HOD again rejects measures to stop foreign accreditation

The nays have it.

Nearly 80 percent of the AVMA House of Delegates voted against a resolution calling for the Executive Board to end accreditation of non-U.S. and non-Canadian veterinary colleges by the AVMA Council on Education.

The resolution, submitted by the New York State Veterinary Medical Society, was just one of the proposals considered by delegates during their 2014 regular winter session, Jan. 11 in Chicago (see stories on following pages).

The HOD has now debated the merits of foreign accreditation three times in the past four years. The previous two occasions were as follows:

• The Texas VMA presented a resolution during the HOD’s 2010 regular annual session in Atlanta requesting the Executive Board to assign a task force to conduct a benefit-risk analysis of foreign accreditation. 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 about how this program benefits our members.” After much deliberation, the HOD defeated the resolution by a margin of 61 percent to 39.
• Eight state VMAs put forth a resolution at the HOD’s 2011 regular annual session in St. Louis that also asked for a task force on the issue. However, this entity was to examine whether U.S. veterinarians benefit from the COE’s accreditation of foreign veterinary schools. The HOD approved the resolution. AVMA staff were tasked with providing a report to members on the role and costs of the Association’s involvement in global affairs. The staff report, “AVMA’s Current Role in Global Veterinary Activities,” came out in November 2012, and the report of the AVMA Task Force on Foreign Veterinary School Accreditation was issued in March 2013 (see Web box at the bottom of the page).

A question of doubt

Oft-repeated concerns about foreign veterinary school accreditation surfaced once again at this most recent HOD session.

Dr. Eric M. Bregman, owner of the Bregman Veterinary Group in Williston Park, N.Y., said that the experience of serving on the AVMA task force caused him to have misgivings about the foreign accreditation process. The New York State VMS formed its own committee to study the issue, which Dr. Bregman served on. The committee’s work resulted in the 2014 resolution from the NYSVMS requesting an end to foreign veterinary school accreditation by the COE by the end of the decade.

In its statement about the resolution, the NYSVMS said the council’s focus should be to “continually improve the quality of the graduates, programs, and institutions of domestic and Canadian veterinary colleges” and that the foreign accreditation process is “resource intensive” and “logistically challenging.”

Further, the resolution’s background expressed concerns about whether accreditation standards are being applied evenly, given the differences in educational models, languages, and cultures among accredited schools. Questions were also raised regarding the council’s standards for research and clinical education, and whether these standards were being met at all the veterinary schools.

Finally, the resolution’s background, noting that the COE expects accredited schools whose graduating seniors normally take the North American Veterinary Licensing Examination to have a pass rate of 80 percent or higher, questioned whether foreign veterinary schools could meet this expectation.

“The NAVLE cannot provide comparative data across all COE-accredited veterinary schools because it is not a requirement for accreditation. With the exception of Ross University and St. George’s University, most graduates from accredited foreign schools do not take the NAVLE because they are not pursuing licensure in the United States or Canada,” according to the resolution’s background.

Dr. Walter McCarthy, New York delegate, said during the HOD meeting that the NYSVMS doesn’t take the matter lightly and understood that ending accreditation of foreign veterinary schools by the COE could have serious implications.

That said, Dr. McCarthy maintained that the practice should be stopped. He has doubts about student quality, for one thing. Some students attend foreign veterinary schools only because they haven’t been accepted to U.S. schools, he claimed, or they enter veterinary school right after completing high school. He added that “these institutions only accept U.S. students because they have guaranteed federal loans.”

Further, Dr. McCarthy said, “Foreign accreditation is a concept that is driven at the highest levels of the AVMA. ... Foreign accreditation benefits the AVMA on a world stage and gives power to influence other countries, but takes away time and power that could be put to better use.”

Speaking from experience

Prior to the HOD session, the AVMA Executive Board issued a 15-page response rebutting concerns raised in the resolution and released answers to a series of frequently asked questions on foreign accreditation. AVMA staff and COE members provided additional information during the House reference committee meetings.

We would like to speak strongly against the resolution. We were proactive in seeking feedback. Each student cited a workforce issue, not a quality issue. So when we told them how many foreign graduates are actually coming, they saw the need for (foreign accreditation), as do we. Touching on quality, I am in the middle of the trenches in clinics, and we take clinics with Ross and St. George’s students and they are just as good as (Louisiana State University) students. Their quality of education has gone up because of accreditation.

- Elise Ackley, Student AVMA president

With regard to the resources required for foreign veterinary school accreditation, Dr. Karen Martens Brandt, acting director of the AVMA Education and Research Division, explained that the COE conducts up to 12 site visits a year. Domestic veterinary schools receive preference over foreign veterinary schools, and this has sometimes resulted in overseas institutions being told their site visit has to be delayed. Also, the AVMA is fully reimbursed for site visits by the foreign veterinary schools.

“As far as resources, ... [t]here are plenty of accrediting bodies that accredit many more schools than we do and are successful,” she said.

Dr. Ronald Gill, a COE member, responded to concerns about accreditation of schools that conduct classes in a language other than English, noting that all correspondence and interactions associated with the accreditation process are conducted in English.

Addressing concerns about NAVLE results, Dr. Gill further explained that “With [regard to] the pass-fail rate on the NAVLE, there is a rubric set up now that allows foreign schools with small numbers of students taking the test to see if they meet the 80 percent pass rate. We have a COE member who is a statistician who has developed this,” he said.

Dr. David E. Granstrom, AVMA chief operating officer and former Education and Research Division director, compared the accreditation process to an open-book test for veterinary schools, but one that is not easy to pass.

“So what happens is, we ask the college to submit a self-study on how they meet the standards, and that’s done the same way internationally and domestically. They explain to us how they meet the standards,” he said. “The integrity of the process has been sacrosanct for a long time. It’s serious business. When it costs a university millions of dollars to fix a facility, we get it—it’s not a fun exercise. We’ve told the veterinary schools in question here—and they’ve been denied many times—to change their faculty and curriculum many times, before they were granted accreditation.”

Voicing their opinion

Prior to the House vote, a number of delegates and others voiced their opinions as to why the COE should continue accrediting foreign veterinary schools.

If we don’t do it, somebody else will. And if someone else is doing it, they might not do as well as we do, and we would have no opportunity to influence that. We do influence veterinary medicine worldwide. There are two classes of veterinarians: the ones who graduated from COE-accredited schools and the ones who did not. The ones who did are held in higher esteem, make more money, and have more opportunities to serve in their communities and the world.

- Dr. Gregg J. Cutler, American Association of Avian Pathologists alternate delegate

Dr. Kathleen Smiler, Michigan alternate delegate, compared what the council has done for international veterinary education to what the Association for Assessment and Accreditation of Laboratory Animal Care International has done for laboratory animal medicine: raise the bar.

“AAALAC accreditation is very important for institutions going for (National Institutes of Health) funding, but it’s a voluntary assessment, so it over-reaches what the Animal Welfare Act requires. What AAALAC has done has been a huge influence internationally not only to improve laboratory animal programs, but also to improve animal welfare in research,” Dr. Smiler said, likening this to how the COE helps the veterinary schools it recognizes achieve higher standards.

Dr. Trevor Ames, president-elect of the Association of American Veterinary Medical Colleges, brought up the World Organisation for Animal Health (OIE) meeting this past December in Brazil, where global veterinary education standards were discussed. Dr. Ames said the AVMA had a prominent role in developing some of the OIE’s materials on education, including its model veterinary curriculum.

“Clearly, the platform the AVMA speaks from would be very different if it weren’t involved in foreign accreditation,” he said. “There is no question the AVMA is the gold standard and what other schools aspire to and (where they) look for expertise. It gives us a loud voice.”

He added that the educational standards set by the OIE have been adopted by the World Trade Organization, and thus, affect foreign trade.

“It’s important that AVMA-accredited schools are there with a loud and influential voice to shape those standards,” Dr. Ames said.

The COE currently accredits 46 veterinary colleges. Of those, 13 are colleges outside the U.S. and Canada, including one that has been accredited by the council since 1972.

Resources:

The AVMA staff report “AVMA’s Current Role in Global Veterinary Activities”

The Report of the AVMA Task Force on Foreign Veterinary School Accreditation

The Executive Board’s response to the New York State Veterinary Medical Society’s 2014 resolution

The FAQ on foreign accreditation

More information about the AVMA’s global efforts

Related JAVMA content:

Statistics shed light on international education (June 15, 2013)

Report finds benefits to foreign accreditation (June 15, 2013)

COE given more time to comply with USDE standards (Feb. 15, 2013)

‘Philosophical differences of opinion’ (Feb. 15, 2013)

AVMA members, staff to study global activities (Sept. 1, 2011)

Board keeps course on foreign veterinary school accreditation (Aug. 1, 2013)

AVMA details its international work (Jan. 1, 2012)