A letter to the Journal of the American Veterinary Medical Association proposing a way to restore trust and confidence in veterinary school accreditation was rejected recently by Dr. Kurt Matushek, JAVMA’s editor-in-chief, because he believes that it “does not add any new information or advance any new argument.” The letter, co-signed by the 20 distinguished colleagues below, expresses our deep concerns about the accreditation and proliferation of schools that do not meet Council on Education (COE) standards and about the divisive and disruptive effects this is having on the AVMA relationships with large segments of the profession. As the controversy continues to simmer, it also bodes ill for the profession’s public image and its reputation among members of the other health professions whose accrediting agencies function with complete autonomy and independence. Under the terms of our proposal, the AVMA and Association of American Veterinary Medical Colleges would continue as the COE’s sponsoring organizations but, in order to eliminate conflicts of interest, neither organization would play a direct role in appointing the committees that select COE members. Instead, a new independent selection committee, with AVMA and AAVMC participation, would be formed by a broad spectrum of stakeholders (academics, practitioner organizations, specialty colleges and others) to determine the size and initial membership of a newly constituted COE. We believe that this step could be implemented quickly and that the transition phase could be managed smoothly. The new COE, like the Liaison Committee on Medical Education (LCME), with its own budget, staff, workplace and permanent legal counsel would function as a separate, wholly autonomous, independent body solely responsible for the COE’s policies, standards, procedures and decisions. Like the LCME, the reasons for its decisions would be reported only to the deans and presidents of schools that are being evaluated. The COE would determine its own budgetary needs and be solely responsible for preparing and submitting mandatory confidential reports to the U.S. Department of Education (USDE). Similar to the LCME, funding would come, as it presently does, mainly from AVMA, AAVMC and the schools, and it would be adjusted as the need arises. By rejecting our letter and dismissing its innovative good-faith proposal, Dr. Matushek ignores the concerns and frustrations of thousands of AVMA members, expressed individually and through state VMAs. He also overlooks serious concerns recently raised by the USDE National Advisory Committee on Institutional Quality and Integrity (NACIQI) that COE’s policies, procedures and decisions are no longer widely accepted by veterinary educators and practitioners, an absolute requirement for continuing the COE as the accrediting agency for American schools of veterinary medicine. In rejecting our letter, Matushek referred to several recent changes in the relationship between the AVMA and the COE that “ensure the COE’s independence.” Moreover, AVMA executives Dr. Ron DeHaven and Dr. David Granstrom have stated publically that a “firewall” separates the COE from the AVMA. That these statements are demonstrably false is evident from the numerous ways in which the COE violates USDE requirements that it function autonomously and independently from its sponsoring organizations and without real or apparent conflicts of interest. For example: The AVMA board appoints the committee that selects the AVMA’s share of COE members. We believe this contravenes the USDE’s requirement “that members of an accrediting agency should not be elected or selected by the board or any related, associated or affiliated trade association or membership organization.” The board’s involvement is a conflict of interest because it cannot be relied upon to appoint a selection committee that does not reflect its views and philosophy. AVMA and AAVMC personnel, including AAVMC’s executive director, are allowed to sit in at COE meetings. Dr. Karen Brant, director of AVMA’s Education and Research Division, who reports directly to AVMA’s executive vice president and chief operating officer, is present at all COE meetings. Other division staff also attend COE meetings. Dr. Brandt and other AVMA staff remain largely responsible for preparing and submitting mandatory COE reports to the USDE. We believe this is an egregious violation of the USDE’s separate and independent requirement concerning the joint use of personnel, services, equipment or facilities. The AVMA and the AAVMC still appoint veterinary school deans to membership on the COE. The AAVMC, essentially a veterinary dean’s organization, selects half the number of COE members. These are obvious conflicts of interest because the small number of veterinary school deans interact regularly and generally know each other well. The COE will never be free of real or perceived conflicts of interest until, like the LCME, it achieves true autonomy and independence with its own budget, staff, workplace and permanent legal counsel. Indeed, the USDE’s criteria for accrediting agency recognition requires that “(t)he agency develops and determines its own budget, with no review by or consultation with any other entity or organization,” and that “the agency has sufficient budgetary and administrative autonomy to carry out its accrediting functions independently.” In short, nothing of substance has freed the COE from AVMA and AAVMC involvement. We find it particularly troubling that apparently the AAVMC and the AVMA have decided that the AVMA’s shallow “listening sessions” will help to satisfy NACIQI’s concerns about the profession’s wide acceptance issue, that the accreditation controversy is satisfactorily settled and that stonewalling is an acceptable way to handle its critics/criticism. If the status quo is allowed to persist, the profession and the public will suffer further irreparable harm. The accreditation and proliferation of vocationally oriented schools that exist outside a biomedical research framework and utilize a distributive, often chaotic and poorly monitored, model for clinical education will continue. With their weak basic and clinical programs, the scientific paradigm that characterizes contemporary medical education will continue to be debased, and thousands of heavily debt-burdened graduates will enter an economically stressed marketplace with a growing surfeit of practitioners. Moreover, as the virtually single-gender applicant pool declines in size and quality, veterinary schools, particularly those of lesser quality, will be obliged to lower admissions standards in order to survive, a situation that threatens the profession’s future, its standing among our sister health professions and society’s welfare. By rejecting publication of our letter, we believe that Matushek has done our profession a serious disservice. Signed by: Ralph L. Brinster, VMD, Ph.D. Richard King Mellon professor of reproductive physiology at University of Pennsylvania School of Veterinary Medicine, recipient of National Medal of Science, and member of National Academy of Medicine and National Academy of Science Gustavo Aguirre, VMD, Ph.D. Professor of medical genetics and ophthalmology at University of Pennsylvania School of Veterinary Medicine and member of National Academy of Medicine Joel D. Baines, VMD, Ph.D. Dean of Louisiana State University School of Veterinary Medicine Stephen W. Barthold, DVM, Ph.D., Dipl. ACVP Distinguished professor emeritus at University of California, Davis, School of Veterinary Medicine and member of National Academy of Medicine John Boyce, DVM, Ph.D. Former assistant director of AVMA scientific activities and former executive director of National Board of Veterinary Examiners L.E. Carmichael, DVM, Ph.D. John M. Olin emeritus professor of virology at Cornell University College of Veterinary Medicine and former executive secretary and chairman of AVMA Section on Research Robert Cherenson, DVM Turlock, Calif., practitioner and former member of AVMA Council on Education Noah D. Cohen, VMD, MPH, Ph.D., Dipl. ACVIM Professor and associate department head for research and graduate studies at Texas A&M University College of Veterinary Medicine and Biomedical Sciences Stephen Ettinger, DVM, Dipl. ACVIM Fellow of American Heart Association and American College of Cardiology William D. Hardy Jr., VMD Director of National Veterinary Laboratory Inc. and adjunct professor of oncology at University of Pennsylvania School of Veterinary Medicine Francis A. Kallfelz, DVM, Ph.D., Dipl. ACVM James Law emeritus professor of medicine at Cornell University College of Veterinary Medicine and former member of AVMA Council on Education Alan Kelly, BVSc, MA, Ph.D. Professor emeritus of pathology and dean emeritus at University of Pennsylvania School of Veterinary Medicine and chairman of NAS Study on Workforce Needs in Veterinary Medicine Michael Kotlikoff, VMD, Ph.D. Cornell University provost and former dean of Cornell University College of Veterinary Medicine Roger McClellan, DVM, DSc, Dipl. ABT, Dipl. ABVT President emeritus and CEO of Chemical Industry Institute of Toxicology, clinical professor at University of New Mexico College of Pharmacy and member of National Academy of Medicine A.M. Merritt, DVM, MS, Dipl. ACVIM Professor emeritus at University of Florida College of Veterinary Medicine Frederick A. Murphy, DVM, Ph.D. Professor emeritus at University of Texas Medical Branch in Galveston, distinguished professor emeritus and dean emeritus at University of California, Davis, School of Veterinary Medicine, and member of National Academy of Medicine Paul D. Pion, DVM, Dipl. ACVIM Co-founder and president of Veterinary Information Network Jim E. Riviere, DVM, Ph.D., DSc, ATS MacDonald chair in veterinary medicine and university distinguished professor at Kansas State University College of Veterinary Medicine, and member of National Academy of Medicine John C. Simms, VMD, MS Shippensburg, Pa., practitioner Jerrold M. Ward, DVM, Ph.D., Dipl. ACVP Distinguished member of American College of Veterinary Pathologists and associate editor of Veterinary Pathology Originally published in the May 2016 issue of Veterinary Practice News. Did you enjoy this article? Then subscribe today!
