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Saturday, February 28, 2015

A New Way Of Veterinary Education

In one of my recent journals I was intrigued by an article entitled "Urgently rethinking the way we teach veterinary medicine".  The premise behind the article is that our current method of developing new veterinarians needs an overhaul and isn't the best way it can be in the 21st century.  I have to say that I agree with many of the points made, and I want to discuss them.  I'll present a quote from the article, then my own thoughts.
"Students are still taught predominantly using centuries-old methods that make them passive recipients rather than active seekers of knowledge—the most common format is a professor standing in front of a group of students and talking...........Colleges are beginning to address the situation by converting lectures to seminars and workshops—the so-called “flipped” classroom in which students assume active leadership roles and faculty serve as coaches. This way, students also learn communication and negotiation skills. This is an exemplary model for training future professionals."
This is one of the points where I'm a bit skeptical, but it's probably my own personal bias.  I think I learn better by attending a lecture and then learning how to apply it.  I think I'd get a bit lost if there was a lack of structure in the classroom.  However, I know that many people with extensive training in teaching methods do advocate this particular way of learning.  I don't think that attending a lecture means that someone isn't an "active seeker of knowledge", so I do take exception with that comment.  Perhaps more of a blended method would bring the best of both styles into the educational system.
"A strong prior academic record is a good indicator of success in the veterinary curriculum, but it is not necessarily an accurate predictor of career success. To effectively assess students’ life-skills, admission interviews need to be mandatory and include comprehensive evaluation of communication skills, interpersonal behavior, creativity and leadership potential. Merit should be given to applicants with a broad range of experiences, both academic and extramural, and formulated prerequisites should be minimal."
I really agree with this point.  When I was applying for vet school I had to go through an interview, and I have to say that I completely nailed it.  I know that many schools have gotten away from this particular admission requirement, probably because it takes time and is more subjective.  But many people who get into and through vet school have the personality of a wet paper bag and virtually no social skills.  It's a bit harsh to phrase it that way, but I can think of many examples in my own class at vet school.  One in particular was a straight-A student, but nobody liked her and she just didn't seem to know how to handle herself in social situations.  I absolutely agree that veterinary students need to be screened for personality and communication skills, not just academic performance.  No matter how smart someone is, if they don't have good interpersonal skills they won't be very successful in their career.
"There is no reason why six-year, European-style veterinary education could not be successful in North America. One approach would be to admit students to a four-year veterinary program after two years of appropriate undergraduate education....Students benefit from reduced tuition and out-of-pocket costs, smaller debt loads, and opportunities to earn income two years earlier."
I'm a big believer in job training, no matter what the job someone wants.  As much as I value my education, I think there has become too much emphasis on a college degree as a measure of competency, when it really doesn't say much about a person's chances for career success.  I've seen too many academics in veterinary medicine insist on the importance of scientific training and development of students, seemingly over basic job performance skills.  Medicine absolutely involves science, and any doctor needs to be able to understand the scientific process, critically analyze studies, and be aware of advancements in the field.  But understanding all of this is different than being a scientist.  Let's be perfectly honest.  Some veterinary students will go into academia and research, but the vast majority just want to work as a doctor.  Most vet students want career training, not scientific training.  They want to be good at practical medicine, not learn how to conduct the latest research.  Personally I see nothing wrong with that!  By de-emphasizing the need for a 3-4 year degree before even getting into vet school we go to a more streamlined system that will help significantly decrease the debt load of new vets.  Considering that this debt is one of the single biggest crises in the veterinary field today, this could be a good solution to the problem.  It works well in many European schools, and I see no reason why it wouldn't work in the US.  The only people I see opposing this are those entrenched in the academic "ivory towers", most of whom have no idea what the real world of veterinary medicine is like.
"Biomedical faculty’s job is to help create competent future veterinarians, not biomedical scientists......Some medical schools have introduced a “clinical immersion” approach, which teaches basic medical science through the solving of clinical problems—for example, one learns practical anatomy and physiology from a patient, not a book."
The first sentence goes back to what I was talking about above.  We need to be turning out great vets, not necessarilly great scientists.  There is a big difference between the two.  Practical teaching is a great way to make book learning stick.  Now, we already do this to a degree during school.  When I was in first year anatomy class we would have cadavers from which we learned anatomy, as well as examining live greyhounds and livestock to make the jump from book to reality.  An extension of this idea is becoming more popular in vet schools, especially the newest ones.  These schools are trading typical classrooms for more clinical, hands-on learning.  There is some merit to this direction, though again I don't think a lecture setting should be completely eliminated.
"Perhaps the biggest effect of technology on the veterinary curriculum may be the growth of online coursework. “Education without borders”—any place, any time—is an apt metaphor for 21st-century learning. In medical education, so-called blended learning (which integrates online and onsite teaching) will become more common as it combines the advantages of both. Veterinary students will increasingly enroll online in courses outside their home campus, which will provide education in areas where the college has limited expertise and expand their options for focused electives."
Education is changing because of technology.  Veterinary medicine needs to follow it.  In the early 21st century online teaching is much more commonplace, and can allow interaction with specialists and educators that are far from the college campus.  This broadens and enhance the educational process. However, none of this takes the place of face-to-face interaction with instructors.  I've taught at the college level, both in the classroom as well as online.  My online students had more struggles and there was less ability for me to help them one-on-one.  I don't think we should ever get rid of that teacher-student interaction, as it's best for both parties.  However, integrating technology as a way to enhance the process is a great idea.
"Training for clinical competency without imparting a keen understanding of the economic ramifications of that training is weak at best and disastrous at worst. Veterinary students are often the victims of their emotional expectations of a career in veterinary medicine, and this fiscally impaired vision can make them easy prey to financial institutions eager to lend them money. The enormous debt load carried by growing numbers of students is the principal factor keeping them from a satisfactory lifestyle, home ownership and practice ownership."
I've been encouraged to see more veterinary colleges providing financial training and advising to the students.  This is something that wasn't emphasized when I was in school in the late '90s, and I think that has contributed to the financial challenges many vets face.  Too many vets graduate without really understanding their financial situation, and fewer still have the training to manage or own a small business.  Fiscal training is essential to the success of new vets.
Overall I found the points made by the authors to be interesting and refreshing.  But my cynical side doesn't see too many changes happening in the near future.  The problem is we have many entrenched academics who learned the process in the late 20th century, before even the Internet was widespread.  I see many (but not all) of these people being resistant to change.  But if we're going to give the best education and changes to new veterinarians, we need to make some changes in the process.


  1. Great article :). It's all about balance really. Our focus for vet nursing education is blended learning using technology. And helping them realise the relevance and application of their knowledge. So some face to face, some online, some flip. It is an evolving process and at times challenging to students and staff! Also takes a lot of time to prepare it all, come up with new ideas etc. The Dove Lewis site is a huge help. Collaboration of good resources becomes important to ensure quality videos, that new methods are used, and we still have a work life balance :)

  2. I'm in my 4th semester in vet school. Not once have we (my class) been pressured to pursue careers in research or academia. We did have to take a 1 credit course about research in veterinary medicine, but it was to tell us how the research occurs and who performs it (very simple and easy course). Otherwise, literally all of my biomedical science professors constantly tell us that we are training to be clinicians.

    The vast majority of our classes are the classic set up: professor lectures (almost always with a powerpoint, but a few refuse to use them) while the class listens, occasionally answering questions by the lecturer. As veterinary students, we don't have the expertise in immunology, pathology, etc that our professors, who usually have an entire alphabets worth of degrees after their name, have. It makes no sense to me why that format would ever be changed.

    Note: I said "The vast majority of my classes..." because we do take two 1 credit courses (1 in first semester and the other in sixth semester) called "Foundations of Veterinary Medicine" that exposes us to ethics, law, managing loans, budgeting as a student, practice management, and other topics. My Public Health/Epidemiology course does, on occasion, have group discussions over real world disease outbreaks/zoonotic transfers. The purpose of the discussions is for my class to apply what we've learned in lecture (like a lab, except it's actually lecture). Also, in my Pathology I course, we performed a group necropsy with a Pathologist, then had to give a presentation summarizing the our findings and connecting it to what we've learned.

    I would say that my school definitely uses a lot of technology in the learning process. Powerpoints, exams done on a computer, and computer programs to teach anatomy (in lecture only, don't worry, we still dissected in a lab 3-4 days a week). We also use digital histology/pathology microscope slides from a database from the University of Calgary CVM on occasion. In class, we use "clickers", special remote controls, that allow us to take real-time in-class quizzes, polls, and/or attendance.

    Finally, starting in semester 1 and ending in semester 5, my school has all students take an occupational skills class. This course builds upon itself, semester by semester, and teaches us how to gather histories, perform physical exams, injections, phlebotomy, suturing, basic animal husbandry, and much much more. All of this involves various models, acting (when needed), and even real animals (when needed). In fact, tomorrow, I will be performing my first ovine P.E. at my school's teaching farm. If any student isn't performing up to par, they attend mandatory practice sessions and further evaluation. In the final semester of this course, all students take a skills exam covering everything from semesters 1-5.

    In case you were wondering, my school is Ross University; the AVMA-accredited vet school in St. Kitts. Sure they accept some students that shouldn't be in vet school, but they eventually get weeded out; many of us were just US school rejects that didn't feel like applying year after year. Our average loan debt is still less than Western University in Pomona. Getting acclimated to the Caribbean is tough at first, but it's home for now. Overall, I don't regret my decision to apply and attend RUSVM. I'm almost done with my 4th semester, then I have 3 more semesters, and I'm off to clinics (hopefully at my alma mater, Iowa State University). My plan is to become an Army veterinarian.

    I really enjoy your blog. I found you when I google searched about practices and payment plans. I came across your blogs concerning one of your associates with the moral of the story being that clients are responsible for getting their pets treatment, vets just provide the service. I couldn't agree more. A vet I once worked for, told me the same thing.

  3. If you look at the actual AVMA debt numbers, undergraduate debt is almost a non-issue. On average, veterinarians report 90% of their student loan is from veterinary school.

    As for spending more time on clinical knowledge and less on basic science, I'd have agreed right out of school... and disagree after more than a decade in practice. A good share of the clinical skills I have now were not taught in veterinary school, because these techniques weren't being done when I was in veterinary school. I fall back on basic science every day, though.

    Meanwhile, I'm a member of a number of professional lists, and some of the questions discussed reflect obvious deficiencies in basic knowledge that should have been learned in veterinary school, new and old graduates alike.


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