White paper advises partnership to reverse veterinarian shortages

Need is critical in population health, public practice
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With final revisions completed in late September, a white paper on meeting the critical needs for veterinarians in population health and public practice has been prepared for publication. Project investigators and co-authors, Drs. Kent H. Hoblet of The Ohio State University and Andrew T. Maccabe and Lawrence E. Heider of the Association of American Veterinary Medical Colleges, prepared the white paper.

The Department of Agriculture's Animal and Plant Health Inspection Service, the USDA Food Safety and Inspection Service, and the Food and Drug Administration's Center for Veterinary Medicine provided support for the project. The white paper will be published this fall in the Journal of Veterinary Medical Education (Vol. 30, pages 287-294) and will be available from the AAVMC by early November in a quadrifold, print version as well. The AAVMC will also post the paper on its Web site, www.aavmc.org.

As corresponding author, Dr. Hoblet presented a draft of the executive summary July 21 during an AAVMC assembly meeting of deans, chairs, and directors of AAVMC member institutions at the AVMA Annual Convention in Denver. At that time, the document was still a work in progress. Dr. Hoblet is professor and chair of the Department of Veterinary Preventive Medicine at OSU. Dr. Maccabe is associate executive director of the AAVMC, and Dr. Heider is executive director.

"There is general recognition that the profession is now at a central decision point," Dr. Hoblet began during his Denver presentation. "Resources are limited, and careful and informed decisions must be made, or opportunities will be lost to the profession and society in general."

From the beginning, the mission of our institutions has been to address needs in animal health and public health, he said. Over the past half century, society has changed, and veterinary medicine and veterinary medical education have reflected those changes. At the same time, critical needs continue to exist in public health, food safety, food security, animal health, and comparative medicine.

"Veterinarians are a unique national resource," Dr. Hoblet said. "Veterinary medicine provides an extraordinary link between agriculture and human medicine."

About 5,000 veterinarians are employed in various federal agencies, state government, industry, and academia (includes only those in public health, preventive medicine, and extension), and another 10,600 in food animal medicine, based on AVMA records, Dr. Hoblet noted. He said this represents 20 percent of (practicing) veterinarians.

"To maintain our current footprint," Dr. Hoblet continued, "we need 500 new entries into population health and public practice per year," or approximately 20 percent of new graduates each year, he said.

Three issues must be addressed, Dr. Hoblet said—recruitment and retention, education and training programs, and the investment needed.

Relative to recruitment and retention, he said the colleges are getting highly qualified students but questioned the diversity of professional interests. One person he interviewed suggested that instead of asking applicants why they are interested in becoming a veterinarian, admissions staff should ask how they plan to use their veterinary degree.

Because public funds are used, the general and long-term needs of society must be considered, Dr. Hoblet said. "The distribution of veterinarians across the breadth of societal needs is affected by complex factors. Adjustments should be made in the admissions process, as required for the benefit of the entire public, and it's up to the colleges to assume the leadership in this task."

The second issue is the professional veterinary curriculum. Public health and preventive medicine training ranges from 30 to 120 contact hours among the 28 U.S. veterinary colleges, Dr. Hoblet said. At least one core course in epidemiology and public health is needed. "The clinical year is a very significant part of the professional program, and we generally do a good job of it. Clinical population health and public practice also need (to provide) a learning experience." He acknowledged the difficulties associated with that and the need to find innovative ways to present public health and preventive medicine clinical experiences.

Practitioner specialty training includes the master's of public health, nonthesis master's degree, and residencies in laboratory animal medicine, among others. "There's a crying need for laboratory animal veterinarians," Dr. Hoblet said, adding that there are 38 existing programs that students should be informed about.

Dr. Hoblet noted a critical need for infrastructure to support research and graduate education, and an extreme shortage of DVM/PhD scientists in epidemiology, pathology, and infectious diseases. "Failure to educate DVM/PhD scientists will adversely affect food security and public health," he said.

The third underlying issue is the investment needed. "National issues require national solutions," Dr. Hoblet said. For that reason, the white paper calls for shared responsibility and accountability on this issue via a partnership between colleges and departments and state and federal governments. National efforts should be optimized to meet challenges in public health, food security, animal health, and comparative medicine for the benefit of all Americans.

Following presentation of the executive summary, there was some discussion about selective admissions. Dr. Hoblet said that intuitively, he has been opposed to trying to identify students likely to pursue these areas of shortage, but the needs are too great to ignore, and he is changing his mind. "We do a great job of (teaching) basic food animal medicine in our colleges, but we don't always expose our students to the more exciting things like we do in companion animal medicine."