Class size increases spur mixed reactions

Some say more graduates needed to fill shortage areas
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News that more universities in the U.S. are looking to establish veterinary schools (see story) and that existing schools are looking to increase their enrollment raises the question of what effect, if any, an increase in veterinary graduates would have on the profession.

Some argue additional schools and spots available could alleviate veterinary shortages in certain areas; others worry that more practitioners would further saturate the field.

Running the numbers

The number of U.S. veterinary graduates in 2011 totaled 2,638, according to DVM Newsmagazine. This represents a nearly 3 percent increase from 2010, although the number of graduates—much like total enrollment figures—has otherwise stayed flat for the past few decades.

The last major increase in U.S. veterinary school student population occurred in the early '80s, when enrollment climbed from 6,943 in 1982 to 8,982 in 1983, or about 29 percent. This increase was due to the opening of veterinary colleges in Mississippi, Oregon, Virginia-Maryland, and North Carolina.

Since then, the number of veterinary school seats has increased annually 1.8 percent on average, according to the Association of American Veterinary Medical Colleges. Total enrollment for the 28 U.S. veterinary schools and colleges hit 10,873 for the 2010-2011 academic year. For the next five years, the annual growth rate projected by the association's advocacy survey data will slow to 0.5 percent. That figure includes anticipated seat increases at existing U.S. veterinary schools and colleges (see JAVMA, Feb. 1, 2011) but not the potential addition of more programs in the United States or accreditation of foreign veterinary schools and colleges.

Help wanted

On the one hand, more graduates could be a much-needed solution to veterinary shortages in certain areas.

Approximately 1,300 counties in the U.S. have fewer than one food supply veterinarian per 25,000 farm animals, and there are 500 counties with at least 5,000 farm animals that have no food supply veterinarians to treat them, according to the AVMA.

Dr. Michael J. Ames, a past president of the Arizona Veterinary Medical Association, said his state is one of those in dire need of rural, large animal, and food animal veterinarians.

Arizona's population has grown from 5 million to 6.6 million in 10 years. Dr. Ames estimates about two-thirds of the state's 1,550 licensed veterinarians practice in urban Maricopa County. The remaining third is split between Pima County and the entire rest of the state. Making matters worse, about half the practitioners in the rest of the state plan to retire in the next eight years, Dr. Ames said, and that's based on year-old figures.

"You go down around Douglas or Safford or Alpine, those areas are very, very spotty. In fact, we have two rural counties without a licensed veterinarian in residence," Dr. Ames said. "It's pretty significant. There's not a real perceived shortage in Maricopa and Pima, but for the rest of the state to make do (on a few hundred) is bad."

The Arizona VMA would like to see an in-state program so more Arizona students would have access to a veterinary education that's not hugely expensive. He and others at the AzVMA had originally approached the University of Arizona to create a 2+2 veterinary program with Oklahoma, but Dr. Ames said the administration wasn't interested.

The reason? Given its budget, the UA is struggling to maintain its current programs, so creating a new one is out of the question, he said. So now, Midwestern University in Glendale is looking to fill the void.

"They're a private university that will make their own decision, but they're being tremendous involving the association and addressing our concerns. We're happy about that," Dr. Ames said.

Offer of employment or advanced education for recent veterinary graduates
2010: 78.9 percent
2009: 79.5 percent
2008: 89.8 percent
2007: 91.7 percent
2006: 91.3 percent
Source: AVMA Graduating Seniors Surveys, 2006-2010

Still, having a veterinary school in Arizona—or anywhere, for that matter—is no guarantee that students will practice in underserved areas. For years, the Western Interstate Commission for Higher Education program recognized the Arizona Native American reservations as underserved areas. This regional organization comprises 15 member states that work to improve access to higher education through student exchange programs and initiatives, allowing students to pay in-state tuition at out-of-state institutions. Any Arizona WICHE graduate who worked on reservations could fulfill their commitment to the program in two years rather than the standard four, but virtually no students took advantage of that offer, Dr. Ames said. Yet, he remains hopeful.

"If we can bring some admissions under local control, we can give preference to students from rural areas. There's no guarantee they'll go back to a small rural community, but statistics bear out there's much more likelihood," Dr. Ames said.

At the crossroads

Not everyone sees new veterinary colleges or more seats at existing institutions as the solution to filling veterinary shortages, but instead, some see them as a cause for concern.

The American Association of Bovine Practitioners ad hoc Committee on Rural Veterinary Practice released a report May 20 stating there is no shortage of rural, private food animal practitioners. They attribute this to, among other things, successful efforts to increase the number of graduates going into rural practice.

"The committee is extremely concerned that the perception by veterinary schools and the public that there continues to be a shortage of rural practitioners is leading to increased class sizes at veterinary schools and the creation of new veterinary schools. Continuing to increase the number of veterinarians interested in serving rural areas will not solve this problem," according to the report's summary opinion. "In fact, creating an 'oversupply' of food supply veterinarians will lead to widespread unemployment or underemployment of food supply private practitioners and will have a significant detrimental effect on salaries for all veterinarians."

Dr. Karen E. Felsted, chief executive officer of the National Commission on Veterinary Economic Issues, agrees. Echoing what's in the AABP report, she says underserved rural areas across the country may exist because they are not able to sustain a veterinary practice. Rural jobs that are available may remain unfilled when, for example, the economics are not sufficient to attract an experienced practitioner.

New prospects

Dr. Felsted said she is sympathetic to veterinary schools and colleges as they deal with drastic budget cuts. However, she said that increasing tuition and seats available may help to make up for the funding losses in the short run but could turn into a problem in the long run.  

For example, she points out that between 1984 and 1994, six private dental schools closed because they had become unsustainable.

Factors that had put now-defunct dental schools at risk are strikingly similar to issues in veterinary education now. According to the 1995 Institute of Medicine publication "Dental Education at the Crossroads: Challenges and Change," those factors were financial issues, noncompetitive patient care programs, declining size and quality of the applicant pool, faculty and alumni resistance to change, and isolation from their universities.

Dr. Felsted and others question how close veterinary education is getting to having to close schools—not open more—given that the veterinary applicant-to-seat ratio has hovered near 2.1-to-1 for the past four years and the mean full-time starting salary has increased by only 6.43 percent in the past five years. In that same time, the mean debt load for students with debt increased by nearly 25 percent—from $100,805 in 2006 to $133,873 in 2010—according to data from the AVMA Graduating Seniors Survey.

"I'm not suggesting we close veterinary schools, but I'm trying to say that as a profession, we need to look overall at what's right for all aspects of the profession, not necessarily what's good for one part of it," Dr. Felsted said.

Then again, a greater number of veterinary graduates may not translate into an oversupply for the profession. Potentially, if admissions requirements remain the same, qualified applicants who go abroad now could be expected to fill seats at new or expanded domestic programs. That would mean a minimal net increase in the number of veterinary graduates entering the U.S. job market.

In addition, graduates produced by new veterinary colleges or as a result of increased class size at existing schools won't hit the job market for another four years, when, potentially, the economy would have improved. This, coupled with the ongoing retirement of the baby boomer generation, could increase the need for replacements in all areas of the profession. Only time will tell.