President’s Update – AVMA/AAVMC meeting in Washington DC

Twice a year (November and April) the officers of the AVMA meet with the officers of the Association of American Veterinary Medical Colleges to discuss issues of mutual importance to the veterinary medical profession and education.  As you can imagine we had a lot to talk about his year.  Topics included:

  • Veterinary medical orientation programs for incoming students;
  • Sharing of Veterinary Internet Content Exchange programs for veterinary medical students which has tremendous potential but lacks funding (anyone care to financially support this great resource??);
  • Our strategic plans and where we might have common interests, including economics;
  • Prioritizing the findings of NAVMEC and how we might move some of those recommendations forward;
  • Management of educational debt (given the much decreased government support for higher education),
  • How to market and increase the value of the veterinary medical degree for the complexity of the education;
  • How to incorporate the principles of the Partnership for Preventive Pet Healthcare into education; and
  • How we might speed up the report from the National Academies of Science on Veterinary Medical Workforce.

This was an all day meeting covering a lot of topics.  The AVMA and AAVMC hope to continue to work closely together to meet many of the challenges facing veterinary medicine now and into the future.

15 thoughts on “President’s Update – AVMA/AAVMC meeting in Washington DC

  1. Apology accepted.

    First of all, I must say accreditation is a complex business that does require significant understanding, on which volumes of information has been written, and which the U.S. Department of Education and the Council for Higher Education Accreditation holds any accrediting body’s feet to the fire, including the AVMA Council on Education. So, I respectfully disagree with you, and that one does indeed need to see the self-study, one does need to be trained in accreditation, one does need to verify the self-study with a site visit , and one needs to be present for the deliberations by the entire Council to make that accreditation decision. It is a long and deliberate process.

    Second, with all due respect to the authors of Commentary articles in JAVMA on whatever topic they choose (which I do read regularly by the way), the Commentary is an opinion piece. I think because it was printed in JAVMA, it may be taken as pure fact (which I can understand as JAVMA has a highly regarded reputation as a credible resource for veterinary medical information), however, even the Wall Street Journal has an op-ed page. The Commentary is opinion. Dr. Marshak was writing about his opinion, which I will defend his right to state. However, times change, and new models of education have evolved and met the standards with methods other than the traditional methods used for previous decades. In addition, his commentary did not have the benefits of all those resources I mentioned earlier that need to be considered when making judgments on specific programs.

    Finally, if you want me to go out on a limb, and state I believe all the schools with favorable accreditation decisions met the 11 eleven standards, I will do that because I do trust the system. If you go on our website, you will find the options available to the COE for accreditation decisions. If we think the Standards need to be changed, we must change the Standards. Every fall 2-4 standards are up for public review. I have been to all the schools seemingly being questioned, either as a COE site team member or as Vice President visiting SCAVMA chapters). I believe in our accreditation system. However, the best judgment over anything else is Standard 11, Outcomes Assessment. If the measurements by which we judge competence are met, then I believe the outcome is good. If we don’t believe that, then we need to change the measurements by which we measure competency. Just one example is the NAVLE. If the students pass the NAVLE, have they learned the material? Do we believe it is a good test? Believe me, it takes talented test question writers to write a fair and good test. Do we need a Clinical Proficiency test for our own graduates and for COE accredited program graduates as well as for ECFVG candidates? That is entirely another subject for discussion. Any system is always able to be improved upon. And in fact, just like veterinary medical programs, that must show continuous improvement of the program, so must any accreditation body.

    Third, in regard to the concerns on foreign school accreditation, as previously stated, we have a task force that has been specifically charged with looking at that issue. Again, I would urge your patience to let them do their work. Nominations have been received, and we are in the process of appointing a balanced task force that can hopefully look objectively at the pros and cons of this issue. I have to say that I think AVMA has clearly heard its members’ concerns through their representatives which resulted in the HOD’s calling for forming this task force. The Executive Board has implemented that request. I know many of your colleagues have concerns, and I know many others think it is imperative to continue providing that service. We will see what the TF says that specifically investigates the issue. Keep in mind the TF is charged with making a report on the issue, not making a recommendation. That will be up to the Executive Board based on a full report of the facts to make such a decision in the best interests of our membership and veterinary medicine.

    On another note, I see from your website you raised Beagles. I don’t raise them, but we have had many beagles over the years, all in need of homes. We do have our love of beagles as a point we can agree upon I hope!

  2. @Greg Nutt

    In reading my last response, I realize that it came across quite poorly. For that I apologize. I believe Dr. Marshak summed up things on this subject quite well in a recent Javma.

    If you would like to go on record and state that all of these schools did in fact meet all 11 standards, I would love to hear it. From the information that has been published, it really doesn’t seem like that is the case.

    I believe that if the AVMA had an open dialogue with its entire membership, and if we all had a vote in the matter, this situation would not likely have come up at all. I say that because most of my colleagues don’t think we should be involved in this to begin with. You probably don’t know that because no one has ever asked.

  3. @René Carlson, AVMA President

    Dr. Carlson,

    I don’t feel like I need to be trained in how to accredit schools, nor do I feel like one must be present for the site visit. The schools simply meet all of the standards or they do not. I believe Javma published a very compelling article on this very subject not long ago. You do read Javma don’t you?

  4. @Ruth Beismer
    I really do appreciate these questions and the dialogue because it really is very important we have members’opinions clearly expressed so we understand the concerns, and so others understand our members’ concerns when we can “bring them to the table” and really start getting down to business in starting to address them. So please understand, I appreciate the comments and appreciate Greg advising others on VIN to express there opinions on this subject here.

    Ruth, your question was not directly addressed at our AVMA/AAVMC meeting, but I will be sure it is brought up during our scheduled discussions. I need you to tell me exactly where you are seeing these statements (school websites and info stated) so I can have specific examples in hand for that discussion. Can you send me the links?
    Thank you.

    Finally, in response to Greg’s comment “that I had stated: 1). These schools fully met the 11 rigorous COE standards for accreditation (which we now know to be untrue)”- I have to say, I guess we do indeed disagree. Unless one has read the self-study prepared by a school, participated in the site visit which includes many individuals from all aspects of the profession trained in accreditation (small animal, large animal, academia, practitioners, etc.), and heard the deliberations at the COE meeting, how can one say “we now know that to be untrue” – that they did not met the standards? How can one make that statement? Unless one was there. Just asking.

  5. I am curious if any mention was made during this meeting of the many references to a “shortage of veterinarians” on vet schools’ websites and promotional materials. Can the AVMA leadership not put any pressure on AAVMC to stop misleading future students?

  6. @René Carlson, AVMA President

    Dr. Carlson,

    At this point I think it is safe to say that we disagree on many things. When I originally expressed concerns regarding the oversupply of veterinarians in the midst of the AVMA’s globalization efforts and the COE’s decision to grant accreditation to several foreign schools, you stated that: 1). These schools fully met the 11 rigorous COE standards for accreditation (which we now know to be untrue) 2). This was not likely to have a negative impact on workforce balance (we will have to wait for time to tell) and 3). I should be more concerned about stateside schools increasing class size ( I agree).

    I have mentioned the numerous studies that have documented the oversupply
    and urge the Executive Board and AAVMC members to re-read the synopsis by Wise and Kushman, Javma vol 187, no.4. Could their analysis have been more accurate? We have a surplus and we know where the majority of the surplus is coming from. Yet, we won’t make a statement or point fingers at the individuals responsible? How about making a policy statement so that prospective students have some truthful information to evaluate before they decide to jump into several hundred thousand dollars worth of debt and an unstable profession? That would be true leadership.

    Any person or organization that worsens our work-supply balance is responsible for ruining our profession. Period. If you want to take blame, good for you. I believe that everyone that has ever been in a position to address this but did not (think executive board and AAVMC) should shoulder the blame and feel compelled to right the wrong. You might be surprised to find that I blame myself as well. You see, I have gladly paid me dues to the AVMA for 15 years assuming that the leadership was making decisions in the best interest of the profession and not the organization. As I have paid closer attention, it appears that this has not always been the case.

    Perhaps it has just been the cumulative effect of many years of honest mistakes that has led us to where we now are. Perhaps these have been misunderstandings between the relative few in our organization that makes decisions and the remaining eighty thousand of us that simply foot the bill. The fact that there is no real way for the masses to effectively demonstrate their opinions to the leadership makes this scenario quite possible.

    If we could change that, if we could give all members a voice within the organization, there may actually decide to get involved. I know that I would if I knew that my effort would not be in vain. As it stands now, my views are not represented as a dues paying member. How would that improve as a volunteer?

    Greg Nutt

  7. Dr Carlson,

    Greg Nutt is right in his analysis of the “failure” of leadership of both the AVMA and the AAVMC to not act swiftly and decisively to correct issues identified in these previous studies which I also have read. People and practices have to be held accountable and changed swiftly in order to prevent further damage and to insure that it does not happen again. Real leaders take ownership of the results of their decisions and policies, face reality as it is, and make decisions instead of calling for another study when facts do not fit their version of reality. If they cannot make decisions or their decisions lead to poor results for the organization, then they must be held accountable and replaced. Our profession is in decline and in crisis and there are enough facts and studies out there for adequate analysis, formulation of a plan and decisive action. Waiting for more veterinarians to graduate with absurd debt and the prospect of stagnant or falling salaries is a dereliction of leadership. I no longer have confidence in the AVMA or the AAVMC to do anything other than make sure they will take care of themselves at the expense of the rest of us.

    Robert Nix DVM

  8. @Greg Nutt
    Greg, your passion and concern for our profession is palpable, and I would love to harness some of this passion toward the solutions rather than at blame. What specifically are the many “profession damaging agendas” so I understand your list of problems we need to address?

    Second, our “lack of accountability” is not the only reason or even the primary reason our profession is facing these challenges. It is a multitude of factors, including changing times, decreased demand for veterinary services, development of the Internet as a resource for information, the large number of people who still want to enter this profession despite the economic challenges of the educational debt, the decreased financial support for all higher education, the economic cycle we are in (once prosperous, and now paying for those indulgences), increasing competition, and workforce distribution issues, such as rural area shortages and academic shortages, and some low cost providers in various areas, to name only a few. This is a complex problem that cannot be oversimplified, and needs improvement and change in several areas, not just any one.

    Third, the blame game has gone on way too long. We need to work on where we are now, and how we get to a better future. AVMA is working on that diligently and we need all of us to pull together to reach this very important and reachable goal line.

    Finally, AAVMC and education are not ruining our profession. They are the reason we even have a profession, the reason you have your degree and career. They provide the resources and networks for us to provide the best animal health care, the best research, and the best education to move this profession forward. However, times change and that requires us to either adapt, or lead the changes for a preferred path and a better future. It is time we all gather together for a serious conversation on how we redirect us to a common vision. AVMA is working hard on that strategy. If you want to see someone held accountable, hold ME accountable. I appreciate your frustration, but frustration doesn’t get me anywhere any faster. Positive attitudes and effective strategies with many people involved will get us there. Keep after us and help us.

  9. Dear Drs. Carlson and Osburn,
    I appreciate your comments and perspectives. I would like to think that we all share a common, paramount goal in having a healthy profession, but the more I hear from our various leaders, the more I realize that there are many profession damaging agendas being pursued.

    Dr. Carlson,
    I disagree with your statement that pointing fingers does not help in these situations. It is only by pointing fingers that we, as a profession, can hold our leaders accountable for their actions and the profession-wide repercussions that occur from said actions. I believe that a lack of accountability is primarily responsible for why our profession is in the state that it is in. Our leaders try to shift blame elsewhere and say “our actions have only caused a little damage while the other guy is causing more problems”.

    Dr. Osburn,
    I appreciate your candor here. For many years, people have used the guise of needing food animal veterinarians to increase enrollment. I find it both refresshing and extremely disturbing to hear that increased class size is primarily a reflection of budgetary factors. I find it shameful that those in a position to shape our profession are selling out our new colleagues and the profession in general in the name of addressing financial shortfalls. We are ALL having financial shortfalls.

    I am not comforted by the fact that class size increases will likely only be modest in the near future. A modest number of additional graduates on top of a system that has been producing too many graduates for many years equals far too many graduates, period. My eight year old knows what happens when supply is up and demand is down. I believe that we all know this too. You and your colleagues within the AAVMC, to put it bluntly, are ruining our profession.

    Greg Nutt

  10. Greg,
    In response to your questions, I asked AAVMC if they wanted to offer their comments for this conversation. The main point here is that these complex challenges cannot be solved by pointing fingers, but rather by everyone working together to reach a desirable future for veterinary medicine, its potential applicant pool, students, and graduates who become AVMA members. You are right, this has been looming for 30 years, but we have taken action. But this problem is not as simple as a fix in a short time, yet I am optimistic that this time will be different. We have been talking with AAVMC. I appreciate Dr. Osburn’s willingness to contribute to this discussion. I have posted their comments below:

    Along with the AVMA, the AAVMC is concerned about students’ increasing debt load and the importance of producing graduates who can meet society’s ever-evolving need for veterinary expertise.

    In terms of tuition costs and debt load, it’s important to recognize the powerful financial factors that are at work. In recent years, the nation’s colleges and schools of veterinary medicine (CVMs) have experienced a dramatic decline in available financial resources, with repercussions felt widely across all of academic veterinary medicine. Over the past three fiscal years, states have cut over $126 million in aggregate funding. This has put tremendous stress on U.S. CVMs to fill severe financial gaps while maintaining institutional quality. This steep decline in state funding has resulted in tuition and seat increases across all sectors of higher education, not just at CVMs. Because of slashed state funding, tuition for resident and non-resident veterinary medical students at the 28 U.S. CVMs has nearly doubled during the last decade, while enrollment has grown approximately two percent annually during the same period.

    A 2010 AAVMC internal survey revealed that while some CVMs do intend to increase the number of available first year seats in the coming years, the overall rate of growth is expected to slow. Most U.S. CVMs are at capacity for physical space and caseload, and unless there is a dramatic shift towards more distributed clinical programs and/or increased state public funding, it’s likely that enrollment growth at the CVMs in the coming years will be modest.

    AAVMC will release new enrollment figures and projections in January 2012, and we look forward to continuing the discussion with our colleagues across the profession.

    Bennie Osburn, DVM, PhD, DACVP
    Interim Executive Director
    Association of American Veterinary Medical Colleges

  11. Dr. Carlson,

    Thank you for your reply.

    I realize that we do not have the most current information with which to draw conclusions on veterinary workforce/economics concerns, but we do have a sizeable body of previous research (Arthur Little, Getz, KMPG, and most recently Bayer) that has consistently shown us the prevailing economic model was/is unsustainable. This is not new. This comes down to basic supply and demand economics! Our past leaders have had this information to help guide our organization to security and prosperity and did not utilize it. I find it odd that we can state there is a shortage of food animal veterinarians if a few communities complain of not having easy access to large animal care, but we cannot state the obvious (that there is a SURPLUS of practicing veterinarians)without a study.

    By the time an abbreviated workforce study is performed and the information made available, your term will have expired and this problem will be passed on to the next president, who will then commission a study to get the most current information, etc., etc., etc,. This is what has been done for the last thirty years or so and that is why we are in the situation that we are in as a profession. Studies are good, as are committees, subcommittes, and task forces, but they are of no value unless they lead to action.

    I do appreciate your committment to dialogue and I urge the AVMA search for ways to open the channels of communication more widely. I fear that you only hear the opinion of a slice of our membership, as few people take the time or know how to contact the leadership. As an examle, I have been an AVMA member and have never been asked what I think by an executive board member or a delegate. This needs to change dramatically.

    Finally, the AVMA states that it believes there are critical workforce issues. I take it that this means the AVMA believes there is an oversupply of practicing veterinarians. I ask, what do the members of the AAVMC have to say about that? Surely our leadership is holding them accountable when the two groups meet, right? I hope we have the courage to ask the tough questions and share the answers. What do they say? Our excess capacity has to come from somewhere, right? You have already stated your opinion that you do not feel that foreign accreditation does or will negatively affect our workforce balance. That leaves only graduating class size as a factor. Where does the culpability land and who will have the courage to make a statement about it?


    Greg Nutt

  12. Greg, you raise an issue we have heard a lot about lately, that of a possible oversupply of veterinarians in a depressed job market, however it does vary depending on some locations. We have discussed this issue with AAVMC, but it is premature to make accurate conclusions or decisions when we don’t have the most recent data. As you stated, the National Academy of Sciences Veterinary Workforce Study has been consistently delayed, but hopefully will be available some time in the near future. Its delay prompted your AVMA Executive Board to authorize RFPs for an abbreviated workforce study of our own. We also released a statement on veterinary workforce as follows:

    “Based on information received from across the profession, the AVMA believes that veterinary medicine is facing critical workforce issues. AVMA has initiated a series of actions, including interactions with stakeholders, engaging membership, and conducting a series of workforce studies that will define and address these economic challenges.”

    This statement supports the second goal statement (Enhance the Veterinary Medical Workforce) under the Economic goal in our Strategic Plan. That Goal statement reads, “Veterinary employment opportunities are
    identified and solutions developed to effectively balance the needs
    of society with the supply of veterinarians.” Read the objectives under that Workforce Goal statement. AVMA is working on it, but we must turn assumptions into accurate assessments.

    Let me say, however, AVMA is very concerned about the increasing educational debt for our students, with a concurrent decrease in demand for veterinary medical services and stagnant compensation. That is why we have made Economics our #1 priority issue this year and it is readily visible in our Strategic Plan, along with Education and Engagement of our members > the three E’s!

    We have discussed this issue with AAVMC, but until we get some current data, it is hard to come to much consensus. AVMA and AAVMC will continue to look at how we can work together to secure a more positive future for this profession and our new colleagues. This is a complex problem, one which requires a big plan and bigger support from many different perspectives and we are putting that plan together. It is a huge endeavor, one that will take time and commitment from several areas of our profession. There needs to be a a true sense of urgency to make progress. The work force studies, upcoming Economics Division, soon to be appointed Veterinary Economics Strategic Committee, and assertive marketing for increased demand will be a great start. We must keep talking about it. We are not complacent.

  13. Dr. Carlson,

    Thank you for updating us. Has anyone in the AAVMC commented on the obvious over-supply of veterinarians with regards to increasing class size. Has the AVMA made an statement to the AAVMC in relation to this. I realize that we are waiting for final results of a work-force study, but common sense and several other studies show that we do in fact have an oversaturation of veterinarians in most, if not all, market segments.

    Has anyone made a statement to the colleges and if so, what has the response been? I am curious because I want to know who will be ultimately responsible when new graduates get out with staggering debt and have minimal job prospects. I am getting cold-called by 2012 grads already looking for a position. Several have shown up in person to apply for a job that does not exist.

    I would like to see someone held accountable for at least adding to the oversupply of over-indebted graduates.

    Thank you
    Greg Nutt