Veterinary professional associate curriculum light on hands-on training

Slightly less than two months after Colorado voters approved a ballot initiative creating the new occupation of veterinary professional associate (VPA), Colorado State University (CSU) is nearing completion of its master’s in veterinary clinical care (MSB VCC) degree program to train VPAs.

The program would be housed in CSU’s College of Veterinary Medicine and Biomedical Sciences. “We continue progressing our master’s degree through CSU’s curriculum approval process,” a CSU spokesperson said.

But not everyone in the profession is on board. Dr. Robert Knapp, AVMA Board of Directors chair, shared concerns based on AVMA member feedback that a graduate who completes the curriculum for the program as currently proposed could “pose substantive risks for the health and welfare of animal patients, the safety of our food supply, public health, and the ongoing trust of veterinary clients.”

He continued, “Consequences of concern include missed and delayed diagnoses, with serious repercussions for zoonotic diseases; botched surgeries, resulting in serious animal harm; and related board complaints and malpractice claims against veterinarians.”

History of MSB VCC program

CSU had been working on its MSB VCC program well in advance of the ballot initiative. In fact, some of the first publications proposing a midlevel practitioner (MLP) in veterinary medicine like the VPA came in 2009. CSU faculty members Drs. Sherry Stewart and Lori Kogan wrote about it in the Journal of Veterinary Medical Education and Dr. Frank Garry in the Western Dairy News.

Discussions about MLPs in Colorado have been ongoing since then, according to Tiana Kennedy, associate vice president for communications at CSU.

In 2022, MLP proponents tried and failed to have the position codified in the state’s Veterinary Practice Act as the Colorado legislature went through the act's sunset review. Instead, recognizing the value and contributions of already well-qualified veterinary technicians, the legislature decided to include them in an updated Colorado Veterinary Practice Act, which granted them title protection, introduced registration requirements, and added two veterinary technicians to the Colorado State Board of Veterinary Medicine.

Although there was broad support for the addition of veterinary technicians to the practice act, proponents continued their advocacy for an MLP. Hoping to objectively explore whether there was a need for the position, Colorado Rep. Karen McCormick convened a legislative working group on the topic, which met biweekly during the summer and fall of 2022.

The working group's consensus was to not introduce an MLP at that point. Rather, members acknowledged that not only recognition, but also improved utilization of veterinary technicians was needed. So, information gathered during working group meetings was used to create the Veterinary Technician Scope of Practice bill.

Enacted with near unanimous support in the Colorado House and Senate, and later signed by Gov. Jared Polis in April, this legislation provided clarity around the tasks that licensed veterinarians may delegate to veterinary technicians and veterinary technician specialists, along with recommended levels of supervision. It also authorized veterinary technicians to apply for the veterinary technician specialist designation as part of their registration, granting title protection for them. 

In the meantime, CSU applied for and received a grant in early 2023 from PetSmart Charities that has partially supported the MSB VCC curriculum design.

With the legislative route to create an MLP looking dim, supporters took a different tack: Create an MLP position via ballot initiative. The group All Pets Deserve Vet Care, funded largely by the Denver Dumb Friends League and the American Society for the Prevention of Cruelty to Animals (ASPCA), gathered enough citizen signatures to put a proposal establishing the new VPA role before voters on Colorado’s November 5 general election ballot.

They did so despite 95% of surveyed veterinarians in Colorado being opposed to the creation of a VPA. In addition, more than 200 national and local veterinary, humane, and breeders’ organizations; veterinary clinics; veterinarians; veterinary technicians; and pet owners spoke out against the measure. Proposition 129 narrowly passed with 52.8% of the vote.

Curriculum development

Should Colorado State’s MSB VCC program be approved, the university anticipates its first class of 20-30 students in the fall of 2025, with graduation planned for 2027. A bachelor’s degree is required for admission.

Preadmission requirements include taking 39-41 credit hours—that is, the amount of credit a student receives for a course—in the subjects of communication, microbiology, math, biology, chemistry, communication, anatomy and physiology, and physics. All prerequisites could be completed in person or virtually, meaning some students may not have any hands-on training until late into the MSB VCC program.

The proposed MSB VCC curriculum itself requires students to complete five semesters, with each semester comprising 12-14 credit hours, or 65 credit hours total. Students would take the first three semesters online, including classes such as clinical anatomy and principles of surgery, which in typical medical curricula would include hands-on laboratories, but in this case, would not.

Students would then receive hands-on training in laboratory classroom settings during the fourth semester, followed by clinical training via internship with an approved community partner during the fifth semester, Kennedy said.

Readiness concerns

Opponents have argued the curriculum would not provide sufficient laboratory and clinical exposure and would put the health and safety of Colorado’s pets and other animals at risk.

“There can be no shortcuts to ensuring the competence of those who treat animals. This program is just that—a shortcut. This curriculum shortchanges foundational knowledge and skills in subjects like physiology, anatomy, and pathology by omitting critical laboratory exposure,” Dr. Knapp said. “Despite this, graduates will be expected to successfully diagnose, prognose, recommend treatment plans, and perform major surgeries, including spays, neuters, and—some have recently suggested—splenectomies, gastrointestinal anastomoses, and limb amputations.”

He also pointed out that during surgery, a VPA wouldn’t be able to respond to an anesthetic issue requiring the administration of a drug outside of a prepared protocol, because—by federal law—they cannot prescribe.

Further, there is currently no accreditation of the educational program, nor is there a comprehensive test required to determine the competence of program graduates.

Medical training programs typically require accreditation before enrolling their first class. However, accrediting bodies such as the Commission on Accreditation of Allied Health Education Programs need at least three programs to establish initial accreditation standards.

“Both early DVM and Veterinary Technician training programs were not accredited until years (even decades) after graduating their first class. We expect to receive accreditation within two years of graduating the first class since there will be three programs enrolling students in 2025 or 2026,” Kennedy said.

However, as Dr. Knapp points out, “This approach lacks consideration for the employability and futures of the initial graduates of MLP programs, as veterinary technicians who have graduated from unaccredited programs can attest. Now that there are well-established examples of how veterinary educational programs can be accredited effectively from their beginning, rather than after the fact, reverting back to this old model seems irresponsible.”

Tuition has not been determined and is subject to the approval process used by CSU and its Board of Governors, Kennedy said.

Additional information provided with Proposition 129 indicated that the Colorado State Board of Veterinary Medicine would oversee examination and qualification processes for this midlevel practitioner, as well as issue and renew registrations and set fees. This would all need to be in place by January 15, 2027.

Veterinary technician and veterinarian education

According to VPA supporters, the idea is that the position’s duties would overlap those of a veterinarian and veterinary technician. Unlike veterinary technicians, though, MSB VCC students would be allowed to diagnose, prognose, recommend treatment plans, and perform surgery under the supervision of a licensed veterinarian.

For veterinary technicians, most accredited programs lead to an associate’s degree after a two-year curriculum, but some—approximately 13% of veterinary technology programs—lead to a bachelor’s degree after four years of schooling.

All students in veterinary technology programs accredited by the AVMA Committee on Veterinary Technician Education and Activities (CVTEA) must complete many hours of hands-on laboratory work, with and without animals. An associate degree in veterinary technology typically requires at least 60 credit hours, while a bachelor’s degree requires around 120 credit hours.

Credentialed veterinary technicians are required to master more than 200 skills, according to the AVMA CVTEA’s Veterinary Technology Student Essential and Recommended Skills List.

The list is broken down into skills, tasks, and decision-making abilities, within the following categories:

• Office and hospital procedures, client relations, and communication
• Pharmacy and pharmacology
• Nursing
• Anesthesia
• Surgical nursing
• Laboratory procedures
• Imaging
• Laboratory animal procedures
• Avian, exotic, and small mammal procedures

All that training leads to their capstone preceptorship, which is a period of clinical experience in a veterinary practice that is designed for additional practice at skills for which they have already demonstrated basic competence.

To matriculate into a doctor of veterinary medicine program, most veterinary colleges accredited by the AVMA Council on Education require prerequisites totaling a minimum of 60 credit hours from an accredited college or university, including a certain number of advanced science courses; high scores on graduate record examinations; and extensive contact hours with animals.

In fact, the mean number of veterinary experience hours obtained in advance of entering a doctor of veterinary medicine program was 1,860 hours for the Class of 2027, according to the American Association of Veterinary Medical Colleges.

For veterinary students at CSU, a minimum of 167 credit hours, not including electives, are required for students, who take 21-26 credit hours each semester. That means graduates of the MSB VCC program would have completed 102 fewer credit hours than veterinary graduates not to mention that a majority of the master’s program would be conducted online.

“We are concerned for the futures of graduates of this proposed program and the veterinary patients who would be cared for by them. Students in this program have insufficient time to gain and assimilate basic knowledge, and very minimal exposure to clinical situations where they can learn to apply it safely and competently,” said Dr. Knapp.

A version of this story appears in the February 2025 print issue of JAVMA