Statistics shed light on international education

Foreign graduates constitute 10% of U.S. workforce
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The AVMA Council on Education has been accrediting veterinary schools outside the United States and Canada for more than 40 years, yet foreign veterinary school accreditation didn’t really become a hot topic of conversation until three foreign schools were recognized in 2011.

These institutions—National Autonomous University of Mexico School of Veterinary Medicine and Animal Husbandry, known as UNAM, in Mexico City; Ross University School of Veterinary Medicine in St. Kitts, West Indies; and St. George’s University School of Veterinary Medicine in Grenada, West Indies—had been petitioning for AVMA COE accreditation for years. But once they were approved, some practitioners became concerned about the potential for increased job competition by immigrating professionals, potential effects on wages in this country, and the possibility that accreditation standards might be diminished.

Infographic: Percentages of students at foreign veterinary schools who are U.S. citizens

Current statistics from the National Board of Veterinary Medical Examiners, which proctors the North American Veterinary Licensing Examination, and the AVMA database, which includes all veterinarians known to the AVMA, show that foreign accreditation recognizes existing, well-performing international programs. They also reveal that many of the graduates from some of the biggest foreign institutions are already U.S. citizens.

Pass or fail

Not every foreign veterinary school operates the same way. Some attract a fair percentage of U.S. students, while others do not. For example, UNAM has no U.S. citizens in its program, and most of the Australian schools do not attract many Americans.

On the other hand are the Caribbean schools. Ross has a mean annual class size of 320 to 375, and St. George’s classes range from 130 to 150 every year. Each student body is typically composed of 85 to 97 percent U.S. citizens. However, these two schools have been in existence since 1982 and 1999, respectively, and have always sent most of their graduates back stateside.

This is evident when comparing the number of veterinary students who took the NAVLE during the 2009-2010 academic year with the number who took it during the 2011-2012 academic year.

Successful completion of the NAVLE is one requirement for licensure, as established by all state veterinary regulatory boards, and taking the exam is generally considered to indicate a desire to practice in the United States.

After the two Caribbean schools were accredited, the number of fourth-year students from nonaccredited foreign schools who took the NAVLE dropped by 322, while the number of fourth-year students from accredited foreign schools jumped by 356, representing a re-classification of students from Ross and St. George’s. Overall, there has been just a 1 percent increase in the number of students taking the NAVLE for the first time and passing the test from 2009-2011 to 2011-2012.

Infographic: Pass rates for the NAVLE as a function of school of graduation

Furthermore, the pass rate for fourth-year students from nonaccredited foreign schools decreased by 23.1 percent in that time frame, whereas the pass rate decreased only 2.5 percent for fourth-year students from foreign accredited schools, attesting to the fact that Ross and St. George’s students performed well on the licensing examination both before and after accreditation. The number of nonaccredited foreign school students who failed the examination bottomed out at 39 percent in 2010-2011 and climbed rapidly to 63 percent the next year.

Ironically, the accreditation of UNAM brought about the most concern that its graduates would flood the U.S. market (see JAVMA, May 15, 2010, page 1031) as it has one of the largest veterinary classes, with the most recent graduate class totaling 335. Yet, “maybe one or two” UNAM students have taken the NAVLE since the institution became accredited in October 2011, according to Dr. John Boyce, executive director of the NBVME.

On the home front

Looking at the bigger picture, AVMA data suggest that international graduates, including American citizens, represent about 10 percent the U.S. veterinary workforce.

The AVMA maintains a database that includes all veterinarians known to the Association—whether living inside or outside the U.S.. The current total as of the end of 2012 was 117,048 veterinarians, and of that number, 99,019 were of working age (70 or younger) and living in the United States.

Of the latter figure, 88.4 percent (87,567) are graduates of the 28 U.S. veterinary schools, 3.6 percent (3,579) are from foreign veterinary schools with high proportions of U.S. citizens (ie, Ross, St. George’s, or St. Matthew’s University School of Veterinary Medicine on Grand Cayman, British West Indies), and 6.9 percent (6,855) are from other foreign veterinary schools. The AVMA database does not have school information for the remaining 1 percent of individuals.

Furthermore, of the 6,855 foreign school graduates, 1,900 had graduated from COE-accredited schools and 4,955 had graduated from other programs.

What's more, the AVMA only tracks graduation school of individuals in its database. The Association does not track citizenship or nationality, nor does it track all graduates from foreign veterinary schools.

Future impact

The COE currently accredits 46 veterinary schools—28 in the United States, five in Canada, and 13 in other foreign countries. The council can conduct a maximum of 12 site visits annually, though it typically conducts only seven per year, including one or two site visits to foreign veterinary schools. Site visits are required once every seven years for schools to maintain accreditation.

The University of Copenhagen Faculty of Health and Medical Sciences in Denmark is one of two foreign institutions actively pursuing accreditation by the AVMA Council on Education. (Courtesy of University of Copenhagen)

According to the AVMA Task Force on Foreign Veterinary School Accreditation report: “For the future, if all foreign colleges that have expressed interest and appear to have a realistic expectation of meeting the standards were accredited, the total number of accredited programs would increase to 51 (including two domestic schools that have expressed interest).”

The most likely candidates among the foreign schools would be the National Veterinary School of Lyon in France, which will have a comprehensive site visit Sept. 22-26, 2013, and the University of Copenhagen Faculty of Health and Medical Sciences in Denmark. Their annual class sizes are 125 and 150, respectively, and neither currently has any U.S. citizens enrolled.