Q: Is there any evidence of undue influence on the COE by the AVMA Board of Directors?
A: Critics have expressed concerns about perceived conflicts of interest regarding the interactions of the COE and the AVMA Board of Directors. The centerpiece of this argument is the belief that the AVMA Board of Directors forced the COE to accredit the Western University of Health Sciences (WUHS) College of Veterinary Medicine under threat of lawsuit. The basis for this belief is the fact that the lawsuit was dropped shortly after the College received a Letter of Reasonable Assurance (LRA) from the Council indicating the proposed program was feasible, if executed as planned. In fact, the LRA was denied twice by the Council and both subsequent appeals failed before the LRA was finally granted. Each time the WUHS plan was reviewed and denied due to non-compliance with one or more accreditation standards, the university made adjustments. Each attempt resulted in compliance with additional accreditation standards. By the third review, the university had addressed all of the Council’s concerns and earned the LRA. The COE never stopped working with the university in accordance with its published policies and procedures. Instead of receiving preferential treatment, the college actually received far greater scrutiny due to the use of a non-traditional curriculum that included 100% problem–based learning (PBL) for didactic courses and a distributed model of clinical education. Since first proposed in 2000, the college has been visited by the COE more than any other accredited college (five focused and four comprehensive site visits as of mid-2015) over the same length of time. Graduate outcomes have been very good. In fact, we’ve seen comments from members who, despite expressing the belief that the college was “substandard,” stated that the graduates with whom they had worked were competent and knowledgeable.
The AVMA Board of Directors has taken a variety of steps to reduce perceived conflicts of interest relative to the COE in response to stakeholder input over the past several years, including the following:
- Eliminated the requirement for Board approval of changes to COE policies and procedures (2007) and the accreditation standards (2013).
- Initiated changes that share responsibility for sponsoring the COE with the AAVMC. These changes were modeled after the medical education accreditation system, the Liaison Committee on Medical Education (LCME), which is jointly sponsored by the AMA and Association of American Medical Colleges (AAMC).
- At its April 2015 meeting:
- Terminated the Board liaison position with the COE
- Agreed to fund independent legal counsel for the COE
- Received notice from the COE that the opportunity for Board members to observe accreditation site visits was being eliminated.
- Revised the COE Selection Committee description to include two former COE members and three at-large members. Members of the Committee will not be allowed to serve simultaneously on the Board of Directors or House of Delegates.
The firewall established by the AVMA BOD and HOD to ensure the autonomy of the COE is more robust than those in place to safeguard the Commission on Dental Accreditation (CODA) from the influence of its sponsor, the American Dental Association, and on par with those in place to ensure the autonomy of the LCME from its sponsors, the AMA and AAMC. Like the COE, the CODA and LCME are autonomous entities housed within the sponsoring organizations. Neither is a completely independent entity.