A comparative education doesn't mean all species are understood equally

Veterinarians are expected to learn vast swathes of clinical knowledge across a variety of economically relevant but practically disparate species of animals, such as this sulcata tortoise and bull terrier buddy. Photo by Elizabeth Anderson Lopez Veterinary medicine’s superpower has long resided in our ability to achieve mastery in medicine by acquiring knowledge spanning a wide array of animal species. By comparing and contrasting one species, genus, family, order, etc. to another, we develop not just a superficial appreciation of taxonomic hierarchy, we achieve an unparalleled understanding of the fundamental inner workings of the creatures we treat. We ingest all this information with an eye toward a more profound knowledge of our patients and their care when we eventually apply it in practice. It does not mean we pretend to know how to manage the care of invertebrates, for example. Nor does it mean we expect, after four years of basic education, to manage the care of fish, ferrets, tigers, and terrapins with equivalent success. We recognize the impossibility of such feats. We also appreciate their impracticality. After all, almost all veterinarians are being schooled to enter a clinical world in which only a handful of species actually matter. This means, in deference to real-world economics, the pedagogical, comparative aspect of our formal education has, at some point, to take a back seat to more practical clinical concerns. To that end, we spend the last two years of our basic education as more-or-less “tracked” students, concentrating our efforts on acquiring a more hands-on brand of knowledge regarding the species most relevant to our careers. While the degree of specialization is standardized to some extent by our schools’ stakeholders and governing bodies, individual veterinary colleges will grant lesser or greater leeway for students to limit their clinical knowledge during these final semesters. Indeed, most students would doubtless prefer to limit their last two years to developing knowledge and skills they can readily put into practice upon graduation. Nevertheless, when we exit our programs we are expected to hold enough varied information in our heads to pass a rigorous standardized test requiring the retention of vast swathes of clinical knowledge across a variety of economically relevant but practically disparate species of animals. At this point, the degree of clinical specialization we are expected to demonstrate has reached a burdensome level of practical sophistication. So much so, in fact, our knowledge at this stage has long since surpassed the pedagogical goals of comparative medicine. After all, a muscular grasp of the medical management of feline triaditis only trivially furthers the ruminant practitioner’s functional medical literacy. A veterinarian-in-training who has attained this surfeit of clinical knowledge has, in my estimation, unnecessarily invested their time and money acquiring an irrelevant and superfluous education. What’s worse, they have invested enormous resources in a branch of veterinary medicine at the expense of the one to which they had already pledged their clinical (and economic!) allegiance. For their part, schools have long since understood the problem. They want to provide a comparative basis for education but, more importantly, they have financial incentives to produce veterinarians who are willing and able to work in all sectors of the animal economy. To do so they need to offer a broad-ranging education that facilitates entry of most any graduate into the agricultural arena along with the more popular area of pet practice. Enter some practical concerns: Increasingly, it seems, NAVLE-takers are finding it difficult to pass all sections of the test. Quite apart from the fact students are required to spend outsized economic resources acquiring practical skills they’ll never employ, some veterinarians will never get the chance to practice if they find it impossible to pass the less relevant portions of the NAVLE. Schools are beginning to recognize their responsibility to—and liability for—those who have amassed crushing debt but are unable to pass a test the schools promised to prepare them for. Not only is the graduate’s career on the line; their accreditation is, too. All schools must see a threshold percentage of their students pass if they are to maintain their right to keep their doors open. Teaching to the test is one solution. Funding their failers’ tutoring is another. Are these disingenuously improvised measures the only solution? They shouldn’t be, of course. Just ask those who have failed to pass the test for the fifth time. After displaying more commitment and perseverance than the rest of us, their careers as clinicians are effectively kaput. In an increasingly specialized world we should acknowledge the impossibility of providing the broad range of detailed clinical knowledge we would like to impart without sacrificing the clinical preparation, learning potential, and the very careers of students who expect to practice in a chosen subset of veterinary medicine. The proposed solution I am not saying we should stop teaching comparatively, nor do I believe every student should be forced to choose only one path. I still believe this is the heart and soul of our brilliance as a profession. Moreover, mixed animal practice is absolutely a beautiful, worthwhile endeavor any of us should be allowed to pursue. However, once students veer off into the clinically practical, in years three and four, they should also be allowed to limit their own curricula to what they personally deem relevant to their careers. So how would this work? The solution is simple. Licensure should be conditional by species or species type. If a student prefers to spend their clinical educational resources entirely on equine medicine, for example, they should be allowed to do so. For their licensure, the only clinical section that should apply is the one dedicated to equine medicine. Of course, any candidate may choose to take all sections of the test but they shouldn’t be expected to gain licensure to practice on all species if they fail the other sections. Students who are spending crazy money on their education should be free to make their own decisions along these lines. Those who argue it will be an end to traditional veterinary medicine should consider a few things: Comparative medicine would remain at the heart of veterinary education. Graduates will tend to emerge better prepared for practice if they don’t have to divert resources to clinically superfluous material. Finally, it is their money to do with as they will—probably a lot more than those who wouldd argue against it ever had to spend. On a personal note: When I first heard of “tracking” in the years just after my own graduation, I was dismayed at what I perceived as a loss in the traditional approach toward comparative medicine. Since then, veterinary medicine has undergone several rounds of evolution, most notably with respect to the sheer volume of clinical information and the undeniable necessity of specialization. Failure to recognize the change and evolve with it does nothing to help animals, much less our students who want nothing more than to be adequately prepared given the extremes of their investment. Patty Khuly, VMD, MBA, runs a small animal practice in Miami and is available at drpattykhuly.com. Columnists’ opinions do not necessarily reflect those of VPN Plus+.

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A comparative education doesn't mean all species are understood equally—or should be

Khuly makes a case for species-conditional licensure

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