Wants information on gender-associated salary differences

We commend the AVMA Veterinary Economics Division for publishing important data about the profession, as exemplified by “Employment, starting salaries, and educational indebtedness of year-2019 graduates of US veterinary medical colleges.”¹ Prior to 2014, however, JAVMA also published annually information about gender-associated differences in starting salaries (overall and by practice type), number of job offers received, and employment benefits offered.² This most recent report did not include salary data by gender, and we believe this lack of gender-associated salary data is a disservice to the profession. Veterinarians need to know about the ongoing gender-associated pay gap in veterinary medicine.

The 2019 AVMA Economic State of the Veterinary Profession report³ does indicate that “[w]omen are offered, on average, $2,683 less than men,” but no further details are provided. In addition, although many AVMA members receive JAVMA in the mail twice monthly, the AVMA economic reports are less accessible; they are not automatically sent to members and there is a charge of $125 for individuals who are not members of the AVMA to purchase them (compared with free access and prominent display of JAVMA in veterinary college libraries, for example). Furthermore, the AVMA economic reports are not indexed in biomedical literature databases in the way that publications in JAVMA are, so they are not as discoverable.

We appreciate the excellent work of the AVMA Economics Division, and we understand the need for the AVMA to earn income from its work. At the same time, the AVMA mission statement includes “advocating for our members” and a core value of the AVMA is being “accountable to the needs of our members.”⁴ A fair income—and an awareness of what constitutes a fair income—is a core need of practicing veterinarians. Because increasing the transparency of salaries can decrease the risk of pay inequities attributable to bias,⁵ the AVMA could serve members better by expanding its data collection, analyses, and publications to include differential salary information for women and for other groups at risk for bias, such as Black and Indigenous individuals, people of color, and LGBTQ+ individuals. The AVMA has the expertise and the platform to improve pay transparency in veterinary medicine. Please maximize the good you can do in this regard by increasing the visibility and accessibility of this valuable information.

Sarah A. Wagner, dvm, phd

Texas Tech University Amarillo, Tex

Virginia R. Fajt, dvm, phd

Texas A&M University College Station, Tex

AVMA responds:

Thank you to Drs. Wagner and Fajt for their thoughtful letter and desire for greater transparency and more fluid communication of our profession's economic data. I agree that information on gender-associated differences in starting salaries, job offers, and employment benefits is important to the profession.

For some history and context, over the past several decades the AVMA has been conducting research on a wide variety of economic topics, including employment, starting salaries, and educational indebtedness of new veterinary graduates, and has made its findings available to members and other stakeholders through various—but disconnected—articles, reports, and posts. Summaries of this research regularly appeared in JAVMA up until 2013, when the AVMA Veterinary Economics Division was established. At that time, much of that content was shifted from JAVMA into stand alone reports available on the AVMA website.

The prevailing thought at the time was that a series of annual reports would better serve the veterinary profession and make it easier to see how results of separate research studies worked together to improve our understanding. As the Veterinary Economics Division has grown and evolved, however, we have learned that although these annual reports continue to have value, providing snapshots of specific findings also has benefits. Therefore, we have again begun publishing results of the annual senior student survey in JAVMA, starting with results of the 2018 survey.¹ In addition, in response to concerns about educational indebtedness of graduates of foreign veterinary colleges who return to the United States, we have published information specifically looking at this group.² The comments from Drs. Wagner and Fajt serve as a good catalyst for us to continue these efforts, and we are preparing a report on gender-associated findings that we expect to publish in JAVMA.

We acknowledge that it would be useful to include differential salary information for other groups at risk of bias. Unfortunately, we currently do not have demographic information for a large percentage of AVMA members, making any results we provide on the basis of race or other characteristics unreliable. Note that the AVMA is committed to improving this situation and is currently developing methods to obtain this information, including encouraging members to self-report this information. Thank you again for taking the time and having the passion and conviction to share your feelings and beliefs. Requests such as these are taken very seriously and help drive our research strategy and outcomes.

Matthew Salois, phd

Director, Veterinary Economics Division

AVMA

Schaumburg, Ill

Antimicrobial resistance: a one health challenge that calls for a focus on students

It is encouraging to see that the AVMA Virtual Convention 2020 will focus on continuing education opportunities to improve antimicrobial resistance (AMR) knowledge and antimicrobial stewardship practices among veterinarians.¹ Although continuing education can contribute to improving stewardship efforts, we believe that further attention should be focused on veterinary student education. Early education has the ability to ingrain good stewardship behaviors prior to graduation and before students develop their own prescribing habits, which may be more difficult to change after years of clinical practice.^2,3

Our experiences suggest that although effective AMR and stewardship training can be implemented during veterinary education, it may not be taught consistently across all US veterinary schools. In some schools, comprehensive training is provided across the preclinical and clinical years; in others, good stewardship practices may not be a focus in preclinical, foundational classes (eg, pharmacology and microbiology), but the importance of good stewardship is underscored by attending clinicians during clinical rotations. In this case, the tertiary hospital setting where many students train is not reflective of the primary care offices where many veterinarians may ultimately choose to practice. Although we represent only two US veterinary schools, anecdotes from others indicate that gaps and inconsistencies exist across veterinary schools, which warrant further investigation.

To our knowledge, no literature exists that highlights AMR and stewardship knowledge, perceptions, and attitudes among US veterinary students; however, studies involving veterinary students in other countries have demonstrated critical deficiencies. For instance, a study among South African veterinary students demonstrated knowledge gaps in basic antimicrobial pharmacodynamics and alternatives.⁴ Shockingly, a third of the 71 respondents who stated they received lectures on AMR and stewardship could not recall what they were.⁴ In the United Kingdom and Australia, veterinary students recognized the importance of the topic and acknowledged the need for more material in their curriculum.^5,6 Global research into this subject has elucidated the potential for gaps in training among US veterinary students, which may be further exacerbated by the lack of a streamlined and uniform approach to teaching these topics among schools. The first step to improving stewardship training will be to understand where the current level is, which can be done through a survey of US veterinary students.

The importance of the veterinary profession's role in one health is more apparent than ever, and as antimicrobial prescribers, we have a responsibility to practice effective stewardship in all veterinary sectors. While the AVMA continues to take critical steps to advance this movement, we must work together to improve the education system for future veterinarians, providing students with the tools to develop appropriate prescribing behaviors and to communicate the importance of stewardship with colleagues and clients. This requires us to step out of our silos and bridge gaps between academia and clinical practice to address the shared one health challenge of AMR and preserve the tool of antimicrobial drugs for future generations.

Laura O'Sullivan, vmd, mph

Havertown, Pa

Gabriel K. Innes, vmd, phd

Department of Epidemiology

School of Public Health

Rutgers University

New Brunswick, NJ

Meghan F. Davis, dvm, mph, phd

Department of Environmental Health and Engineering

Bloomberg School of Public Health

Johns Hopkins University

Baltimore, Md

Veterinary community outreach

I want to thank Bacek et al¹ for their letter suggesting that they have recently seen alarming increases in the numbers of confirmed cases of parvoviral enteritis and hospitalizations attributable to it. In their letter, the authors speculated that one of the factors contributing to this increase could have been limited availability of preventative veterinary care during the earlier stages of the COVID-19 pandemic.

In contrast, the Indianapolis community appears to be seeing the opposite effect. Two of the largest affordable-care clinics in the area, which typically bear the burden of diagnosing and treating most cases of parvoviral enteritis in our community, have seen drastic decreases in numbers of parvovirus cases this year. One of the clinics, the West Michigan Street Veterinary Clinic, has seen a 25% decrease in the number of parvovirus cases this year, compared with last year. The other, FACE Low Cost Animal Clinic, has seen the number of positive tests decrease by half this year, compared with last year.

Through collaborative efforts over the past year and a half between local nonprofit organizations, animal shelters, veterinary clinics, and animal welfare agencies, Indianapolis has deliberately worked to decrease the number of parvovirus cases. Veterinarians, veterinary nurses, veterinary clinic staff members, and other stakeholders have held multiple free vaccination clinics, performed door-to-door in-home vaccination campaigns, and appeared in news segments with local media about the importance of vaccinating dogs against parvovirus. Although we cannot be certain that the decrease in parvovirus cases in Indianapolis is due to our efforts, we are confident they have contributed to it.

Community outreach efforts are immensely beneficial to pets and pet owners alike. I would argue they are beneficial to veterinarians and veterinary staff members as well. Most people who join the veterinary profession have a compassionate heart and want to help both animals and people.

If veterinary clinics would allow each staff member 1 to 2 paid days of volunteer work per month (in lieu of working in the clinic), this would not only benefit the community but also improve the mental and emotional health of those staff members. With increased awareness of and focus on veterinarians’ mental health and well-being, I think we need to look at the profession at large and ask how it might be contributing to the problem. By refocusing on giving back and providing an outlet for veterinarians and staff members to reconnect with their community, we can allow ourselves to understand the perspective of struggling pet owners, feel truly appreciated for our work, and empower pet owners in our community to develop a trusting connection with veterinarians.

Leslie Brooks, dvm, mph

SOAR Initiative

Indianapolis, Ind

Setting goals for diversity and inclusion

Lately, it seems that big corporations have been falling all over each other to let consumers know about their commitment to diversity and inclusion. I often wonder, though, what exactly these businesses are doing to move their corporate cultures toward fulfilling that commitment. My suspicion is that a great deal of their efforts are merely lip service. Now that the veterinary profession is aware of diversity and inclusion issues, it seems to me that it is time to articulate clear plans and goals for improving these issues, lest our actions become nothing more than the equivalent of jumping on the bandwagon. All too often, calls for diversity and inclusion are too vague to be of any real value and lack meaningful measures to document improvement.

I don't doubt that our veterinary colleges are committed to improving inclusion and diversity, but it is time to start moving away from simple platitudes and toward specificity about how we achieve those goals. In a recent letter to the editor, Bernstein et al¹ suggested that “[a]dmissions policies must be designed with specific racially just and diversity-conscious goals.” However, the terms “racially just” and “diversity-conscious” are sufficiently unclear as to make me wonder what admissions policy changes the authors advocate. Are they suggesting policies such as affirmative action or quotas? What exactly does a racially just and diversity-conscious admissions policy look like? Perhaps substituting “racially neutral” for “racially just” would improve clarity. It's time that we discuss specific answers to these and other diversity and inclusion-related questions.

In my opinion, efforts to increase diversity and inclusion should be directed toward recruiting underrepresented individuals throughout grade school, high school, and undergraduate studies to increase the pool of qualified underrepresented individuals interested in joining the veterinary profession.

John S. Parker, dvm, mba

Briarpointe Veterinary Clinic

Novi, Mich

Editor's note:

In an ideal world, racially neutral policies would indeed be racially just. Sadly, as is all too obvious from recent events, we live in a world that is far from ideal. Systemic racism and other forms of discrimination continue to disadvantage individuals from marginalized and underrepresented communities, and simply closing our eyes to those inequities does not make them go away.

As Bernstein et al¹ point out in their letter, any attempt by veterinary college admissions committees to “select highly qualified applicants while ignoring sociocultural context reinforces discrimination, systemic racism, and exclusion.” That doesn't mean that admissions committees must turn to affirmative action policies or quotas or that colleges must accept “less qualified” candidates. It does mean that admissions committees must examine and question how they identify qualified candidates and must understand that seemingly objective criteria, such as grade point averages and test scores, alone are not the best criteria and may not correlate with professional success.

Kurt J. Matushek, dvm, ms

Editor-in-Chief