Food Animal Veterinary Medicine: Leading A Changing Profession

Food Supply Veterinary Medicine Food Animal Veterinary Medicine: Leading A Changing Profession Robert L. Larson ABSTRACT The veterinary profession has gone through periods of profound change in response to economic and social changes. We are currently in another such period: profound change is required in order for the profession to remain relevant in a marketplace where a rapidly expanding knowledge base and new technologies demand an ever-increasing level of expertise in a greater variety of areas. However, the veterinary profession is perceived both internally and by the public as possessing a narrow set of skills that supports a narrow group of careers focused on salvaging ill or injured companion animals. It will be necessary to dramatically change the way veterinary students are recruited and trained, as well as how graduate veterinarians are licensed and provided continuing education, in order for the veterinary profession to capitalize on our historical strengths and provide service and leadership in a greater diversity of career paths. Even though the number of veterinarians needed to provide primary care for livestock is decreasing, both the level of expertise demanded by livestock owners and the value of veterinary involvement on livestock farms are increasing. Colleges of veterinary medicine appear challenged to meet the changing needs for veterinary services in animal agriculture because of the declining percentage of veterinary students interested in food animal careers. Fortunately for animal agriculture, the skill set needed by food animal veterinarians is also needed by several emerging segments of the veterinary profession that have tremendous potential for rapid growth, including employment in all segments of food production systems, environmental monitoring and management, bio-security and disease eradication, laboratory diagnostics, and federal regulatory and bio-defense roles. Like previous periods of profound change, this moment in history will require creative thought, open discussion, and a willingness to step into the unknown. PERSPECTIVE The veterinary profession and the training that veterinarians receive from colleges of veterinary medicine have undergone continual, gradual change since the establishment of the profession, as well as occasional short periods of profound change. We are now in one of those periods of profound change. Mechanization revolutionized agriculture, and the primary focus of veterinary medicine up to that point, the horse, rapidly declined in numbers and value. In response, veterinary medicine changed, adding expertise in other farm animals. Then, as the perceived value of pets and an emphasis on the human animal bond increased, veterinary medicine changed again, adding expertise in companion animals. Now, as food production, environmental management, and national security evolve into systems management rather than individual animal intervention, veterinary medicine must again add expertise in a new area if it is to remain relevant in the changing world and the changing marketplace. With continued consolidation in agriculture, the number of production units and veterinarians needed to directly serve those production units is declining. This change in the number of veterinarians involved in primary care of farm animals has accompanied a dramatic change in the services required of veterinary medicine by animal agriculture. 1 These services now include more accurate diagnosis of all the infectious and non-infectious components of disease problems; quantification of the effects of disease or production losses; identification and quantification of costs for alternate intervention strategies; control strategies to prevent contact with infectious agents (bio-security); control strategies to prevent the occurrence of production-limiting factors (sub-optimal nutrition, housing, sanitation, etc.); monitoring of control strategies to ensure their efficacy and cost-efficiency; improvement of animal comfort; reduction of animal stress; and reduction or elimination of the use of antimicrobials and surgical interventions. The economic importance of animal agriculture in most states with colleges of veterinary medicine and in the United States as a whole is great enough to drive profound changes in the skills that new graduate veterinarians must possess in order to adequately serve those assets. However, both the profession and colleges of veterinary medicine appear to have difficulty in meeting that need because a shrinking percentage of each graduating class is involved with primary care of livestock. Fortunately for animal agriculture, the skill set needed by food animal veterinarians is also needed by several emerging segments of the veterinary profession that have tremendous potential for rapid growth, including all segments of food production systems (including leadership in corporate and regulatory environments); environmental monitoring and management; bio-security and disease eradication; laboratory diagnostics; and federal regulatory and bio-defense roles. If one compares the skills needed in current and expanding roles for veterinary medicine, it is obvious that a great deal of overlap occurs (Table 1). JVME 31(4) 2004 AAVMC 341

Table 1: Skill Sets for in Veterinary Medicine Primary Care / Mixed Animal Practice Rural practice Required/Essential Skills Population(s) at risk Rapidity of spread Rapidity of immune protection from natural exposure Necropsy Interpretation of results (epidemiology / statistics) Physical examination of individual animals Physical examination of farms Female and male reproductive physiology Quality Assurance Residue avoidance Antimicrobial resistance avoidance Animal welfare stress reduction, comfort Foreign animal disease surveillance Treatment of animal disease ** Medicine Surgery Nutrition Agricultural economics / agricultural marketing Genetics / animal breeding Food Systems Management / Consulting Management positions in: food processing, food distribution, and food retail companies Veterinary service positions in: food processing, food distribution, and food retail companies Consulting service to: food processing, food distribution, and food retail companies Required/Essential Skills Food microbiology** Disease dynamics (specifically food-borne): Population(s) at risk in animals and humans Rapidity of spread in animals and humans Rapidity of immune protection from natural exposure in animals and humans Pathogen reservoir Interpretation of results (epidemiology / statistics) Labor training / education Animal welfare stress reduction, comfort Press relations** Food Animal Production Medicine /Consulting Swine production medicine Dairy production medicine Beef production medicine Poultry production medicine Aquaculture production medicine Sheep / goat production medicine Ecology / Environmental Management Government regulatory agencies Corporate regulatory compliance Note: Items marked with asterisks (**) are unique to a particular career area; the rest are nearly universal across career areas. 342 JVME 31(4) 2004 AAVMC

Table 1 Continued Population(s) at risk Rapidity of spread Rapidity of immune protection from natural exposure Necropsy Result interpretation (epidemiology / statistics) Nutrition Genetics / animal breeding Female and male reproductive physiology Agricultural economics / agricultural marketing Use of databases to monitor and evaluate production, health, and economic return Labor training/education Physical examination of individual animals Physical examination of farms Quality assurance Residue avoidance Antimicrobial resistance avoidance Animal welfare stress reduction, comfort Soil / water / air / plant / animal Nutrient cycling Pathogen cycling Foreign animal disease surveillance Result interpretation (epidemiology / statistics) Use of databases to monitor and evaluate variables of interest Physical examination of ecosystems Quality Assurance - ecosystem Residue avoidance Antimicrobial resistance avoidance Soil / water / air / plant / animal Nutrient cycling Pathogen cycling Labor management Genetic engineering (required soon) Treatment of animal disease Biosecurity / National security United States Department of Agriculture (USDA) Centers for Disease Control and Prevention (CDC) Department of Homeland Security State Departments of Agriculture Military: screening protocols, reaction protocols Border control: inspection, identification, screening protocols, reaction protocols Food companies: product safety, quality/safety assurance Laboratory Diagnostician University diagnostic teaching, research, and service State / federal laboratories Private and corporate laboratories Note: Items marked with asterisks (**) are unique to a particular career area; the rest are nearly universal across career areas. JVME 31(4) 2004 AAVMC 343

Table 1 Continued Population(s) at risk Rapidity of spread Result interpretation (epidemiology/statistics) Use of databases to monitor and evaluate variables of interest Physical examination of premises and containers Animal welfare stress reduction, comfort Foreign animal disease surveillance Press relations Microbiology, pathology, genomics Laboratory procedures ** Population(s) at risk Rapidity of spread Rapidity of immune protection from natural exposure Necropsy Result interpretation (epidemiology/statistics) Use of databases to monitor and evaluate variables of interest Animal welfare stress reduction, comfort Statistical and epidemiological monitoring of populations Foreign animal disease surveillance Note: Items marked with asterisks (**) are unique to a particular career area; the rest are nearly universal across career areas. The skills needed most by food animal practitioners, mixed animal practitioners, food animal consultants, food production system specialists, environmental experts, bio-security experts, and laboratory diagnosticians are primarily monitoring and diagnosis in biological systems. Statistics, epidemiology, growth and reproductive physiology, diagnostic technology, individual animal biology, infectious agent biology, and ecosystem biology are the core competencies. Such areas of emphasis differ from current admissions criteria, veterinary curricula, and licensing examinations. In addition, this emphasis is different from the public s view of the veterinary profession. 2 According to the KPMG Mega Study, only 11% to 24% of the general public is aware that veterinarians are employed in areas such as medical research, the environment, public health, and food safety. 3 Eyre points out that being a veterinary graduate represents a curious paradox. We are among the most highly regarded and trusted professional groups; yet the majority of the public perceive us narrowly as companion-animal doctors and are generally unaware of the diversity of career paths. 2 Not only the public but also undergraduate students, who are potential recruits and veterinary students, have a very restricted view of the profession. 4 Students attending some veterinary colleges primarily have contact with clinical veterinarians. And within that subset of the profession, a majority of their contact is with companion animal clinicians. In other areas of veterinary training, an increasing number of instructors are not veterinarians. This is a fairly clear, but misguided, signal to students that most veterinarians are companion animal clinicians and that other career paths are unusual. Veterinary students who participated in the recent symposium Agenda for Action: Veterinary Medicine s Role in Biodefense and Public Health (held in Washington, DC, November 1 3, 2002) made an astute observation: It is amazing that veterinary school professors are confused as to why they cannot attract students to careers in the biomedical sciences and public health, when the admissions process places selection pressure on individuals who have a primary interest in private practice. 5 They followed with a pointed question: Are individuals with a biomedical research background not attractive to veterinary schools, or is it the other way around? 5 I opine that both the profession and the public have a perception of veterinary medicine almost wholly based on the veterinarian as a family practitioner for pets, and that this perception impairs our ability to recruit a diverse student body and to graduate veterinarians with diverse career goals. In contrast to perceptions, only 50% (34,524/69,029) of veterinarians are involved in small animal exclusive or feline exclusive practice. 6 Therefore, at this time, half of all veterinarians in the United States are not involved in small animal practice. Approximately 20% are engaged in either private population health practice with a significant food animal component or public practice in one of its various forms. 7 Economic reward, which is a good indication of societal needs and values, also indicates that a narrow view of the veterinary profession focused on companion animal practice is misguided. In a survey of 1997 veterinary salaries, large animal exclusive private practitioners had the highest mean and median incomes of any practice type ($76,360 mean and $62,500 median for large animal exclusive vs. $65,884 mean and $53,003 median for all practice types). 8 Large animal exclusive practitioners had the lowest percentage of any practice category earning < $48,000 annually (25.5%) and the second highest percentage earning the highest salary range reported. 8 Equine exclusive private practi- 344 JVME 31(4) 2004 AAVMC

tioners had the highest percentage earning > $118,000 (23.9%), and large animal exclusive had the second highest percentage at 18.2%. 8 In order to respond to salary price signals, expected growth areas within the veterinary profession, and the expanding scientific knowledge base, profound changes in veterinary recruiting, curricula, licensing, and continuing education must occur. All career paths and roles for veterinary medicine, including companion animal practice, will benefit from significant change in these areas. The skills required by a majority of twenty-first-century graduate veterinarians will be focused on biologic system management, system problem solving, and leadership. The only questions are these: How long will it take for veterinary medicine to make the necessary advances? and, Will we as a profession be leading these emerging fields, or will we be supplanted by other professions that adapt earlier? OPPORTUNITIES I perceive a desire on the part of many leaders in food animal veterinary medicine to work with colleges of veterinary medicine, the American Veterinary Medical Association, state veterinary medical associations, state licensing boards, specialty colleges, and professional organizations to accomplish profound changes in the recruitment and instruction of veterinary students in response to economic and societal pressures. Some of the problems that I see facing the veterinary profession include a lack of diversity in the intellectual interests and strengths of veterinary medical students, an emphasis in the veterinary curriculum on salvage procedures for poor health and production problems, and a lack of advanced training in many current and emerging career fields. The diversity of the intellectual strengths and interests and hence the diversity of career interests of graduating veterinarians is too narrow and does not encompass the breadth of opportunities for veterinary medicine in the twenty-first century. Many areas of current and future societal needs that veterinarians can fill are not attracting new graduates. Both the selection process and the training system currently in use emphasize a narrow set of intellectual strengths and skills. Because of current teaching and testing methodologies, most academic testing relies on the multiple-choice format, with questions presented at Bloom s taxonomic knowledge level rather than at the level of analysis, synthesis and evaluation. 9 I suspect that this biases grade point average to favor students whose learning strengths include memorization of single, non-linear facts (i.e., skills that are not used anywhere in business, biology, or life except academia). Students with learning strengths in other areas (mathematical, linear, abstract thought, and problem solving) are likely at a disadvantage if multiplechoice formats are the primary determinant of academic success. Therefore, college entrance committees could enlist experts in psychology and education to use current tools or develop new tools to evaluate mathematical, logical, problem-solving, and communication skills needed in veterinary medicine and have these tools replace GPA as a predictor of professional success. In addition, courses that strengthen quantification skills and that attract students possessing these skills should be added to both pre-veterinary and veterinary curriculums. These classes could include statistics, epidemiology, calculus, advanced mathematics, economics, logic, and communication. I recognize that a simplistic solution to increasing diversity of intellectual strengths is not likely to be of any greater advantage to the veterinary profession than the current simplistic system of GPAs and entrance examination scores. 10 However, a high level of difficulty should not preclude an important effort from being undertaken. Another strategy to add diversity to the veterinary profession is to increase the number of pre-veterinary degree paths that meet admission requirements. By actively recruiting students progressing toward engineering, food science, agriculture economics, public health, statistics, or epidemiology degrees for admission, colleges of veterinary medicine can ensure that students enter veterinary college with diverse career goals and will broaden and strengthen the profession. Many of these students will not have had exposure to veterinary practice and may not have considered a career in veterinary medicine prior to starting their undergraduate degree. If we could attract these students, I would consider this a positive change for our profession. Actively recruiting minority students will not only add racial and ethnic diversity to the veterinary profession but is likely to contribute to career path diversity by increasing the breadth of experiences and worldviews within the profession. 11 Once a more diverse student body begins entering veterinary colleges, desiring greater depth of training in a broader number of career options, the current single-track curriculum will need to change. Both human and companion animal medicine currently focus on the salvage of ill or injured individuals to reduce pain and suffering and prolong life. In contrast, livestock practitioners and other food and ecosystem veterinarians focus on systems to promote health, production, and other goals that avoid or minimize the occurrence of ill or injured individuals. These skill sets are very different and require different training. Medical and surgical treatment as salvage procedures are already absent or greatly de-emphasized in many veterinary roles and careers and will continue to be reduced in demand to all but careers serving companion animals. As veterinary medicine faces the challenge of changing to meet the advancing needs of livestock production, delay could cause irreparable harm to the profession. The skills required in twenty-first-century animal agriculture careers, as well as in emerging food system, ecosystem management, and regulatory and bio-security careers, rely on technologies and knowledge such as epidemiology, computer applications, and problem solving that are not restricted to veterinarians. If our profession neglects livestock production and related emerging fields, it seems reasonable to expect more competition from other professions. 12 If and when epidemiology becomes a significant element in the education of animal scientists, food scientists, and other professionals, the competition from these quarters could be formidable. 12 The increasing number of career options for veterinary professionals and the exponential growth in information and knowledge make a single curriculum, whether broad-based or narrow-track, inadequate to meet the needs of our profession and the society we serve. The engineering profession has recognized that it cannot adequately prepare students to enter diverse fields such as civil, chemical, mechanical, biological, and nuclear engineering; while some areas of JVME 31(4) 2004 AAVMC 345

instruction are common to all engineering fields, many specialized classes are required to prepare students interested in pursuing a particular career path. Similarly, veterinary education can still offer broad-based core biological science training while at the same time moving toward greater depth of training in specialized areas. Cooperation between colleges of veterinary medicine to identify centers of excellence that will offer in-depth instruction in particular specialty areas and to facilitate student transfers from other institutions will be necessary to optimize faculty expertise and geographic proximity to appropriate facilities. With more narrow and in-depth training, the profession will need to move toward limited licensure to acknowledge the growing diversity and value of a veterinary degree. Not only does the professional veterinary curriculum need to undergo profound change, veterinary continuing education must also respond to changing demands by society and our profession. To strengthen lifelong learning, which is necessary to remain proficient, and to increase the opportunities for retraining if an alternate veterinary career path is desired in mid-career, more post-graduation degree and non-degree options are necessary. 7 The advent of distancebased education and the creation of centers of excellence at colleges of veterinary medicine will allow veterinarians at any career stage to receive advanced training in specialty areas. Short-term continuing education courses, longer-term certificate courses, and more traditional degree courses for graduate veterinarians should become an increasing focus for colleges of veterinary medicine and for the veterinary profession. SUMMARY We are fortunate to be living in a time when an interest in and love for biological sciences is being rewarded with profound discoveries and yet challenged by continued mysteries. However, within the biological sciences, the veterinary profession has both a public and an internal perception of possessing a narrow set of skills that supports a narrow group of careers. In reality, the veterinary profession has an opportunity to provide service and leadership in a more diverse group of career paths than at any time in our past. Like previous periods of profound change, this moment in history will require creative thought, open discussion, and a willingness to step into the unknown to seize a great opportunity. REFERENCES 1 Cullor J, Galland J, Gillespie J, Henry S, Osburn B. Developing a role for veterinarians in the global food industry. In Proceedings, 95th Annual Convention of the Kansas Veterinary Medical Association, Wichita, KS, January 14 17, 1999. Topeka, KS: KVMA, 1999:1 3. 2 Eyre P. Engineering veterinary education. J Vet Med Educ 29:195 200, 2002. 3 Brown JP, Silverman JD. The current and future market for veterinarians and veterinary medical services in the United States. J Am Vet Med Assoc 215:161 183, 1999. 4 Ilgen DR, Lloyd JW, Morgeson FP, Johnson MD, Meyer CJ, Marrinan M. Personal characteristics, knowledge of the veterinary profession, and influences on career choice among students in the veterinary school applicant pool. J Am Vet Med Assoc 223:1587 1594, 2003. 5 LaBranch T, Tack D. Addressing the need for veterinarians in biodefense and public health: Perspectives from veterinary students. J Vet Med Educ 30:173 175, 2003. 6 2004 AVMA Membership Directory and Resource Manual. Schaumburg, IL: Division of Membership and Field Services, 2004 p23. 7 Hoblet KH, Maccbe AT, Heider LE. Veterinarians in population health and public practice: Meeting critical national needs. J Vet Med Educ 30:287 294, 2003. 8 1997 income of US veterinarians. J Am Vet Med Assoc 214:1489 1491, 1999. 9 Kennedy D. Bloom s Taxonomy <http:// www.uwsp.edu/education/block1/ blooms_taxonomy.htm>. Accessed 4/20/2004. University of Wisconsin, Stevens Point, WI, 2004. 10 Edmondson KM. More on improving the veterinary admissions process. J Vet Med Educ 29:94 95, 2002. 11 Coffman JR. Veterinary medical education and a changing culture. J Vet Med Educ 29:66 69, 2002. 12 Nielsen NO. Will the veterinary profession flourish in the future? J Vet Med Educ 30:301 307, 2003. AUTHOR INFORMATION Robert L. Larson, DVM, PhD, ACT, ACAN, ACVPM, is Director of Veterinary Extension and Continuing Education at the University of Missouri, Columbia, MO 65211 USA. E-mail: larsonr@missouri.edu. 346 JVME 31(4) 2004 AAVMC