AAVSB issues receive attention in Boston

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During the AVMA House of Delegates session July 12-13 and the subsequent AVMA Annual Convention in Boston, two controversial activities of the American Association of Veterinary State Boards were discussed and saw some action. Following are reports on the status of the PAVE program for foreign graduates and the AAVSB draft model practice act. Discussions are currently under way between the AVMA and AAVSB officers for possible future collaboration on these issues.

AVMA House of Delegates registers concern about PAVE; debate rolls on at AAVSB delegate assembly

After just a few comments from delegates July 13, the AVMA House of Delegates approved Resolution 5—to publicize the negative effect a proposed national program would have on assessing U.S. educational equivalency and accreditation standards.

The California VMA and the House Advisory Committee submitted the resolution, calling for the AVMA to develop a plan for veterinary and public awareness of the harmful effect the sponsors and many others believe would result from the PAVE program proposed by the American Association of Veterinary State Boards.

State veterinary medical boards must initiate legislative or regulatory changes in state practice acts to accept PAVE—the Program for the Assessment of Veterinary Education Equivalence—as an alternative to the AVMA Educational Commission for Foreign Veterinary Graduates program.

On the House floor, California delegate Dr. Michael P. Andrews urged his colleagues to approve the resolution, even though the AVMA has already been alerting state leaders and the entire membership about this issue. Vote for the resolution because it sends an important message, Dr. Andrews urged. PAVE is not the only issue, he added, referring to the AAVSB proposed model practice act, which has also drawn sharp criticism.

Wisconsin delegate Dr. René A. Carlson said that the Wisconsin Veterinary Examining Board was set to vote with its national organization—the AAVSB—until Wisconsin VMA representatives told them of PAVE's pitfalls. Now the board plans to vote against adopting PAVE in Wisconsin.

In Reference Committee 3, discussion took much the same direction. Dr. B. Taylor Bennett, delegate from the American Society of Laboratory Animal Practitioners, said, "This is a solidarity issue. We need to show that the leadership of this organization is concerned about undermining the value of the veterinary diploma."

Executive Board member Dr. Joan M. Samuels told the reference committee the AVMA is expending a lot of people hours as well as money to make sure states understand this critical issue.

"I think the AAVSB believes that our goals and mission are in direct conflict with theirs, but improving animal and human health is in our mission statement. So we believe our missions are complementary, even though not exactly the same. The AAVSB believes we're out for ourselves. This is one hurdle we have to overcome."

Discussion at AAVSB delegate assembly
At the AAVSB Delegate Assembly July 16, Dr. James R. Corley, AAVSB president, said he has been unable to convince the AVMA that foreign veterinary graduate certification is a licensure credential issue, and the AVMA has been unable to convince him that it is part of approval and accreditation. He said the AAVSB goal is "to accurately and appropriately determine educational equivalence to the gold standard. The gold standard is a graduate of an accredited [or approved foreign] program."

AAVSB delegates discussed the program at the July 16 meeting, but no action was taken.

Dr. Corley said the AAVSB brought its concerns regarding the ECFVG program to the table at a June 2000 meeting with the AVMA and National Board Examination Committee. The AAVSB sees the problems as inappropriate use of the licensing and screening examinations, a conflict of interest in having a professional association determine what the AAVSB interprets as a licensure credential, and problems with the Clinical Proficiency Examination, including standardization and availability.

Dr. Sue Chadima, Maine delegate and chair of the PAVE Board, presented an overview of PAVE.

"A lot of the confusion is '[aren't] the ECFVG and PAVE very similar?' and the answer is yes, they are very similar, with a couple of distinct and very important differences," Dr. Chadima said.

One difference is in the step 3 of the four-step PAVE and ECFVG programs. PAVE will include a new examination for foreign graduates that it believes covers areas not tested on the North American Veterinary Licensing Examination (NAVLE).

"We feel it's important that the NAVLE—which is each individual state's board [exam] for most of us, our entry-level national licensing exam—comes at the end of an educational process, not as a means to enter a qualifying process. That is a major difference between PAVE and ECFVG," Dr. Chadima said.

Under PAVE, candidates who pass the qualifying examination would be eligible for step 4—participation in a program of evaluated clinical study or a clinical skills assessment examination, which is still being developed.

The ECFVG program has two means of completing step 4 of the certification process—a year of evaluated clinical experience or the Clinical Proficiency Examination. In July the AVMA Executive Board directed the ECFVG to continue to offer both pathways, and to contract with consultants to evaluate and standardize the experience. The ECFVG had introduced a plan to eliminate the year of clinical experience. The board also directed the ECFVG to look into the advisability of developing a preclinical certification examination to be used as step 3 instead of the NAVLE (see board report, page 587).

PAVE Board member, Dean Ralph Richardson of Kansas State University complimented the ECFVG and the AVMA on acting to retain the clinical year. "Now one of my very serious concerns is no longer an issue as far as ECFVG equivalency is concerned.

"I remain concerned about entry-level skills for that senior year," he said, or whether there can be a better preclinical assessment than NAVLE, which he called "a post-training program exam, not an entry-level exam."

An AAVSB delegate asked whether PAVE could create an unintended opportunity for students at foreign schools to skip the fourth year. Dr. Chadima said, "That's a valid, legitimate question, but more appropriately examined at the school level. I think it's a concern, but I'm not sure it's pertinent to our mission to protect the public."

AVMA Executive Board member, Dr. Roger Mahr was invited to comment. Dr. Mahr noted that offering an alternative to ECFVG creates two pathways or standards for foreign graduate certification. He discouraged that pursuit and assured the AAVSB assembly that the AVMA is interested in working with them to resolve concerns with the ECFVG program.