The recent release of the AVMA's highly anticipated study of the veterinary workforce in the United States¹ was an important milestone and provided valuable empirical data for consideration. Although some believe the study vindicates their assertion that academic veterinary medicine is producing too many graduates for the current market, we suggest that the study instead indicates that the issues are more complex and demand additional scrutiny and insight.

We should recognize and embrace this study for what it is: a clarifying and important step toward understanding the dynamics impacting the veterinary profession. We should also recognize that this study demonstrates a level of scientific rigor and sophistication that speaks to AVMA's commitment to address the economic issues affecting our profession.

The current operating environment for veterinary medicine has been shaped by structural economic imbalances rooted in the way owners are willing to pay for high-quality clinical care for companion animals, the high cost of medical education, Internet-era changes in the way goods and services are sold to consumers, and changes in agricultural production practices, to name just a few. These stressors have been apparent and building for many years and have been considered in a wide range of economic studies.² There are no easy answers for these fundamental problems, and they are each worthy of additional discussion and debate.

In light of this workforce study, we would like to share some insights about academic veterinary medicine and address some misperceptions that exist regarding what colleges of veterinary medicine can and cannot do, now that excess capacity in some market sectors has been demonstrated. First, we need to remember that workforce imbalances and the economic spasms they engender periodically occur in various professions. In the early 1900s, the rise of tractors and automobiles was accompanied by a precipitous decrease in the number of draft horses, with a concomitant negative impact on the veterinary profession. But, veterinary medicine adapted and flourished. Similarly, some thought the dentistry profession would be diminished once mass fluoridation of public water supplies was instituted, but that profession successfully retooled to focus on preventive and cosmetic care. As we look to the future, we should find ourselves similarly inspired by today's challenges. Throughout the careers of the veterinary students now studying in our colleges, the population of the world will grow by 2 billion, with the population of the United States alone growing by 100 million. Our profession must find a way to meet the increasingly complex health-care needs of billions of people and animals in the years ahead. Despite concerns regarding our current operating environment, we believe there are meaningful career growth opportunities for veterinarians in the years ahead.

Some have advocated for a mandate from the Association of American Veterinary Medical Colleges (AAVMC) and the AVMA that veterinary colleges in the United States reduce their class size. However, no authority exists for either organization to take such measures. Veterinary college faculty and administrators use their best judgment as professional educators to make decisions regarding appropriate class size, and those decisions must be justified to university administrations who, in turn, are accountable to the university's boards of trustees and, in most cases, the state government. Each college is responsible for determining its own class size. Over the past decade, several colleges of veterinary medicine enlarged their classes in response to a perception that there was an unmet demand for veterinarians. Recognition of the need to increase the capacity to train veterinarians was so widespread that the Veterinary Workforce Expansion Act was introduced in the US Congress in 2005. Additionally, the US Government Accountability Office (GAO) issued a report in 2009 warning of a “growing shortage of veterinarians nationwide, particularly of veterinarians who care for animals raised for food, serve in rural communities, and have training in public health.”³

Creating institutional change in veterinary colleges and their supporting universities takes time.⁴ Enrollment at US colleges of veterinary medicine remained essentially flat from 1983 to 2003, but as concerns about an impending shortage of veterinarians became more broadly recognized, many colleges developed strategies in the early 2000s to expand their class sizes to meet society's growing needs. Generally speaking, the process of increasing a college's class size can take anywhere from 7 to 10 years. This process starts with a detailed, multilevel review of the request to increase class size, which includes a careful analysis of the evidence that there is an unmet need for more veterinarians. Increased operating and capital support must then be obtained, facilities must be built or renovated, and faculty must be hired, all of which take additional time. Finally, even after the incoming class size is increased, 4 more years will pass before those students become veterinarians. Although the 2013 AVMA workforce report likely will not alter plans to expand class size that are already in motion, it may very well inform plans for future class size expansion or establishment of new veterinary colleges, considering that universities and states will certainly include the workforce report findings in their decision making.

The economic challenges facing our colleges are real and pervasive. However, the rising tuition and student debt problems plaguing academic veterinary medicine are not unique; they are systemic throughout higher education. During the post-World War II expansion, state and federal governments recognized that a high-quality system of higher education for American citizens would help develop and sustain a productive and talented workforce and spark research and innovation. After many decades of steady investment in higher education, states began 20 to 30 years ago to systematically reduce their support for public higher education. That trend is especially visible at our nation's major public research universities, where many of the US colleges of veterinary medicine are located. On a per-student basis, state support in inflation-adjusted dollars declined by a mean of 20% between 2002 and 2010.⁵

To help offset this decrease in state and federal support, the colleges of veterinary medicine have worked diligently to develop alternative sources of revenue. For example, the colleges have dramatically enhanced their private fundraising operations over the past 20 years. But, the costs of providing a high-quality education continue to rise. The problems in academic veterinary medicine are a microcosm of what is happening throughout higher education and reflect a critical national problem that is affecting all colleges and universities.

Some within the veterinary profession have expressed concerns that the opening of new colleges of veterinary medicine and the accreditation of foreign veterinary colleges will only exacerbate the current excess capacity in the veterinary medicine. Importantly, when evaluating colleges for accreditation, the AVMA Council on Education bases its decision entirely on the ability of each college to meet the standards of accreditation, as evidenced by a detailed self-evaluation and confirmed by site visits that include interviews with external stakeholders. The Council on Education cannot consider economic or political factors when making accreditation decisions, and doing so would risk violating federal restraint of trade laws. With regard to accreditation of foreign veterinary colleges, the AVMA recently convened a task force to consider this question. The task force affirmed the importance of veterinary education in improving and elevating global animal health to the benefit of animals and people in the United States and worldwide, concluding, “Accreditation of foreign schools adds a network of veterinary schools outside the United States that are increasing the knowledge base within and outside of the US veterinary profession.”⁶ We are confident that recent actions undertaken to reconstitute and enhance the Council on Education will ensure that the accreditation process continues to foster and sustain the highest possible standards of professional education in veterinary medicine, an achievement that will continue to position veterinarians as superbly qualified and compassionate medical professionals.

In addition to a sustained pattern of diminishing government support for academic veterinary medicine, another problem has shaped the profession's current operating environment. Our country is only recently beginning to recover from the greatest economic contraction since the Great Depression. This economic shock substantially reduced consumer demand for clinical veterinary services. As millions lost their jobs and equity in their homes, they also lost their ability to pay for clinical care for their pet dogs and cats, particularly preventive care. The good news is that there are signs that the nation's economic recovery is gathering momentum. Reports suggest that joblessness is declining and that the housing market is improving. Equity markets fluctuate substantially but presently hover near all-time highs. In addition to these encouraging signs, and despite popular misconceptions, the employment rate in the veterinary profession would seem to be far better than national averages. In a survey⁷ performed by the AAVMC, employment rates for the graduating classes of 2011 and 2012 were calculated as 98.4% and 97.7%, respectively. These rates are far better than the rates for most college graduates and are particularly impressive considering the current national unemployment rate of 7.3%.

Market forces will ultimately work to restore the equilibrium between capacity and demand in the veterinary profession. Without question, those who are successful in gaining admission to veterinary college are extremely bright and capable individuals. Importantly, the quality and quantity of the applicant pool has continued to improve. One way of evaluating demand is to examine the input side of the equation. Clearly, well-informed and thoughtful students continue to make the decision to attend veterinary college despite the recent rise in uncertainty associated with starting salaries and employment opportunities. By law, we cannot ration education, nor unfairly deny those who seek it.

The economic challenges facing our profession are considerable. Any progress we make will likely come in the form of incremental changes and will require the engagement of each and every one of us. The AAVMC will continue to engage in constructive dialogue with organized veterinary medicine through meetings with the AVMA and in other forums and venues. We need to work together to better interpret and understand the forces affecting our current operating environment and the trends that are shaping the future and, ultimately, to create positive change.

We believe the worst thing we can do is to discourage intelligent and talented students from considering and pursuing careers in veterinary medicine. As veterinarians, we should be ambassadors for veterinary medicine in every dimension of our lives; it is a role that we embrace, whether we realize it or not, in our practice environment and in every aspect of our social lives. What is the logic of denigrating the veterinary profession when we have all spent so much of our lives building public understanding and respect?

Diminishing the importance and value of the veterinary profession discourages an important subset of applicants from considering entering the profession. Some students have known since elementary school that they wanted to be veterinarians when they grew up, and their career trajectories are completely focused on clinical practice. Others, representing a growing subset of applicants, are high-achieving, broad-minded students who received extensive science, technology, engineering, and math training in high school and entered undergraduate school thinking about a career in the health professions, but unaware of all their options. These are the students whose aptitudes and interests can lead them toward productive and fulfilling careers in the public practice sectors of veterinary medicine, where demand exists and where their interests and capabilities will help expand the horizons of our profession.

When we critically examine the current operating environment and consider the economic constraints with which the profession has coped for the past 30 years, we see cause for optimism. During this year's AVMA sesquicentennial celebration, we are reminded of the tremendous leadership that the AVMA brings to our profession. Notably, we see the AVMA's investment in establishing a division devoted to veterinary economics as evidence of its commitment to improving the future.

In academic veterinary medicine, we see the important work being achieved by groups such as the Veterinary Educator's Collaborative, which is working to develop and share best practices in veterinary education, and the AAVMC Financial Literacy Task Force. We see the consumer education and professional development program developed by the Partners for Healthy Pets beginning to gain traction. We see news from the American Animal Hospital Association that practice revenues rose 5.6% from 2011 to 2012. Importantly, we see various sectors of the profession, from the AVMA and AAVMC to a wide variety of business and other organizations, working together to foster progress and improvement.

None of these positive trends erases the very real economic challenges we face as a profession. Every view and every voice has a place in the dialogue about the future of veterinary medicine. However complex the challenges we face, it seems clear that the most promising solutions will emerge from a united community bound by oath and loyalty to common principles, purposes, and aspirations. With an intellectually sound understanding of the legitimate challenges of the present times, we believe the evidence supports a much more optimistic view of the future than is sometimes apparent in our profession.