Veterinary medicine initially focused on the care of animal species, such as equids and farm animals, important for transport, war, and agriculture. However, as the US population has evolved from a largely rural population to one that is mostly urban, veterinary medicine has shifted to an emphasis on companion animals.1 This shift has been accompanied by reports of shortages of veterinarians in practice disciplines related to food animal medicine and food safety,2–5 compiled under the term food supply veterinary medicine.6,7 The US Government has identified these shortages as a high-priority issue and, in 2003, passed legislation allowing repayment of educational loans for veterinarians who choose to practice in underserved rural areas or in disciplines related to food animal medicine or public health.8
Various reasons have been proposed to explain the shortage of veterinarians in food supply veterinary medicine. Some authors have proposed that there is a deficiency of veterinary students interested in food animal practice.4,9 However, results of a recent study10 involving veterinary students in Canada contradict the hypothesis that few veterinary students are interested in careers related to food animal medicine, and it is possible that the perception of a deficiency in veterinary students interested in food animal medicine reflects the variable and intermittent emphasis placed by some US veterinary schools on attracting veterinary students interested in food animals.11 Others attribute the shortage of veterinarians in food supply veterinary medicine to an inability to retain veterinarians in rural practices,12,13 with a perceived low salary for rural practitioners being cited as a possible reason both for the lack of interest and the inability to retain veterinarians in food supply veterinary medicine.12,13 However, starting salaries for graduating veterinarians entering large animal practice have consistently been higher than starting salaries for individuals entering other practice disciplines.14,15
Importantly, although terms such as food supply veterinary medicine, large animal practice, food animal practice, and RVP are commonly used, these terms are not necessarily synonymous.16 Thus, distinctions should be made between these various disciplines because factors important to the shortage of veterinarians in food supply veterinary medicine, large animal practice, or food animal practice may not be the same as factors important to the shortage of veterinarians in RVP. The present study was developed as part of a concerted effort to better understand factors that influence veterinarians to enter and remain employed in RVP. Specifically, the purpose of the study reported here was to identify factors associated with influencing veterinarians and veterinary students to become interested in and choose a career in RVP.
Materials and Methods
Study protocol—The study was conducted as a cross-sectional descriptive study of veterinarians and veterinary students in the United States. An online survey was developed and made available to all veterinary students in the United States and to veterinarians in any area of practice. The study protocol was reviewed and approved by the institutional review boards of Oregon State University and The Ohio State University.
Survey development—Survey questions were developed by the authors to solicit information on factors that they considered likely, on the basis of personal experience, communication with colleagues, and a literature review, to have influenced individuals to be interested in or pursue a career in RVP. The initial questionnaire was pilot tested by a group of veterinary students and faculty members, and the survey was revised on the basis of their comments. The final questionnaire consisted of 17 questions, including 5 multiple-choice questions, 3 yes-no questions, 4 ranking questions (ie, questions that asked respondents to rank the importance of factors on a scale from 1 [low importance] to 5 [high importance]), 3 fill-in-the-blank questions, and 2 open-ended questions.a
Survey questions were organized into 5 sections. The first section solicited information on interest in RVP, with the first question being a yes-no question about whether respondents were interested in this area of practice. Respondents who answered no were directed to the last section of the survey, which contained questions designed to elicit demographic data. Respondents who answered yes were directed to a multiple-choice question about when they first became interested in RVP. They were then provided a list of factors and asked to rank the importance of each factor on a scale from 1 to 5 (1 = low importance; 3 = average importance; 5 = high importance) with regard to its influence on developing their interest in RVP (respondents were also allowed to answer not applicable).
The second section of the survey solicited information on respondents who had decided to pursue a career in RVP, with the first question being a yes-no question about whether they had ever worked in RVP. Respondents who answered no were directed to the demographic data section of the survey. Respondents who answered yes were directed to additional multiple-choice and open-ended questions that asked respondents to rank the importance of each of various factors on a scale from 1 to 5 with regard to its influence on their decision to pursue a career in RVP.
The third section of the survey solicited information on respondents who had previously worked in RVP during their career but no longer did and on factors related to why they had left RVP. Results for this section of the survey are published elsewhere.17
The fourth section of the survey solicited information on respondents' personal definition of RVP, including animal species served and community characteristics such as size, distance to nearest metropolitan area, number of veterinarians in the community, and role of agriculture in the local economy.
The fifth section of the survey solicited basic demographic information on respondents, including gender, age, year of graduation from veterinary school, background experience with livestock, and country and state of current residence.
Where applicable, questions in all sections of the survey included an other response that allowed respondents to specify other factors or reasons not specifically included in the available answers. All of these other responses were reviewed separately by at least 2 coauthors and assigned to categories designated by each coauthor. After all responses were assigned, categories selected by the coauthors were cross-matched, and if the coauthors differed with regard to their classification of an answer, a consensus was reached as to which category that answer should be assigned. Kappa values for inter-rater agreement ranged from 0.932 to 0.972 for these questions. Most respondents used the open-ended questions to emphasize or explain the scores they assigned for the multiple-choice answers. Thus, no new categories of answers were generated from answers to the open-ended questions.
Survey distribution—Invitation letters containing a link to the survey and soliciting the participation of all veterinary students and veterinarians in any type of practice were distributed to the AVMA, all specialty associations listed in the AVMA directory, all state veterinary associations, all student veterinary associations, and all members of the Academy of Rural Veterinarians. Associations receiving the invitation letter were asked to distribute it as widely as possible, including through newsletters, mail, and e-mail. The invitation letter informed potential respondents about the study's objectives and its voluntary nature, as required by the institutional review boards of the participating institutions.
The online survey was administered through the use of standard software.b No pretrial calculations of sample size were performed, and given the voluntary nature of the survey, the invitation letter was distributed to as many associations as possible to obtain the maximum number of responses. The Web link remained accessible from January 1, 2008, through May 19, 2008.
Data analysis—To avoid biases associated with differences in culture, education systems, and population background, only responses from the United States (as determined by IP address of the respondent) were used in the study. A response rate could not be calculated because the degree of overlap in membership for the various associations to which the invitation letter was sent was not known. Although it was possible for an individual to complete the survey more than once, no efforts were made to identify duplicate responses from individuals because it was considered unlikely that any individual respondent would choose to complete the survey more than once.
Respondents were categorized into 4 US regions (West, South, Midwest, and Northeast) according to the classification used by the US Census Bureau.18 Respondents with an IP address that did not originate in the United States were excluded from the study.
Respondents were also categorized into 4 generational categories according to definitions of the American Association of Retired Persons.19 Generational categories included the silent generation (≥ 62 years old; born before 1946), baby boomer generation (43 to 61 years old; born between 1946 and 1964), generation X (31 to 42 years old; born between 1965 and 1978), and generation Y (≤ 30 years old; born after 1978).
Year of graduation was used to categorize respondents into groups on the basis of number of years of professional practice experience. Categories consisted of veterinary students (no graduation year listed or graduation year of 2008 or later), recent graduates (1 to 2 years since graduation), skilled veterinarians (3 to 5 years since graduation), experienced veterinarians (6 to 12 years since graduation), and seasoned veterinarians (> 12 years since graduation). Limits for the categories were selected after consultation with private practitioners on the perceived professional skills of graduate veterinarians.
Two dichotomous background variables were identified: rural versus urban and experience with versus no experience with livestock. Combining responses to these 2 variables resulted in 4 possible categories: rural background with previous livestock experience, rural background without previous livestock experience, urban background with previous livestock experience, and urban background without previous livestock experience.
For questions that asked respondents to assign an importance score ranging from 1 to 5 for each of several listed factors, differences between demographic groups were analyzed by comparing proportions of respondents that assigned a high score (4 or 5) to each factor by means of the Z test,c with values of P b 0.05 considered significant. For analyses that involved comparison of > 2 categories, such as comparisons between generational categories or practice experience categories, a Bonferroni correction was used to preserve an overall A value of 0.05.
Results
A total of 1,318 responses were recorded for the online survey. However, 51 responses were from individuals who could not be allocated to a country on the basis of their IP address, and an additional 51 responses originated from individuals in 19 countries other than the United States. These 102 responses were excluded from the study, and the remaining 1,216 responses were included (Table 1). Two of the responses included in the study were from individuals working for the military and stationed overseas. Not all respondents answered all questions.
Demographic characteristics of individuals who responded to an online survey on factors associated with veterinarians and veterinary students having an interest in or pursuing a career in RVP.
Factor and categories | All respondents | Men | Women |
---|---|---|---|
All respondents | 1,216 | 592 | 536 |
Generational category | |||
Silent generation (≥ 62 y) | 85 | 83 | 2 |
Baby boomers (43–61 y) | 425 | 292 | 132 |
Generation X (31–42 y) | 253 | 110 | 141 |
Generation Y (≤ 30 y) | 365 | 105 | 259 |
Background | |||
Rural with livestock experience | 663 | 409 | 252 |
Rural with no livestock experience | 49 | 19 | 30 |
Urban with livestock experience | 278 | 125 | 151 |
Urban with no livestock experience | 143 | 39 | 103 |
Professional practice experience | |||
Veterinary student | 263 | 75 | 187 |
Recent graduate (1–2 y) | 91 | 25 | 65 |
Skilled veterinarian (3–5 y) | 68 | 25 | 43 |
Experienced veterinarian (6–12 y) | 170 | 66 | 103 |
Seasoned veterinarian (> 12 y) | 529 | 395 | 133 |
Geographic region | |||
West | 347 | 140 | 162 |
South | 341 | 163 | 128 |
Midwest | 316 | 154 | 119 |
Northeast | 116 | 46 | 50 |
For each factor, number of respondents does not equal total number of respondents because not all participants responded to every question.
Definition of RVP—When respondents were asked to define RVP, 93.4% (1,066/1,141) indicated that RVP could be characterized as the practice of veterinary medicine in any community in which agriculture represented a significant part of the local economy. Only 22.0% (248/1,128) of respondents included working in mixed animal practice as part of the definition, whereas 11.0% (124/1,128) included working exclusively with food animal species in the definition of RVP. In the comment part of this section of the survey, many respondents seemed to associate RVP with geographic location and population density; however, a clear cutoff of number of inhabitants per square mile could not be identified.
Interest in RVP—Overall, 92.4% (1,124/1,216) of respondents reported having had an interest in RVP. Respondents (n = 92) who reported not ever having had an interest in RVP were mostly women (59), young (37 identified as generation Y and 26 identified as generation X), veterinary students (37), or from an urban background (67).
Of the 1,124 respondents who indicated having had an interest in RVP, 431 (38.3%) reportedly developed this interest before 8th grade, 310 (27.6%) reportedly developed this interest during high school, 190 (16.9%) reportedly developed this interest during undergraduate school, 145 (12.9%) reportedly developed this interest during veterinary school, 8 (0.7%) reportedly developed this interest during graduate school, and 25 (2.2%) reportedly developed this interest during some other time of their life. Fifteen (1.3%) did not report when they developed their interest in RVP.
When asked to rank the importance of various factors to their having developed an interest in RVP, 60.0% (664/1,106) of respondents ranked having relatives with a farm background as being of high importance (ie, a score of 4 or 5 on a scale from 1 to 5), whereas 47.6% (526/1,106) ranked having a veterinarian in RVP as a mentor, 46.6% (515/1,106) ranked being exposed to RVP during veterinary school, 35.3% (390/1,106) ranked being a member of 4-H or FFA, 34.4% (380/1,106) ranked influence of parents, and 23.2% (257/1,106) ranked having read the stories of James Herriot as being of high importance.
Association of gender and interest in RVP—Information on gender was provided by 1,128 respondents, of whom 592 were male and 536 were female. The distribution of male and female respondents was skewed by age (Figure 1), with most respondents in the 2 older generational categories being male and most respondents in the 2 younger generational categories being female.
Classification by gender and generational category for respondents (n = 1,216) to an online survey on reasons why veterinarians enter RVP in the United States.
Citation: Journal of the American Veterinary Medical Association 236, 8; 10.2460/javma.236.8.849
A higher proportion of male (96.5%) versus female (88.8%) respondents reported having had an interest in RVP (Table 2). Proportions of women who developed their interest in RVP before 8th grade (45.4%) or during veterinary school (18.6%) were significantly higher than the corresponding proportions of men who developed their interest in RVP during these periods (33.8% and 9.2%, respectively), whereas the proportion of men who developed their interest in RVP during high school (35.0%) was significantly higher than the proportion of women who developed their interest in RVP during high school (18.8%). For both males and females, however, interest in RVP generally developed early in life.
Distribution of responses by gender for individuals who responded to an online survey on factors associated with veterinarians and veterinary students having an interest in or pursuing a career in RVP.
Factor | No. (%) of men | No. (%) of women | P value |
---|---|---|---|
Respondent had an interest in RVP | 571 (96.5) | 476 (88.8) | < 0.001 |
Time when respondent first developed an interest in RVP | |||
Before 8th grade | 192 (33.8) | 215 (45.4) | < 0.001 |
High school | 199 (35.0) | 89 (18.8) | < 0.001 |
Undergraduate school | 101 (17.8) | 74 (15.6) | 0.395 |
Veterinary school | 52 (9.2) | 88 (18.6) | < 0.001 |
Graduate school | 6 (1.1) | 2 (0.4) | 0.417 |
Other | 18 (3.2) | 6 (1.3) | 0.067 |
Factors ranked as being of of high importance in developing an interest in RVP* | |||
Relatives with a farm background | 401 (70.6) | 225 (47.4) | < 0.001 |
Veterinarian in RVP as a mentor | 294 (51.8) | 207 (43.6) | 0.010 |
Exposure to RVP in veterinary school | 256 (45.1) | 233 (49.1) | 0.222 |
Member of 4-H or FFA | 214 (37.7) | 153 (32.2) | 0.076 |
Parental influence | 220 (38.7) | 136 (28.6) | < 0.001 |
Read stories by James Herriot | 94 (16.5) | 152 (32.0) | < 0.001 |
Factors ranked as being of high importance in pursuing a career in RVP* | |||
Rural lifestyle | 428 (90.5) | 254 (86.7) | 0.130 |
Herd-level animal care | 326 (68.9) | 155 (52.9) | < 0.001 |
Individual animal care | 236 (49.9) | 199 (67.9) | < 0.001 |
Location of family and friends | 274 (57.9) | 152 (51.9) | 0.118 |
Community need for veterinary care | 227 (48.0) | 157 (53.6) | 0.153 |
No. of available jobs | 135 (28.5) | 98 (33.4) | 0.176 |
Salary and benefits | 134 (28.3) | 85 (29.0) | 0.904 |
There were 592 men and 536 women who indicated (yes vs no) whether they had ever had an interest in RVP; 568 men and 474 women who indicated they had an interest in RVP provided information on when they first developed this interest, and 568 men and 475 women who indicated they had an interest in RVP ranked the importance of each of the indicated factors on a scale from 1 (low importance) to 5 (high importance). Finally, 473 men and 293 women who reported pursuing a career in RVP ranked the importance of each of the indicated factors.
Factor was assigned an importance score of 4 or 5.
The proportions of men who ranked having relatives with a farm background, having a veterinarian in RVP as a mentor, and the influence of parents as being of high importance in their developing an interest in RVP were significantly higher than the proportions of women who ranked these factors as being of high importance (Table 2). By contrast, the proportion of women who ranked having read the stories of James Herriot as being of high importance was significantly higher than the proportion of men who did.
Association of generational category and interest in RVP—Information on generational category was provided by 1,128 respondents, of whom 85 were of the silent generation, 425 were of the baby boomer generation, 253 were of generation X, and 365 were of generation Y. Age and years of professional practice experience were highly correlated (Pearson r = 0.963; P < 0.001); however, individuals identified as baby boomers or generation X were identified in all categories of professional practice experience, including veterinary students.
There were significant differences among generational categories with regard to proportion that reported having had an interest in RVP, with 89.7% of generation X and 89.9% of generation Y respondents reporting having had an interest in RVP, compared with 97.6% of silent generation and 96.9% of baby boomer respondents reporting having had an interest in RVP (Table 3).
Distribution of responses by generational category for individuals who responded to an online survey on factors associated with veterinarians and veterinary students having an interest in or pursuing a career in RVP.
Factor | No. (%) of respondents | |||
---|---|---|---|---|
Silent generation | Baby boomers | Generation X | Generation Y | |
Respondent had an interest in RVP | 82 (97.6)a,b | 411 (96.9)a | 226 (89.7)b | 328 (89.9)b |
Time when respondent first developed an interest in RVP | ||||
Before 8th grade | 24 (29.3)a | 151 (36.7)a,b | 102 (45.7)b | 131 (40.1)a,b |
High school | 40 (48.8)a | 125 (30.4)b | 47 (21.1)c | 76 (23.2)b,c |
Undergraduate school | 7 (8.5) | 69 (16.8) | 37 (16.6) | 62 (19.0) |
Veterinary school | 8 (9.8) | 46 (11.2) | 31 (13.9) | 54 (16.5) |
Graduate school | 0 (0.0) | 4 (1.0) | 1 (0.4) | 3 (0.9) |
Other | 3 (3.7)a,b | 16 (3.9)a | 5 (2.2)a,b | 1 (0.3)b |
Factors ranked as being of high importance in developing an interest in RVP* | ||||
Relatives with a farm background | 55 (67.9) | 244 (59.5) | 144 (64.0) | 184 (56.1) |
Veterinarian in RVP as a mentor | 33 (40.7) | 180 (43.9) | 108 (48.0) | 181 (55.2) |
Exposure to RVP in veterinary school | 33 (40.7) | 188 (45.9) | 111 (49.3) | 157 (47.9) |
Member of 4-H or FFA | 31 (38.3) | 135 (32.9) | 78 (34.7) | 123 (37.5) |
Parental influence | 30 (37.0) | 139 (33.9) | 71 (31.6) | 117 (35.7) |
Read stories by James Herriot | 2 (2.5)a | 96 (23.4)b | 76 (33.8)c | 73 (22.3)b |
Factors ranked as being of high importance in pursuing a career in RVP* | ||||
Rural lifestyle | 63 (92.6) | 331 (90.4) | 153 (86.0) | 134 (87.6) |
Herd-level animal care | 43 (63.2)a,b | 221 (60.4)a | 105 (59.0)a | 112 (73.2)b |
Individual animal care | 41 (60.3) | 206 (56.3) | 97 (54.5) | 90 (58.8) |
Location of family and friends | 36 (52.9)a,b | 178 (48.6)a | 113 (63.5)b | 98 (64.1)b |
Community need for veterinary care | 40 (58.8)a,b | 167 (45.6)a | 79 (44.4)a | 98 (64.1)b |
No. of available jobs | 16 (23.5)a,b | 89 (24.3)a | 64 (36.0)b,c | 65 (42.5)c |
Salary and benefits | 8 (11.8)a | 70 (19.1)a | 70 (39.3)b | 72 (47.1)b |
There were 84 silent generation, 424 baby boomer, 252 generation X, and 365 generation Y respondents who indicated (yes vs no) whether they had ever had an interest in RVP; 82 silent generation, 411 baby boomer, 223 generation X, and 327 generation Y respondents who indicated they had an interest in RVP provided information on when they first developed this interest, and 81 silent generation, 410 baby boomer, 225 generation X, and 328 generation Y respondents who indicated they had an interest in RVP ranked the importance of each of the indicated factors. Finally, 68 silent generation, 366 baby boomer, 178 generation X, and 153 generation Y respondents who reported pursuing a career in RVP ranked the importance of each of the indicated factors.
In each row, values with different superscript letters were significantly (P < 0.05) different.
See Table 2 for remainder of key.
Significant differences were also found among generational categories with regard to proportions reporting having developed an interest in RVP before 8th grade or during high school (Table 3). The proportion who developed an interest in RVP before 8th grade was significantly higher for generation X respondents than for silent generation respondents, but the proportion who developed an interest in RVP during high school was significantly higher for silent generation respondents than for respondents in the other 3 categories.
Proportions of respondents who ranked various factors as being of high importance in developing their interest in RVP did not differ among generational category, except that the proportion of generation X respondents who indicated that having read the stories of James Herriot was of high importance was significantly higher than proportions for the other 3 generational categories.
Association of background and interest in RVP—Information on background (rural vs urban) and livestock experience (yes vs no) was provided by 1,133 respondents (Table 4). The proportion of respondents with a rural background who indicated that they had an interest in RVP was significantly higher than the proportion of respondents with an urban background who did, and the proportion of respondents with livestock experience who indicated that they had an interest in RVP was significantly higher than the proportion of respondents without livestock experience who did.
Distribution of responses by background (rural vs urban) and livestock experience (yes vs no) for individuals who responded to an online survey on factors associated with veterinarians and veterinary students having an interest in or pursuing a career in RVP.
Factor | No. (%) of respondents | |||||
---|---|---|---|---|---|---|
Rural | Urban | P value | Livestock experience | No livestock experience | P value | |
Respondent had an interest in RVP | 699 (98.5) | 353 (84.0) | < 0.001 | 897 (95.6) | 155 (80.7) | < 0.001 |
Time when respondent first developed an interest in RVP | ||||||
Before 8th grade | 335 (48.2) | 73 (20.7) | < 0.001 | 392 (43.9) | 16 (10.3) | < 0.001 |
High school | 213 (30.6) | 75 (21.3) | 0.002 | 268 (30.0) | 20 (12.9) | < 0.001 |
Undergraduate school | 91 (13.1) | 87 (24.7) | < 0.001 | 139 (15.6) | 39 (25.2) | 0.007 |
Veterinary school | 42 (6.0) | 98 (27.8) | < 0.001 | 70 (7.8) | 70 (45.2) | < 0.001 |
Graduate school | 2 (0.3) | 6 (1.7) | 0.035 | 6 (0.7) | 2 (1.3) | 0.271 |
Other | 12 (1.7) | 13 (3.7) | 0.079 | 17 (1.9) | 8 (5.2) | 0.078 |
Factors ranked as being of high importance in developing an interest in RVP* | ||||||
Relatives with a farm background | 500 (71.6) | 128 (36.6) | < 0.001 | 607 (67.8) | 21 (13.7) | < 0.001 |
Veterinarian in RVP as a mentor | 380 (54.4) | 124 (35.4) | < 0.001 | 453 (50.6) | 51 (33.3) | < 0.001 |
Exposure to RVP in veterinary school | 298 (42.7) | 194 (55.4) | < 0.001 | 401 (44.8) | 91 (59.5) | 0.001 |
Member of 4-H or FFA | 328 (47.0) | 40 (11.4) | < 0.001 | 363 (40.6) | 5 (3.3) | < 0.001 |
Parental influence | 308 (44.1) | 50 (14.3) | < 0.001 | 350 (39.1) | 8 (5.2) | < 0.001 |
Read stories by James Herriot | 150 (21.5) | 97 (27.7) | 0.031 | 208 (23.2) | 39 (25.5) | 0.553 |
Factors ranked as being of high importance in pursuing a career in RVP* | ||||||
Rural lifestyle | 506 (91.5) | 178 (82.8) | < 0.001 | 611 (89.3) | 73 (86.9) | 0.317 |
Herd-level animal care | 362 (65.5) | 120 (55.8) | 0.016 | 436 (63.7) | 46 (54.8) | 0.043 |
Individual animal care | 300 (54.2) | 137 (63.7) | 0.022 | 384 (56.1) | 53 (63.1) | 0.190 |
Location of family and friends | 336 (60.8) | 90 (41.9) | < 0.001 | 382 (55.8) | 44 (52.4) | 0.413 |
Community need for veterinary care | 291 (52.6) | 95 (44.2) | 0.043 | 343 (50.1) | 43 (51.2) | 0.959 |
No. of available jobs | 160 (28.9) | 74 (34.4) | 0.163 | 211 (30.8) | 23 (27.4) | 0.481 |
Salary and benefits | 173 (31.3) | 47 (21.9) | 0.012 | 198 (28.9) | 22 (26.2) | 0.891 |
There were 710 respondents with a rural background, 420 with an urban background, 938 with livestock experience, and 192 with no livestock experience; 695 respondents with a rural background, 352 with an urban background, 892 with livestock experience, and 155 with no livestock experience who indicated they had an interest in RVP provided information on when they first developed this interest, and 698 respondents with a rural background, 350 with an urban background, 895 with livestock experience, and 153 with no livestock experience who indicated they had an interest in RVP ranked the importance of each of the indicated factors. Finally, 553 respondents with a rural background, 215 with an urban background, 684 with livestock experience, and 84 with no livestock experience who reported pursuing a career in RVP ranked the importance of each of the indicated factors.
See Table 2 for remainder of key.
There was a significant interaction between background (rural vs urban) and livestock experience with regard to time when respondents first developed an interest in RVP (Figure 2). For each of the factors examined, except exposure to RVP during veterinary school and reading stories by James Herriot, a higher proportion of respondents with a rural background than respondents with an urban background ranked the factor as being of high importance in developing their interest in RVP (Table 4). Similarly, for all of the factors, except exposure to RVP during veterinary school and reading the stories of James Herriot, a higher proportion of respondents with livestock experience than respondents without livestock experience ranked the factor as being of high importance in developing their interest in RVP. Exposure to RVP during veterinary school was ranked by a higher proportion of respondents with an urban background and respondents with no livestock experience as being of high importance in developing their interest in RVP.
Distribution of time when respondents reportedly developed an interest in RVP for respondents grouped on the basis of background (rural vs urban) and previous experience with livestock (yes vs no). Asterisks indicate significant (P < 0.05) differences between background and previous experience with livestock combinations (ie, rural background with previous livestock experience [A], rural background without previous livestock experience [B], urban background with previous livestock experience [C], and urban background without previous livestock experience [D]).
Citation: Journal of the American Veterinary Medical Association 236, 8; 10.2460/javma.236.8.849
Association of region and interest in RVP—Regional distribution of respondents was fairly uniform, except that fewer respondents were from the Northeast. Because of the low numbers of respondents in groups after stratifying for other variables shown to be associated with having an interest in RVP, potential differences among US regions could not be evaluated.
Factors associated with pursuing a career in RVP—Of the 1,124 respondents who indicated having had an interest in RVP, 805 (71.6%) reported pursuing a career in RVP, 293 (26.1%) did not pursue a career in RVP, and 26 (2.3%) did not answer this question. When asked to score the importance of various factors in their decision to pursue a career in RVP, 791 respondents answered the question. The proportion of respondents assigning high importance to rural lifestyle (705/791 [89.1%]) was significantly higher than proportions assigning other factors high importance. The 2 factors with the lowest proportions assigning them high importance were number of available jobs (241/791 [30.5%]) and salary and benefits (225/791 [28.4%]). Four hundred ninety-five of the 791 (62.6%) respondents rated herd-level animal care, 449 (56.8%) rated individual animal care, 436 (55.1%) rated location of family and friends, and 399 (50.4%) rated community need for veterinary care as being of high importance in their decision to pursue a career in RVP.
A higher proportion of men than women assigned high importance to herd-level animal care in their decision to pursue a career in RVP, whereas a higher proportion of women than men assigned high importance to individual animal care (Table 2). In general, higher proportions of generation Y respondents assigned high importance in their decision to pursue a career in RVP to the factors herd-level animal care, location of family and friends, community need for veterinary care, job availability, and salary and benefits than did respondents in other generational categories (Table 3). Finally, higher proportions of respondents with a rural background assigned high importance to the factors rural lifestyle, herd-level animal care, location of family and friends, community need for veterinary care, and salary and benefits than did respondents from an urban background (Table 4).
Discussion
The present study was developed to better understand factors that influence veterinarians to develop an interest and pursue a career in RVP. Overall, 38.3% (431/1,124) of respondents reported that they developed their interest in RVP before 8th grade and 65.9% (741/1,124) reported that they developed their interest in RVP before graduating from high school. Having relatives with a farm background was ranked by the highest proportion of respondents (664/1,106 [60.0%]) as being of high importance (ie, a score of 4 or 5 on a scale from 1 to 5) in their developing an interest in RVP. Overall, 79.8% (897/1,124) of respondents interested in RVP reported having livestock experience in their background. Therefore, targeting children before 8th grade, encouraging individuals with relatives who have a farm background, and fostering livestock experience may help increase the number of veterinarians interested in rural practice. However, this may not be sufficient to meet the expected demand because, as the US population increasingly becomes urbanized, fewer individuals will likely have relatives with a farm background or livestock experience. Thus, efforts will have to be made to attract veterinarians from other backgrounds to RVP. For individuals with an urban background, our findings suggest that it may be helpful to focus these efforts on increasing exposure to rural environments and promoting livestock experience early in life and during veterinary school.
Respondents in the present study overwhelmingly characterized RVP as the practice of veterinary medicine in any community where agriculture represented a significant part of the local economy. Importantly, the definition of RVP did not focus on the specific animal species served, the distance to the nearest metropolitan area, or the type of practice (eg, mobile vs hospital based). Because rural veterinarians have traditionally tended to livestock, RVP has often been considered synonymous with large animal practice or food animal practice. However, our results illustrate that for most respondents, RVP was distinct from large animal and food animal practice. In contrast, 2 recent studies3,13 referred interchangeably to food animal practice, large animal practice, and rural practice, ignoring the distinct differences between these categories. Furthermore, the term food supply veterinary medicine has recently been introduced, and in some instances, this term is used as a substitute for the term food animal medicine,7 causing further confusion. Therefore, programs designed to increase interest in food supply veterinary medicine may do little to enhance interest in RVP, which is not specific to food animals or food production.
For the survey used in the present study, we elected to not provide a specific definition of RVP for survey participants because we believed that it was imperative to allow each respondent to answer the questions on the basis of his or her own definition of RVP, without reference to a standard definition. It is possible that differences in interpretations of the term RVP may have introduced some unknown degree of bias in our results. However, this approach did allow us to collect information on how respondents defined RVP.
For respondents in the present study who indicated an interest in RVP, this interest generally developed early in life. In part, this likely reflected exposure early in life to relatives with a farm background and to livestock. The influence of early exposure to rural life on the decision to pursue a career in RVP has been reported previously.16,20 Thus, our findings reinforce the suggestion that efforts to increase recruitment of veterinarians into RVP should focus on grade school children. Owing to differences in the importance that men and women placed on various factors, methods used to recruit women into RVP may need to be different from the methods used to recruit men. Targeted recruitment programs in grade school children would have a lag time of at least 10 to 15 years before results could be observed (ie, until children currently in grade school would graduate from veterinary school). Importantly, the sustained decrease in population in rural areas in the United States21 will make it difficult to identify sufficient numbers of children with a rural background. Therefore, efforts targeting children in urban communities will need to be increased.
Importantly, exposure to RVP during veterinary school was ranked as being of high importance in developing an interest in RVP by a high proportion of respondents, particularly among respondents from an urban background and respondents without any livestock experience. We perceive that the majority of current veterinary medical students are individuals from urban backgrounds with little or no livestock experience.12 Thus, concerted efforts should be made to expose these individuals to RVP during veterinary school. However, recent trends in some veterinary schools to emphasize early tracking into species-specific areas22,23 may limit students' exposure to various aspects of RVP. We believe that schools and colleges of veterinary medicine should make a concerted effort to expose students to RVP throughout the entire education process, in addition to providing RVP experiences during senior-year clinical rotations.
In contrast, membership in youth programs such as 4-H and FFA was cited by lower proportions of respondents as being of high importance in developing their interest in RVP. This concurs with findings of a previous study10; however, other studies4,20 have found that these programs were important factors in developing an interest in RVP. Possible explanations for this discrepancy may be the inclusion of some factors in the present study that better accounted for an interest in RVP or that controlled for possible confounding. For example, most respondents who ranked membership in 4-H or FFA as being of high importance in developing their interest in RVP also had relatives with a farm background.
Factors reported by the highest proportions of respondents as being of high importance in their decision to actually pursue a career in RVP reflected both personal and professional concerns, with rural lifestyle ranked as being of high importance by the highest proportion of respondents, followed by herd-level animal care and individual animal care. Male respondents were more likely to assign high importance to herd-level animal care, whereas female respondents were more likely to assign high importance to individual animal care. It is possible that differing definitions of RVP between men and women may have influenced this result. To our knowledge, this is the first time that gender differences have been identified regarding preferences for herd-level versus individual animal care, and we believe that additional studies should be initiated to identify behavioral differences by gender in veterinary medicine.
Surprisingly, lower proportions of respondents rated salary and benefits as being of high importance in their decision to pursue a career in veterinary medicine. Thus, employers wishing to recruit veterinarians into RVP should consider emphasizing personal (eg, rural lifestyle and community need) and professional (eg, commitment to herd-level animal care and individual animal care) aspects over considerations such as salary, benefits, and job availability. This finding contradicts the belief that low salary is one of the reasons for the lack of interest in RVP.13 However, salary was still important, especially among younger respondents.
Limitations of the present study are inherent to many types of survey studies.24 Specifically, there likely was some degree of response bias, in that individuals with an interest in RVP were more likely to complete the survey than were individuals without any interest in this area of practice. In addition, there likely was some degree of misclassification bias, which is inherent to studies involving questionnaires with multiple-choice questions and fixed answers, because respondents are forced to choose an answer that may only partially describe their intended answer.
The invitation letter for the survey used in the present study was sent to multiple veterinary organizations, who were asked to distribute it as widely as possible. It was not possible, therefore, to calculate a response rate because membership in each association could not be determined and there was an unknown amount of overlap in the membership of the associations to which the invitation letter was sent. The title of the survey on the Web site was “Factors that influence retention of rural veterinarians,” and this wording likely selected for respondents with an interest in RVP, even though the invitation letter specifically indicated that all veterinarians regardless of species interest were encouraged to participate. Nevertheless, a high proportion of survey respondents reported having an interest in RVP. Thus, it is likely that the respondent population was not representative of the general population of veterinarians in the United States. However, we were unable to determine the representativeness of the sample population.
Potential bias may also have occurred in interpreting and categorizing responses to the open-ended questions on the survey. To help minimize this type of bias, responses were categorized separately by 2 individuals, and if these individuals differed in their classification of any response, a consensus was reached as to which category the response should be assigned.
In conclusion, our study suggests that recruitment efforts need to be targeted to reach prospective veterinarians at an early age. Potential new rural veterinarians need to be mentored early on by veterinarians in RVP and should have ample opportunities to experience RVP throughout their training in veterinary school.
ABBREVIATIONS
FFA | Future Farmers of America |
RVP | Rural veterinary practice |
Copies of the questionnaire are available from the corresponding author on request.
Survey Gizmo, Widgix Software Co, Boulder, Colo. Available at: www.surveygizmo.com. Accessed May 20, 2008.
Minitab 15, Minitab Inc, State College, Pa.
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