Heated debate in Atlanta

HOD forgoes analysis of COE foreign accreditation function
Published on September 01, 2010
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By Susan C. Kahler 

AVMA delegates debated scientific evidence, expressed concern about consequences, and questioned the motives of fellow representatives during debates over proposals presented in late July.

During their 2010 regular annual session, members of the AVMA House of Delegates ultimately defeated a resolution connected with accrediting foreign veterinary colleges and passed two and defeated one connected with antimicrobial use. Two articles about those decisions are part of the JAVMA News coverage of the HOD's session July 29-30 in Atlanta, as are a summary of House Advisory Committee and council elections and an AVMA Bylaws change that will give the liaison member on the AVMA Council on Education appointed by the Association of American Veterinary Medical Colleges a vote on council matters. 

Members of the AVMA House of Delegates debate in Atlanta, left to right: Drs. Mark Cox, Texas alternate delegate; M. Gatz Riddell, American Association of Bovine Practitioners alternate delegate; Mark Starr, National Association of State Public Health Veterinarians representative on the Advisory Panel to the HOD; Gregg J. Cutler, American Association of Avian Pathologists alternate delegate; and Billy Martindale, Texas delegate.

For AVMA Annual Convention coverage, see story.

What the Texas VMA saw as a straightforward request for review of the AVMA Council on Education's function of accrediting foreign schools became the subject of robust debate by the House of Delegates at its regular annual session in late July in Atlanta.

In Resolution 1, the TVMA called on the Executive Board to assign a task force to do a benefit-risk analysis of the council's accreditation of foreign veterinary schools and prepare a report for presentation at the HOD's 2011 regular annual session.

After ample deliberation, the resolution was defeated July 30 by a voting margin of 61 percent to 39 percent.

The dialogue began July 29 at the HOD informational session following a screening of the AVMA-produced video "Setting the Standard," which provided context about AVMA involvement in accreditation and the COE process. COE Chair James J. Brace and Dr. David E. Granstrom, director of the AVMA Education and Research Division, then fielded questions.

A representative question was: How does the council evaluate a school whose program is in a foreign language? Answer: Foreign site visits must be conducted in English, although the curriculum does not have to be taught in English. Another example: What happens if a U.S. Department of Education policy conflicts with a foreign higher education policy? Answer: If that were to happen, the school would not meet the COE standards. A third query: Can students from Mexico short-circuit the English proficiency requirement? The question was a reference to a Mexico City-based veterinary school's pursuit of COE accreditation. Answer: It's incumbent on the state boards to ensure that foreign students from COE-accredited institutions meet English language requirements.

Dr. Granstrom advised the delegates that the COE is scrutinized every 10 years by the Council on Higher Education Accreditation and every five years by the Department of Education. Internally, the AVMA Governance Performance Review Committee conducts a periodic critical review, and two task forces were formed in the late '90s to assess specific aspects of the council. Foreign accreditation was suspended in 1997, and the COE spent a year discussing its role in international accreditation. The following year, a Task Force on Foreign Veterinary Medical Education was established to evaluate continuation of the process. The task force recommended continuation with full cost recovery, citing as reasons globalization, emerging zoonotic diseases, and food safety concerns.

Later that day in Reference Committee 3, key points raised—in addition to whether an analysis was needed—related to a lack of clarity in the resolution, the TVMA's emphasis on the resolution being a member-driven initiative, concerns about foreign graduates' English language proficiency, and potential underlying motivations of the resolution.

Back in the HOD July 30, reference committee Chairman Ken Bartels said, "We had two hours of solid discussion on the merits and demerits of the resolution. The biggest issue I thought came up was our understanding from the TVMA alternate delegate (Dr. Mark Cox) that this was a grassroots issue and kind of a test—does AVMA want to listen?"

After the delegates passed an amendment to the resolution to clarify a procedural point, Dr. Bartels made a motion on behalf of the reference committee that the resolution as amended be referred back to the Texas VMA with instructions to work with the AVMA to clarify the outcomes they desire. The HOD disapproved this.

On the HOD floor, Texas Delegate Billy Martindale said, "We believe the vast majority of AVMA members do not know why the AVMA accredits foreign veterinary schools or how the process works. Questions are being asked ₀ about how this program benefits our members."

Dr. Gregg J. Cutler, American Association of Avian Pathologists alternate delegate, said, "I want to welcome everyone to the world economy. … Why does AVMA accredit? Somebody has to, and they are doing a very fine job."

Earlier that morning, foreign veterinary dignitaries had cautioned the HOD about efforts outside the U.S. to establish international minimal education standards, which would imperil the perceived COE gold standard.

Dr. David A. Prigel, delegate from Missouri, thought the statement the TVMA included with the resolution seemed unrelated to the resolution itself, fueling questions about the resolution's candor. (See resolution and accompanying statement in JAVMA, July 1, 2010.)

"What really bothers me about this is I'm old enough to have lived through discrimination," Dr. Cutler said. "It's not what's written in this; it's what's not written in this. AVMA will not tolerate this kind of thinking—we believe in diversity."

Addressing potential economic motivations behind the resolution, Executive Board member Dr. Larry Dee said, "Should the mission of COE include protecting the economic viability of veterinarians? That's the elephant in the room."

Another point of contention revolved around doubts about the competence of individual graduates of COE-accredited foreign schools, as suggested in the resolution's accompanying statement as well as by Texas alternate delegate Dr. Cox, who had said in reference committee, "I have a problem with waiving (individual assessment) just because the school is accredited."

To view the video "Setting the Standard," described in the report on page 602, visit www.avmatv.org  and select the "Becoming a Veterinarian" channel under the Careers heading.

Maine Delegate Susan B. Chadima objected on the HOD floor, saying, "It is inappropriate and offensive to use school accreditation in a licensure mode."

Responding to some of these comments, Dr. Martindale said, "It's a bit unfair for some to accuse our motives as other than what is written."

Dr. Granstrom addressed the concern that foreign accreditation does not ensure proficiency of individual graduates. He noted that Standard 11—Outcomes Assessment—assesses the "product"—the students—through site-team interviews with graduates and their employers.

Dr. Granstrom said the council is concerned with this: "Do they produce an entry-level veterinarian, and not an entry-level veterinarian from that country, but as defined by the COE?"