HOD: hasten effort to improve certification process

A pivotal development that happened just a week before the AVMA House of Delegates convened in Philadelphia has derailed a proposed resolution but has led to passage of a substitute resolution that is in sync with the tide of change. 

This spring, the Texas VMA submitted Resolution 5, which, in part, called for the AVMA to work with the American Association of Veterinary State Boards to complete the establishment of a single, independent body for certifying graduates of veterinary schools not accredited by the AVMA. 

The chain of events was set in motion when the AAVSB wrote to the AVMA in July 1999, saying that the 38 member boards represented at its 1999 Delegate Assembly adopted a resolution calling for the AAVSB to assume responsibility for administering the AVMA Educational Commission for Foreign Veterinary Graduates program. The National Board Examination Committee would assume responsibility for developing and administering the Clinical Proficiency Examination, in conjunction with the AAVSB. 

For many reasons related to standards, quality, and oversight, the AVMA declined to cede administration of the ECFVG program to the AAVSB. Subsequently, at its July 2000 Delegate Assembly, delegates directed the AAVSB to proceed in developing a new assessment program called Program for the Assessment of Veterinary Education Equivalence. 

The widely held conviction that having multiple pathways for certification was not in the best interest of these graduates or the profession led to a series of meetings between AVMA and AAVSB representatives, beginning in September 2001. They agreed on the desirability of having a single, independent educational equivalence assessment program and consulted attorneys, who determined this may be legally feasible. 

This spring when submitting Resolution 5, the TVMA conveyed its frustration by stating in the background that the AVMA and AAVSB have had time to resolve this issue but did not appear to be any closer to a resolution than they were two years ago. 

The defining moment in the AVMA-AAVSB negotiations came July 15 after the two organizations met in Kansas City, Mo., and, unable to reach consensus on the composition of an independent program, issued a joint, concluding statement that said philosophically, the AVMA and AAVSB could not reach agreement regarding the first of several important issues—what should be the organizational structure of an independent entity? 

The consensus reached by the representatives was to agree to disagree for now. 

"Through these discussions, the AVMA and AAVSB have gained a better appreciation for each association and the respective role each plays," the statement read. "The AVMA and AAVSB remain committed to their respective missions, serving the American public and the veterinary profession to the best of their abilities." 

One of the stumbling blocks to reaching an agreement was the organizations' clashing definitions of an independent body. The AAVSB envisions a body that operates independently of the professional association and, to be consistent with the AAVSB mission, must have a majority of board members from the regulatory community. In contrast, the AVMA supports one that is governed by an autonomous organization whose operation is independent and separate from that of its founding organizations. 

Conflicting ideas for the body's organizational structure were another impediment. Whereas the AAVSB favored combining the ECFVG program and PAVE under the AAVSB umbrella, the AVMA wanted a structure modeled after that of the Educational Commission for Foreign Medical Graduates program. 

On July 23, there was extensive discussion of the new state of affairs in HOD Reference Committee 3, where Texas VMA officials expressed the continuing desire for the AVMA to move forward with the initiative of improving the certification process, even without the AAVSB. 

On July 22, the Executive Board gave its consent for two such enhancement activities. First, the board approved, in concept, exploring the potential of developing a temporary Clinical Proficiency Examination site, possibly to test ECFVG candidates in Las Vegas prior to the final development of a Western Veterinary Conference site. 

The board also approved a new AVMA staff position in the Education and Research Division for an ECFVG testing coordinator. This individual will, among other things, oversee quality assurance and development programs for the assessment tools used to evaluate veterinary knowledge and skill levels of graduates of nonaccredited schools, schedule examinations, collect fees, and communicate with candidates. 

July 24 during the HOD, Texas VMA delegate, Dr. Tony W. Brown, requested permission to introduce a substitute resolution (technically, an amended motion) from the TVMA. The HOD made a minor change to update the text, then agreed to a brief recess to enable the House Advisory Committee to consider whether to recommend approval of the amended resolution. 

For procedural reasons, the HOD took HAC's advice to disapprove amended Resolution 5 but to approve the same verbiage under the visage of a new Resolution 7. This approved resolution states the following: 

RESOLVED, that the American Veterinary Medical Association (AVMA) has attempted to work with the American Association of Veterinary State Boards (AAVSB) to establish an autonomous organization, the operation of which is independent and separate from that of its founding organizations, to administer a process to certify educational equivalence of those veterinarians who have graduated from non-AVMA-accredited colleges of veterinary medicine. 

HOWEVER, it appears that these efforts have now been rendered ineffective by the outcomes of a July 15, 2004 joint meeting of AAVSB and AVMA representatives wherein these representatives were unable to reach agreement on fundamental issues incumbent to the eventual success of the undertaking. 

THEREFORE, the AVMA should continue unabated and with deliberate haste its efforts to improve the certification process. 

After passage of Resolution 7, Dr. Brown told the HOD, "It has been a strong feeling of the Texas Veterinary Medical Association that it is not healthy for the veterinary profession as a whole to have more than one pathway for dealing with our foreign graduate friends." 

He emphasized that this is both a licensing and an accreditation issue, and he also stressed the importance of a process that encourages foreign schools to seek accreditation.

Dr. Brown continued, "As it turns out, it appears that the actions and conversations produced by the AVMA in its language regarding independent and autonomous, and its willingness to discuss something in that regard, is much more in line with the intent of Texas VMA and its Resolution 5, than what came out of the meeting with the AAVSB."