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Saturday, May 9, 2009

To Specialize Or Not

Here's a recent comment that I thought warranted further discussion.

I'm quite surprised they don't offer more specialization since as a vet it seems you can go into a variety of different speciality areas (my neighbor is a large animal vet). Do you think if they retained the basics for every major area, but included more specialization it might increase the productivity of vets?

Veterinary medicine has changed a lot in the last 100 years. When our society was more rural, veterinarians were mostly working on the farm animals, and would see the dogs and cats while they happened to be on the farm. In the last 50-60 years, our culture has dramatically shifted to animals being pets and family members, not livestock and workers. This has also changed the focus of veterinarians and where you find most of them. In 1909 most vets will have been found working the farms. In 2009 most of them will be working on companion animals.

Almost every veterinary school in the US started with an agriculture land grant and that bias still shows. Vets are also the leading experts in diagnosing emerging serious diseases in animals, especially those transmittable to humans (swine flu, avian flu, etc.). By having the knowledge of all species, we have a better ability to observe and report these diseases, thus upholding the part of our veterinary oath that involves protecting the public health. As a secondary point, having the training we receive in school allows us much more flexibility to pursue a myriad of career options, often different from where we thought we would be when we graduated.

On the flip side is the argument that we simply have to know too much. Think about everything a MD has to know about human anatomy, physiology, and medicine. Now take that same depth of knowledge and apply it to a dozen different species that have radical differences. Cram all of this training in the same time it takes human medical students to learn their one species, and you get an idea of the difficulty involved in obtaining a veterinary degree. Many people argue that because the nature of veterinary practice has changed, there should be a "limited licensure" that allows vets to practice on certain species to the exclusion of others. For example, I would have a license that allowed me to practice on companion animals and pets, but not livestock.

There are good arguments on both sides of the issue, and it has been a hot-button topic in the field for several years now. On one side I can understand the historic and current need for vets to monitor all kinds of animals for diseases and general public health (including food inspection). Yet on the other side I remember only tiny details of my training in livestock, and can never see myself working with those animals again. I'm not sure that that part of my training has ever been useful to me.

So back to the comment...we already get basic training in all major areas, and do have the opportunity for certain amounts of electives to direct part of our interests and education. For example, I took electives in ultrasound, avian medicine, and exotic pets because I had interests in these areas. Some of my classmates took extra classes on equine or large animal medicine and surgery. I can't say that any of this "specialization" is really going to increase our productivity greatly, though it did help me start off with more knowledge in the areas I thought I might practice.

By the time I retire in another 25-30 years, I fully expect the profession to be radically changed from what it is today. We'll see what changes happen and how future veterinarians are trained.