfortable, she said yes, and I walked away so she could do her job. I got a "talking to" later that I shouldn't be letting the techs bandage things. Umm, what?


I really could keep going, but I will stop here.

 

[MixedAnimals77]

Just a few brief thoughts on the mid-level issue and another slightly randomly related thought

1) Liability #1, I should NEVER be responsible for them if they are dx and tx. I also don't have time to over see all of their stuff AND mine AND what my staff is doing. There's always risk for gross negligence and I have enough on my own to worry about I wouldn't want the equivalent of a midlevel under me.
2) As Jaynaali stated it's not really helping us rural folk. There isn't much left to the pie tbh. I want to pay my support staff more before I pay a midlever. At the same time defining those "basic" things also is an issue and does it leave enough for me to do. ie I saw 3 ear appointments and 3 vaccine appointments today. On a "slow" day that would have been the majority of my afternoon. In the same stroke I've heard "basic" sx to include a spaying-NOTHING is "simple" about a spay.
3) Lets get some standard tech regulations across the nation before we talk about creating a whole new position. Heck also lets make sure we are requiring our doctors to continue learning (I'm looking at you FL)
------------------------------------------------------------------------------
My other thought, we recently got a veterinarian from Mexico who is working as a technician and did not graduate from the avma accredited school in Mexico City. Our standards of care and perhaps money for our pets are SO different. Mexico is definately much more what I would consider a diagnostician or midlevel care type work and understanding. Their dream is to pass the foreign accreditation, but TBH it's going to take quite a bit of studying to be doctoring at the level I do and understanding the why and treating. TBH we will see how it pans out but there's definatley a knowledge gap. ie ear and ear cytology skill are great, but then we were discussing cushings vs addisons and past knowing what they were and where the masses form for cushings I'm not sure they could've diagnosed either off of labs. Their disease base or recognition pattern is also less, diagnosed puppy strangles the other day and they asked how I knew that.

Some of my technicians have as much if not more knowledge than them. I think there's much more room for growth and responsibility of the technician, a position we already have in place to "fill the gap". At this point I would trust my senior technicians before them. So I'm not a fan of midlevel if it's going to be "basic" knowledge only because many of our technicians can already fill that role.

 

[Horsin'Around]

I 100% agree with the above. What is "basic", no one can tell from an appointment title. The lame dog may have a torn nail or could have IMPA or osteosarcoma. The sore ear could be a simple allergy flare yeast infection or a chronic AD dog with a stenotic calcified pseudomonas ear that might need a TECA. It's simply impossible to tell what needs a doctor or a mid-level associate and that frustration of thinking you're coming in for one thing with a PA and then being pushed to see a DVM is real. I've seen an assistant/tech appointment for anal gland expression turn into a doctor's appointment and booking for mass removal.

 

[SkiOtter]

2. What about clinic finances - primary care is the bread and butter of most practices, if that was taken over by midlevels, how would a DVM clinic be expected to survive, knowing that not all clients will be pursuing advanced diagnostics? Would higher level care or anything other than well visits and common sicknesses be then spread out even further, and made even less accessible to patients who need it? What would happen to the overall quality of vet med as a whole?

More to the point, a lot of GP vets go into vet med as much for the wellness appointments as they do the complex cases. The wellness appointments are a great breather for a GP to be able to have a mental break between the hard cases.

I would literally leave veterinary medicine entirely if I had to see only sick patients and no wellness. I love my wellness appointments. There is a reason I am not in ER or Urgent Care. I don’t want that life.

 

[SV88]

I agree with the general gist of your posts, and how students are often thrown into the crucible after graduation, BUT.....

You can never predict what your chosen field is going to be like in ANY discipline, whether it be medicine, engineering, business, whatever. For the vast majority of students, the experience that you get pre-professional school is NOT going to be fully reflective of the realities of the job, because when you are there in a student position you are shielded from a lot of it simply because you are inexperienced, don't have the knowledge base, etc - just as @DVMDream said.

I'll use a hockey analogy. If I spent hours and hours at the rink at stick-and-pucks practicing, and going to scrimmages....sure, I might get good at the mechanics of hockey, gain decent positional awareness, get good cardio, and all those building blocks. But when I'm thrown into my first real competitive game with a win on the line - when its not longer a scrimmage and the speed and aggression is real - things are extremely different and it takes time to adjust the knowledge base to the new environment. However, it's a catch 22 - I can't become accustomed to a game environment unless I play in a game, and I can't be effective in a game unless I have skill and practice because no team would take me and put me in a position of responsibility without it. We ideally would want students to come in with a full experience of what a job in veterinary medicine is like...but its impossible to give them that because they literally can't do the job first without the training. They will always be shielded from a lot of it simply because they are not vets (yet).

So how to we address this and best prepare our new graduates? Personally, I think that the answer lies way more on the early career mentoring side than the pre-vet school experience. Because then, you have the knowledge base to actually perform the job and you are going to be put in those stressful positions that a pre-vet student never would be. And unfortunately, early career mentoring quality is not something that can be standardized given how our system is currently set up. So this is a very long and roundabout way of saying that as of right now, I don't think there is a easy solution or that expecting more "practice" hours from pre-veterinary students will solve the issue.

The worry that I have is more along the lines of are the schools (old and new) going to be able to support the students adequately as our profession evolves? Not just with board pass rates, but tools to be successful as veterinarians. Tools like work/life balance, mental health awareness, boundaries, etc. I think the veterinarian has the highest burden on them, not just personally but as the leader of their respective teams. My experiences are my own, and I'm not saying the people I've interacted with are the majority, but it still really sucks to have an ER vet friend repeatedly tell you that "this is nothing like they prepared us for in school." (And she graduated 5 years ago from a well established program). I think the education process will need to change, and I have thoughts on that which I'll refrain from stating since I have not yet gotten accepted to a DVM program and experienced it myself. I think more clinic time and better mentorship is a great launching point.

At the end of the day, all I want is for people who go to school for 8+ years and take out six figures in debt to be happy and satisfied in their jobs. Not leave the field, not post on social media about not loving their patients, and not feel helpless and stuck in a position that they earn the highest amount of money but have no passion for the actual job. I have personally known veterinarians (far more than a couple) who had 50 small animal hours, 100 equine, and end up in small animal ER because it's a good income. The one downside of a teaching hospital is that it's not a real representation of the world, so even an ER rotation won't accurately mimic a private practice ER that isn't in a large hospital with a myriad of specialists. THAT'S what I think is missing, teaching hospitals or huge practices like AMC or Angell are not reality for the majority of veterinarians. The reality is Urgent Vet, or VEG, or some other type of ER where you aren't supported with specialists well. But that may be a completely different conversation.

TL;DR: Everyone deserves to be happy, or at least content, when they're 250k in debt and almost a decade of education in for a career.

 

[VeggieTrex]

Medical education generally needs to start evolving. There is simply too much information avaliable on any given subject. New research is published everyday, and parsing the relevant from the irrelevant is extremely important. Both when determining what to teach students, but also students ability to efficiently find additional resources.

I almost went down the Library and Information Studies path. Getting the right person to the right thing can make a huge difference.

 

[SV88]

What are your thoughts on having an intermediate job like a physicians assistant in Vet med? One that doesn't take as much schooling, but possibly could help bridge the gap between the technician and DVM in terms of being able to address and treat lower level concerns in most animals.
Less schooling, but still allowing some diagnostic ability would probably go a long way to addressing areas of true vet shortages maybe? Since with less schooling comes less debt and a better ability to live in a rural area and provide some basic services.

I think if we are going to consider mid-level roles, we need to look at the VTS communities. They've already got 4+ years, a boarded DVM (clinical practice) or specialist signing off, and they took an additional board exam. We already have these people in play in our field, we need to use them. I was working on my cardiology VTS before I made the swap to want to actually be a cardiologist. It's hard AF, some of the questions on the exam were ones that were at the level of my cardiologist. We have hundreds of VTS ECC, they can be used! Have them unblock cats, have your VTS surgery drape in and then close SQ/skin after the body wall, have your VTS IM handle their own appointment block for the stable chronic patients. There is a place for them, but before we get to that we need to use our credentialed staff better and get title protection for them. A credentialed technician can bring in $90k of gross revenue to a GP in one year, they are VALUABLE. They need to be valued and retained in the field, and compensated accordingly (better than unlicensed staff). That's got to be the first step before going to a MLP.

 

[JaynaAli]

I’m not in any way trying to downplay the education and knowledge that specialty-certified techs have (I’ve learned so much from techs during my training), but my issue with the increased tech duties you propose is liability. As vets we’re already liable for actions of staff, but there’s a jump in risk between “regular” tech tasks and minor surgery or diagnosing/medical decision making. Unblocking a cat seems simple enough but has LOTS of potential complications (bladder rupture, urethral injury, sedation/anesthesia complications, arrhythmias from hyperkalemia…) I am responsible for my choices and actions but I don’t want to be liable for someone else’s surgical or medical mistakes. I think some techs would be a little more hesitant to do things if full liability for their actions was on them.

 

[MixedAnimals77]

I think more clinic time and better mentorship is a great launching point.

At the end of the day, all I want is for people who go to school for 8+ years and take out six figures in debt to be happy and satisfied in their jobs. Not leave the field, not post on social media about not loving their patients, and not feel helpless and stuck in a position that they earn the highest amount of money but have no passion for the actual job.

I preach to my college kids about the debt and they get to experience the terrible clients but alot falls on deaf ears/think itll be different for them/choose to bury their head in the sand.

I think this is the romantacized part of vet med if you will. I agree everyone deserves to be happy and should be "content" with their job after that much schooling and $, however, this is where I argue that we should be mentoring people at the end of the day that this field is just a job. At some point it's just not worth it period just like any other job. Theres this notion around vet med especially in the prevet years that you should be happy and fulfilled and passionate about being a veterinarian. It's the biggest lie. I also think its part of the reason people are dissatisfied is because instead of looking at it as just a job alot of prevets/vets look at it as their identity. Then when reality comes around that it is just a job theyre stuck with the decision often because of the $ and time spent. If you think about it there's 168 hours in a week. If you work 40 of those hours that's less than 25% of your week. The satisfaction and passion needs to come from a person's own personal preferences/hobbies/etc. Setting that expectation is where I think we fail.

As for me I wouldn't say I'm dissatisfied or super content about my job. I'd also say I'm not burning with passionate about it. While I love some clients and pets I despise others. Overall I like the place I work at and my coworkers and have no plans to leave and overall try to do a good job because sick pets are depending on me. BUT it is just a job, I draw hard boundaries and thats how I stay sane. I recognized that early on and I had a plan B if didnt get in or it was going to cost me more than 200k. No matter what though, I'm always happier when I'm doing the things I want- taking my dogs to the ponds swimming, travelling. Heck if I won enough money to retire I'd be done. Maybe I'd do something here or there but I'd be on the next plane to a new country or hibernating for a few solid weeks doing almost virtually nothing just recouping and relaxing about my new found freedom from work. But that would be true for me if i was in any profession, because its just a job.

 

[battie]

At the end of the day, all I want is for people who go to school for 8+ years and take out six figures in debt to be happy and satisfied in their jobs. Not leave the field, not post on social media about not loving their patients, and not feel helpless and stuck in a position that they earn the highest amount of money but have no passion for the actual job. I have personally known veterinarians (far more than a couple) who had 50 small animal hours, 100 equine, and end up in small animal ER because it's a good income.

Agreed with the first half, that people deserve to be happy. I don't think anyone disagrees with you here.

But in regards to the bolded, that's on those doctors for making that choice, and on the clinics for fostering the culture that creates this negativity. There's a point where the schools' responsibility ends and the graduated doctor's responsibility begins (both the new grads and the old in charge of mentoring us newbies). This applies for any person in any profession. Once you graduate and you are looking for a job, you pick what you will and will not compromise on. Is the money worth the steep learning curve of ER? It was for me. I didn't have any true ER hours prior to vet school. But I really enjoy my job and have been super successful. Once someone has been in a job 4-6 months, you know if it's a right fit. You can go back to 2021 fall and see my posts about disliking my GP job (95% of my pre-vets hours were GP). I stuck it out cause I got pregnant much faster than I thought I would.

Like Jayna and Mixy said, this backend dissatisfaction won't be resolved by requiring every applicant to have X hours of experience in a, b, c categories because not all GOs, ERs, equine mobile, etc. are the same either. There are some ERs with a bad reputation in my area; where the quality of life isn't nearly as good as what we have. If someone only worked for them or us prior to vet school, they would be in the same predicament.

And most important is Mixy's point. We need to start teaching everyone in vet med it's a job. The standards we hold ourselves and the profession to are ridiculous tbh.

 

[SV88]

I’m not in any way trying to downplay the education and knowledge that specialty-certified techs have (I’ve learned so much from techs during my training), but my issue with the increased tech duties you propose is liability. As vets we’re already liable for actions of staff, but there’s a jump in risk between “regular” tech tasks and minor surgery or diagnosing/medical decision making. Unblocking a cat seems simple enough but has LOTS of potential complications (bladder rupture, urethral injury, sedation/anesthesia complications, arrhythmias from hyperkalemia…) I am responsible for my choices and actions but I don’t want to be liable for someone else’s surgical or medical mistakes. I think some techs would be a little more hesitant to do things if full liability for their actions was on them.

It does, but you've got VTS ECC who are far more trained and have done more than the incoming DVM intern. If a DVM is drowning in patients, has a seizure dog being triaged, a GDV rolling in, and a hemoabdomen getting a transfusion, then use your VTS! The VTS have had their knowledge AND skills signed off MULTIPLE times by a board-certified specialist, not to mention you'll have built up a solid relationship with them working together. A VTS has years of experience AFTER being a credentialed technician, the process is modeled after the DVM residency program. I'm not saying every single unblocking needs to be a VTS, and maybe the hyperkalemic laterally recumbent cat who needs calcium gluconate is one the DVM does. Heck, the moral of the story is if your day is going to crap and you need to be doing other things, use your well trained and experienced staff. A VTS is an expert in their field, and they deserve to be acknowledged and utilized for it. I guarantee you an ECC or IM VTS is fully prepared for complications, and they're not doing these things willy-nilly. The patients have been examined/evaluated, and directions/orders from their doctor (diplomat or ER) given, it's a team collaboration not just hiding in a back corner.

Liability wise, I've seen FAR sketchier things done by unlicensed staff which would be on the DVM's license/RVT's license (state depending). It's not just the DVM license that is a risk with liability, any credentialed technician can also be called before the board. I think that (way down the road) if we were to utilize a mid-level role or even the VTS at the highest capability of their licensure, and then the credentialed staff at the highest level of THEIR licensure, it would actually help people understand the risks and liability with each role. Right now, some private practice ERs are the wild west (in a bad way). I think more responsibility would also come with more respect for the process of credentialing / VTS specializations.

Again, our field is nowhere near that right now. Our more immediate issue is attrition of support staff, if we are churning out all these new DVMs (with and without the new programs) we need the support staff in place to allow the veterinarian to do their job.

 

[honeypot999]

Midwestern University Announces New College of Veterinary Medicine Proposal

Coretta Cosby Patterson, D.V.M., DACVIM-SA, will serve as the Dean of the proposed new College

www.midwestern.edu

And another one 🫠

 

[Cowsrcool]

Midwestern University Announces New College of Veterinary Medicine Proposal

Coretta Cosby Patterson, D.V.M., DACVIM-SA, will serve as the Dean of the proposed new College

www.midwestern.edu

And another one 🫠

Was just about to post this here.. sigh.. at what point do these new programs/schools popping up get turned down? Does the AVMA have the power to stop more schools from being opened? With many having the projection of opening in 2026 when does the pool become oversaturated

 

[battie]

Was just about to post this here.. sigh.. at what point do these new programs/schools popping up get turned down? Does the AVMA have the power to stop more schools from being opened? With many having the projection of opening in 2026 when does the pool become oversaturated

The AVMA has complete control through the COE because they are the only certifying force in the industry. However, they were sued by Western University for declining their bid because of their distributive method. Since then, the AVMA has not been willing to deny accreditation.

 

[supershorty]

Does the AVMA have the power to stop more schools from being opened?

The power? Yes.
The spine? Apparently not.

 

[MixedAnimals77]

I have a suspicion many of these new programs will struggle to get/stay accredited based on deficiencies we are seeing with a few current programs...most notably lack of appropriate staff for teaching.
TBD.
I'm sworn to confidentiality in my role but there are some interesting and potential changes coming down the pipeline-I'm hoping for the better if they come to fruition...ominous I know😆

 

[battie]

I'm sworn to confidentiality in my role but there are some interesting and potential changes coming down the pipeline-I'm hoping for the better if they come to fruition...ominous I know😆

Like I said previously, I'm just glad there is some fresh blood with recent vet school experience on the board. I'll stalk VIN for major updates.

 

[WhtsThFrequency]

The worry that I have is more along the lines of are the schools (old and new) going to be able to support the students adequately as our profession evolves? Not just with board pass rates, but tools to be successful as veterinarians. Tools like work/life balance, mental health awareness, boundaries, etc. I think the veterinarian has the highest burden on them, not just personally but as the leader of their respective teams. My experiences are my own, and I'm not saying the people I've interacted with are the majority, but it still really sucks to have an ER vet friend repeatedly tell you that "this is nothing like they prepared us for in school." (And she graduated 5 years ago from a well established program). I think the education process will need to change, and I have thoughts on that which I'll refrain from stating since I have not yet gotten accepted to a DVM program and experienced it myself. I think more clinic time and better mentorship is a great launching point.

So here's the question - is that really the schools' responsibility? And if so, how on earth are we going to add significant coaching/student support responsibilities on top of the current workload of our already overworked, underpaid, and burned out faculty?

We're doing this at my institution - adding both a formal longitudinal professional identity program AND what is essentially an individualized coaching program where we are assigned a set of students from each class and they meet with us regularly throughout their entire preclinical curriculum to discuss all of these issues in addition to academic strategies, etc. It is focused not on us being content experts to help them with the subject matter (which we already do), but rather acting as "life coaches" in a way. Sounds great right? Problem is, its just another thing on our already completely overloaded plates. We're exhausted. Our own work-life balance is dog**** most of the time. Faculty well-being is always put on the back burner compared to student well-being. And now in addition to all of the actual science/medicine curricular elements we are supposed to manage, and all our other service and research obligations that are necessary for maintenance of our position, we have to manage this too? I love working with students and helping them, both in actual medical science and in general mentoring...and I am going to do my absolute best with these additional responsibilities in these topics because I want all my students to succeed and be well-adjusted, happy people....but not going to lie, there is a part of me that is dreading the additional workload given how thin I am already spread, and how thinner I continue to be spread every year. Expecting existing faculty to also do all this in addition to what they are already having to do (much of which the students are blissfully ignorant of because they only really see us when we are actively in class with them)...we don't have the bandwidth.

The alternative to in-house/programmatic student mentoring and coaching is what, seminars every now and then on work-life balance, leadership, and mental strength and things like that? You know for a fact students are going to blow those off and snooze through 'em. They are far to wrapped up in learning the medicine to care. Putting yet another responsibility like this on the schools simply isn't feasible unless you literally hire more people to specifically focus on that - and with how university budgets are, that's a hard sell.

 

[WhtsThFrequency]

The tl;dr of the above is that (and I'm not dismissing your thoughts SV88, or saying that you can't get there from here - but I always try to advocate for faculty and "humanize" us to students on these forums who may not understand our position. Especially newer and younger faculty such as myself, because when the chips go down, we are the boots-on-the-ground(classroom?) workhorses.

I think its very easy for people not in academia to say "schools should do/be responsible for X, or schools should do/be responsible for Y" (whether X and Y refer to actual curriculum content/design/modification or more of the "life skills" realm that we are discussing, which sometimes blurs the line between mentoring and parenting), because they don't understand 1) the unfortunately glacial pace of academic change, 2) how overburdened faculty are and how much more we have to do behind the scenes that students are not aware of, 3) the continuing lack of state financial support for public institutions, and how what money we do acquire gets funneled into extremely rigid budgetary streams, 4) how much we really do love teaching and want to help and improve the system (or else why the heck would we take such a pay cut and be here), but many times we just don't have the bandwidth for everything being asked of us, and 5) how our own well-being and boundaries are just as important as the students'.

 

[SV88]

The AVMA has complete control through the COE because they are the only certifying force in the industry. However, they were sued by Western University for declining their bid because of their distributive method. Since then, the AVMA has not been willing to deny accreditation.

So what happens to the students who are in the initial class, and the school doesn't maintain or get accreditation? Is that a thing?

 

[Cowsrcool]

So what happens to the students who are in the initial class, and the school doesn't maintain or get accreditation? Is that a thing?

Any student who is at a school that loses accreditation does still graduate with their dvm it’s just they cannot accept new incoming classes (I think) (but also poses the question of are the students who stay at that school adequately supported or learning)

 

[WhtsThFrequency]

As far as I know, it depends on whether it is a downgrade situation to provisional versus a complete loss. With a loss, the school is not allowed to accept any more students and the current students would have to transfer to other schools with the AVMA's assistance. Your degree program would not be considered to be within an accredited institution, which would also more than likely prevent you from even taking the NAVLE.

To my knowledge this has not happened to any currently accredited veterinary or medical school, except for one MD school that briefly lost accreditation and some students did transfer, but I believe their accreditation was reinstated pretty soon after (ie months) in a provisional capacity. Kinda uncharted territory.

 

[battie]

So what happens to the students who are in the initial class, and the school doesn't maintain or get accreditation? Is that a thing?

Once the first class takes the NAVLE and graduates, the accreditation is evaluated. If there is a deficiency, then that school gets 1-2 years to fix that deficiency and may not be allowed to accept more students in that time. Depends on what the COE decides.

If the school fails it's provisional accreditation again, then they lose all accreditation and the students are transferred to a new institution and the school is closed.

This has not happened to a vet school in the last 30-40 years. But some of these parameters are truly objective (NAVLE pass rate as an example). So there's less wriggle room as more of these schools come on line

 

[SV88]

The tl;dr of the above is that (and I'm not dismissing your thoughts SV88, or saying that you can't get there from here - but I always try to advocate for faculty and "humanize" us to students on these forums who may not understand our position. Especially newer and younger faculty such as myself, because when the chips go down, we are the boots-on-the-ground(classroom?) workhorses.

I think its very easy for people not in academia to say "schools should do/be responsible for X, or schools should do/be responsible for Y" (whether X and Y refer to actual curriculum content/design/modification or more of the "life skills" realm that we are discussing, which sometimes blurs the line between mentoring and parenting), because they don't understand 1) the unfortunately glacial pace of academic change, 2) how overburdened faculty are and how much more we have to do behind the scenes that students are not aware of, 3) the continuing lack of state financial support for public institutions, and how what money we do acquire gets funneled into extremely rigid budgetary streams, 4) how much we really do love teaching and want to help and improve the system (or else why the heck would we take such a pay cut and be here), but many times we just don't have the bandwidth for everything being asked of us, and 5) how our own well-being and boundaries are just as important as the students'.

I know, no worries I just see it from a lot of different angles in my personal life, and I guess to me I wish that there was a better way to inform students. If you're 19, 20, 21, 22 going into the field you've probably got some degree of rose-colored glasses on. I totally agree that, for most of them, it wouldn't make a difference. They're determined and they're going to be a DVM come hell or high water. I just think it sucks for the few who really don't have a clue, haven't seen the reality, and sign up for the debt only to regret it on so many levels a few years later. That must be the epitome of feeling trapped, and that would worsen any mental health struggles they already have. To be fair, I'm sure this happens with other professional fields as well. Also, there are other avenues for DVMs besides clinical practice if they end up really hating it. I just have some firsthand experience with friends who have expressed those sentiments, and worse on NOMV, which I hate for them.

I also really think that academia (especially these new schools) are going to significantly suffer from not having enough support staff. When I worked at a teaching hospital, especially on some rotations like anesthesia, the teaching was HEAVILY influenced and reinforced by the technicians. If the faculty are already overburdened that really does not help the situation. Without a strong paraprofessional staff it will negatively impact that students experience on clinics being DOCTORS in training. If we are churning out new DVMs like this, we also need to stop the hemorrhage of technicians and assistants leaving in droves. Not only for the DVMs professionally when they've graduated, but through their training process as well. Faculty and residents have their own set of responsibilities to worry about.

And I agree with the sentiment that classes on finances/mental health and wellbeing/work/life balance would fall on deaf ears for a lot of the students who just want to learn the medicine. I guess I don't really have a good answer for the schools helping the students, as long as those avenues are available to those who want it. I would attend them FWIW. And you're correct that it's not entirely the responsibility of the program, their job is to produce veterinarians. It's the individual's job to want to care for themselves.

 

[DVMDream]

And I agree with the sentiment that classes on finances/mental health

So we had an entire guest lecture on financing and how to tackle/address the loans after graduation. It basically boiled down to: Don't buy a house, don't buy a new car, dump as much money as possible on the loans as quickly as you possibly can.

Which, seems like great advice, but veterinary graduates are adults often starting life. They want to settle into their own lives. They want to have a home to call their own. They don't want to drive their clunker for another 20 years. Some want to start families. Some want to travel. Some want to enjoy more than the barebone basics of life. There was no balance to the financial advice. It was an all or nothing view.

I didn't listen to it. I bought a house fairly soon after graduation and I am SO glad I did, had I listened to their advice I would have 2.5=3x the interest rate on a home loan and I likely would not have been able to afford purchasing a house. I purchased a car immediately after graduation as well, was my graduation present to myself. I have since paid that car off. I actually recently traded that car in and got another new car, wanted to upgrade to an SUV.

Are classes on finances a good idea? Yeah, if they are balanced, but I find anyone I have talked to had a similar financial discussion I received. Don't do anything, don't buy anything, don't live life, just pay loans and that isn't feasible advice. Sure, if you do that you will be set up well in the next 10-15 years, provided you don't burn yourself out and hurt your entire soul in the process.

 

[DVMDream]

We're doing this at my institution - adding both a formal longitudinal professional identity program AND what is essentially an individualized coaching program where we are assigned a set of students from each class and they meet with us regularly throughout their entire preclinical curriculum to discuss all of these issues in addition to academic strategies, etc. It is focused not on us being content experts to help them with the subject matter (which we already do), but rather acting as "life coaches" in a way. Sounds great right?

This actually sounds terrible. No offense to you, but you aren't a trained therapist, psychologist, counselor, etc. This just seems like a band-aid to fill a void that really should be filled by hiring professionals who can actually provide that support. I am sure you are doing the best you can with it and supporting your students, but damn, that is so not your job. They really should let you just focus on what is your job. Of course there is little chance they bring in trained professionals to provide that support, because, well, funding.

I really wish this country prioritized education and mental health more than we do and would provide funding for these things. It would help so many problems if we cared about these things and gave them adequate funding. But yanno, got have 3423422 military tanks and weapons we will rarely, if ever, need.

 

[SV88]

So we had an entire guest lecture on financing and how to tackle/address the loans after graduation. It basically boiled down to: Don't buy a house, don't buy a new car, dump as much money as possible on the loans as quickly as you possibly can.

Which, seems like great advice, but veterinary graduates are adults often starting life. They want to settle into their own lives. They want to have a home to call their own. They don't want to drive their clunker for another 20 years. Some want to start families. Some want to travel. Some want to enjoy more than the barebone basics of life. There was no balance to the financial advice. It was an all or nothing view.

I didn't listen to it. I bought a house fairly soon after graduation and I am SO glad I did, had I listened to their advice I would have 2.5=3x the interest rate on a home loan and I likely would not have been able to afford purchasing a house. I purchased a car immediately after graduation as well, was my graduation present to myself. I have since paid that car off. I actually recently traded that car in and got another new car, wanted to upgrade to an SUV.

Are classes on finances a good idea? Yeah, if they are balanced, but I find anyone I have talked to had a similar financial discussion I received. Don't do anything, don't buy anything, don't live life, just pay loans and that isn't feasible advice. Sure, if you do that you will be set up well in the next 10-15 years, provided you don't burn yourself out and hurt your entire soul in the process.

That sounds horrendous. That's one person's perspective, and it might work for the odd student who can live with their parents or have dual incomes. My husband is very budget conscious and he often watches videos on FIRE. Some of the people in the videos are able to successfully live off of one salary entirely and dump the second salary into loans, but that assumes you have two incomes to do so. Not everyone coming out of veterinary school, actually I would say very few people, is in that position.

I think the education needs to be a process, which honestly needs to start earlier in the education system. Taxes? Health insurance deductible vs OOP maximum? Interest rates? Credit? Savings with compound interest? All of that plays in, none of which would be done in a single lecture session. If the sessions are just someone preaching to you, blegh, that's a total waste of time.

 

[battie]

which honestly needs to start earlier in the education system.

AKA high school. Cause all those considerations are a factor in every single job out there.

 

[SV88]

AKA high school. Cause all those considerations are a factor in every single job out there.

Ah yes, when humans are at their most impressionable and want to invest every ounce of attention they have on long term finances....... Honestly, maybe our country is just SOL. 😆

 

[battie]

Ah yes, when humans are at their most impressionable and want to invest every ounce of attention they have on long term finances....... Honestly, maybe our country is just SOL. 😆

I mean, we're making the argument that vet school is way too late, which is absolutely true. Gotta start somewhere. A basic personal finance class is way more worthwhile overall than any math above algebra for the average American. Hell, calculus was a waste of my time for sure. Should have taken statistics unfortunately.

Nerd wallet had a great podcast with a high school finance teacher last week or the week before where he puts it all in context for teenagers. Cause you're right, high schoolers don't care about retirement or anything like that. But he now has the most popular elective in the school cause he puts money in context for them rather than the BS we get in vet school.

Granted, if we had better early personal finance education in high school, I feel there would be a steady shift in higher education where more people would go into the trades or not go to school at all. Which, honestly, isn't a bad thing.

 

[thenontraveler]

I mean, we're making the argument that vet school is way too late, which is absolutely true. Gotta start somewhere. A basic personal finance class is way more worthwhile overall than any math above algebra for the average American. Hell, calculus was a waste of my time for sure. Should have taken statistics unfortunately.

Nerd wallet had a great podcast with a high school finance teacher last week or the week before where he puts it all in context for teenagers. Cause you're right, high schoolers don't care about retirement or anything like that. But he now has the most popular elective in the school cause he puts money in context for them rather than the BS we get in vet school.

Granted, if we had better early personal finance education in high school, I feel there would be a steady shift in higher education where more people would go into the trades or not go to school at all. Which, honestly, isn't a bad thing.

I took a 2 credit personal finance class my last term of college to fill in my full time status and it was the best thing I ever did. My mom was a HUGE follower of the "don't take on any debt, Dave Ramsey cult" and I also followed that until I learned how to manage debt within the boundaries of the life I want to live. I am so glad I got that course because it has allowed me to do quite a bit more with my life than would have been possible had I continued to follow what my mom taught me growing up.
I think a finance class actually drawing from a new grads actual reality is a great idea (in undergrad or high school) I think waiting until vet school or medical school is WAAAAY too late.
I also think it should start early and add on, so it's a more thoroughly understood topic than just a single class can cover.
Start talking about how to add up costs in elementary school, comparison shop and how to calculate interest on a car loan or a house loan by using real world examples.
Talk about how credit cards actually work (not free money) and how to responsibly build credit so kids are not out on their own at 18 making bad choice for lack of knowing. Most parents don't even know how the world works anymore so it is really hard to rely on that for all the financial advice.

This turned into a much longer post than I thought. Apparently I feel very strongly about solid financial education for kids 🤣

 

[battie]

Most parents don't even know how the world works anymore so it is really hard to rely on that for all the financial advice.

This is a huge factor for me. I didn't know what I didn't know, right, so when I inherited a family member's life insurance policy, I just let it sit. I should have done a lot more with it in hindsight. I have a friend who is not willing to do any sort of stock market thing like an index fund cause it scares him. But for most people, the stock market would be a great supplement for retirement.

And completely agree with the Dave Ramsey thing. And the only debt I have is student loans and the house. I do follow the snowball method for my loans where I try to focus mostly on the highest interest. We try really hard not to take on more debt (I'm going to be willing to for a new deck in the fall, though). But that's not realistic any longer for the average American.

 

[WhtsThFrequency]

This actually sounds terrible. No offense to you, but you aren't a trained therapist, psychologist, counselor, etc. This just seems like a band-aid to fill a void that really should be filled by hiring professionals who can actually provide that support. I am sure you are doing the best you can with it and supporting your students, but damn, that is so not your job. They really should let you just focus on what is your job. Of course there is little chance they bring in trained professionals to provide that support, because, well, funding.

I really wish this country prioritized education and mental health more than we do and would provide funding for these things. It would help so many problems if we cared about these things and gave them adequate funding. But yanno, got have 3423422 military tanks and weapons we will rarely, if ever, need.

Yeahhhh exactly. I mean, I’ve definitely “mentored”/helped students in these things before, but that’s been more informal and with those who chose to open up to me with someone I could help with.

We are gettin trained for it of course (read:more meetings and seminars I have to go to :/ )and it isn’t really meant to be like a true therapy thing (thank goodness - they emphasize that we are NOT counselors and are supposed to refer to students to help for stuff like that) , but it’s also like…I’m not sure what tf we are supposed to do then. It seems very nebulous and time consuming. Guidance in goal development, helping them find their identity, helping them develop conscientious behaviors, stuff like that….