Starting from day one
The question "Who is a veterinarian?" may seem like it has a simple answer—someone who has been awarded a veterinary degree. But what does having a degree mean? Someone who graduates from the University of Ibadan in Nigeria may have a different skill set from someone who graduates from the University of Calgary in Canada.
A few countries and regions have made efforts to define and harmonize the combination of knowledge, skills, and experiences that new veterinary graduates need to have when entering the veterinary profession. The Royal College of Veterinary Surgeons accomplished this in the early 2000s when it developed lists of the essential day-one and year-one competencies required of veterinary surgeons. At about the same time, the AVMA Council on Education began defining the critical competencies expected of new graduates from accredited veterinary colleges. And just this year, the Association of American Veterinary Medical Colleges, through the North American Veterinary Medical Education Consortium, spelled out core competencies for graduates of U.S. and Canadian schools.
Now, defining the essential competencies required of veterinary graduates has reached a global level. The World Organisation for Animal Health (OIE) is working to provide guidelines and tools to enable all countries to apply a standardized approach to improving the quality of veterinary education. The effort is largely directed toward developing countries and countries with economies that are in transition. The organization anticipates its work will result in these nations improving the competencies of their veterinarians and, thereby, the performance of their veterinary services in all areas.
Building up capacity
Historically, the OIE has focused on sharing animal disease information and improving animal health worldwide. At the request of member countries and as identified in recent strategic plans, the OIE expanded its mission to include work on animal welfare, animal production, food safety, and food security. But this proved not to be enough, said Dr. Alex Thiermann, president of the OIE Terrestrial Animal Health Code Commission.
The global H5N1 avian influenza outbreak in the mid-2000s demonstrated the vulnerability of all countries resulting from an inability in some countries to detect disease outbreaks early and respond rapidly. Thus, the international community recognized the need to strengthen veterinary infrastructures as a global public good.
Responding to increased interest in international trade, companies in many developing countries with weak veterinary infrastructures attempted to develop their own export certification process for animals and animal products, Dr. Thiermann said. He added that this demonstrated once again the importance of a credible veterinary service, as international veterinary certification of exports can be done only by official veterinary authorities.
These circumstances made apparent the need to evaluate veterinarians' performance and improve veterinary infrastructures. The OIE convinced the international community of the importance of doing so to help reduce the risk of another disease outbreak in developing countries as well as to guarantee the credibility of international veterinary certificates and ensure safe trade.
Current estimates suggest that 80 percent of the OIE's 178 member countries are lacking an appropriate infrastructure for veterinary education, said Dr. Bernard Vallat, director general of the OIE, in December 2010. He added that many countries are obliged to use foreign-trained veterinarians and have little to no capacity to evaluate the quality of the education these veterinarians received.
So in 2007, the OIE created a tool to evaluate the performance of veterinary services in a country, the "OIE PVS tool." The evaluation is performed by OIE experts at the request of the national authorities. It determines the current level of performance of a country's veterinary services on the basis of 46 competencies—from human, financial, and physical resources to laboratory infrastructure to market access. In a second phase, another team of experts identifies and prioritizes gaps in the country's ability to comply with OIE international standards, to form a shared vision with stakeholders, and to carry out strategic initiatives to reduce those gaps.
Day-one competencies
Early PVS evaluations revealed that the level of competency of a country's veterinarians was a critical element in the effective performance of the country's veterinary services, and the experts observed substantial differences when comparing the competencies of veterinarians among countries. The OIE felt the need to evaluate this area more and to provide guidance on the minimum competencies that veterinary educational institutions should aim to provide as they develop and refine their veterinary curriculum.
The effort began at an OIE conference in October 2009 that examined veterinary education and model standards. Meeting in Paris, the international group drafted 28 recommendations on the harmonization of basic competencies delivered by veterinary educational institutions worldwide (see JAVMA, April 1, 2010).
Following the conference, the OIE established the ad hoc Group on Veterinary Education to define those "day-one" competencies. AVMA CEO Ron DeHaven chairs this group comprising nine other international veterinary authorities. The group is not trying to define accreditation standards, prescribe a specific curriculum, or accredit veterinary educational programs or institutions, he said during a presentation at the second World Conference on Veterinary Education, May 13 in Lyon, France.
Instead, the goal is to address the particular needs of developing countries on subjects to be covered when educating veterinarians for work in the public and private sectors. Veterinary educational institutions would continue to be responsible for deciding how to deliver their curriculum.
Dr. Thiermann said these competencies can allow veterinary educational institutions in Third World countries to raise the competence levels of their graduates.
"So these day-one competencies are the first step and a significant step in beginning to define what are the basic requirements accepted worldwide for calling someone a veterinarian and, therefore, being able to harmonize the veterinary workforce among all OIE member countries," he said.
Meeting of the minds
The draft minimum competencies the ad hoc group developed are defined as skills, knowledge, attitudes, or aptitudes, and have been divided into three levels.
The general competencies cover basic and clinical veterinary sciences fundamental to the entirety of the curriculum—not just to delivery of national veterinary services—such as animal welfare and food hygiene and safety.
Specific competencies directly relate to the skills needed to perform various tasks in accordance with international standards found in the OIE Terrestrial Animal Health Code.
Discussing the ad hoc group's recommendations was the primary objective of the second World Conference on Veterinary Education in May. The event brought together deans and veterinary professionals from throughout the globe. In Lyon, attendees approved 16 resolutions relating to the minimum competencies and other educational issues. These were presented to the 178 delegates at the 79th OIE General Session May 22-27 in Paris.
After review and amendments made on the floor, the World Assembly of Delegates approved six of the 16 resolutions, including one that stated: "The OIE should in the future present a framework and recommendations to the World Assembly of Delegates on the day one minimum competencies required by veterinarians for countries to meet the OIE quality standards for veterinary services (both public and private components), taking into account existing input prepared by the ad hoc Group on Veterinary Education ... ."
Dr. DeHaven said, "In general, I think the resolution validates the work done thus far and authorizes us to proceed with developing global minimum competencies for veterinary education as it relates to those functions relevant to a national veterinary service (regulatory authority)."
Getting it in writing
At the same meeting, Dr. Thiermann brought an amendment to the floor that incorporates new language referring to the day-one competencies under the requirements on quality of veterinary services in the Terrestrial Animal Health Code.
Even though the competencies have yet to be finalized, he said that including the concept in the OIE code is a way to bring to the international community's attention the critical nature of day-one competencies for veterinary graduates.
The amendment sparked debate on the floor. Some members raised the issue of how these day-one competencies, not yet fully defined, could affect them. They expressed concern that noncompliance with these day-one competencies could result in trade impediments.
Dr. Thiermann explained that, while these competencies are not directly related to trade requirements, having the country's veterinary professionals posses these competencies would improve the credibility of their veterinary services and, thereby, facilitate trade.
"The problem developing countries are facing today is that, often, importing countries are not accepting the veterinary certification issued by certain veterinary services as being in compliance with the OIE international standards," Dr. Thiermann said. "The importing countries say, 'We don't have certainty that what is contained on the international veterinary certificate is credible.'"
He continued, "The OIE is putting more detail in the code in respect to necessary aspects of an effective and credible veterinary service, and these are then included as critical competencies in the PVS evaluation tool. This will all result in a more transparent and impartial assessment of the credibility of a veterinary service."
The amendment to the OIE international standards was adopted at the meeting.
Diagnosis and treatment
Looking ahead, the ad hoc Group on Veterinary Education will further refine the day-one competencies and postgraduate training recommendations at its next meeting, Aug. 2-4 in Paris. These will likely be published as reference documents on the OIE website, as has been done for other topics mentioned in the international standards, sometime by next year's OIE General Session in May 2012.
Dr. Thiermann anticipates that once they are further described and officially adopted, the day-one competencies will be incorporated into the PVS evaluation tool. Thus far, the OIE has performed evaluations in more than 110 countries, mostly developing nations, including almost all the African countries in the OIE. Although the PVS tool helps countries to identify their strengths and weaknesses, that's not the end of the story. Once countries have examined the results of the evaluation, they call on the OIE to help identify and prioritize actions needed to improve their veterinary services, the so-called GAP Analysis. Some 35 countries have gone through that process already, Dr. Thiermann said, receiving a road map to progress.
"Like the phrase goes, 'Diagnosing a disease doesn't make the patient feel any better,' but now the OIE is also providing the treatment,'" Dr. Thiermann said.
For a more detailed look at the day-one competencies, visit www.oie.int and look for the 2011 report that will be available from the 79th General Session of the World Assembly of OIE Delegates.