“Learning is not the product of teaching. Learning is the product of the activity of learners.”John Holt
In his more than 25 years of general practice, Dr. Mike Dyer has seen the many challenges new veterinary graduates face. He and his partners employ approximately 20 veterinarians in 9 practices in the tristate area encompassing southeastern Ohio, eastern Kentucky, and western West Virginia. Typically, he says, it takes about 2 years for a new graduate to become fully prepared for practice. “It's like we've had to complete their clinical training once we hired them,” says Dr. Dyer, whose Appalachia-based practices require veterinarians who “have the grit to try things.”
Surveys of recent graduates and their employers bear out Dr. Dyer's observations and highlight the need for a revised educational model that better prepares veterinary graduates for the realities of private practice; a model that will produce more-competent and more-confident veterinarians who are ready to practice on their first day in the profession and can command salaries commensurate with their proficiency. More recently, veterinary organizations and employers have begun to realize their roles in helping new graduates transition into the workplace. However, new graduates must first possess the critical skills on which to build. The goal of any educational model is to produce capable veterinarians ready to do their best with the resources at hand for practices like Dr. Dyer's. Many of his clients have limited financial resources and are unwilling or unable to drive several hours to a specialty referral hospital, such as an academic veterinary medical center, for more costly, technologically advanced veterinary care. Yet, it is in such an academic center that most veterinary students spend much of their final year of training, observing and applying the knowledge they acquired during their preclinical years (Figure 1).
There is obvious value in having veterinary students spend time observing specialists manage the types of cases typically referred to academic veterinary medical centers. Still, hands-on experience is crucial for success in private practice, and in our experience, most new graduates are comfortable only with those procedures and treatments in which they actively participated during their clinical training and are not comfortable taking primary responsibility for procedures and treatments they learned only through observation. Additionally, new graduates often are not comfortable modifying treatment protocols they have been taught. However, because veterinary medical education programs have only a limited amount of time to teach veterinary students, the knowledge and skills students acquire during their college training represent only a sample of all that is needed to be successful in private practice.
The traditional model of veterinary education in the United States and Canada tends to limit the spectrum of treatment options new graduates feel comfortable offering clients, potentially decreasing the care they can provide. “When you're 3 hours from a specialist or the client has limited resources and a dog has a broken leg, it's gut-wrenching to tell a family, ‘We can't do anything for you,'” says Dr. Dyer. “No one should have to euthanize their pet because it can't be provided some level of care.”
The challenge, as outlined by Stull et al,1 is that “given the highly sophisticated nature of procedures commonly taught and observed in veterinary colleges, veterinarians (most notably recent graduates) may be unaware of, and lack the knowledge and skills to offer, a wide spectrum of care options for a given condition and therefore may be unable to communicate to clients the relative effectiveness and costs of options along this spectrum.” This challenge has been documented many times, and veterinary students and employers alike have called for enhanced opportunities for hands-on learning to better prepare graduates to handle the demands of private practice from day one. Specifically, employers and recent graduates have suggested the need for additional training in business management,2 communication skills,3 and other nontechnical competencies,4 and new graduates have expressed a desire for more experience with general practice5 and point-of-care diagnostic testing6 as well as additional training in procedures such as dentistry7 and ophthalmoscopy8 and imaging techniques such as ultrasonography. They also desire training in strategies for addressing the veterinary needs of underserved communities,9 such as navigating conversations about financial concerns and presenting a variety of treatment options to clients. Veterinary employers seek to hire graduates who have a wider range of skills on day one.10 The Ohio State University veterinary students and new graduates have been vocal about the need for more experience with hands-on skills training earlier in their schooling and for mentoring opportunities during veterinary school and after graduation. In the past, this training has received less emphasis in our curriculum than would be ideal.
As a result of these concerns, The Ohio State University College of Veterinary Medicine has started to shift its approach to preparing veterinary students for careers in general practice by building a program based on the concept of spectrum of care. This new approach aims to produce competent and confident veterinarians who can meet the needs of and provide satisfactory outcomes for animals and their owners under a wide range of circumstances and conditions. In short, this new approach aims to produce new graduates who, with the help and support of mentors like Dr. Dyer, have the necessary background and skills to immediately enter veterinary practice.
Funding for the Preparing for Excellence in Veterinary General Practice program was provided, in part, by the Stanton Foundation.
The authors thank Drs. Susan Borders, Mike Dyer, Brian Forsgren, David Haeussler, Brian Holub, Jennifer Jellison, Beth Kellogg, Robert
Knapp, Ira Niedweske, Todd Shockey, Matt Stonecypher, and Kimberly West for serving on the advisory board for the Preparing for Excellence in Veterinary General Practice program; and the faculty, staff, and students of The Ohio State University College of Veterinary Medicine for their time, effort and input in guiding the design, development and delivery of various programmatic elements.
- 1. ↑
Stull JW, Shelby JA, Bonnett BN, et al. Barriers and next steps to providing a spectrum of effective health care to companion animals. J Am Vet Med Assoc 2018;253:1386–1389.
- 2. ↑
Louisa Poon WY, Covington JP, Dempsey LS, et al. Evaluation of a primary-care setting at a veterinary teaching hospital by a student business group: implementing business training within the curriculum. J Vet Med Educ 2014;41:189–196.
- 3. ↑
Meehan MP, Menniti MF. Final-year veterinary students' perceptions of their communication competencies and a communication skills training program delivered in a primary care setting and based on Kolb's experiential learning theory. J Vet Med Educ 2014;41:371–383.
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. , Meehan MP Menniti MF Final-year veterinary students' perceptions of their communication competencies and a communication skills training program delivered in a primary care setting and based on Kolb's experiential learning theory. J Vet Med Educ 2014; 41: 371– 383.
- 4. ↑
Cake MA, Bell MA, Williams JC, et al. Which professional (non-technical) competencies are most important to the success of graduate veterinarians? A best evidence medical education (BEME) systematic review: BEME guide no. 38. Med Teach 2016;38:550–563.
- 5. ↑
Dixon WHR, Kinnison T, May SA. Understanding the primary care paradigm: an experiential learning focus of the early veterinary graduate. Vet Rec 2017;181:480–484.
- 6. ↑
Roth IG, Meindl AG, Eckman SL, et al. Eliciting the student perspective on point-of-care diagnostic testing in association with a primary care rotation. J Vet Med Educ 2019;46:225–234.
- 7. ↑
Anderson JG, Goldstein G, Boudreaux K, et al. The state of veterinary dental education in North America, Canada, and the Caribbean: a descriptive study. J Vet Med Educ 2017;44:358–363.
- 8. ↑
Mowat FM, Royal KD, Westermeyer HD. Ophthalmoscopy skills in primary care: a cross-sectional practitioner survey. Vet Rec 2018;182:435.
- 10. ↑
Kreisler RE, Stackhouse NL, Graves TK. Arizona veterinarians' perceptions and consensus regarding skills, knowledge, and attributes of day one veterinary graduates. J Vet Med Educ 2020;47:365–377.
- 11. ↑
Association of American Veterinary Medical Colleges. Competency-based veterinary education (CBVE). Available at: www.aavmc.org/programs/faculty-educators/cbve/. Accessed Dec 10, 2020.