More on the future of veterinary education

It is with great interest that I address the letter to the editor written by Eric Fish.¹ Mr. Fish believes that core basic and species-specific training with limited licensure will modernize veterinary medicine.

I believe that by doing this, we would contribute to the greater problem of the shortage of large animal veterinarians. It would also contribute to the inexperience in general practice that some believe occurs in new graduates. It takes time for information to be processed and used correctly by all veterinarians, especially new graduates. The time devoted to multispecies education will produce veterinarians who are better suited not only to make important decisions, but also to decide which species best suits their interests.

My veterinary clinic actively mentors and employs veterinary students and new graduates. I believe that those students who can work with or at least show interest in multiple species have an advantage over students who elect early on to study only small or large animals. These people are more employable because of their versatility. We don't expect excellence out of new graduates; that is difficult for even the most seasoned veterinarian. The information needed to practice as a mixed-animal practitioner is not beyond the intelligence of even an average veterinary student. It only takes the desire to do so and the work ethic necessary to polish those skills over the years.

Veterinary medicine provides new graduates with an exciting, challenging, rewarding career. Limiting oneself to only specific parts of veterinary medicine without exploration of the whole will limit one's potential and most likely one's satisfaction. I encourage the North American Veterinary Medical Education Commission to remain firm in their idea that all students should be cross-trained in all species.

Now, if you don't mind, I need to start surgery to fix this dog's knee. Lunch may be short so I can finish the cryptorchid horse. My receptionist reminded me to take along enough vaccines for the farm dogs when I am in the country doing pregnancy checks on the cows. Also, I need to neuter two farm cats. It's going to be a great day.

Thomas Bettenhausen, dvm

Missouri Valley Veterinary and

Pinehurst Veterinary

Bismarck, ND

I wish to respond to the letter to the editor by Eric Fish¹ regarding the future of veterinary education.

I am a 1958 graduate of the Michigan State University College of Veterinary Medicine. I am still in active practice. At school, we were responsible for the variety of species that we might encounter in our professional lives. I am so thankful for having that educational opportunity, and I will tell you why. Medical doctors are licensed to practice on only one species. We get all the rest. You may think that you know how you will spend the rest of your life, but you may be surprised. It is sort of a train ride, and from time to time, you stop at a station and can change trains and go in a different direction.

Let me share with you my history. When I graduated, I worked for a state government doing food inspection. It was a ticket to the area of the country where I wanted to live.

After a period of time, I joined a private companion animal practice and then started my own practice. I had a special interest in avian, reptile, exotic, and wildlife species, which I incorporated into the practice. Independent study, classes, lectures, textbooks, journals, and conferences brought me up to speed in treating these species. Public health, particularly zoonotic diseases, became a great interest, and I became involved in this field. After some 40 years, I sold the practice and emigrated to Australia, where I now practice and participate in a number of research projects. Many of the species I care for are the same as in the United States with the same diseases and lesions, but wildlife species are quite different and a large part of my practice involves wildlife species. In addition, I now have a farm and raise Wessex Saddleback pigs, Highland cattle, Wilshire Horned sheep, alpacas, poultry, and rabbits. We also keep Clydesdale horses and breed Border Terriers. Could I have foreseen 52 years ago where I would be and what I would do today? No, but the training I received in school prepared me for the joyous train ride I have been on and will continue to take.

Do not back yourself into a corner. It leads to boredom and burnout. Keep an open mind to possibilities and changing trains when the opportunity arises. Remember the profession is not just a job: it is a way of life, and you can write your own job description, provided you have the basics.

James M. Harris, dvm

Mayfair Veterinary Clinic

Sandy Bay, TAS, Australia

Questions whether dogs bites are on the rise

We are writing in response to the February 1, 2011, JAVMA News article titled “Hospitalizations for dog bites nearly double in 16 years.”¹ That title or a version of it unfortunately has appeared in several other publications (including a major US newspaper)^2,3 summarizing the report⁴ from the Agency for Healthcare Research and Quality. We are concerned that this title inaccurately promotes the idea that we have an epidemic of dog bites in the United States, further inflaming the debate on this issue. Mark Twain is said to have paraphrased from a quote attributed to Disraeli, that there are “lies, damn lies, and statistics.” Nowhere than in this title could there be a better illustration of that axiom. In our opinion, the title, although technically defensible, gives a misleading view of the data presented. First, most of the increase in number of hospitalizations occurred within a two-year period more than 15 years ago, from 5,100 hospitalizations in 1993 to 8,800 hospitalizations in 1995. The number of hospitalizations then plummeted to 6,400 in 1996, increased to 7,700 in 1997, and then fluctuated around that level for the next five years. All we can reasonably conclude from this pattern is that hospitalizations resulting from dog bites fluctuated over time and that there were some anomalous increases and equally large decreases that have yet to be explained. It is not even possible to conclude that the rise from 1993 to 1995 represents a real increase in incidence because we don't know whether there were any changes in the method of data collection during those years. The increase (9,500 hospitalizations) during the last year of data reported (2008) may also simply represent one of those anomalous shifts, rather than a consistent pattern of increase. It is premature to conclude that the 2008 increase represents a continuing trend. The numbers of hospitalizations in 2006 and 2007 were considerably lower (8,400 and 8,200, respectively), which is less than the number reported for 1995. So one could just as easily and quite legitimately report, with only a slightly different slice of the data, that hospitalizations resulting from dog bites in the United States decreased over the 12 years from 1995 to 2007, while the US dog population and percentage of households owning dogs increased by more than 25%.⁵ That would make for a very different headline and one more supported by the data. This conclusion is also supported by the data in Figure 2 of the AHRQ publication, which shows the rate (eg, number of dog bite–related hospitalizations/100,000 people) peaking in 1995 and then staying relatively flat from 1997 to 2008, at about 2.8 dog bite–related hospitalizations/100,000 people. Unfortunately, that statistic was not highlighted in any of these news reports. The truth is that dog bite–related hospitalization rates have remained relatively static on a per-capita basis, despite a steady increase in the US dog population. This is good news for dogs, owners, and communities. We encourage interested readers to access the original report online.

Gary J. Patronek, vmd, phd

Vice President for Animal Welfare

Animal Rescue League of Boston

Boston, Mass

Margaret R. Slater, dvm, phd

Senior Director of Epidemiology

Shelter Research and Development

ASPCA

Urbana, Ill

More on the need for veterinarian-scientists

I enjoyed Dr. Marshak's commentary “The vanishing veterinarian-scientist”¹ and subsequent letters^2,3 and wanted to comment from an industrial veterinarian's viewpoint.

I was a small-town Illinois mixed-animal practitioner when I moved into a large pharmaceutical company's research and development division. It was a division dominated by individuals with PhD degrees, and I was at first overawed by them. However, I soon learned their areas of science were very narrow. I learned I had a much broader base owing to my veterinary training in all basic sciences. I could not compete with their in-depth knowledge; however, in many cases I could better interpret the use of their findings. A project team system was used in this laboratory. I recall the day I was made a project team manager, directing a group of individuals with PhD degrees and their acceptance of a veterinarian who had an understanding of their areas of science but not as much depth of knowledge. As a project team director, I developed a talking knowledge of all areas and could well represent our project team to management.

Later, as I progressed up the corporate ladder, I eventually became vice president of research and development in my division. I had individuals from a wide variety of scientific disciplines reporting to me, including medicinal chemistry, pharmacology, toxicology, tissue residues, clinical medicine, and regulatory affairs.

From these experiences, I believe a veterinarian with a PhD who is trained in the basic sciences can compete in the scientific world. From this background, I agree with Dr. Marshak that the major emphasis being placed on clinical specialties is eroding the future of veterinary scientists. We must provide veterinarians with rigorous doctoral-level basic science training if our profession is going to compete in the scientific world.

How we obtain this position is going to be difficult. Again, it is an issue that our profession and our schools must face if we want our profession to compete successfully in the greater world of science.

George C. Scott, dvm

West Chester, Pa

Thoughts on the shortage of food animal veterinarians

A recent JAVMA News report¹ linking the need for more food animal and public health veterinarians with an attempt to rectify this problem by increasing veterinary school class sizes raises important questions about the wisdom of continuing down this path. Data provided by the AVMA from 2006 to the present indicate no noteworthy change in the percentage or actual number of veterinarians who identify themselves as being employed exclusively or predominantly in food animal medicine.² Similarly, over the past five years, the percentage of new graduates entering food animal practice has not increased.³ Nevertheless, the JAVMA News report stated that about a third of all US veterinary schools expect to increase their class sizes, even though nationwide, the number of veterinary school applicants per available seat is not increasing and state financial appropriations for veterinary schools are on the downswing. The report indicated also that veterinary school applications are anticipated to decrease because potential future earnings do not warrant the debt load students know they will incur.

In the absence of additional or as-of-yet unproven incentives, such as helping to pay off student loans for those entering food animal practice,⁴ increased class sizes do not seem to be an effective remedy to the current and presumed future shortage of food animal veterinarians. Because veterinary classes are inevitably filled, this raises the question of where these students are going when they graduate. The answer is that they are entering advanced studies programs, with the percentage of new graduates entering advanced studies having increased from 32.9% in 2006 to 49.2% in 2010.³ The result, as expected, is that the number of veterinary specialists has increased every year since 2006.⁵ Unfortunately, the number of food animal specialists has remained small.

As I sit in my sheltered academic ivory tower (actually, a basement office) pondering this apparent inconsistency of purpose, I wonder if an increase in class size and tuition leads to additional revenue for fiscally strapped veterinary schools or if the need for additional student resources typically negates any financial gain. Perhaps others can shed light on this issue and provide at least one reason for increasing class sizes while not increasing the number of graduates entering food animal medicine.

Jerald Silverman, dvm, daclam

Director, Department

of Animal Medicine

Professor, Department of Pathology

University of Massachusetts

Medical School

Worcester, Mass