The trouble with the vet school curriculum: Part 2 - Preparation, politics and MY solutions
Veterinary students ultimately find themselves lodged between a rock and a hard place. The “rock” is the school’s need to educate them broadly and deeply. The “hard place” is the veterinary profession’s requirement that students emerge fully versed in the private practice lingua franca (i.e., with the well-developed ability to function independently in clinical practice).
It seems incredulous that such would be the expectation, especially given that veterinarians don’t normally undertake internships and residencies (where, in the case of physicians, this kind of clinical preparation is typically conferred).
Yet the recent drive to “track” and clinically train students more intensively within the alloted four years is the direct result of this practical demand from the profession: “Get these new grads up to speed. Their skills lag far behind our needs.” Indeed, the past decade has seen this common practice owner’s lament elevated to the forefront of veterinary politics.
That’s partly because new grads are pricey, what with the rise in tuition expenses and the need to compensate a heavily indebted young veterinarian at a livable rate. But it’s also because busy hospitals don’t have the time to break in new grads and provide effective mentorship––not when they know that the employment contract expires at the end of the year (and that all that hard work might just go elsewhere).
That’s why there’s increased pressure placed on new grads to deliver...from day one. It only makes sense that employers get what they’re paying for, right?
Case in point: A much-touted survey published in the JAVMA (Journal of the American Veterinary Medical Association) back in 2004 confirmed this professional hand-wringing by ranking the skills veterinarians on the ground wished their freshly-minted colleagues possessed.
Heading up the practice owner’s wish list for skills? Surgery.
Apparently, practice owners are in need of licensed veterinarians who also happen to know how to handle surgical situations with comfort and aplomb. This is the trait they most desire to see significantly developed before a new hire hits their hard-worked tile floors.
The political powers in the profession have taken this critique of student surgical prowess to heart. That’s why, this week, a follow-up survey is now being passed around to veterinary surgeons so they can offer their take on what veterinary students should be learning to better hone their surgical skills for imminent life in practice.
But here’s where veterinarians like me lift a questioning hand: Can we really expect veterinarians to learn the necessary skills to be critical thinking diagnosticians and teach them to be comfortable in surgery within the confines of four short years? I don’t believe so.
The current push to yield to veterinary employer demands for surgical skills seems incredibly ill-advised to my way of thinking. I have a hard enough time imagining how students can cram all the basic learning and clinical principles into four years––without worrying unduly about the technical challenges they’ll confront in the first few years out of school.
The political push is on, however, for students to graduate with these skills in tow––a Quixotic expectation that undermines the fabric of our current educational approach.
That’s why I’ve come to the conclusion that the problem of an intensive, science-based curriculum and the technical limitations of a four-year program has to be attacked from several angles before it will yield to everyone’s needs and the current political demands. To that end, here’s my three-pronged proposal for a veterinary school curriculum overhaul:
1. Up the entrance requirements to free up time in vet school
Why not require that more of the basic sciences be addressed in the undergrad portion of the curriculum? Anatomy, physiology, embryology, biochemistry and molecular biology should be undergrad coursework. Human coursework is a perfect introduction to veterinary models. Who cares if students are exposed to the very basics on computer programs in a human-focused academic setting?
From experience, I know that students can still achieve a well-rounded liberal arts education while completing a rigorous “pre-med” or “pre-vet” curriculum as long as they’re properly motivated. Nothing is lost with the addition of a few more requirements in undergrad education.
2. Move to a case-based learning model to hone critical thinking techniques
As I see it, the dearth of solid critical thinking is what dogs new grad veterinarians––not the lack of soon-to-come surgical skills. To build on these from the very beginning of veterinary school, I recommend case-based learning.
Adopting this concept means that veterinary schools will go the way of the many progressive business, law and medical schools. Case-based learning offers real-world scenarios for students to dissect as diligently as they would their anatomy cadavers.
When combined with traditional lectures, this serves the need for profs to teach in a structured way while limiting the curiosity-stifling cramming and mind-numbing memorization required for the traditional multiple-choice examinations.
3. Make “clinics” clinically relevant with a move to expand veterinary teaching hospital services
The trend towards rarefied specialization means that students learn far less about basic wound care and X-ray interpretation than they do about how to prep a case for a total hip replacement and properly observe an interventional radiology-style catheter placement. This needs to change.
That’s why I propose that veterinary schools expand their hospitals to allow general practitioners and less academically-focused specialists to serve as “attendings,” as is done in the human medical profession.
Not only will this model allow students to take part in more real world medicine, it’ll also mean that veterinary schools will be forced to become more entrepreneurial. They’ll lay claim to a new income source while teaching their students more effectively, thereby funding more of their own research with their own dollars and solving the political problem of inappropriate clinical preparation. What could be better?
Sure, my three-pronged solution wouldn't solve the surgical skill issue, but veterinary education isn't about providing highly skilled technicians, no matter what the marketplace clamors for.
OK, so now it’s time for YOUR thoughts....