Miami is a city with a problem, one that's being reported in various parts of the country. According to many, the area does not have enough veterinarians.
"It's a big headache when you have a small clinic," said Dr. Sergio Vega, a past president of the Dade County Veterinary Foundation and owner of a small animal practice in Miami. "It's really a problem when you need to get a relief veterinarian." Finding an associate or selling your practice, he says, is also difficult.
An untapped pool
Although hard data are difficult to come by, the problem of underserved Latino communities is prevalent in many areas of South Florida, according to anecdotal evidence. "There are many veterinarians who say they cannot recruit veterinarians because they don't necessarily want to move to the area—they don't have the language capability," said Dr. Paul Gibbs, a professor of infectious diseases at the University of Florida.
In Miami, Spanish is, more often than not, the language of choice. According to the U.S. Census Bureau, 67 percent of people in Miami speak Spanish in their homes, and 44 percent of this population speaks English "less than very well."
The situation is frustrating for some because the area has a potentially untapped pool; South Florida has many veterinarians from Cuba and South American countries, but they are not yet licensed in the United States. If they can gain licensure, they might be a solution to the problem.
"Many pet owners would welcome a Spanish-speaking veterinarian, although many of the Spanish-speaking clients also speak English," Dr. Vega said. "There is always going to be a fraction of the community that cannot communicate in English."
To gain a veterinary license in Florida, most foreign-trained individuals must satisfy state requirements and complete four steps of the Educational Commission for Foreign Veterinary Graduates Program. For the ECFVG program, they must provide proof of graduation from an AVMA-listed veterinary institution, prove fluency in English, and pass the North American Veterinary Licensing Examination. And finally, they must demonstrate clinical skills by passing a hands-on examination or successfully completing one year of evaluated postgraduate clinical work.
Only veterinarians who emigrate from Cuba for political reasons are exempt from completing all four steps. Because of a 1989 provision in the Florida statute, they are not required to go through the ECFVG program, although they must pass the NAVLE and provide proof that they received a veterinary degree from a Cuban school.
A helping hand
The NAVLE can be a stumbling block for some foreign-trained veterinarians. Some test takers have difficulty with the format of the multiple-choice test or struggle with the English language. Other veterinarians have difficulty with it because of the nature of the knowledge they did or did not gain from their veterinary school. "If you are a veterinarian who has trained overseas, there is often a different perspective on what is taught and how it is taught," Dr. Gibbs said. And still others are just not qualified, period.
Because of the practitioner scarcity in South Florida, roughly two years ago, Dr. Vega approached administrators at the University of Florida's College of Veterinary Medicine and asked them to develop a NAVLE preparatory course to help foreign graduates with that part of the process. Administrators responded, and the course, which cost $2,000, was offered for the first time in November 2001, running 12 weeks.
Sending faculty down to Miami was impractical, given the distance, so a distance learning course, to be taught in English, was developed, in conjunction with Nova Southeastern University in Fort Lauderdale. Individuals who took the course were given a series of videotaped lectures, 29 tapes in all, and were encouraged to watch an assigned tape prior to class, held twice a week.
In each class, students reviewed that tape together, and then the lecturer featured on the tape was videoconferenced to the classroom for a question-and-answer session. Faculty also responded to questions via e-mail and phone during the 12 weeks. Topics covered small and large animal medicine and ran the gamut, including surgery, infectious diseases, bacteriology, pathology, immunology, pharmacology, radiology, ophthalmology, and foreign animal diseases.
Dr. Joseph DiPietro, dean of the University of Florida's College of Veterinary Medicine, emphasizes that the course was not developed to create an alternative pathway for applicants. "All it was (trying) to do was provide a preparatory course for the students that allows them to know better where they stand, given the various disciplines on the NAVLE, and have a better approach to studying (their) weaknesses," he said.
Dr. Silvana Herrera, a small animal veterinarian from Argentina who now works in Florida as a veterinary technician, is currently going through the ECFVG program. She found the basic science lectures in the preparatory course particularly helpful. Her veterinary school emphasized other areas, she said.
Other students came from countries including Cuba, Venezuela, Mexico, Peru, Ecuador, and Puerto Rico.
Making the grade
Of the 53 individuals who took the course, 22 sat for the NAVLE in April 2002. Many chose to keep studying and take the examination during the next testing period, which just recently took place in November and December. "I think there were a number of students who thought it would be great to take this exam, and they hadn't realized, ahead of time, how really difficult it is to become licensed in North America," Dr. Gibbs said.
Of the 22 who took the examination last spring, roughly 20 percent passed. Dr. Herrera was among them and thinks the course helped her greatly. "I really enjoyed the course and it was really useful for the exam," she said.
Dr. Gibbs realizes, however, that the success rate is not that impressive. He says he doesn't know whether a lack of knowledge, a language problem, or both are to blame. He is curious to see how the remaining 32 candidates perform when they take the examination, and he plans to keep improving the course.
The University of Florida did not offer the course again this past November because only 20 prospective students lived close enough to make the trek to Nova Southeastern University. Dr. Gibbs knows, however, that a need for the course still exists, not only for veterinarians in South Florida, but also for many foreign-trained veterinarians in other states.
At press time, faculty at the University of Florida were in the process of putting the entire course on the Web at www.vetmed.ufl.edu/forvet/navle. They estimated that it would be available by early 2003.
Individuals will be able to access the site with a password, and question-and-answer sessions will take place through an e-mail forum. At press time, it was uncertain whether the course would be offered for free or some minimal cost.
Dr. DiPietro says his college's distance learning course in forensic toxicology has attracted many interested students and that distance learning is a focus of the university. "It's among the priorities of the place. We do have ideas about going other places with other types of courses by distance ed," he said.
Only time will tell if the NAVLE course turns out to be a real success but, if it does, it may help veterinarians besides those trained in other countries. Dr. Elizabeth A. Sabin, assistant director of the AVMA's Education and Research Division, says the online course may prove useful for U.S. students who need extra help in studying for their licensure examination.