An Open Letter to the Veterinary Medical Community from the President of the AAVMC

I would like to personally thank the AAVMC and AAVMC President, Tufts Dean Deb Kochevar for her rapid, relevant and information packed response to David Segal's article in the Sunday Feb 24 New York Times.

This is exactly the response we need from organized veterinary medicine.

Dean Kochevar's letter is timely, data driven and direct.  

Thank you, thank you, thank you.

It's not perfect- there are some criticisms to be made- but criticism and judgement are different.  My judgement of this response is very positive.  With leadership like this we have hope for rapid, real improvement.

Unfortunately we're not going to see that improvement if we allow this:

“...data from our latest research, conducted several months following graduation, shows that 98.4% of 2011 U.S. graduates and 97.7% of 2012 graduates report being employed in veterinary medicine at least six months after graduation. That’s an impressive employment rate by any standard, and one that contrasts sharply with the dire picture presented in the article – and the nation’s 7.9% unemployment rate.”

No ma’am it does not.  

It shows that the AAVMC is able to get a response from 70.1% (2011) and 67.1 % (2012) of recent graduates.  Of those respondents, "98.4% of 2011 U.S. graduates and 97.7% of 2012 graduates report being employed..."

The study openly acknowledges that the unemployed were likely not to be represented.  

“The percentage of graduates who are unemployed... may be less likely to... have received the survey.”

(3rd slide, Study Limitations)  

Self reporting bias exhibits in two forms: those experiencing negative or below average results are less likely to report at all, and those experiencing positive and above average outcomes tend to exaggerate the degree of their success.  So it would be a more accurate assumption that those who did not report were unemployed than that those not reporting exhibit the same employment rate as those reporting.

Allowing for the study limitations as openly acknowledged by the AAVMC, more realistic employment rates are (70.1 * 0.984=) 69%, 2011 and (67.1 * 0.977=) 66%, 2012.  This equates to unemployment rates of 31% (2011) and 34% (2012).  This is much more consistent with the AVMA employment data, is far worse than the national average unemployment of 7.9%, and demonstrates a clearly negative trend.

My second and more serious criticism of the data treatment in this response regards this:

"The starting salary data as presented in the article ($46,971) is skewed because it includes lower salaries associated with the approximately 30% of graduates who seek post-DVM internships and residency programs,"

If internships count as jobs for employment purposes why do they not count as jobs for salary purposes?  

Either these are jobs, in which case they are included in both the employment and salary calculations- or they are not in which case they are excluded from both.  Pick one. 

“which are paid training opportunities similar to what physicians undertake.”

Yes and no.  They are paid.  They are not mandatory, nor regulated in any way as to content; the training content is therefore highly questionable.   Evidence that completion of an internship without subsequent residency has a significant negative effect on lifetime income (“Impact of internship on veterinarian salaries, 2009” JAVMA, Vol 239, No. 6, September 15, 2011) bears out the questionable value of the training received.  

Furthermore, as there are only about 30% as many residencies as internships, we know 70% of those doing internships are consigned to that lowered income category.  Since 100% of these positions are unregulated, and 70% of them do not lead to residency and certification, how can these positions possibly be considered comparable to those physicians undertake?

Let's admit that in many cases internships are neither advanced or training.
Nor are they real jobs- or if they are, they are real bad jobs.

On to more pleasant criticisms.

Our students often pursue a veterinary medical education after having worked in clinical practices, on ranches and farms and in biomedical research laboratories. They understand the breadth and potential of the profession. To assure that they also appreciate the initial investment necessary to join any health profession, we have taken measures to develop an enterprise-wide “financial literacy” program that helps students take a more strategic approach to financing their education.  

This is very pleasingly true.  The AAVMC Educational Debt Task Force is working with the AVMA Veterinary Economic Strategy Committee to develop resources that will help students acquire and apply financial management skills  and therefore minimize debt at all stages of the veterinary educational process- prevet, vet school and post graduation.

None of this is to belie the important thesis of this article: the cost of a veterinary medical education is high and veterinarians’ salaries should be higher.

Walk into one of our nation’s colleges of veterinary medicine and you’ll see it’s not much different than a human medical school (save perhaps for the skeletons used in anatomy labs).  Training medical professionals in multidisciplinary learning laboratories to provide the quality of care our society deserves is not cheap.

Which is why schools should be applauded for their efforts to develop distributive teaching models that move clinical education into the community hospitals, as in human medicine, and their efforts to develop centers of excellence that allow them to share facilities instead of duplicating equipment and capabilities at every single school to teach every single student every single thing.

The rising cost of modern medical education has been made even more challenging by the fact that state governments have been inexorably defunding higher education for years.  From 2010-2012, for example, our colleges experienced $104 million in budget reductions.

One more negative criticism, as I cannot let this pass.  

Things are tough all over.  Join the crowd.  Practitioners are hurting, students are hurting, clients are hurting.  The federal government is in the same shape as the states, partly because it is providing the loan dollars these students are handing over to the AAVMC member institutions to make up for the slashed state appropriations.  Easy access to unlimited federal student loan money is coming to an end.  

"we need to make sure that ... we do not deter or discourage talented students with the wherewithal to take on the challenges and rewards of a veterinary career."

The best way to do this is to provide merit based funding for far fewer students than we currently admit.  But admitting this would mean radically changing or closing schools.  

It would also mean saying no to the young but adult children of taxpaying, complaining voters; saying no to children is not a strong suit for many American parents, and saying no to constituents is a skill very few politicians acquire.  

The alternative is to let young people run up ruinously large private loans that cannot be discharged in banckruptcy, all in pursuit of a dream that won’t pay off for most of them.