To identify factors that may have influenced veterinarians’ decisions to not pursue careers in clinical academic veterinary medicine.
363 board-certified veterinarians.
An online survey, open from July 7 to July 21, 2015, was used to gather data from board-certified veterinarians who were members of ≥ 1 of the 22 specialty organizations recognized by the American Board of Veterinary Specialties of the AVMA. Responses from those who reported never to have held an academic appointment were included in the study. Results were compiled and analyzed by gender and clinical discipline.
Approximately 10,000 board-certified veterinarians were solicited to participate in the survey, and 1,314 (13.1%) responded. Among those, 363 (27.6%) reported never having held an academic position. Females more commonly reported no interest in teaching (44/185 [23.8%]) and disagreement with the statement that compensation in academic medicine was too low (39/164 [23.8%]), compared with responses by males (24/158 [15.2%] and 22/148 [14.9%], respectively). The strongest magnitude of interrater agreement was for the paired survey statements regarding too much bureaucracy and excessive expectation for committee and administrative work (weighted κ, 0.569).
Many factors contribute to veterinarians’ decisions about whether to pursue careers in academic medicine, and results indicated that some factors may vary depending on gender or clinical discipline. Recognition of these factors may help guide academic leaders in devising strategies and programs to enhance veterinarians’ interest in clinical academic medicine careers.
To identify factors that individuals in clinical residency training programs consider when making a choice for or against a career in academic clinical medicine.
207 veterinarians in clinical residency programs.
An online survey was distributed to 1,053 veterinarians participating in clinical residency training programs overseen by organizations recognized by the AVMA American Board of Veterinary Specialties. Results were compiled and decision factors were analyzed by means of principal component analysis to identify latent factors from the set of survey items. These factors were then used to construct a decision tree to predict respondents’ choice of whether to enter academic medicine or private clinical practice.
207 (20%) responses were analyzed. Ninety-three of 194 (48%) respondents reported a desire to pursue a career in academic medicine, and 101 (52%) reported a desire to pursue a career in private clinical practice. Principal component analysis identified 14 items clustered on research, clinical teaching, classroom teaching, and clinical practice. A decision tree was constructed that resulted in an overall accuracy of 82% in predicting a resident's career choice of academic medicine versus private clinical practice. The construct of professional benefits had a negative effect on desiring a career in academic medicine, whereas the construct of professional priorities and having had a positive residency training experience had a positive effect on desiring a career in academic medicine.
Understanding factors that attract and encourage residents who might have an aptitude and interest in academic medicine holds important implications for addressing the shortage of veterinarians entering academic medicine.
To determine the perceptions of training, self-efficacy, and mentoring among veterinary clinical specialty trainees on the basis of their career interest.
207 veterinarians who were either in a residency training program or had recently (within 2 years) completed one in a specialty recognized by the American Board of Veterinary Specialties.
An online survey was used to collect data about the respondents' perceived preparedness for an academic career, training emphasis, and mentoring received during training and demographic information. Results were compiled and compared by professional career interest (ie, academic medicine or private practice) and gender.
Included respondents represented 20% (207/1,053) of those invited. Preferred career choice was academic medicine for 48% (93/194) of respondents and private clinical practice for 52% (101/194) and did not differ by gender. Respondents perceived their likelihood of success in an academic career as high, and these perceptions did not differ by gender or preferred career choice. Mean self-efficacy scores for teaching were high among all respondents for most but not all listed teaching skills and did not differ by gender or preferred career interest. Mean self-efficacy scores were low for formulating research hypotheses and designing studies. Perceptions of training emphasis indicated strong mentoring in the areas of clinical practice and teaching with less mentoring and training emphasis in multiple areas of research and academic activity.
CONCLUSIONS AND CLINICAL RELEVANCE
Lower self-efficacy of veterinary clinical specialty trainees in aspects of academic career appeared to be related to training emphasis and mentoring. Enhancement of emphasis on the identified areas of weakness may improve the interest and success of trainees in an academic career.
Objective—To compare clinical, clinical pathology, and outcome variables between geriatric and nongeriatric horses.
Design—Retrospective case-control study.
Animals—690 horses (345 horses ≥ 20 years old and 345 horses > 1 and < 20 years old) examined at a referral hospital.
Procedures—Medical records were examined, and data collected included horse description, diagnosis, outcome, and CBC and serum biochemical analysis results. Cases were horses ≥ 20 years old, and controls were horses > 1 and < 20 years old.
Results—Mean ± SD age was 23.9 ± 4.6 years for cases and 9.2 ± 3.6 years for controls. Arabian and pony breeds were significantly overrepresented in the geriatric group, compared with the control group. Diagnoses related to the digestive system, musculoskeletal system, and respiratory system were most common in this hospital population overall (cases and controls). Colic was the most common health problem overall. Digestive system disorders were significantly more prevalent among cases. Short-term survival rates for most categories of colic were no different for cases than for controls, with the exception of the category idiopathic colic. Considering all conditions, cases were significantly more likely to be nonsurvivors than were controls. Minor differences in serum biochemical results were found in some disease subcategories. Geriatric horses with colic were not more commonly euthanized than were adult nongeriatric horses.
Conclusions and Clinical Relevance—Results indicated that in this population of horses in a referral hospital, age was associated with the prevalence of specific disease conditions. Few differences between cases and controls were found in serum biochemical values.
Objective—To identify factors associated with outcome (ie, survival and return to function) following treatment of horses with septic tenosynovitis.
Design—Retrospective case series.
Animals—51 horses with septic tenosynovitis.
Procedures—Information was obtained from medical records and through follow-up conversations with owners. Factors analyzed for an association with outcome included affected limb, etiology, duration of clinical signs prior to examination, presence of complications, primary treatment, secondary treatments, number of surgical procedures, and hospitalization time.
Results—Concurrent complications were identified in 41 (80%) horses. The primary treatment consisted of through-and-through lavage in 26 (51%) horses, tenoscopy in 20 (39%), and tenosynoviotomy combined with lavage in 5 (10%). Forty (78%) horses were discharged, and 37 (73%) survived at least 1 year after surgery; 21 of the 37 (57%) returned to their previous or a higher level of performance. Percentages of horses that survived 1 year after discharge and percentages that returned to their intended use did not vary significantly among treatments. Horses with tendon rupture or sepsis of an adjacent joint were significantly less likely to survive. Horses with tendon injury or pannus were significantly less likely to return to their intended use.
Conclusions and Clinical Relevance—Results suggested that various factors were associated with outcome in horses with septic tenosynovitis. However, surgical technique was not found to be associated with survival rate or rate of return to intended use.
Objective—To determine effects on anal pressure of
horses after local injection of the external anal sphincter
with Clostridium botulinum toxin type B.
Animals—11 healthy adult horses.
Procedure—Peak and resting anal sphincter pressures
were measured with a custom-made rectal
probe that was connected to a pressure transducer.
Pressures were measured before treatment and after
injection with botulinum toxin type B (BTB) or saline
(0.9% NaCl) solution. Dose titration with 500, 1,000,
1,500, and 2,500 U of BTB was completed. Physical
changes, behavior, and anal pressure were recorded
for each horse.
Results—Injection of 1,000 U of BTB caused a significant
reduction in peak anal pressure from days 2 to
84, compared with pressure in control horses.
Maximal effect of the toxin was observed within the
first 15 days after injection, followed by a slow return
to baseline during the 168-day period. Injection of
2,500 U of BTB in the anal sphincter in 1 horse resulted
in lethargy, generalized weakness, and dysphagia
for 14 days. Adverse clinical effects were not
observed in horses after injections with 500, 1,000, or
1,500 U of BTB.
Conclusions and Clinical Relevance—The effect of
focal intramuscular injection of BTB in horses is similar
to that reported for other species. However, horses
appear to be more sensitive to BTB, compared
with other species, and clinical signs of botulism may
develop at doses exceeding 1,500 U. Injections of
BTB in the external anal sphincter of mares may be
useful to reduce incisional dehiscence after repair of
perineal lacerations. ( Am J Vet Res 2004;65:26–30)
Objective—To quantify peripheral blood neutrophil apoptosis in equine patients with acute abdominal disease (ie, colic) caused by strangulating or nonstrangulating intestinal lesions and compare these values with values for horses undergoing elective arthroscopic surgery.
Animals—20 client-owned adult horses.
Procedures—Peripheral blood was collected from horses immediately prior to and 24 hours after surgery for treatment of colic (n = 10) or elective arthroscopic surgery (10), and neutrophils were counted. Following isolation by means of a bilayer colloidal silica particle gradient and culture for 24 hours, the proportion of neutrophils in apoptosis was detected by flow cytometric evaluation of cells stained with annexin V and 7-aminoactinomycin D. Values were compared between the colic and arthroscopy groups; among horses with colic, values were further compared between horses with and without strangulating intestinal lesions.
Results—Percentage recovery of neutrophils was significantly smaller in preoperative samples (median, 32.5%) and in all samples combined (35.5%) for the colic group, compared with the arthroscopy group (median, 66.5% and 58.0%, respectively). No significant differences in the percentages of apoptotic neutrophils were detected between these groups. Among horses with colic, those with strangulating intestinal lesions had a significantly lower proportion of circulating apoptotic neutrophils in postoperative samples (median, 18.0%) than did those with nonstrangulating lesions (66.3%).
Conclusions and Clinical Relevance—The smaller proportion of apoptotic neutrophils in horses with intestinal strangulation suggested that the inflammatory response could be greater or prolonged, compared with that of horses with nonstrangulating intestinal lesions. Further investigations are needed to better understand the relationship between neutrophil apoptosis and inflammation during intestinal injury.
Objective—To create a mathematical model to assist in early prediction of the probability of discharge in hospitalized foals ≤ 7 days old.
Study Design—Prospective study.
Procedures—Medical records from 910 hospitalized foals ≤ 7 days old for which outcome was recorded as died or discharged alive were reviewed. Thirty-four variables including historical information, physical examination findings, and laboratory results were examined for association with survival. Variables associated with being discharged alive were entered into a multivariable logistic regression model. Accuracy of the model was validated prospectively on data from 163 foals.
Results—Factors in the final model included age group, ability to stand, presence of a suckle reflex, WBC count, serum creatinine concentration, and anion gap. Sensitivity and specificity of the model to predict live discharge were 92% and 74%, respectively, in the retrospective population and 90% and 46%, respectively, in the prospective population. Accuracy of an equine clinician's initial prediction of the foal being discharged alive was 83%, and accuracy of the model's prediction was 81%. Combining the clinician's prediction of probability of live discharge with that of the model significantly increased (median increase, 12%) the accuracy of the prediction for foals that were discharged and nonsignificantly decreased (median decrease, 9%) the accuracy of the predication for nonsurvivors.
Conclusions and Clinical Relevance—Combining the clinician's initial predication of the probability of a foal being discharged alive with that of the model appeared to provide a more precise early estimate of the probability of live discharge for hospitalized foals.
Objective—To identify risk factors for equine protozoal myeloencephalitis (EPM) among horses examined at 11 equine referral hospitals.
Animals—183 horses with EPM, 297 horses with neurologic disease other than EPM (neurologic controls), and 168 horses with non-neurologic diseases (non-neurologic controls) examined at 11 equine referral hospitals in the United States.
Procedures—A study data form was completed for all horses. Data were compared between the case group and each of the control groups by means of bivariate and multivariate polytomous logistic regression.
Results—Relative to neurologic control horses, case horses were more likely to be ≥ 2 years old and to have a history of cats residing on the premises. Relative to non-neurologic control horses, case horses were more likely to be used for racing or Western performance.
Conclusions and Clinical Relevance—Results indicated that cats may play a role in the natural epidemiology of EPM, that the disease is less common among horses < 2 years of age relative to other neurologic diseases, and that horses used for particular types of competition may have an increased risk of developing EPM.