New vet schools

[battie]

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boss lady is big on keeping things in house. Her philosophy is why let someone pay $6k (or more) for a splenectomy at Referral Hospital when we can do it here for half or less and still do a quality job?

I'm purposely externing for 2 weeks at a nearby "specialty" hospital where the vets try to keep everything in house and maybe 1/4 to 1/3 of them are actually boarded. They just do very focused CE in areas they're interested in. I know I will most likely end up in small animal GP or ER (or both?) and I don't want to refer everything out.

Unfortunately, I think this kind of mentality in GPs has really fueled the slant toward increasing specialist care to the point where many places are referring even the more routine surgeries and newer GPs to that practice don't get the mentorship (especially surgical) that would allow them to feel comfortable keeping those things in house. And so the cycle continues, which is unfortunate.

I think part of this problem is also coming from the vet school. We have a great variety of clinicians being "encouraging" of a GP doing things. Our ophthalmologist is all about GPs doing their thing and doing procedures they are comfortable with. She just says, "This is technically more difficult, but the info is out in the literature and at CEs. So if you want to do this as a GP, go for it if you're comfortable." However, some of our internists are like, "This is for referral only!!!" when that simply isn't (or can't) be the case. So we are taught things that the specialist will do only in a specialist setting, or are encouraged to do it only in a specialist setting rather as GPs. So grads are encouraged to not feel comfortable to do it.

 

[LetItSnow]

That's wild, but unfortunately I get it. GP is so non-standardized that you have no way of knowing what kind of medicine that person has been practicing during their time out.

That is precisely it.

I think most clients appreciates the continuity of care, but I also understand that not every GP wants to be doing an emergent splenectomy or managing a blood transfusion or whatever.

And at some point - how many things can you be an expert at? Can you as one individual do GOOD orthopedics work and GOOD internal medicine work (including ultrasounds and scoping and bone marrow aspirates and ...) and GOOD emergency/stabilization work and GOOD general practice work?

I personally don't think so. The cost of keeping that equipment, and staying current with using it, and .... meh. I don't know that I think it's feasible.

I think you can maybe have a larger general practice that has doctors with extended interests into those areas. Sorta one of those "oh yeah, Dr. A loves orthopedics and Dr. B loves internal medicine stuff" but for a typical general practice clinic? Probably not. And with so many of those patients requiring overnight care and it becoming more standard of care to only hospitalize with on-site staff .... it's tough.

I also think scheduling/revenue is making it a challenge for general practices to do good emergency work. I don't know personally, but my impression from the referring community is that more and more they are so tightly scheduled (in order to stay profitable) that when they DO get an emergent case, they often don't have the human resources to handle it, even if they do have the skill and equipment.

 

[LetItSnow]

And, of course, referral medicine begets referral medicine to some extent, which isn't necessarily fair to the GP. For some % of our owner population, they will want "the best" and if they know there's a specialist, they'll want that.

We love to talk about the quality we provide in referral medicine. And in truth, we do provide a higher level of care than most general practices. No getting around that. But at some level it also sounds - unintentionally - like we're saying general practices aren't providing quality medicine, when in fact most of them are.

I often question whether the higher level is necessary. This kinda dovetails to that comment I made last week about a vague feeling that maybe we're pushing standard of care too high and should take it back a notch to allow people to practice adequate medicine rather than ever-pushing for the highest level of care possible.

 

[Georgethecat]

Now that I'm dealing with football withdrawal symptoms....I decided to dig up a pdf that I found several years ago. It's a chart that Stanford (2014) put together on the cost for US vet schools. I also, in a moment of boredom, decided to update that chart. In almost every case, seats have been added at each school and costs have risen a fair amount. I went to each vet school's website and obtained the # of seats and cost data directly from the source. Please excuse, and point out 😉, any errors. Gotta say that some schools made it VERY difficult to find what should be transparent information.

For comparison's sake, I will post both pdf's.

 

[DVMDream]

Those are valid points, and like I said, limited licensure comes with negatives. But I also think you're exaggerating the downside to make it seem as bad as possible.

The question shouldn't be "would it make things more difficult for some people" ... the answer to ANY CHANGE will always be "yup." You can't implement changes that are 100% positive for every person invested in the issue. The question is "overall, would it be a benefit"; i.e. would it help more people than it hurts. And I think the answer to that is yes.

You describe it as going to school "basically 3 separate times" but I didn't say that. When <I> think of limited licensure (and god knows it would take years of industry experts deciding how it really should be best implemented) I think of something more like tracking-on-steroids. Plenty of schools already do tracking; this would just take it a bit further. And then testing into whatever area you wanted. It would have to be done in a way that still allowed people to do multiple areas if they wanted, but also that allowed people who did not want that flexibility to dig deeper into their area of expertise. I personally would have benefited from not taking equine/bovine/etc classes and instead diving deeper into emergency medicine, imaging (esp sonography), etc. It also would benefit by reducing the overall class load that was necessary if someone did feel comfortable locking into an area of practice. That translates to substantial cost savings, which also helps mitigate that whole debt/pressure issue that you talked about. At several thousand dollars a class, how much could I have saved not taking avian/bovine/porcine/equine/whatever classes?



I agree that that is a risk - there's a sense of "oh ****, now I have even fewer doors than I had before". It's not quite as bad as you say because a) not really THAT many people move between those areas (except perhaps LA/Equine to SA), and b) some of those areas you used as an example don't necessary require a license for the job (some industry, some research, etc.). But yes, it definitely could have that effect for some people.

I definitely agree there are negatives. Absolutely no question. I just see the benefits as outweighing those negatives. Or, at a minimum, those negatives are something to be considered when crafting the system to help minimize or avoid them. I understand your disagreement, though.

So how are you going to tell an owner of a rabbit that presents to your ER that all the vets present can't treat the rabbit because they are only licensed in dog/cat medicine? We don't currently have enough distinction within current veterinary medicine to do this. The general public already can't differentiate what is really an emergency and what isn't? Who is going to retrain the public that not all vets are the same (I mean we know this to be true currently, but the public does not). Are we going to open up ER clinics specific for exotic pets?


You've mentioned jumping to what I am currently doing at some point and you wouldn't be able to jump to this position if limited licensing was a thing. Heck something as simple as going from GP to shelter medicine which a lot of vets do wouldn't be possible with limited licenses. How much will the cost for licensing at each state board increase since now they have to evaluate exactly what species every vet is allowed to practice on?

I think you are making it much more simplified than it actually will be in reality to be honest.

 

[that redhead]

@batsenecal @LetItSnow The hospital I work in is definitely larger- seven doctors and lots of support staff. We admittedly have our niches- for example, I do all of the exotics and am building my surgery skills with boss lady; two do ultrasounds (I’d also like to learn this better). We all do very high quality dental work. But we’re all quite capable with stabilizing or working up weird med cases. We also know when there’s not much else we’re capable of doing.

As for emergent (or “emergent”) cases, we charge an ER fee and we fit them in. Sometimes it means staying late or seeing two cases at once but we make it work and clients are grateful not to have to pay a referral clinic to make their dog vomit or treat their week-long ear infection.

As for referrals, I still will always offer people the referral for the more complex cases or non-responders (derm, anyone?) But many people do not want to spend that money, and as someone practicing in a relatively affluent area, I can only imagine other places are even harder to convince clients to go. I don’t think that means “good enough is good enough” should prevail, though; I think GPs should be stepping up their game (within reason).

 

[DVMDream]

(And even further down the road, I think ER will almost certainly become its own boarded specialty if the field continues down the road it's on.)

If this does happens how are boards going to determine what is ER vs what is something a GP can do? I mean does a pyo fall into ER? Can a GP stabilize a HBC or is that not allowed since technically it is ER medicine?

Yeah, I certainly hope that never happens.

 

[that redhead]

If this does happens how are boards going to determine what is ER vs what is something a GP can do? I mean does a pyo fall into ER? Can a GP stabilize a HBC or is that not allowed since technically it is ER medicine?

Just like other specialties? Like you can be a boarded radiologist and I can be a GP and I’m still allowed to do an AUS? Just because something is commonly done in specialty practice doesn’t mean a GP is going to be stopped from doing it; I think we naturally self-limit in those cases.

 

[LetItSnow]

So how are you going to tell an owner of a rabbit that presents to your ER that all the vets present can't treat the rabbit because they are only licensed in dog/cat medicine?

Exactly how we already do it. We made that decision a few years ago in our practice; none of our 5 ERs or 2 ER/referral hospitals treat anything other than cats and dogs. It has not been the problem you think it would be. When I started we did treat those species (and I sorta miss treating rabbits in particular); as a practice our doctors decided we would stop.

I'm not sure where I said I think it would be simple. In fact, my comment about it taking years of expert consideration strongly implies that I understand it is anything but simple.

 

[LetItSnow]

If this does happens how are boards going to determine what is ER vs what is something a GP can do? I mean does a pyo fall into ER? Can a GP stabilize a HBC or is that not allowed since technically it is ER medicine?

Yeah, I certainly hope that never happens.

I don't understand the point. There are already plenty of specialties that overlap with GPs. GPs do surgery, yet there are boarded surgeons. GPs do dentistry, yet their are veterinary dentists. GPs do just about everything for which there are boarded specialists. How would ER be any different?

And yes, a GP should certainly stabilize a patient to the best of their ability and utilize medical judgment as to whether it's likely to benefit the patient more to take time to stabilize or likely to benefit the patient more to get them to a higher-care facility more quickly. That's a judgment call, and often a difficult one. But I don't see what it has to do with boarding?

Sorry, I'm not tracking the point. Elaborate?

 

[DVMDream]

One thing I like about my current (GP) job is that we do a lot of stuff on our own, despite having some big referral centers quite close by. I think the most common thing we end up referring for is overnight care because we don't have eyes on patients 24/7. Certain docs I've worked with here and elsewhere don't want to do the more involved things and would rather refer sooner, but boss lady is big on keeping things in house. Her philosophy is why let someone pay $6k (or more) for a splenectomy at Referral Hospital when we can do it here for half or less and still do a quality job? I think most clients appreciates the continuity of care, but I also understand that not every GP wants to be doing an emergent splenectomy or managing a blood transfusion or whatever. Unfortunately, I think this kind of mentality in GPs has really fueled the slant toward increasing specialist care to the point where many places are referring even the more routine surgeries and newer GPs to that practice don't get the mentorship (especially surgical) that would allow them to feel comfortable keeping those things in house. And so the cycle continues, which is unfortunate.

The biggest reason I had to refer most things is because I would be alone or with one other doctor and the clinics I worked at packed the schedule full easily a week in advance then would regularly "fit in" things, so I'd be seeing a patient at least every 10-20 minutes. I can't really work in an ER surgery. Not only that most clinics I worked at the tech staff were on the job trained people straight out of high school who'd have no clue what a PVC is or what to watch for. The skill levels of the tech varied from I have barely been here and I can maybe walk a pet around the building to I can monitor anesthesia but really only for the bare basics.

I have had to regularly stop to train techs on drawing blood, restraint or how to work a damn microscope.

Not all GP clinics are the same, attempting an bigger surgery at most of the clinics I worked at was not going to happen.


It isn't really the mentality of "I don't want to" but more the realization that for many GP's they really can't do those ER cases without significant risk to the patient.

And if I had a big boss lady pushing me around telling me I had to keep an emergent case, I wouldn't stick around that clinic long. I actually had an office manager tell me I had to offer to do a GDV on a 10 year old Great Dane who was having audible arrhythmias at the GP clinic in the middle of the day with a full schedule of appointments, another surgery already occurring and a tech staff that had never seen one of these done, let alone know the complications to be monitoring for during anesthesia. Neither myself or the other vet had cut one. I point blank told her that wasn't going to happen, dog would be offered best care for it and if that wasn't possible, then would offer to consider in house, then euthanasia. She wasn't happy, but I will not risk my license because of a bossy owner or office manager and I will offer best care to the pets.

 

[LetItSnow]

. She wasn't happy, but I will not risk my license because of a bossy owner or office manager and I will offer best care to the pets.

That story highlights one of my biggest peeves with this industry. Wayyyyyyyyyyy too many medical decisions are being made by support staff, officer managers, etc. Or, at least, way too much pressure is being put on doctors by them.

I was talking with my staff about this on a quiet night recently and I commented that I didn't think it really made sense that in this industry there's this trend of a CVT (or whatever term your state uses? LVT? Etc - you know what I mean) becoming a practice manager, and one practice after another has a "former tech" as a manager. The specific example we were talking about was some medication stocking decisions that came out of hospital management without ANY consultation with the DVM staff. Just this email letting us know we're getting rid of rimadyl chewable and going to generic carprofen tabs. I had a hissy fit (along with a few other doctors) because when I tell techs to 1/4th 75mg caps ... #1 it doesn't work well, and #2 the techs give me grief. And, of course, it's easier for an owner to give the chewables. Why the heck was a former tech (who hasn't actually worked on the floor in many years) making that decision without input from the medical staff?

They all looked at me and rolled their eyes and were like "yeah, but you doctors can't run it... you'd give all the services away and none of you know anything about money."

I just sat there thinking "and techs do?" Like, what inherently makes techs good at managing a hospital?

I still don't get it.

 

[DVMDream]

I don't understand the point. There are always plenty of specialties that overlap with GPs. GPs do surgery, yet there are boarded surgeons. GPs do dentistry, yet their are veterinary dentists. GPs do just about everything for which there are boarded specialists. How would ER be any different?

And yes, a GP should certainly stabilize a patient to the best of their ability and utilize medical judgment as to whether it's likely to benefit the patient more to take time to stabilize or likely to benefit the patient more to get them to a higher-care facility more quickly. That's a judgment call, and often a difficult one. But I don't see what it has to do with boarding?

Sorry, I'm not tracking the point. Elaborate?

I guess it is more so when the vet boards will decide that that particular procedure or problem has to be done by a boarded specialist and start penalizing GP vets for doing certain procedures. I just see the more specialties we develop the more likely it is going to go the way of GP only being able to do spay/neuter, clean teeth (no extractions), simple lacerations and vaccines/preventive care, maybe mildly affected skin/ears and that will be it that at some point the vet boards will decide we have to refer for x procedures or y cases.

I guess I am confused by you too, you keep saying we need to back off on specialization in the field but at the same time are arguing for more specialization (limited licensure is creating more specialization)?

 

[that redhead]

The biggest reason I had to refer most things is because I would be alone or with one other doctor and the clinics I worked at packed the schedule full easily a week in advance then would regularly "fit in" things, so I'd be seeing a patient at least every 10-20 minutes. I can't really work in an ER surgery. Not only that most clinics I worked at the tech staff were on the job trained people straight out of high school who'd have no clue what a PVC is or what to watch for. The skill levels of the tech varied from I have barely been here and I can maybe walk a pet around the building to I can monitor anesthesia but really only for the bare basics.

I have had to regularly stop to train techs on drawing blood, restraint or how to work a damn microscope.

Not all GP clinics are the same, attempting an bigger surgery at most of the clinics I worked at was not going to happen.


It isn't really the mentality of "I don't want to" but more the realization that for many GP's they really can't do those ER cases without significant risk to the patient.

And if I had a big boss lady pushing me around telling me I had to keep an emergent case, I wouldn't stick around that clinic long. I actually had an office manager tell me I had to offer to do a GDV on a 10 year old Great Dane who was having audible arrhythmias at the GP clinic in the middle of the day with a full schedule of appointments, another surgery already occurring and a tech staff that had never seen one of these done, let alone know the complications to be monitoring for during anesthesia. Neither myself or the other vet had cut one. I point blank told her that wasn't going to happen, dog would be offered best care for it and if that wasn't possible, then would offer to consider in house, then euthanasia. She wasn't happy, but I will not risk my license because of a bossy owner or office manager and I will offer best care to the pets.

I’ve been working solo at our sister clinic for a bit now, and I totally hear you on that. My OM doesn’t get it and will schedule a wellness spot when I’m in a dental that needs like a million extractions. It’s gotten much better but SO frustrating at first.

My previous clinic was like that with unskilled labor, doctors doing tech stuff and just not good quality of medicine. I left and I’m SO much happier for it. My current boss, while a no nonsense tough cookie, is someone I respect and who also trusts my judgement. I would have referred that GDV without blinking! And occasionally there are cases (when I’m solo) that I can’t manage as the only doctor there. You’ve got to know your limits and protect your boundaries for sure. Non-vets in the practice don’t usually “get it”.

 

[DVMDream]

That story highlights one of my biggest peeves with this industry. Wayyyyyyyyyyy too many medical decisions are being made by support staff, officer managers, etc. Or, at least, way too much pressure is being put on doctors by them.

I was talking with my staff about this on a quiet night recently and I commented that I didn't think it really made sense that in this industry there's this trend of a CVT (or whatever term your state uses? LVT? Etc - you know what I mean) becoming a practice manager, and one practice after another has a "former tech" as a manager.

They all looked at me and rolled their eyes and were like "yeah, but you doctors can't run it... you'd give all the services away and none of you know anything about money."

I just sat there thinking "and techs do?" Like, what inherently makes techs good at managing a hospital?

I still don't get it.

Most of the office managers around here were former receptionists, they don't know anything about medicine or tech work.

And most of our techs aren't licensed, because this state doesn't require licensing to be a vet tech.

 

[that redhead]

My previous job actually had a great OM. Not a tech or receptionist and not any formal training but she was just a good leader by nature, stuck up for the docs, etc. Although I like my current place better, one OM is a former tech (she’s solid but is too much of a weenie with nasty clients) and the other is more business oriented and her lack of ANY medical understanding is such a pain...

 

[DVMDream]

I had an office manager tell me that fixing a laceration isn't surgery, when she squeezed in a dog with a laceration and I told her we really aren't going to be able to fit in a surgical procedure that particular day. I told her that I'd be happy to still look at it to be sure it needed surgery, but if it did need surgery, I would have to refer it and she kept telling me it isn't surgery.

 

[LetItSnow]

I guess it is more so when the vet boards will decide that that particular procedure or problem has to be done by a boarded specialist and start penalizing GP vets for doing certain procedures. I just see the more specialties we develop the more likely it is going to go the way of GP only being able to do spay/neuter, clean teeth (no extractions), simple lacerations and vaccines/preventive care, maybe mildly affected skin/ears and that will be it that at some point the vet boards will decide we have to refer for x procedures or y cases.

I guess I am confused by you too, you keep saying we need to back off on specialization in the field but at the same time are arguing for more specialization (limited licensure is creating more specialization)?

Fair. I didn't mean to be confusing, but I can see that.

Partly ---- I have my own 'confusion' on it. Not really confusion, but ... I have mixed feelings, some that are contradictory, yanno? I'm not an expert on all things wrong with the field, so some of my thoughts probably contradict others. My fault.

I don't think we should limit GPs from doing that stuff. I think we <have> to let GPs continue doing that stuff, because otherwise a lot of that becomes unaffordable for some % of clients, and that's not good for our patients. I would be disappointed if state boards started saying things like "woahhhhhhh, that GP did a TPLO? Not ok." I don't see that anywhere in the near future, provided the procedure is done meeting standard of care?

But also partly - I don't think of limited licensure as more specialized in the same sense we talk about medical specialization. I think of it more as ... focused, maybe.

There's a subtle nuance to it that is different for me, and I think it's reflected in how I think about it from an educational standpoint. I don't think of limited licensure as extending the time it takes to do a DVM, whereas specialization I think does extend the educational period (internship+residency).

Sorry, that probably doesn't help clarify much. 🙂

 

[DVMDream]

Sorry, that probably doesn't help clarify much. 🙂

No, it makes sense. But how would you jump from ER to join me at this uber cool job if limited licensure were a thing? 😉

 

[battie]

Now that I'm dealing with football withdrawal symptoms....I decided to dig up a pdf that I found several years ago. It's a chart that Stanford (2014) put together on the cost for US vet schools. I also, in a moment of boredom, decided to update that chart. In almost every case, seats have been added at each school and costs have risen a fair amount. I went to each vet school's website and obtained the # of seats and cost data directly from the source. Please excuse, and point out 😉, any errors. Gotta say that some schools made it VERY difficult to find what should be transparent information.

For comparison's sake, I will post both pdf's.

For your Iowa contract seat tuition, if you're talking about Nebraskans that do the 2+2 program, then they pay in state tuition (at least they did when undergrad friends went through the program).

 

[Georgethecat]

For your Iowa contract seat tuition, if you're talking about Nebraskans that do the 2+2 program, then they pay in state tuition (at least they did when undergrad friends went through the program).

If info regarding contract seats wasn't readily apparent on the school website, I moved on. But that's good information for Iowa St 🙂. The WSU info kind of made my head hurt. Lots of options there with Pullman, Logan and Bozeman. If I got any of that mixed up, please let me know!

Bottom line is I was trying to provide in a consolidated format general info on current # of seats per school and the price tags involved.

There's no one right way to pick a vet school to apply to.....but cost has to be a BIG concern. If your application isn't a good fit for your instate or you don't have an instate school, you should give some serious thought as to which school/schools your application would be competitive for and establishing residency. Yes, it delays you by a year and might not be feasible for some due to familial obligations (savings from $100k - $150k plus interest amortization), but it's worth consideration.

Not sure I have much faith in universities' pre-vet advising, especially as it pertains to cost......... And it's no easy task to try and manage life/school/work etc as a pre-vet student. Kind of aggravating to find so much out of date/conflicting/or just wrong info on the few site like AAVMC or VIN that do provide comprehensive information (I get it that they probably rely on the vet schools to send them up to date info). I'll syop my ramblings now.

 

[Coopah]

If info regarding contract seats wasn't readily apparent on the school website, I moved on. But that's good information for Iowa St 🙂. The WSU info kind of made my head hurt. Lots of options there with Pullman, Logan and Bozeman. If I got any of that mixed up, please let me know!

Bottom line is I was trying to provide in a consolidated format general info on current # of seats per school and the price tags involved.

There's no one right way to pick a vet school to apply to.....but cost has to be a BIG concern. If your application isn't a good fit for your instate or you don't have an instate school, you should give some serious thought as to which school/schools your application would be competitive for and establishing residency. Yes, it delays you by a year and might not be feasible for some due to familial obligations (savings from $100k - $150k plus interest amortization), but it's worth consideration.

Not sure I have much faith in universities' pre-vet advising, especially as it pertains to cost......... And it's no easy task to try and manage life/school/work etc as a pre-vet student. Kind of aggravating to find so much out of date/conflicting/or just wrong info on the few site like AAVMC or VIN that do provide comprehensive information (I get it that they probably rely on the vet schools to send them up to date info). I'll syop my ramblings now.

Your files made me happy, but I'm a weirdo with a strange love of excel and finances. It's super cool to look at OOS tuition compared to other schools! Unfortunately, it doesn't take cost of living into account, and while Davis is super low for tuition OOS, it does have high COL. Also, it doesn't necessarily take into consideration average tuition increases, or things like medical insurance that the school doesn't cover or charges for, but not everyone needs that so I completely understand excluding it (please ignore me). Anyways this was super cool, and thanks!

 

[Georgethecat]

Your files made me happy, but I'm a weirdo with a strange love of excel and finances. It's super cool to look at OOS tuition compared to other schools! Unfortunately, it doesn't take cost of living into account, and while Davis is super low for tuition OOS, it does have high COL. Also, it doesn't necessarily take into consideration average tuition increases, or things like medical insurance that the school doesn't cover or charges for, but not everyone needs that so I completely understand excluding it (please ignore me). Anyways this was super cool, and thanks!

I also have a strange love of excel, numbers, and finances. Glad I could brighten someone's day 🙂.

I did briefly consider including things like COL and insurance, but dropped it because every school handles insurance differently. Some people might still be on their parent's insurance or on a spouse's insurance. Some areas I could make a reasonable guess on COL (Davis & UPenn having high COL for instance), but a lot of places like Minnesota I know nada about. And no matter the location, each person is going to have a different standard of living. I also take the VIN COL estimate with a grain of salt. Their estimated COL for CSU has to be low based on what I've read on SDN and from family who lives in CO.

Also thought about average tuition increases, but most schools do NOT make that information readily available to the public. Texas A&M was the exception and listed prices for the next 4 years. For IS it was $24,654, $25,544, $25,723, $27,826 for years 1-4. It was hard enough to find info on whether or not schools charged extra for the clinical summer between 3rd and 4th years.

The historical data was very interesting to me. Wisconsin used to be a great deal for both IS and OOS. Since 2014 IS tuition has risen by 68% and OOS has risen by 96%!!!!!

 

[Coopah]

I also have a strange love of excel, numbers, and finances. Glad I could brighten someone's day 🙂.

I did briefly consider including things like COL and insurance, but dropped it because every school handles insurance differently. Some people might still be on their parent's insurance or on a spouse's insurance. Some areas I could make a reasonable guess on COL (Davis & UPenn having high COL for instance), but a lot of places like Minnesota I know nada about. And no matter the location, each person is going to have a different standard of living. I also take the VIN COL estimate with a grain of salt. Their estimated COL for CSU has to be low based on what I've read on SDN and from family who lives in CO.

Also thought about average tuition increases, but most schools do NOT make that information readily available to the public. Texas A&M was the exception and listed prices for the next 4 years. For IS it was $24,654, $25,544, $25,723, $27,826 for years 1-4. It was hard enough to find info on whether or not schools charged extra for the clinical summer between 3rd and 4th years.

The historical data was very interesting to me. Wisconsin used to be a great deal for both IS and OOS. Since 2014 IS tuition has risen by 68% and OOS has risen by 96%!!!!!

Fascinating! It's things like Wisconsin that sadden me, because there is no reason for it to have risen that much other than they saw other schools charging that much and realized they could get away with it

 

[twelvetigers]

Now where did all the pre-vets go, since we have had a very civil and fleshed-out conversation about our concerns?

 

[Georgethecat]

Fascinating! It's things like Wisconsin that sadden me, because there is no reason for it to have risen that much other than they saw other schools charging that much and realized they could get away with it

Google is one of my other friends.... Appears tough times fiscally for the state of Wisconsin, state funding cuts, and they recognized that it was cheaper to go to Wisco OOS than Illinois IS at that time.

Office of the Chancellor

The chancellor of the University of Wisconsin–Madison leads a flagship public land-grant and research university that, guided by the Wisconsin Idea, advances learning, discovery, and public service to benefit communities across Wisconsin and around the world. #12 Among public universities U.S...

chancellor.wisc.edu

 

[battie]

It's crazy for the Wisconsin numbers. One of their faculty interviewed here at Illinois after they changed their tuition price. At the student meet and greet, she was surprised at how many people had applied for our class. Their applications dropped to below 800 after they changed their tuition.

 

[ilovebirds]

Now where did all the pre-vets go, since we have had a very civil and fleshed-out conversation about our concerns?

Hello, pre-vet here. This discussion is much more productive now and I want to participate. I wanted to ask a question going back to opening new vet schools and people filling those seats. When I joined SDN last summer, I remember the two mantras were “rankings don’t matter and go to the cheapest option.” Do you guys think that vetmed will start moving in the direction where ranking *does* matter?

My second question, I guess kind of related to the first but also not really, is if you think unqualified candidates will be admitted. I feel unqualified saying this myself as I haven’t heard back from any school with a final decision (ugh waiting SUCKS), but from stalking *alllll* the threads it seems like there are a lot of people who apply with lower stats that don’t get in. Not knocking anyone with lower stats at all because grades are not always my friend either, but I guess as someone with one foot inside and outside of this profession, I wonder if the less-than-stellar candidate will get in simply bc they are willing to pay whatever it takes to get in and those schools need students. Hopefully that doesn’t come off as b*tchy, I’m just genuinely curious.

 

[Doggo Labs]

For your Iowa contract seat tuition, if you're talking about Nebraskans that do the 2+2 program, then they pay in state tuition (at least they did when undergrad friends went through the program).

This is still true, about 27 seats are NE students and they pay instate all four years, the others contract seats are from SD (I know SD pays the OOS/IS tuition so students only pay IS tuition all four years), ND, and CT (not sure what they pay for tuition).

 

[deleted676737]

This is still true, about 27 seats are NE students and they pay instate all four years, the others contract seats are from SD (I know SD pays the OOS/IS tuition so students only pay IS tuition all four years), ND, and CT (not sure what they pay for tuition).

Oh, did CT get their contract seats with ISU back? I thought they’d discontinued them several years ago, but I’ve also been out of school for a while now so it’s possible I’m misremembering that.

 

[Doggo Labs]

Oh, did CT get their contract seats with ISU back? I thought they’d discontinued them several years ago, but I’ve also been out of school for a while now so it’s possible I’m misremembering that.

I never knew they lost them... I’m at ISU right now and I think they still have seats but I guess I don’t know now 🤔

 

[deleted676737]

I never knew they lost them... I’m at ISU right now and I think they still have seats but I guess I don’t know now 🤔

It looks like CT isn’t listed on the contract states page anymore, so I think those contract seats are gone.

Contract/State Programs - Future DVM Students

College of Veterinary Medicine

vetmed.iastate.edu

 

[Doggo Labs]

It looks like CT isn’t listed on the contract states page anymore, so I think those contract seats are gone.

Contract/State Programs - Future DVM Students

College of Veterinary Medicine

vetmed.iastate.edu

I guess you learn something new everyday 😉

 

[Coopah]

Hello, pre-vet here. This discussion is much more productive now and I want to participate. I wanted to ask a question going back to opening new vet schools and people filling those seats. When I joined SDN last summer, I remember the two mantras were “rankings don’t matter and go to the cheapest option.” Do you guys think that vetmed will start moving in the direction where ranking *does* matter?

My second question, I guess kind of related to the first but also not really, is if you think unqualified candidates will be admitted. I feel unqualified saying this myself as I haven’t heard back from any school with a final decision (ugh waiting SUCKS), but from stalking *alllll* the threads it seems like there are a lot of people who apply with lower stats that don’t get in. Not knocking anyone with lower stats at all because grades are not always my friend either, but I guess as someone with one foot inside and outside of this profession, I wonder if the less-than-stellar candidate will get in simply bc they are willing to pay whatever it takes to get in and those schools need students. Hopefully that doesn’t come off as b*tchy, I’m just genuinely curious.

I think the only way rankings will ever matter is if the vets that the "lower ranked" schools produce are somehow of lesser quality. I don't really see that happening because in order to be AVMA accredited, the school has to demonstrate that the curriculum and everything will produce competent vets. So far I've not heard anything bad, even of the students coming out of the island schools. So far the AVMA accreditation process has held everyone up to snuff, I hope they continue to do so and fully expect it.

I don't know if "unqualified" applicants would be admitted because I'm unsure of how anyone defines "unqualified". One aspect would be unable to complete the program, but so far that's rare and usually not due to strictly academics. A different perspective would be someone who doesn't do the field justice. As much as I hate to think about it, I have heard the horror stories of what happens to a few of those people who get out in the world and when they think no one is watching do whatever they want. They are usually caught and prosecuted thankfully, but it still happens.

So no, I don't think they'll take "unqualified" applicants because I don't think the majority of applicants are unqualified. I think it's very competitive and a lot of qualified applicants don't get in every year.

 

[PippyPony]

If anything, I'd imagine that OOS acceptance rates will drop even lower at the schools with the cheapest OOS tuitions -- at least for a while. Might boost their rankings depending on how US News calculates them these days (admission rate is a factor in the undergrad rankings, at least).

But unfortunately, over time that probably means those tuitions will rise even higher and/or they will lose in-state spots as schools realize they can compete in a different pricing tier.

And on the unqualified applicants part... New schools will have to provide a certain level of education and stick to admitting people who they think can hack it, or else they won't meet the criteria to stay accredited.

 

[ajs513]

@Coopah i think it would be difficult to gauge a school’s quality of its graduates after graduation since that’s pretty impossible to gauge and describe. Something like percentage of graduates specializing and which fields they go into wouldn’t work because specializing doesn’t specifically mean you’re a higher quality graduate than someone who didn’t. Other ways would likely be more subjective and anecdotal.

Something that can really tell how well a school prepares its students is its NAVLE pass rate. Yes, a standardized test doesn’t define you as a person or how good of a doctor you’ll be, but if a school consistently has pass rates in the 80’s then that’s saying something. On the flip side, if a school consistently has pass rates of 98% then that’s also saying something. Whether that lower number is because the school itself isn’t doing a good job or if it’s an issue with the students hasn’t been explored I don’t think. I think it’s also a bit of a taboo issue which would make it a little prohibitive.

 

[Coopah]

@Coopah i think it would be difficult to gauge a school’s quality of its graduates after graduation since that’s pretty impossible to gauge and describe. Something like percentage of graduates specializing and which fields they go into wouldn’t work because specializing doesn’t specifically mean you’re a higher quality graduate than someone who didn’t. Other ways would likely be more subjective and anecdotal.

Something that can really tell how well a school prepares its students its NAVLE pass date. Yes, a standardized test doesn’t define you as a person or how good of a doctor you’ll be, but if a school consistently has pass rates in the 80’s then that’s saying something. On the flip side, if a school consistently has pass rates of 98% then that’s also saying something. Whether that lower number is because the school itself isn’t doing a good job or if it’s an issue with the students hasn’t been explored I don’t think. I think it’s also a bit of a taboo issue which would make it a little prohibitive.

I'm speaking more anecdotally as word tends to get around. For example for a while (still may predominate) Davis grads had a reputation for being very book smart but not very good with procedures, and since they've adjusted the curriculum to allow us more procedure time. I think this would be the only way (besides low NAVLE pass rates but that would result in loss of accreditation if it were consistent) because that would affect hiring. So for example a pre-vet that was shadowing would hear things in the clinic like "don't go to school X, no one will hire them", or "school Y has crappy clinicians". Something of that sort was my thought process.

Either way I doubt it'll ever happen because mostly the ranking system is crap and depends largely on the amount of research the school produces and grant money and nothing to do with the quality of education whatsoever.

 

[Minnerbelle]

That story highlights one of my biggest peeves with this industry. Wayyyyyyyyyyy too many medical decisions are being made by support staff, officer managers, etc. Or, at least, way too much pressure is being put on doctors by them.

THIS!!! I actually really love general practice and am damn good at it. I very rarely have clients upset with me, and I’m only bothered by clients once in a blue moon. Even the annoying ones typically don’t bother me. I’m highly skilled in surgery and dentistry, and I practice high quality medicine but am also adept at working with lower income clientele. I’m a good producer.

But I hate working in general practice because of ****ing management. There’s a lot I can put up with, but being managed as a doctor by a lay person or tech is not something I can tolerate. And vast majority of gps ****ing run that way. Even if not officially, either the front desk or tech staff for some reason carry a lot of power. I don’t mind collaborating, but the second I feel like I’m getting bossed around by lay person/tech, I’m out. I’ve bounced around between a number of jobs (all but one because I kept getting poached with better offers at a time I was getting fed up with the above issue). But I’m done now. I’m leaving gp. Same circus different clowns. It’s a shame because I was born to be a kickass gp.

 

[Minnerbelle]

Now where did all the pre-vets go, since we have had a very civil and fleshed-out conversation about our concerns?

I like how sassy you’ve gotten over the years.

 

[LetItSnow]

Do you guys think that vetmed will start moving in the direction where ranking *does* matter?

Depends on what you mean by 'matter'.... If you're talking about graduating with a DVM/VMD and going into clinical practice, then no, I don't think they will ever matter in any practical sense. Employers are interested in your medical and people skills, and there is a broad assumption that if you earned a DVM and passed NAVLE, you have a decent chance of being equal with all the others who did that.

Caveat: I don't know if that is true for non-practice type of jobs.
Caveat: There are ALWAYS people out there who will say "You went to that school??? I can't stand that school."
Caveat: Grades can matter for internships.

My second question, I guess kind of related to the first but also not really, is if you think unqualified candidates will be admitted.

Unqualified candidates have always been admitted, and always will be, because the evaluation process is not perfect. That's why there are grades and NAVLE and state boards and other means of weeding out people who are not up to learning and practicing competent medicine.

I suppose your real question is "do you think more unqualified candidates will be admitted if more seats are added" and to me, that's not really the concern. One of the fundamental purposes of the COE is to ensure that schools are providing a minimally-acceptable curriculum. So in theory, any average student in an accredited school ought to come out with at least an acceptable base knowledge. Yeah, there's a period of time with provisional accreditation, but that sort of stuff comes out in the wash. It's not a big deal. And there are bumps in any road for a school getting started. That stuff doesn't bother me.

I think plenty of qualified candidates go unadmitted every year. From the pre-vet side of things, that sounds like a travesty of justice, I get it. But it's also real life. In alllllllllll sorts of areas of life, more people apply for some resource than there are resources available. And at the end of the day, what matters isn't how many people want to be vets - it's how many vets the region (town, county, state, country, whatever) can support. I used the astronaut example earlier and I'll use it again. The USA only needs a handful of astronauts. There are probably thousands upon thousands of people who would love to be astronauts who could meet the minimum requirements to do so. So a bunch of people go disappointed. It's life.

Where we're at in this industry is we need to think realllllll hard about whether we want to churn out more veterinarians per year and whether that is good for our animal-owner population, the animal population, and the veterinarians. What we should NOT do is say "there are X qualified applicants a year and since the govt will guarantee practically unlimited COA loans for anyone, we should make sure seats are available for everyone who wants to be a vet and is qualified." That is a mistake, but I think that is how - understandably - many pre-vets look at it because of their huge emotional bias.

 

[ilovebirds]

I think the only way rankings will ever matter is if the vets that the "lower ranked" schools produce are somehow of lesser quality. I don't really see that happening because in order to be AVMA accredited, the school has to demonstrate that the curriculum and everything will produce competent vets. So far I've not heard anything bad, even of the students coming out of the island schools. So far the AVMA accreditation process has held everyone up to snuff, I hope they continue to do so and fully expect it.

I don't know if "unqualified" applicants would be admitted because I'm unsure of how anyone defines "unqualified". One aspect would be unable to complete the program, but so far that's rare and usually not due to strictly academics. A different perspective would be someone who doesn't do the field justice. As much as I hate to think about it, I have heard the horror stories of what happens to a few of those people who get out in the world and when they think no one is watching do whatever they want. They are usually caught and prosecuted thankfully, but it still happens.

So no, I don't think they'll take "unqualified" applicants because I don't think the majority of applicants are unqualified. I think it's very competitive and a lot of qualified applicants don't get in every year.

If anything, I'd imagine that OOS acceptance rates will drop even lower at the schools with the cheapest OOS tuitions -- at least for a while. Might boost their rankings depending on how US News calculates them these days (admission rate is a factor in the undergrad rankings, at least).

But unfortunately, over time that probably means those tuitions will rise even higher and/or they will lose in-state spots as schools realize they can compete in a different pricing tier.

And on the unqualified applicants part... New schools will have to provide a certain level of education and stick to admitting people who they think can hack it, or else they won't meet the criteria to stay accredited.

To your second comment, as someone from Ross, this is already happening. I went in with less that stellar stats ( 2.78 VMCAS cumulative gpa but 3.7 last 45 and good GRE scores). I knew ross was taking a chance on me and it was the only chance I had so I felt like I had to take it. I’m actually doing really well, but a lot of students I’ve already seen completely fail out of the school, or fail a course and are held back. It’s really heartbreaking. But just as an aside, I think EVERYONE feels the way you do and the imposter syndrome is very real. Just know that no one has it all figured out, and even the best vet students feel like they aren’t good enough at one point or another.

So "unqualified" was definitely not the best term to use. I appreciate the feedback a lot. I guess when I said "unqualified," I was more referring to schools lowering their standards, but it is clear that AVMA holds high standards for schools that would not allow it to happen. I am hoping to go into lab animal but have recently been talking to my small animal mentor (who owns the clinic and is the only doctor, with only one tech and one receptionist) who wants me to come back and work in the hope I can run it if need be (since none of his kids want to be vets). Obviously that's waaaaay down the line but I have really enjoyed reading this forum and learning about the issues in vetmed, especially regarding small animal medicine. I have learned so much about this world because of you all and I really appreciate you guys continuing to answer all of our questions and share your experience.

 

[LetItSnow]

But I’m done now. I’m leaving gp. Same circus different clowns. It’s a shame because I was born to be a kickass gp.

Psssst.... ownership......... 😉

 

[LetItSnow]

So "unqualified" was definitely not the best term to use. I appreciate the feedback a lot. I guess when I said "unqualified," I was more referring to schools lowering their standards, but it is clear that AVMA holds high standards for schools that would not allow it to happen. I am hoping to go into lab animal but have recently been talking to my small animal mentor (who owns the clinic and is the only doctor, with only one tech and one receptionist) who wants me to come back and work in the hope I can run it if need be (since none of his kids want to be vets). Obviously that's waaaaay down the line but I have really enjoyed reading this forum and learning about the issues in vetmed, especially regarding small animal medicine. I have learned so much about this world because of you all and I really appreciate you guys continuing to answer all of our questions and share your experience.

I doubt schools will have to lower their standards, at least in an immediate sense. Most schools already get more applicants than they need that meet their minimum standards.

In some sense, sure, by definition if you keep increasing seat numbers in the industry with a relatively static number of applicants, then yes, lesser-capable individuals (on paper) get seats. That doesn't bother me, because as long as they demonstrate competency, there is no reason they can't be doctors.

I don't see this issue as a big problem. *shrug*

 

[itsrocky]

I think part of this problem is also coming from the vet school. We have a great variety of clinicians being "encouraging" of a GP doing things. Our ophthalmologist is all about GPs doing their thing and doing procedures they are comfortable with. She just says, "This is technically more difficult, but the info is out in the literature and at CEs. So if you want to do this as a GP, go for it if you're comfortable." However, some of our internists are like, "This is for referral only!!!" when that simply isn't (or can't) be the case. So we are taught things that the specialist will do only in a specialist setting, or are encouraged to do it only in a specialist setting rather as GPs. So grads are encouraged to not feel comfortable to do it.

I saw someone on Facebook say the other day that only boarded surgeons should ever be doing prophylactic gastropexies. Kind of a stretch I think personally. I think there’s very few things you shouldn’t be able to do if you are skilled/trained in it, and understand all of the risks and complications. There’s always conditions that yes will do best with 24/7, gold standard care, but it’s not always an option.

And yeah like things can’t be referred all of the time. My job is going to be me in a practice that’s hours away from the nearest major city, and the only animal hospital for quite some miles. Many people can’t afford speciality care, so they do a lot in house and are well trained to do so. It’s a lot of the reason I picked my job.

 

[amwildlife]

Now where did all the pre-vets go, since we have had a very civil and fleshed-out conversation about our concerns?

Since you are so curious, I, and many others, probably had to work all day. This is the crap I am talking about. Which is why I stopped responding a long time ago.


Sent from my iPhone using Tapatalk

 

[twelvetigers]

Since you are so curious, I, and many others, probably had to work all day. This is the crap I am talking about. Which is why I stopped responding a long time ago.


Sent from my iPhone using Tapatalk

Despite minnerbelle's comment, I wasn't trying to be snarky. It's a conversation. We are all talking about our concerns with new schools and more seats without other changes. I mean - you don't want to talk about it anymore? Do you see where we're all coming from? Or, does it seem like we're all still just a bunch of bullies?

Maybe I need a different avatar lol

 

[ziggyandjazzy]

I'm speaking more anecdotally as word tends to get around. For example for a while (still may predominate) Davis grads had a reputation for being very book smart but not very good with procedures, and since they've adjusted the curriculum to allow us more procedure time. I think this would be the only way (besides low NAVLE pass rates but that would result in loss of accreditation if it were consistent) because that would affect hiring. So for example a pre-vet that was shadowing would hear things in the clinic like "don't go to school X, no one will hire them", or "school Y has crappy clinicians". Something of that sort was my thought process.

Either way I doubt it'll ever happen because mostly the ranking system is crap and depends largely on the amount of research the school produces and grant money and nothing to do with the quality of education whatsoever.

I feel like low NAVLE pass rates is relative. Like, I consider 80% to be very low but apparently schools can have this and not worry about losing accreditation?
And earlier it was mentioned that LMU had low pass rates compared to other stateside schools. So they are either admitting people who will never practice, or not training them properly like Aj said

 

[Coopah]

I feel like low NAVLE pass rates is relative. Like, I consider 80% to be very low but apparently schools can have this and not worry about losing accreditation?
And earlier it was mentioned that LMU had low pass rates compared to other stateside schools. So they are either admitting people who will never practice, or not training them properly like Aj said

But is that consistently low? I wouldn't be surprised if that prompted a review from the AVMA.

 

[ziggyandjazzy]

But is that consistently low? I wouldn't be surprised if that prompted a review from the AVMA.

They opened in 2014 so graduated their first class in 2018 iirc. I have no idea what prompts review from the AVMA. All I've heard is that 80%+ is fine but I'm not sure of the specifics.
Also, I remember hearing Ross' NAVLE rates have steadily declined as well.

 

[amwildlife]

Despite minnerbelle's comment, I wasn't trying to be snarky. It's a conversation. We are all talking about our concerns with new schools and more seats without other changes. I mean - you don't want to talk about it anymore? Do you see where we're all coming from? Or, does it seem like we're all still just a bunch of bullies?

Maybe I need a different avatar lol

You werent “trying” to be snarky, I find that SUPER hard to believe.

I stopped responding because I am wasting my breath.
I do not have time to be on SDN all day reading the same information you guys are saying over and over again. I have 2 jobs and by the time I work, get home, and open this app I am 200 replies behind.

Besides what y’all are saying has not changed my mind, I get it sure. You’re older, you have degrees, you have been through it. At the end of the day though, its my life and my ‘mistake’ to make.


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