OK, that was my attempt at campy.  I don't do graphics. But there is a showdown coming in accreditation, and not between the COE and anyone else.  

There was a lot of attention paid to the NAVLE at the COE hearing in December.  It is a convenient metric for accreditation- but not a very good one.  The ECVFG would be much better.

The NAVLE (North American Veterinary Licensing Exam) was designed to protect the public by identifying those graduates who had failed to acquire even the minimum book knowledge needed to keep them from being a threat to the public.  It is very good at that- but when we equate that to an assessment of how good a program is, it misleads us into thinking we've got actionable data about program quality.  All we really know from a school's NAVLE pass rate is how many of a program's students won't be a threat to the public.  Not the same thing.

Even if it did accurately assess a program's quality, the NAVLE pass rate for schools is set absurdly low. The minimum rate a school has to get to be or remain accredited is 85% (meaning up to 15% of its graduates could be an easily identifiable threat to the public and the school could still be accredited.  

Um.  Hopefully we could aim a little higher?  Ah, but the deans cry, it is higher!  We're all above 90!  95!  98!

Which prompted NACIQI members to ask... if everyone aces the test, shouldn't the test be harder?

To which the COE members and staff present gave acknowledgement that it was virtually impossible to detect any differences in a school's performance over time when pass rates are always that far above the minimum- and that this needed to be addressed.  Interestingly, raising the minimum was not even discussed as an option; rather, AVMA staff stated they are developing statistical procedures for monitoring trends- but they don't know if that'll work either.

Which leaves us where we started; we have this wonderfully convenient metric, a single objective exam that all students take every year... which is misapplied, set too low and is too easy. 

Which brings us to the ECFVG, the Educational Commission on Foreign Veterinary Graduates.  This is a program run by the AVMA, and it is one of two routes by which graduates of unaccredited veterinary school can become eligible for licensure in the US. It is much, much harder than the NAVLE.  Overall it resembles the USMLE with different timing.  ECFVG requires documentation of surgical experience;  the four hour BCSE (Basic and Clinical Skills Exam) assessing classroom knowledge, and the CPE: a 3 day, hands on exam in which the candidate must correctly perform all the skills expected of an entry level veterinarian.  

As the bulletin says, 

 Only well-prepared candidates will be able to pass the CPE.

Well-prepared.  In other words, this test is designed to be a direct assessment of how well prepared a graduate is.  Which is an excellent metric for how well a school prepared a graduate.  

Why would we not want all students to take this test, and why would all schools not want  their students take this test?

Well, it's expensive.  Like, $8000 expensive.  It takes about a year.  And... a lot of them would fail, which would be embarrassing and cause huge turmoil for the schools.  And, perhaps most importantly of all, it's controlled by the AVMA, which has been burning bridges with the profession as fast as it can for the last ten years.  Politics notwithstanding, a rigorous test exists for assessing how well a school prepares its graduates.  We should figure out how to use it, or a similar test, to assess all graduates of accredited schools.