Restricted licensing for DVM graduates?

[xl3000]

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Background to this question: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2387255
A quote: "Simply put, the debate has been about whether professors can, in a 4-year professional program, educate individuals who are eligible for a license that allows them to present themselves as competent practitioners in all animal species, and in all aspects of veterinary medicine." I think this is a bit of a challenge for students too. Would you support restricting veterinary licenses to specific areas (say food animal, small companion animal, equine, zoo/wildlife etc.)?

 

[No Imagination]

Wow, nice find. Thanks for the link.

Until salaries go up, don't see it happening IMO, but who knows

 

[sumstorm]

This would be a disaster for many small to medium zoos, which hire vets who run thier own SA, LA, MA clinics. Generally the zoo vet is paid as much as or more than the zoo director (top position) and if they had to hire a specialist that was in extermly limited quantity (especially at first) and who would likely need to relocate, they probably would have to go without veterinary services alot of the time.

 

[DVMorBust]

This would be a disaster for many small to medium zoos, which hire vets who run thier own SA, LA, MA clinics. Generally the zoo vet is paid as much as or more than the zoo director (top position) and if they had to hire a specialist that was in extermly limited quantity (especially at first) and who would likely need to relocate, they probably would have to go without veterinary services alot of the time.

Agreed. Although, wouldn't you think there would be some sort of 'grandfathering in' situation? Wouldn't there have to be, to keep stuff like this from happening?

 

[alliecat44]

"Zoo medicine/unusual species" is one of the proposed areaas of specialization/licensure. The zoo community is already pretty small as it is.

I think that the logistics of this transition would be a nightmare: some schools specializing in certain things? Maybe have central instiutions for core requirements and then being sent out to others for further specialization? How would the application process work? Would this make it more competitive? On the plus side, I can't see any way this would make things more expensive. Rather, I could see fewer credits actually being cheaper for students.

Personally, I think limited licensure really is the future of veterinary medicine. Trying to cram in all of the knowledge we have now into the same amount of time used to teach 1950's medicine (before they even knew about DNA!) seems increasingly ludicrous. There's just too much. As a vet student, there's so much binging and purging--and half of this is information that you are never going to use. Personally, I would rather REALLY LEARN the things I'm going to use in practice and remember a much higher percentage of it than be able to recount a much lower percentage of information I'm never going to use again.

I think a licensing exam for just small animals/just food animals/just equine/whatever is a great idea. It also keeps medicine at a higher standard. Want to switch from food animal to small animal in twenty years when your back gives out? Sure, no problem--just study these materials (which should be developed, maintained and readily available) and take the test. And if you want to do mixed animal, that's fine too--take more than one exam.

The more I know about veterinary medicine, the more terrifying I find the prospect of someone switching fields after even 5 years in a different type of practice. There's too much info and it's changing too rapidly. Like I could switch to horses after 10 years in small animal?? I wouldn't have a clue! But right now, that's totally fine and legal. I have a problem with this--without getting into the whole "standard of care" debate.

People are upset because this takes away the right for them to change their mind during vet school. Vet school is a privelege. Veterinary experience is *supposed* to be a heavily-weighted part of the admissions process. Why isn't that enough to direct you as to what type of medicine you want to practice? Why is it too much to ask that you have a direction when you start vet school? If you want to change your mind halfway through, sure--but do so at your own expense and time commitment.

I know this position is probably relatively unpopular on these boards, when most people aren't in vet school yet--but really and truly, I would so much rather know the stuff I'm going to be using and know it WELL rather than using my brainpower to memorize and dump a bunch of stuff I'm never going to use. And I would rather preserve the level of medicine practiced on ALL species by requiring a limited licensure exam if you want to switch areas of practice.

Again, I would never pretend to be able to figure out the logitstics, but I agree this is inevitable--and I would argue that it is necessary.

Okay, off my soapbox. 🙂

 

[sumstorm]

"Zoo medicine/unusual species" is one of the proposed areaas of specialization/licensure. The zoo community is already pretty small as it is.

Many small zoos actually use SA/LA vets as thier primary veterinarian. Generally the pay is not great enough to provide a salary that is reasonable unless the vet works elsewhere or has thier own clinic. Many of theses zoos are 4+ hours from other zoos, so working at 2 or more zoos to provide an adequate salary wouldn't necessarily be reasonable. So if the vet wasn't liscenced in both exotics and another field, it would be problematic. For the zoos, the cost of hiring an individual vet is pretty high. The zoo community, in terms of people, is very small. In terms of animals, it is huge.

I think that the logistics of this transition would be a nightmare: some schools specializing in certain things? Maybe have central instiutions for core requirements and then being sent out to others for further specialization? How would the application process work? Would this make it more competitive? On the plus side, I can't see any way this would make things more expensive. Rather, I could see fewer credits actually being cheaper for students.

Explain exactly how it would be cheaper? I doubt schools will chop a year off of study. I could see it being less intense, but I don't see DVM going to a 3 year program. Not all schools charge per credit...and not all count credits the same way. I do agree implementation would be a nightmare...and I am willing to bet that it would only take a few schools refusing to change over to create huge issues. Also, what would happen with UK/Canada/Aus schools? Would those schools become unaccredited?

I think a licensing exam for just small animals/just food animals/just equine/whatever is a great idea. It also keeps medicine at a higher standard. Want to switch from food animal to small animal in twenty years when your back gives out? Sure, no problem--just study these materials (which should be developed, maintained and readily available) and take the test. And if you want to do mixed animal, that's fine too--take more than one exam.

Ummm....if the school only teaches X (as you proposed above) then how can it train someone to Y? Why would taking an exam prove that you can work in the field? I would thin you would have to go back to school for at least a year to retrain in another field. I wonder how insanely that would affect admissions. If your initial training didn't include EVERYTHING, then how could you ever switch fields later on? Not saying there aren't issues with the current system, just saying there is something wrong with the logic that a test is going to magically make you able to treat in a field that you didn't study at all previously.

People are upset because this takes away the right for them to change their mind during vet school. Vet school is a privelege. Veterinary experience is *supposed* to be a heavily-weighted part of the admissions process. Why isn't that enough to direct you as to what type of medicine you want to practice? Why is it too much to ask that you have a direction when you start vet school? If you want to change your mind halfway through, sure--but do so at your own expense and time commitment.

Let me get this straight...becaue the vast majority of my veterinary experience going into vet school is zoo medicine, I shouldn't be able to attend vet school with an interest in population medicine/pathology, just because there weren't opportunities where I was to work under the supervision of a DVM in population medicine/pathology? Someone who lives 5 hours from the nearest zoo should never have the opportunity to decide that they are interested in zoo medicine while in vet school because they couldn't afford to pay to do internships at the zoo several hours away? Veterinary experience CAN be heavily weighted for admissions WITHOUT slotting an individual into a single field. Also, if your talking of different schools having only certain specialties and only training to those specialties, changing your direction would mean GIVING UP YOUR SPOT AND REAPPLYING. I am 9 years out of school and am going into vet med believing I want to go in one direction, but aware that exposure to other opportunities may alter that course, and I even put that in my PS...so I doubt it was frowned upon.

Maybe I am completly wrong, but I actually see this as creating as many problems as it cures, both for various fields of vet meds, the individuals, and society.

 

[xl3000]

I think Sumstorm and Alliecat have stated a lot of the arguments I was thinking of. I'm not sure which position to support (pro restricted licenscing or against it). No matter what, it is quite clear to me that continuing education will be very important (and is important) for vets.

 

[xl3000]

. Also, what would happen with UK/Canada/Aus schools? Would those schools become unaccredited?

The person who wrote the article is a Canadian Vet School prof, and I really hope that Canada and the US would move together on this issue. Canada might do some sort of restricted licensing without US involvement, but this would be very logistically and practically difficult.

Ummm....if the school only teaches X (as you proposed above) then how can it train someone to Y? Why would taking an exam prove that you can work in the field?

Why does taking a licensing exam proove you can work in any field of animal medicine?

 

[sumstorm]

Not sure I understand your last question as a response to my question?

I see both sides....but I probably have a bit more of a 'non-vet' perspective having had to work in non-profits, NGO's and other agencies that have to hire vets....and knowing who we hired and why.

Occassionaly advantages of a non-trad is having a lot of experience on the outside looking in.

 

[xl3000]

Now when you take the licensing exam you can work in any field of vet medicine. Why would an exam for one field only of vet medicine be any less valid than the current set up?

And I guess my opinion doesn't really matter, I'll just live with what ever system is set up.

 

[sumstorm]

Oh, I see what your saying.

Here is what I was saying...current model we are trained in a variety of fields and take a single test that is then valid for all those fields (theoretically, since you can't get hired in many without boarding or intern/residency, etc.)

Future model, as was proposed is that we are training in a single field, and test in a single field. if you then change career, you go back and test for another field. The issue is that you would lack any training in that field.

A cheap, down and dirty comparison would be mechanics.

My father is/was (now supervisor) a diesel mechanic for tractor-trailers. He works in a company that also repairs diesel engines in earth moving equipment, older vehicles, and things like campers. Essentially they can repair anything that is a diesel (and he can do it all because it didn't use to be as specialized as it is now.)

Fast forward 30+ years. He can't hire most mechanics trained today because they are trained on non-diesel engines. They don't understand the difference. They may be certified engine mechanics, but their certification means nothing to him. Add in the advances in engines and proprietary computer systems and he needs not just diesel mechanics, but mechanics trained to specific 'brands' of engines. There are mechanics that are qualified and could learn the stuff and would be skilled at transferring thier knowledge, but he can't hire them because they aren't certified. His company can't afford to pay for the certifications, and neither can the mechanics themselves. The knowledge is exclusive, which makes it more problematic, and the certifications require both retrianing and testing. What is he dealing with? A major shortage of certified/qualified diesel mechanics and no actual way to solve the situation, UNLESS they increase charges signficantly for thier clients (truck drivers) who can't afford to pay more, especially in a poor economy.

I would submit that the lab medicine industry, and parts of the nursing industry are dealing with the same issue.

I listened to the same argument about nursing training/education 7 years ago when my mother wanted to be a surgical nurse (your required to learn all forms of nursing before you specialize) and she couldn't stand to deal with kids, mentally unstable patients, and senile patients....she would rather the patients be unconscious BEFORE she dealt with them. For obvious reasons, she didn't become a nurse.

I really see both sides and will deal with both sides, but it just seems to make vet education even more exclusive to those in a socio-economic position to pursue various types of education than it currently is. Of course, just my opinion, maybe it will change when I am in vet school, but by nature I like being a generalist.

 

[jasps]

Coming from an outsiders point of view so take with a grain of salt...

I don't understand why it would be such a logistical nightmare to organize restricted licensing, the concept seems pretty straight forward to me.

Many vet schools already make student "stream" into their area of interest for 3rd and 4th years; these streams are usually SA, LA and Equine. Currently, students are still going through a more generalized program even with the streaming due to the fact that they have to pass the all-species NAVLE to qualify. If the NAVLE were to be split up into separate qualifying exams from SA, LA, exotics, etc, then students would be able to have a more focused learning experience using the streaming method in those 2 years or perhaps starting as early as 1st year.

So basically, all vet schools would have to switch over to a "streaming" type program. The hitch to this is that it would involve schools offering more courses with fewer students per course - more expensive! But from what I understand, most of the material from 1st and 2nd year is pretty general in terms of the animal body. So to minimize extra cost, the streaming could be restricted to 3rd and 4th year (one year of class, one year of rotations), those two years should offer plenty of time to be able to specialize adequately, and really the only extra expense *might* be from the more specialised courses offered for that one year. The streamed rotations shouldn't make much of a difference since it just means you would have longer rotations in some areas, and none in others. It seems completely doable and many schools already do it to a lesser extent. A bonus to this, is that students would still have time to change their minds in 1st and 2nd year of vet school. I agree that it's a bit ludicrous to expect incoming pre-vet students to know exactly what they want do without having been intimately involved in the field the way current vet students are.

Streams such as exotics, zoo med, avian med, etc may be a bit trickier to deal with. I could see those streaming options only being offered at certain schools and being VERY competitive, especially considering demand for those vets is MUCH lower than SA and LA.

So anyway, my rambling ends here. Thoughts?

 

[alliecat44]

1. I understand the problem as it pertains to zoo medicine. What would you say about a program specifically for zoo medicine? And improving the overall care provided at zoos, including small zoos? Or perhaps providing an exemption for zoo work, since the jobs are so few and far between, to continue to make it attractive.

2. Many schools DO charge by the credit hour. In all honesty, even if it doesn't make it cheaper, it can't make it more expensive. I'd rather be spending my dollars learning information I'd actually be using, instead of basically throwing thousands of dollars away. Certain programs might have a lower cost of production, so to speak--though I have no idea if a LA setup at a vet school level would be cheaper or more expensive than a SA setup. Worst it can cost is to stay the same (with the current astronomical tuition increases, anyway).

3. The UK/Australian/etc schools that are accredited now and what would happen to them in terms of American accreditation--no idea. But the graduates from AVMA-accredited schools have to take the NAVLE to practice here just like we do, so if they wanted to practice here, I imagine they'd have to pass the same exam we do. Or go back to using the ECFVG, or whatever the US decides to do about foreign graduates.

4. A licensing exam could require extra training--or it could not. Why couldn't a graduate go back and audit courses in a different area? Why wouldn't schools allow that, or some sort of pro-rated tuition system? Or have continuing education materials updated and maintained to help you prepare for such an exam. This would, of course, be done by the licensing bureau. No taking more courses necessary if you learn the material. Perhaps there could be a certain number of hours you needed to spend with a colleague in your new field of choice who has already been approved for this/offered their services.

Right now, you don't even have to pick up a textbook or a journal--just change your ad in the yellow pages and that's it. Plenty of LA folks make the switch later in life because "that's where the money is" and still give every dog and cat injections of Penn G and dexamethasone. Taking some sort of exam at least a) highlights a practitioner's weaknesses and b) protects the public.

5. sumstorm, I never said that a person could only go into the field of vet med in which they have experience. You can CHOOSE whatever area you want to go into--regardless of whether you have experience in it or not. You're not limited until you sign up for a particular program--and who knows what that would look like? Maybe we all have the same first year core classes, such as anatomy and physiology, before we're divided up. During first year, we hear from plenty of veterinarians in "alternative" veterinary fields as it is--perhaps having one of them mentor you and allow you to determine whether you do indeed want to do career path X or Y would be very beneficial.

6. No comment on the admissions process, as again I have no idea what it would look like. However, if a veterinarian wanted to change their area of focus, I don't see how/why there should be an additional admissions process later in life, as you've already been practicing as a veterinarian, professional courtesy, etc etc etc. As I said, a) taking more courses might not necessarily be needed; and b) I have no idea what the logistics would look like.

And by the way, I am a non-trad as well and extremely sensitive to the admissions process, having been through it four times myself. I also like to think that as a non-trad with many years of work experience I bring perhaps some fresh perspectives.

Many small zoos actually use SA/LA vets as thier primary veterinarian. Generally the pay is not great enough to provide a salary that is reasonable unless the vet works elsewhere or has thier own clinic. Many of theses zoos are 4+ hours from other zoos, so working at 2 or more zoos to provide an adequate salary wouldn't necessarily be reasonable. So if the vet wasn't liscenced in both exotics and another field, it would be problematic. For the zoos, the cost of hiring an individual vet is pretty high. The zoo community, in terms of people, is very small. In terms of animals, it is huge.



Explain exactly how it would be cheaper? I doubt schools will chop a year off of study. I could see it being less intense, but I don't see DVM going to a 3 year program. Not all schools charge per credit...and not all count credits the same way. I do agree implementation would be a nightmare...and I am willing to bet that it would only take a few schools refusing to change over to create huge issues. Also, what would happen with UK/Canada/Aus schools? Would those schools become unaccredited?



Ummm....if the school only teaches X (as you proposed above) then how can it train someone to Y? Why would taking an exam prove that you can work in the field? I would thin you would have to go back to school for at least a year to retrain in another field. I wonder how insanely that would affect admissions. If your initial training didn't include EVERYTHING, then how could you ever switch fields later on? Not saying there aren't issues with the current system, just saying there is something wrong with the logic that a test is going to magically make you able to treat in a field that you didn't study at all previously.



Let me get this straight...becaue the vast majority of my veterinary experience going into vet school is zoo medicine, I shouldn't be able to attend vet school with an interest in population medicine/pathology, just because there weren't opportunities where I was to work under the supervision of a DVM in population medicine/pathology? Someone who lives 5 hours from the nearest zoo should never have the opportunity to decide that they are interested in zoo medicine while in vet school because they couldn't afford to pay to do internships at the zoo several hours away? Veterinary experience CAN be heavily weighted for admissions WITHOUT slotting an individual into a single field. Also, if your talking of different schools having only certain specialties and only training to those specialties, changing your direction would mean GIVING UP YOUR SPOT AND REAPPLYING. I am 9 years out of school and am going into vet med believing I want to go in one direction, but aware that exposure to other opportunities may alter that course, and I even put that in my PS...so I doubt it was frowned upon.

Maybe I am completly wrong, but I actually see this as creating as many problems as it cures, both for various fields of vet meds, the individuals, and society.

 

[sumstorm]

People are upset because this takes away the right for them to change their mind during vet school. Vet school is a privelege. Veterinary experience is *supposed* to be a heavily-weighted part of the admissions process. Why isn't that enough to direct you as to what type of medicine you want to practice? Why is it too much to ask that you have a direction when you start vet school? If you want to change your mind halfway through, sure--but do so at your own expense and time commitment.

🙂

Actually, I went by what you said! 😀

I do have a direction: to earn my DVM and practive veterinary medicine, I just am not sure which area I want to practice in (I recently saw posts where 2nd & 3rd years aren't sure, so I don't feel bad about it.)

As for going back to school, realisticly, if there was a vet school in every state, that might be feasable. Since you are a non-trad, I am sure you know what it is like to pick up your entire life and relocate for a relativly brief period of time...how costly and challenging that is. There might be some suitablity to working with other vets in the field, but remember that not every vet feels obligated ot educate and train other vets....what hapens if a shortage happens (or the only vet in your local region that did LA died, and your trying to pick up the slack from his practice because you life in ag economy.... I live near several counties with steer ag economies and NO LA vet.)

As for zoo medicine...I think on the philisophical side, it is a wonderful idea. I also know that zoos don't have the funding to afford specialized medicine. Less than 5 zoos in the US obtain enough money to cover thier operating costs, all others operate at a loss. Of course, during stressful times, that means many will struggle and some will close. An exemption might work.... but I could also see that infuriating someone who did take the stream who doesn't get the position because they aren't local and would cost too much. Many zoos also have locality rules (you must live in the supporting city or county.)

I don't disagree with exams per se...but I do realize that it will be expensive, and I am pretty sure the people paying for that cost will either be the vets themselves, or the clients...and there is only so much cost that clients can/will handle (whether client = zoo, owner, farmer, etc.) I really don't want to spend a small fortune on vet school which still has limited economical return, and 10 years from now, have to relocate again, and spend another small fortune (during which time I won't be practicing.) That might be incredibly selfish of me, but I do know there are vets who manage to keep thier skills across a broad range of fields, and there are other vets who shouldn't even be practicing in the field they are currently in because they could care less about updating skills.

Seriously, you dont have to be a LA switching into SA to think dex is the solution for everything.

As I said, just my opinion. Perhaps a solution would be to have 'hubs' at vet schools with remote sights in cities that are no farther than 6 hours apart for retraining, and to have short intensive (less than a month) retraining programs.

Having said that, I think every vet owning a practice should have a background in business or management. I am amazed at how many practices are damaged by the lack of knowledge of the vets in these fundamental areas. At the very least they need enough skill to hire an excellent manager, which doesn't seem terribly common.

 

[chris03333]

Why am I completely against it?

Because there are many people who:
-only have experienced a narrow area of vet med and really have no clue what they want to do when they graduate.
- think they want to go into "X" field, get out into the "real world" and realize quite quickly that they were wrong
- work in a field for a long time then develop allergies to said species they work with
- work in a field for a short/long time and get injured, thus are unable to stay in said field of choice

You can switch fields (pretty common to go large to small etc) without ever having to go back to vet school....

If someone ever told me I would have to go back to vet school I would basically say screw you (but that is much nicer than the words that would actually be spoken)

There are my 2 cents (**disclaimer**I didn't read anything other than the title of the thread so if I am off topic, carry on)

 

[sumstorm]

Why am I completely against it?

Because there are many people who:
-only have experienced a narrow area of vet med and really have no clue what they want to do when they graduate.
- think they want to go into "X" field, get out into the "real world" and realize quite quickly that they were wrong
- work in a field for a long time then develop allergies to said species they work with
- work in a field for a short/long time and get injured, thus are unable to stay in said field of choice

Nope, your on target without reading, and much more concise than I am!

I had forgotten the challenge of allergies, particularly in lab animal work. Eli Lilly told me they have a high rate of vet change over in their labs due more to acute allergy development than any other cause.

 

[2quick]

There are people in my class who have completely switched their focus during fourth year (ie. small animal to equine, pathology to small animal, etc...), and I know of many other vets who have done the same at some point in their careers. I think this flexibility is one of the great things about a veterinary degree.

 

[robeezy08]

I don't disagree with exams per se...but I do realize that it will be expensive, and I am pretty sure the people paying for that cost will either be the vets themselves, or the clients...and there is only so much cost that clients can/will handle (whether client = zoo, owner, farmer, etc.) I really don't want to spend a small fortune on vet school which still has limited economical return, and 10 years from now, have to relocate again, and spend another small fortune (during which time I won't be practicing.) That might be incredibly selfish of me, but I do know there are vets who manage to keep thier skills across a broad range of fields, and there are other vets who shouldn't even be practicing in the field they are currently in because they could care less about updating skills.

I agree that extra licensing will lead to increase specialization = vets will eventually demand for more pay = higher costs for the client.

The report searches to "identify ways in which the profession should respond to the changing needs of society, and make specific recommendations. One of the recommendations is that "changes in the licensing and accreditation systems are absolutely essential for the successful evolution to the new concept of veterinary medical education."

My question - what is this new concept of vet med? I think for larger cities and high income neighborhoods, clients can afford cutting edge technology/procedures, but for rural america or even parts of suburban america, there's no way someone would be able to afford a specialist over a general practitioner.

What are rules/regulations governing the use of CE credits and or certifications but not licensing per se - like in order to renew your DVM license, you need X amount of CE credits OR in order to work/own an AAHA accredited hospital you need X amount of CE credits...are there "reward" systems in place to encourage vets to pursue CE credits...or even punishement to those w/o CE credits in their field of interest. In human med, even though you have a license to perform a wide variety of procedures - surgery, u/s, botox injections... you'll get sued and lose big time if you perform a procedure in which you were not certified.

There are people in my class who have completely switched their focus during fourth year (ie. small animal to equine, pathology to small animal, etc...), and I know of many other vets who have done the same at some point in their careers. I think this flexibility is one of the great things about a veterinary degree.

Also agree here, that flexibility in vet med is appealing to many, myself included!

 

[alliecat44]

Why am I completely against it?

Because there are many people who:
-only have experienced a narrow area of vet med and really have no clue what they want to do when they graduate.
- think they want to go into "X" field, get out into the "real world" and realize quite quickly that they were wrong
- work in a field for a long time then develop allergies to said species they work with
- work in a field for a short/long time and get injured, thus are unable to stay in said field of choice

You can switch fields (pretty common to go large to small etc) without ever having to go back to vet school....

If someone ever told me I would have to go back to vet school I would basically say screw you (but that is much nicer than the words that would actually be spoken)

There are my 2 cents (**disclaimer**I didn't read anything other than the title of the thread so if I am off topic, carry on)

All of these are valid reasons for switching areas of practice. None of these are reasons why a) more in-depth education in your initial area of interest would be bad; or b) requiring a licensing exam (without "going back to vet school"--see above for some suggestions on how to do this) would be inappropriate.

 

[alliecat44]

It's interesting--I would never have thought I would be in favor of limited licensure before I became a vet student. In my mind, part of the nobility of being a veterinarian is/was that of caring for all species. I've been toying with the philosophy for about a year now, and it's only in the past 3-4 weeks that I've really found myself settling on one side of the debate.

sumstorm, of course I understand why logistically this would be extremely difficult--and yes, especially for catering to the entire applicant base. Believe me, I hear you about relocating as a "mature" student--and I plan on doing it at least twice more for an internship and *knock on wood* residency. It's a pain and it sucks. Perhaps further education could include online/distance education/training for taking the licensing exam, instead of having to set foot back in vet school. Perhaps it would be a set number of contact hours with an approved clinician. Of course many doctors wouldn't WANT to do this--but plenty of them would. Perhaps there could be some sort of incentive or reimbursement program or something. As I said, there are many details that would need to be worked out (and I'm certainly not the one to do it! 😀)

Of course I am painfully aware--after over a decade in referral practice, where every case we see is previously managed by another veterinarian--that there is some bad, bad medicine out there. However, if we started with limited licensure, I think that fewER people would be practicing archaic medicine.

As I said before, limited licensure can have many different manifestations. To those who want to change their minds uup through fourth year--okay, why not? Sure, you're able to change your mind--but you'll still go through an exam that's more rigorous than NAVLE section X on subject X, and you'll ONLY have to study for/take the section X. However, you'll know X in much more detail than required by the NAVLE. You might not be as good at Y, but that's okay--unless sometime down the road you change your mind again, or get hurt, or whatever and then are held to the same standards as new graduates entering into field Y. You'll have read study materials for the Y exam, perhaps taken a couple of online classes, shadowed at a local Y practice or at the vet school if it's close enough, and take the exam when you feel prepared. Whether that's two weeks or two months or whatever later is up to you.

Here's just an example for you. This week, we had three exams: virology, radiology, and cardiology. Now, the cardiology section is the ONLY cardiology we get before fourth year. (Of course small amounts of it are present in classes like pharmacology, etc, but actually identifying, diagnosing and treating cardiac disease in small animal patients--this was it.) How much time did we have? 15 lectures. 15 hours TOTAL of cardiology. One hour on arrythmias. One hour on ECGs. Two hours on heart failure (one on pathophysiology and one on actually doing something about it). Three hundred pages of notes for the three-week cardio section, and we were held responsible for exam material on all of it.

Which is fine, but I also had to cram 30+ pig viruses in my head for my virology exam three days prior. Same amount of time on pig viruses as small animal cardiology.

Pig viruses are very important, they're interesting, and they're extremely relevant. As a scientist, I--like all of you--have an almost insatiable curiosity about all things medical/animal. I found it very interesting.

However, would my time have been better used by hearing 15 more hours of lectures on small animal cardiology, when I'm never going to touch a pig that's not on a fork or in a bun for the rest of my life? Are the future swine practitioners well-served by shoving all the stuff about pig viruses to the side so they can cram in 300 pages of small animal cardiology?

Therre's simply TOO MUCH INFORMATION out there now. Fifty years ago, in all honesty, people didn't know a whole lot. There were no molecular diagnostics to develop or interpret. Hell, there were barely any antibiotics.

The amount of knowledge has increased oh, I don't know, maybe ten times? And that's a conservative estimate. Yet the length of our education remains the same.

That seems like a problem to me. How else to fix it? make vet school five years, and incur even more astronomical debt?

 

[karmapple]

So, granted, I probably have no idea what I'm talking about seeing as how I've never set foot in a veterinary school class yet. However, what Alliecat says makes sense to me.

At my interviews, tours, and orientations at KSU and OSU, a big deal was made about a "broad-based education" and how this is better. But all I could think was, "How much information about equine/ food animal am I going to be shoving into my brain that I will NEVER use? Will I know enough when I get out of school to even be an adequate small animal veterinarian when half of my educational time was spent learning things that weren't relevant to my career?" I have no idea, but this is my fear, and this is why I feel it is almost mandatory for me to do an internship.

I have worked with vets who were straight out of vet school, and they seem very much to be jack-of-all-trades, master-of-none. They also all seemed to be very panicked about how little they felt they knew, but I'm sure all professionals feel this way straight out of school. At least, I think so.

 

[alliecat44]

Everyone's so quiet...would love to hear more views.

 

[WhtsThFrequency]

I was going to have a longer comment.....but I can't top your reply, alliecat, you hit the nail SQUARE on the head!

 

[DocDVMD]

.

 

[Angelo84]

I'll come back later--cardio exam....

 

[alliecat44]

I was going to have a longer comment.....but I can't top your reply, alliecat, you hit the nail SQUARE on the head!

Thanks!

Angelo, good luck on your cardio exam--hope it goes better than mine did. Very interested to hear what other vet students think (and pre-vets too, of course!).

 

[KKibo]

Absolutely ridiculous.

Part of having a DVM degree is that is a comparative animal science doctorate.

However, I don't think one year of school clinics is enough to get quality experience. Two years, possibly.

On the other hand, I could see restrictive licsenes that don't allow fresh graduates to own a practice (until they have 2-4 years of experience working as an associate)

 

[Capella]

By the time I graduate from Oklahoma State I feel I will be able to competently handle all major domestic species. This is the primary educational goal of our university, and there is very little "tracking" into specific fields. The only things I think I'll be deficient in are exotics, small animal orthopedic surgery (need a residency anyway), major equine surgery (need a residency and/or expensive equipment), and the miscellaneous weird stuff. Of course, I won't have the most valuable thing of all, which is experience. I don't see how a piece of paper will help me with that -- I will need time and mentorship, which I don't have to pay a school for.

I'm just finishing up my 2nd year here and I'm amazed at how many principles can be applied across the major domestic species -- and how much of the material we're starting to hit for a second or third time. Now, it still is a LOT of information, but it's not as intimidating as it once was now that I can see connections and figure out what is trivial (I don't really need to know the name of every enzyme in sugar metabolism).

The greatest thing about veterinary medicine is that we receive a broad education that requires us to think, problem solve, and use a variety of resources because it's impossible to stick every little detail in our head. It would be a great tragedy for veterinary medicine to go the way of human medicine -- experts that know very little about anything else, constrained to lab results and reference ranges.

Now I'll restrain from my rant on how we can't figure anything out without the almighty CBC/Chem/UA…

 

[sumstorm]

I understand what your saying and the points you are making.

Here is the thing:

Lets say that instead of your current focus on SA you are interested in LA.

So then, the pig viruses would be very important.

You take pig viruses and not SA cardio. You then are in LA for the next...lets say, 15 years, then you injure yourself, can't handle the phsical demands, develope an allergy, whatever. Either way, you HAVE to switch fields.

Lets assume your personal life didn't stand still. You now have a wife, and kids, and a house and probably a mortgage.

And you have very limited initial knowledge on SA...you skipped those classes so that you could memorize more pigs stuff, right?

Sounds like under the new scheme, your options are going to be:

1) study for and take an exam (lets be realistic, just as you say you are doing in vet school, most of us can study for an exam and perform a great brain dump, which means you wouldn't be any better of a practitioner for taking an exam)

2) interning under another vet in the field (which, again, could mean relocating, would cost you money when you still need to pay a mortgage, may not be something the supervising vet wants to deal with, may not be relevant to the practices in your area....because training your competition down the street isn't a good business practice for most vets)

3) attending classes online (still no hands on experience, again the ability to perform and ditch for exams, in some areas impossible to do becaue of proctoring issues, validity of material, etc)

4) return to school (which are already extremly limited, would again require relocation, etc.)

So, I do see validity in what you say. What bothers me is, like many other things, far better for areas where there is sufficient money, sufficient access to technology, sufficient access to specialists, sufficient access to vets, etc. It may also work very well for large classes of vet medicine (namely, I think, SA)

What it leaves behind are rural communities where vets need to have MA practices, practices that need to deal with exotics because they are legal as pets in that area, small to medium zoos and animal refuges, shelters that deal with chickens as well as cats, and other places sitting at the edge of where money runs out.

In an ideal world, money would never be an issue: the vet who has to retrain would glady do so without concern over paying a mortgage or helping thier child with college, a client deciding between expensive treatment and euthanasia of a pet, a shelter between gas chambers and beuthanasia, or a zoo between an MA vet and a specialist.

Unfortunatly, there is another reality. The vets who are excellent will continue to be excellent in any field because they will learn the material they need when they need it. They will do this the same way students in schools do; reading, communicating, etc. They will do it without jumping through a series of hoops. The vets who are lazy will continue to be lazy and will find ways to get through those hoops.

I just see entire communities that will suffer while thier vet has to go through retraining. Maybe that is because I grew up in those communities.

On the exotics front, there are very few vets that specialize in one species. When our sloth became ill at the zoo I worked for, I sent out a few emails to a few list serves, then got on the phone. Within 1 hour I had tracked down the few vets who are considered in the top of the field in sloth medicine. That includes 3 in south america, 2 in the US, and 1 in Europe. Let's be realistic, will this now be unnecesarry for a zoo vet? Will, by retraining and retesting, he all of a sudden know all the issues that could pertain to every animal in a zoo (considering that many zoos also have domestic animals?)

If we do this, does that mean 50 years from now every SA vet will be up-to-date on every technique and drug? Or will some learn info about improved techniques and Rx's and still chose the familiar?

I am not, by nature, a specialist. That might be my basic objection, but my experience has put me in contact with vet medicine across a number of fields in nearly every environment possible. I can't help but feel that while it may improve treatment in areas where money is available, it will do it at the cost of the vet. I also thing those organizations that sit on the financial fringe will collapse during such a transition, and may not recover in the aftermath.

I also experienced the similar transition in nursing and technology in human medicine. I am referring to the change over in nursing programs that make the programs longer, and have started to eliminate positions for LPN's, along with the change over from MLT's to MT's in the labs. Both transitions have resulted in higher costs, shortages of qualified professionals, and according to some studies, reduction in quality of care. I realize this isn't quite the same thing...but there are similarities as both required retraining in the original field. At the same time, medicine is becoming increasingly open to NPs and PAs, partly in response to the need to increase quality care and reduce costs.

I also think that this will affect the areas of vet medicine studens are willing to study; if I can't change from LA to SA if I need to, maybe I should never practice LA.

Also, will this work the other way around? Will we require specialists, like SA cardiologists and dermatologists to retrain if they then go into GP?

I fully confess that I was a pre-med that was balancing my time between vet med and human med, so I have some exposure to the results of similar changes in other fields. Maybe cost shouldn't be an issue...I hear plenty of people on SDN say 'an additional 20k a year for vet school doens't matter' and maybe I am a minority because I know what it is like to depend on vets who can 'do it all.'

Perhaps half the vet schools should become specialists institutions....but realize that will increase the cost for vet school....what if your instate now becomes specialized in medicine that you aren't interested in? What if there isnt' enough interest in some fields for a school to really take it on (or it is limited to a single school?) Basic economics will suggest that will drive costs up. Maybe it would be a good thing...for states that chose to specialize in SA, they may recieve a 'brain boost' in influx of post-bac students needing to gain residency in hopes of gaining admissions. The other institutions could still graduate generalists that take the current/updated full NAVLE. Maybe I will change my mind while in vet school.

I suppose I see the costs as much as the benefits, and the costs scare me. Accredited/liscensed veterinary medicine is a relatively young field. I agree that changes are needed, but I am not sure this is the change, or that the field of veterinary medicine is financially able to support this change. Hopefully, I guess, I am wrong. I still think the vets that, as a client, I would want treating animals are the ones that these type of regulations are just a hindrance to....and that unlike other hurdles, these ones won't be passable by individuals who just go through the motions.

 

[chris03333]

All of these are valid reasons for switching areas of practice. None of these are reasons why a) more in-depth education in your initial area of interest would be bad; or b) requiring a licensing exam (without "going back to vet school"--see above for some suggestions on how to do this) would be inappropriate.

So how about in lab animal medicine, where I am a clinical vet and Joe Shmoe MD, Phd, decides he wants to do work with agean lizzards (or insert whatever random not typical lab animal here)...you seriously expect me to go back and take a reptile examination, before I can be the approved veterinarian for the care of his animals (which he has to have one before he can start the work)?

Just an example of where it may be awkward.

Also in my "typical" day, I may see fish, amphibains, mice, rats, degus, cats, dogs, rabbits, guinea pigs sheep, cows, pigs, gerbils, and monkeys...what types/how many tests would I need to take to do my job? I tend to think NAVLE gave me the background I needed and now it is up to me to do my continuing ed (which I think should be rerquired for every vet).

 

[chris03333]

Absolutely ridiculous.

Part of having a DVM degree is that is a comparative animal science doctorate.

That is a much more blunt version of my opinion

 

[loo]

👍 I share Chris03333's and Capella's views on this issue.

Personally, I think a limited licensing scheme would exacerbate the vet shortage in certain areas of practice.

There's no doubt that what you are learning now will become dated by the time you graduate...but is that the sole reason for creating a "guild-like" veterinary practice system?

Jeez, I sure hope we DON'T follow the human medical model.

I don't want to be "tracked" into a limited area of practice. I want the joy of keeping my mind open to different veterinary experiences. I want the power to choose if I want to specialize; and not be "forced" to go down a narrower path, excluding/deemphasizing other species of animals in my initial professional education. You can't run without learning how to walk first!

Veterinary college is not a trade school.

 

[Fairyblastt]

Interesting thread, to add onto the issue brought up with lab medicine, I have to wonder are we really drawing the lines in the correct places? Sure it's really easy to divide it up into LA, SA, exotics, and what have you... but if the point is to force people to specialize (and that's what it looks like to me), shouldn't it be a bit more specific, and shouldn't there be a biological reason to group certain species together? Shouldn't we then group nonruminants and ruminants separately? They're very different animals, afterall. But that would mean that swine would have to get yanked out of LA and put into SA... Except then we couldn't call it that anymore.

How would we handle birds? Right now the way we group avian medicine is akin to saying "mammal medicine", without accounting for the wide variety found in bird species. A budgie is not a canary, and neither of these have all that much in common with a broiler... Certainly there's a line where none of this would be useful... but if I had a water buffalo (and oh, don't I wish I did), I might feel more comfortable bringing it over to the local beef vet than over to the zoo vet who say, worked primarily with large cats or birds or frogs or something. Exotics are rather exotic yes, but usually they have way more in common with a particular domestic species than they do with each other. So then, if I wanted to do exotic med, I really ought to take all the tests if I'm going to be the only one allowed to touch them! (heh, no water buffalo for you!)

That doesn't seem very logical to me, but if you're going to tell people to specialize, putting similar animals together on some sort of physiological basis makes more sense to me than saying "all animals on a farm go here", "all pet like things go here" and "all wikipedia animals go here"...

 

[Angelo84]

All right cardio exam over. By the way how do you do cardio in 15 hours? Our cardio courses runs all semester....

I also disagree with the limited licensure idea.

While I agree that there is a ton of information to be learned in vet school an awful lot of it crosses species. Working on your earlier example of pig viruses many of those viruses have "look alikes" in other species such as calicivirus in cats and vesicular exanthema in pigs. So I would argue that anything you learn in one species has interconnections to other species of interest. Now yes you can argue there are some diseases that only hit one species so if we aren't interested then we shouldn't have to learn that information.

We are taught how to treat a variety of species and overall the skills you use to work up a patient are the same whether the patient is a horse, cow, dog, bird, or reptile. So if someone wants to switch fields I think they should be required to do a certain amount of CE in the topics that don't "translate" to bring them up to speed.

Not tracking in school allows you to leave your options open. I had a wide variety of experience coming into vet school and quite frankly I enjoyed most of them.

The limited licensure idea would also be problematic in underserved areas or more specialized species. If I am licensed in dog/cat medicine and someone wants me to also look at their rabbit or bird currently I can do that. If I wasn't licensed in that area I would have to send them to someone else that may not be within an area that they are willing to travel.

The only way to fix the "bad vets" that are still practicing 1950s medicine is to require CE. That way at least they will be exposed to new techniques and hopefully will adopt the ones that need updating.

Sorry this is less than coherent...see beginning of post!

 

[sumstorm]

Over 75% of zoos house at least one domestic species, and 20% of farms host at least one 'exotic' species (alpalca, bison, etc.) Add in things like hedgehogs, canaries, rabbits, ferrets, prarie dogs, turtles, frogs, snakes, etc kept as pets.....

 

[aspiringDVM]

Couldn't resist throwing in my two cents...

All right cardio exam over. By the way how do you do cardio in 15 hours? Our cardio courses runs all semester....

I also disagree with the limited licensure idea.

While I agree that there is a ton of information to be learned in vet school an awful lot of it crosses species. Working on your earlier example of pig viruses many of those viruses have "look alikes" in other species such as calicivirus in cats and vesicular exanthema in pigs. So I would argue that anything you learn in one species has interconnections to other species of interest. Now yes you can argue there are some diseases that only hit one species so if we aren't interested then we shouldn't have to learn that information.

We are taught how to treat a variety of species and overall the skills you use to work up a patient are the same whether the patient is a horse, cow, dog, bird, or reptile. So if someone wants to switch fields I think they should be required to do a certain amount of CE in the topics that don't "translate" to bring them up to speed.

Not tracking in school allows you to leave your options open. I had a wide variety of experience coming into vet school and quite frankly I enjoyed most of them.

The limited licensure idea would also be problematic in underserved areas or more specialized species. If I am licensed in dog/cat medicine and someone wants me to also look at their rabbit or bird currently I can do that. If I wasn't licensed in that area I would have to send them to someone else that may not be within an area that they are willing to travel.

The only way to fix the "bad vets" that are still practicing 1950s medicine is to require CE. That way at least they will be exposed to new techniques and hopefully will adopt the ones that need updating.

Sorry this is less than coherent...see beginning of post!

I agree with almost everything here. I think the breadth of the veterinary education allows us a better understanding of each species because we can view it within the context of our knowledge of many other animals. And as Angelo pointed out, often skills and techniques for diagnosis and treatment are applicable to a variety of species (although critical differences certainly exist).

The burden of specialization on undeserved areas is one of the most compelling arguments against limited licensure in my opinion. If a community can barely support a mixed animal practice, it certainly cannot employ two or more specialized vets, and the animals and people of the area really suffer (especially considering that many of these people are likely farmers who depend on their livestock for their livelihood).

This may seem naive to the rest of you, but all of the vets I have worked with have been excellent at recognizing their limitations, conferring with their colleagues, and referring cases to specialists when necessary. Even though she may be licensed to do it, my boss (who owns a small animal clinic) is not about to start going out and performing arthroscopies on horses or breeding soundness exams for cattle.

Finally, I agree that a solid amount of mandatory continuing education is the best and most realistic solution. It would keep professionals current on new developments in their chosen field and allow them to build depth into the overall breadth of the basic veterinary education. I also think that requiring a one-year internship after graduation from vet school might be a good idea as well (I think this might actually be a requirement in some states?).

Over 75% of zoos house at least one domestic species, and 20% of farms host at least one 'exotic' species (alpalca, bison, etc.) Add in things like hedgehogs, canaries, rabbits, ferrets, prarie dogs, turtles, frogs, snakes, etc kept as pets.....

Really, alpacas are considered exotics? I would have thought they'd be classified as small ruminants.

 

[sumstorm]

Really, alpacas are considered exotics? I would have thought they'd be classified as small ruminants.

I had to think about this.... and call an alpaca breeder. They are classified by the USDA as 'alternative livestock.' Most LA vets do not/will not treat alpacas...and from what I was told by the zoo vet I worked for as much of that has to do with the unique breeding physiology and the differences in erythrocytes.

If ruminant was the only concern, giraffes would not be exotics. I do not have a definitive answer, the numbers came from a USDA report from 2005, but I don't currently have the complete citation (it was before I started scanning articles into my computer....I just have the notes on a hard drive.)

My understanding was (when I was helping my parents deal with this on their farm) is that alternative exotic livestock includes bison, cattalo, beefalo, reindeer, antelope, elk, water buffalo, red deer, fallow deer, ostriches, llamas, alpacas, guanacos, vicunas, yaks, musk oxen. That list was based on the USDA's FSIS voluntary exotic animal inspection program.

Of course, that may have changed in the past couple of years!

 

[sumstorm]

Ooops....just got a correction.

July 2008 the USDA officially reclassified alpacas as 'farm livestock.'

 

[alliecat44]

I can understand where those against the idea are coming from, and agree that for underserved areas, this would be problematic. For lab animal/zoo types, requiring an exam for each species is ludicrous--moreover a lab animal/exotics-type exam that encompasses a great deal of these species. As I have said repeatedly, the logistics of such a massive transition would be incredibly complex. Most assuredly there would be many kinks to work out and specifics to take into consideration and make exceptions for.

I think anyone is sorely mistaken in thinking that after graduation from a traditional well-rounded veterinary school you are able to competently practice on hedgehogs, birds, chimpanzees, etc. The vibe here seems to be that a limited licensure structure would take away a ton of massive education involving these species. As it is now, for example, my school has one semester each in lab animal medicine (which will be an elective starting next year) and exotic animal medicine. When you're talking about hundreds of species--again, this is a drop in the bucket.

The only species-specific exam would be equine, I would think--though people much smarter than me would be the ones to determine that. 🙂

Any argument made about the similarities between disease syndromes across species could just as easily be made as a pro-restricted licensure argument. After all, that's that much less CE/exam prep you have to do since there are so many similarities...so I really don't think this is a valid argument against it.

We all agree the logistics would be very ugly to figure out. But let's drop the focus on the actual detailed implementation of such a program (whatever it would look like) and think of the reasoning behind it. Not the romantic notion of being an animal doctor able to treat all species--because believe me, I had this too--but the actual cut-and-dried fiscal and temporal reality of current veterinary education.

Do any of you have an alternative solution to the ratio between time of education (four years) and how much we have to learn across all species, most of which will not ever be used? Is it to go to vet school year round, add a year onto the curriculum, require an internship (!)? The way the current system is set up and the rapid nature of knowledge acquisition, I just don't see a four-year model as being sustainable for very long.

As an aside, I would imagine that more intesnive focus on an area of interest (whether it be for the last 1, 2, or 3 years of the veterinary curriculum) would supply more confident graduates into the private practice arena. Currently there's a rising problem with new grads being overwhelmed with info and feeling like they HAVE to do an internship even if they don't want to specialize just to get some sort of expereince--this is a multifactorial problem--and I think a more intensive tracking/limited licensure program might alleviate this issue.

Angelo, cardio in 15 hours is ridiculous. It's part of our Medicine I class. We only had 15 hours on neuro, too. Now it's about 20 hours on GI...glad to hear you're getting more cardio; I'll send my cases to you. 😉

 

[alliecat44]

Couldn't resist throwing in my two cents...


The burden of specialization on undeserved areas is one of the most compelling arguments against limited licensure in my opinion. If a community can barely support a mixed animal practice, it certainly cannot employ two or more specialized vets...



Finally, I agree that a solid amount of mandatory continuing education is the best and most realistic solution. It would keep professionals current on new developments in their chosen field and allow them to build depth into the overall breadth of the basic veterinary education. I also think that requiring a one-year internship after graduation from vet school might be a good idea as well (I think this might actually be a requirement in some states?).

Firstly, a community could still have ONE vet--who took both exams. Maybe even both straight out of vet school.

Second, CE IS mandatory. Well, attendance is--but there's no holding you accountable for a) actually listening to the lectures; b) staying at the lectures (instead of signing in and leaving, while still getting your CE credit), or c) actually demonstrating the acquisition of knowledge (i.e., a quiz/etc). IMHO, this is one reason the current system is flawed.

Requiring a one-year internship after graduation is pretty infeasible in my opinion. Not enough instiutitions offer them, their quality varies tremendously (there is no set of standards for a practice offering an "internship"), and it can prevent you from starting to pay off your student loans for a year AND prevent you from earning an appropriate starting salary for a year. In many cases, this is not a good decision financially.

But that's a discussion for another thread...

 

[Angelo84]

CE being mandatory depends on the state. I don't know off hand which but there are states that do not require CE.

I would argue that in graduating from vet school you have learned the tools you need to treat any species. You will go through the same process of obtaining a history, physical exam, lab tests and coming up with differentials and a treatment plan. Many of the oddball exotics are related to species we do know more about and can extrapolate from. There is also always the option of calling for help from other vets that may be more experienced in treating hedgehogs.

Depending on how narrowly we divy up the restricted licensing if I wanted to work on dogs, cats, ferrets, horses, rodents, and birds I would have to get multiple licenses--in essence doing the current vet school curriculum. While I agree that for people that come into vet school determined to treat only dogs and cats (or other species specific training) we could shorten the curriculum. But then for those people that were only going to treat dogs and cats what do they do when they have been out three years and a client that has been coming to them for a few years with thier dog and cat wants to add a rabbit? In this new system that vet would either have to refer the client to someone else that is licensed in rabbits (and risk losing the client to the other practice that can treat all of her pets) or go out and get licensed in rabbits as well (taking how long??)

Also if mixed animal vets have to be in school longer to learn more than one species that cost will have to be passed onto the clients making veterinary care less affordable.

The other thing I would worry about is patients not getting the care they need because no vet in the area is licensed to practice on that species. This already is happening in more rural areas that don't have access to a large animal vet. Clients end up treating their animals themselves with mixed results which I would argue is not the best situation for the animal.

 

[chris03333]

CE being mandatory depends on the state. I don't know off hand which but there are states that do not require CE.

Michigan is one (and I really wish they would change that).

 

[aspiringDVM]

Firstly, a community could still have ONE vet--who took both exams. Maybe even both straight out of vet school.

How would this really differ from the current system with a single test that covers a variety of species?

 

[alliecat44]

How would this really differ from the current system with a single test that covers a variety of species?

This is exactly why I don't think it would be the disaster predicted regarding rural communities.

 

[sumstorm]

This is exactly why I don't think it would be the disaster predicted regarding rural communities.

But then how would it reduce the amount of material you need to cover in school?

 

[alliecat44]

But then how would it reduce the amount of material you need to cover in school?

Perhaps you don't start "tracking" or "concentrating" or what have you until your second year. Or perhaps the curriculum is the same for the first three years, and your clinical year is spent in your area of focus. For a mixed-animal practitioner, maybe you spend six months in LA and six months in SA. Or maybe there's a special track/situation/exam for those wishing to practice in communities of less than X number of people.

As I said, I DO NOT KNOW THE LOGISTICS. But I think it's pretty clear that there are many possible permutations on what they would look like, and as I said before, many specific situations/etc that would need to be addressed.

I really think that this, in some form, is going to be the future of veterinary medicine. Whether it happens in ten years or fifty. There's simply far too much to know and extending the length of training would make an already cost-prohibitive degree even more so.

 

[sumstorm]

Don't quite a few of the schools already do this in third or fourth year?

I am not certain that I really believe that we always increase knowledge. I think while we increase some knowledge, we let other material 'go.'

IE the diagnosis and treatment of diabetes has changed radically. How many of us would know how 'sweet' urine should or shouldn't taste? Or the other ways to determine if it is 'sugared'? (anyone ready for a picnic?) Or that, pre-insulin, it could be treated somewhat successfully with lupine, trigonella, and zodoary seed? Do vets learn how to increase insuline production in bovines and porcines pre-extraction anymore?

I know that medical doctors don't cover that stuff anymore (even the diabetes specialists) because it isn't 'relevant' anymore (at least, not until your trapped in a country where refrigeration is a problem and you are out of insulin and the airports are closed down by political protests!) I learned a lot of it from my first husband's mother...who used it to keep her son alive while they traveled across Africa 30+ years ago. It is knowledge that developed in medicine, but as we replaced the treatments and tests with others, we stopped learning/teaching it. Not saying good, bad, or otherwise. Just that while there may be more knowledge, it isn't always a case of just adding knowledge onto other knowledge....we also drop some knowledge, or replace it.

Just a thought, and I realize that is a human example (I am far more versed in human diseases and thier history than most animal disease, except perhaps hoof and mouth.)

 

[No Imagination]

I'm not going to try and comment on everything I don't agree with concerning restricted licenses, but the aspect I feel strongest about is the financial constraints.

The idea that a vet (most kinds) will be able to pass on the cost of additional course work, ie residency, whatever you want to call it, is just plain wrong.

The amount a vet on average can make is constrained not by the number of vets in the field (and restricted licencing will by definition reduce and not increase the number of practicing vets in any one field), but by what the market can support.

We are not Human doctors, who's practice is a need. Like it or not, veterinary care, in most industries, is a luxury item for most. While their are certainly some people who feel their animals trip to the vet is a necessity, the vast majority feel otherwise.

All this (specialized licensing) will do is cause a reduction in number of vets, increased schooling, increased costs (to the vet) and most importantly, take away a vets ability to practice in the field of his/her choosing.

Worse case scenario, it leads to an increase in vet costs and unlicensed vets practicing veterinary care - Like in Pennsylvania. There you have Nurse Practitioners diagnosing, treating, and writing prescriptions without a MD signing off.

Lets learn from the mistakes of MD's, and not repeat them.

http://www.umm.edu/ency/article/001934.htm

Some nurse practitioners work in clinics without doctor supervision. Others work together with doctors as a joint health care team. Their scope of practice and authority depends on state laws. For example, some states allow nurse practitioners to write prescriptions, while other states do not.

Diagnosing, treating, and managing diseases
Providing prescriptions and coordinating referrals
Performing certain procedures, such as a bone marrow biopsy or lumbar puncture

Just call me Chicken Little if you want...

 

[alliecat44]

sumstorm: this is why I estimated that our knowledge has only increased about 10x or so--no idea how accurate that is, but was trying to account for all of the historical or subsequently proven as incorrect items that are no longer taught. Think about it: fifty years ago, we barely had antibiotics. I doubt many radiographs were taken of any domestic species. Advanced imaging modalities did not exist. We didn't even know about DNA. There were many, many, MANY diseases of which we were unaware or which had not yet developed or been brought into this country. There were no molecular diagnostics. And on and on and on....and our curriculum has not changed in duration. When you get to veterinary school, I encourage you to think about what you are learning and the equivalent quantity of information might have been fifty years ago (not accuracy, but quantity).

No Imagination, I'm not advocating residencies for everyone, or talking about extending the duration of the veterinary education. (Though many people on here seem to assume that that is the case.) For many reasons, I agree that would be catastrophic and unnecessary. What I am suggesting is this: Let's keep it four years, but let's do it in a smarter, more targeted way to facilitate better care and more confident and capable new graduates. And let's preserve the level of medicine practiced by requiring folks to be up to date on their new field of choice before switching.

I think it could be done in a way to minimize the cost. If education is four years, it's four years. I don't think an additional exam should or would cost an exhorbitant amount of money. Study materials could be at least partially subsidized, especially for people who are switching into large animal practice.

 

[No Imagination]

For many reasons, I agree that would be catastrophic and unnecessary.

I take it then that we are talking strictly in hypotheticals, an academic exercise.

Sounds good, I can do that.

First, I certainly agree that in the perfect world, that would be a more perfect scenario.

I don't think an additional exam should or would cost an exhorbitant amount of money. Study materials could be at least partially subsidized, especially for people who are switching into large animal practice.

Your right, that would be the easy part. But wouldn't that be a detriment or at least a major hurdle to any older vets interested in switching fields? A vet who is has been working for 10+ years isn't of the same mindset (student) as a recent graduate.

Most vets I know who have been practicing for 10 - 15 years probably couldn't pass the NAVLE now. Most MD's I know certainly couldn't pass Step 2 much less the licensing exam.

That is not a bad thing, its simply a trade off between academic/explicit knowledge and practical/tacit knowledge.

Right now we are ruled by ethics. Not to practice in area's that we are not educated or comfortable to practice in. Sure, there is no law that says a SA vet couldn't perform surgery on a horse, but they don't. Much in the same reason Sumstorms dad doesn't try and rebuild someones corvette (though he could try)

Whats wrong with leaving it that way?