Tech Talk: A look at advanced degrees

Is advanced degrees the way to go for veterinary technicians? Photo: Bigstock/Elnur Previously, I have addressed some of the challenges credentialed veterinary technicians face: not earning a living wage, a perceived lack of respect, and feeling we are not being used to the full extent of our education and training. Some of these challenges are related to the issues of lack of a standard credential, scope of practice, or title protection. Over the past three decades, various groups have discussed issues of and potential solutions to under-utilization, and some groups continue to study and research these same issues today. Meanwhile, there are not enough veterinarians or credentialed veterinary technicians to meet the needs of the profession. Part of the reason is fatigue and burnout is running rampant in both groups of veterinary professionals. As a result, credentialed veterinary technicians continue to leave the field. Are we any closer to finding a solution? Mid-level practitioner The idea of a mid-level practitioner—a nurse practitioner or physician’s assistant-type role, are being discussed by various individuals and organizations. One veterinary publication recently asked, “Would you be supportive of creating a mid-level veterinary position similar to a physician assistant?” Over the next several hours, amidst the 513 likes, 19 shares, and 270 comments, individuals offered interesting insight into the issue: “No. We absolutely need to get RVTs, and vets paid better across the board first. Also, the RVT needs to be mandatory, not optional.” “Instead of creating another position, we need to start implementing a standard nationwide for technicians: they should all be required to be schooled and pass a licensing test to be called technicians and do the tasks of one. If not, they are a veterinary assistant and nothing more. Technicians who are properly schooled and licensed are an incredible asset to DVMs when allowed to do what they have been taught to do; we don’t need to further muddy the waters in this field.” “That position already exists, it’s called a RVT. I think we could utilize them more than we already do to fill that type of role. But, I do think veterinary medicine is a different beast, the patients can’t communicate with you as in human med, therefore I think that diagnosis, treatment, surgery, etc. should only be performed by a veterinarian.” “Definitely not. This profession is known to cut costs with staff; soon the new position will replace the job of the vet just for the practice to cut costs. Already an underpaid profession and already too many lay people in the profession who don’t know what they are doing.” “Takes the load of the basic cases off our vets with the legal aspect stating a scope of work that allows, vaccinations inj rv, v+/d+ patient work ups that are then escalated to the DVM. Enabling practices to see more clients, less stress on DVMs and higher job satisfaction because they practice the interesting cases they went to school for.” “I think it’s jumping the gun a bit, considering veterinary nursing isn’t even standardized yet.” “Yes! My goal would be to become a Vet Nurse Practitioner to help alleviate my vet’s workload and use more of my knowledge and skills.” “And don’t forget about our VTS groups that are already highly proficient at advanced techniques.” Most of the comments were negative, as is somewhat common in social media. Some were positive, and some individuals did not seem to fully understand the role of the nurse practitioner or physician’s assistant in human medicine. Others seemed to support a similar role in veterinary medicine, but only after addressing the other issues that currently plague the profession in all states. I am a huge supporter of increasing credentialed veterinary technician wages, optimal utilization, credentialing requirements, title protection, and defined scope of practice in all states. However, my question is: Do all these issues need to be addressed in every state before creating a new role? Could not a NP or PA-type position be created, and legislation passed, to allow for the new role in states that require graduation from an accredited college program, passing the Veterinary Technician National Exam (VTNE), and continuing education to maintain a legally protected credential with a defined scope of practice? In New York, for example, these standards have been in place for years. Anyone who does not meet the requirements to be a Licensed Veterinary Technician (LVT) is a veterinary assistant and may not legally be called a veterinary technician or perform tasks restricted for LVTs. Why should the veterinary profession be held back, be penalized because other states do not have these laws in place? As with any other change to the legal scope of practice for veterinary professionals, or any other medical profession, changes to the laws in each state will be required. The more important question, in my opinion, is why can’t we empower credentialed veterinary technicians to provide more advanced patient care and management while still practicing within the current AAVSB model scope of practice? (Board Services | AAVSB) More advanced degrees Is there a need for additional advanced college degrees such as the Masters of Veterinary Clinical Care currently being developed by Lincoln Memorial University (LMU)? I attended a virtual information session on this new degree, which is awaiting accreditation. LMU plans to launch this new degree in January 2022. The presenters were very clear. Those graduating with this advanced degree may not legally make a diagnosis, a prognosis, prescribe medication, or perform surgery. The degree would not create a new legally recognized veterinary position. In states with legal credentialing requirements for veterinary technicians, these individuals would practice under current practice acts while hopefully being allowed by the licensed veterinarians who supervise them to manage patients more independently, with less direct involvement by the veterinarians. A veterinarian-client-patient relationship, of course, will still be required. However, the hope of the program developers is those holding this degree would take a patient history, examine the patient, order diagnostics, review results, and use this information to present their suggested treatment plan to the supervising veterinarian. The licensed veterinarian would review the information being reported and suggest a plan to make the diagnosis, approve the suggested treatment plan (making any necessary changes as needed), therefore, prescribing the suggested medications. Similar to how veterinary interns’ function, this model would drastically reduce the amount of time required for a licensed veterinarian to deal directly with a case. Some veterinary technicians are questioning if those graduating with this master’s degree, or a similar degree being considered by other universities, will be allowed to practice at this more advanced level. Would they be compensated at a higher wage? How would this be accomplished with the existing VTS credentialed technicians who often are not being utilized to the full extent of their knowledge, education, and technical skillset or paid an appropriate higher wage? In order for this to succeed, I believe a significant communication plan is required to educate veterinarians and hospital administrators on the need for the advanced degree. It occurred to me that NAVTA and the VTS academies may not have done enough to educate the entire veterinary profession on the Veterinary Technician Specialist (VTS) credential, the extensive application process, and requirements to achieve and maintain this distinction. There are some VTSs who do practice at a very advanced level, managing appointments and cases, working as an extension of the veterinarian presenting their findings, suggesting treatment plans, etc., to the DVM/VMD as described above. Unfortunately, that is not always the case. Some do not have the opportunity to practice at this level using the full extent of their knowledge and skill, and may not be paid a higher wage than their colleagues without a VTS credential, or perhaps even without any credential at all. What is a Veterinary Technician Specialist (VTS)? The National Association of Veterinary Technicians in America (NAVTA) Committee on Veterinary Technician Specialties (CVTS) was formed in 1994 and is recognized by the American Veterinary Medical Association (AVMA). This was in response to a growing interest among veterinary technicians to attain a higher level of recognition for advanced knowledge and skills in specific disciplines. The CVTS provides guidelines to veterinary technician organizations to facilitate the formation of a specialty organization. The Academy of Veterinary Emergency and Critical Care Technicians (AVECCT) held the first technician specialty technician exam in September 1998, which led to the first group of veterinary technician specialists (VTS). NAVTA currently recognizes 16 approved VTS Academies. Links to all the NAVTA approved VTS Academies are listed on the NAVTA website. Specialties - National Association of Veterinary Technicians in America (navta.net) What is an Academy? An Academy is a not-for-profit corporation consisting of a group of credentialed veterinary technicians who have completed a formal process of education, training, experience, and testing to qualify. In other words, all members of the Academy must be a VTS in that specialty, and the Academy is responsible for reviewing and approving applications from prospective candidates, developing and administering the qualifying exam, as well as establishing recertifying requirements. How is a Veterinary Technician Specialty Academy formed? An established veterinary technician specialty society, veterinary technician association, or veterinary technician special interest group seeking NAVTA recognition as a Veterinary Technician Specialty Academy must form an organizing committee, consisting of no less than 10 members. All members of the organizing committee must be credentialed veterinary technicians who are recognized as exceptionally qualified specialists in their field with a minimum of seven years of experience of the past 10 years in the specialty with no less than 75 percent of time (at least 1500 hours/year) spent being devoted to the specialty. Exceptionally qualified specialists are defined as individuals who produce scholarly work within the specialty area such as a combination of teaching, lecturing, peer-reviewed work, research, or consulting. The organizing committee must complete and submit an extensive petition to the CVTS for review. The CVTS may, and often does, return the petition to the organizing committee indicating any deficiencies, asking for clarification, etc. Once the CVTS is satisfied that the application meets the CVTS requirements, a recommendation is sent to the NAVTA Executive Board requesting final approval. The full NAVTA CVTS guidelines are available on the NAVTA website: CVTS_Guidelines_July_2018_fi.pdf (ymaws.com). Application requirements to become a veterinary technician specialist The specific application requirements vary by Academy. However, the basic requirements for all the specialties include the following: Applicants must be credentialed veterinary technicians for a certain number of years (generally three years or 6,000 hours) prior to beginning the application process; working a specific percentage of their time in the chosen area of specialization. Supporting documentation is required. Applicants must log cases they have participated in managing and supporting over a one-year period (specific start and submission dates vary by Academy), generally 40-50 cases are required. In addition to demonstrating the variety of cases the applicant has worked with during this time, case logs also serve to demonstrate the advanced skills performed by the applicant. Applicants must have had a significant role in these cases. Professional written case reports, generally two to five are required, to demonstrate the applicant’s advanced knowledge of the diseases and patient management. Applicants must have had a significant role in these cases. An advanced technical skills list that must be signed off by a diplomate, VTS, or, in some cases, another qualified veterinarian if a specialist is not available (requirements vary by Academy) attesting the applicant has mastered and is proficient in performing. An advanced knowledge list which must be signed off by a diplomate, VTS, or, in some cases, another qualified veterinarian if a specialist is not available (requirements vary by Academy) attesting that the applicant has demonstrated advance knowledge of the subject. Advanced knowledge and skills lists are created by each Academy and are based on role delineation surveys of veterinary specialists, current VTS members, and other stakeholders within the specialty. A minimum number of CE hours in the specialty, generally 40 to 50 hours. A specific number of potential exam questions, including the correct and three incorrect answers. All questions must be appropriately referenced. The application process Applications are submitted once a year at a date determined by the Academy, have a specific review process, and, if approved, qualify the applicant to take the certification examination. Exams are given once a year at the national conference associated with the specialty. In 2021, NAVTA contracted with a secure remote testing company using facial recognition and exam monitoring using artificial intelligence to record the entire exam process and flag suspicious activities to allow for virtual testing due to the COVID-19 pandemic. Applicants who pass the exam become a VTS. Those who do not pass may take the exam again (usually up to a total of three attempts) without submitting a new application. The VTS must recertify once every five years. Requirements vary, but generally include continuing education in the specialty presented by a specialist, writing articles/books, lecturing, serving on Academy committees, or holding an office. These activities are then applied to a point system towards recertification. Retaking the exam, is also an option to recertify, although seldomly done. Recommendations If you are a credentialed veterinary technician with a passion for a specific discipline of veterinary medicine, learning, and advancing your career, consider pursuing a VTS! If you are a hospital administrator, manager, supervisor, or veterinarian and have credentialed veterinary technicians on your team who enjoy learning, who strive to provide exceptional care for their patients and clients, encourage them to pursue a VTS. AS well, consider providing additional educational and financial support. Veterinary technicians who feel supported, respected, valued, treated, and paid well are well worth the investment! Ed Carlson, CVT, VTS (nutrition) is the 2021 NAVTA president and has served on multiple NAVTA committees. He is also the director of technician learning and development for Ethos Veterinary Health and VetBloom. He is also the president of the Massachusetts Veterinary Technician Association and the treasurer of the New Hampshire Veterinary Technician Association. He obtained a VTS (Nutrition) in 2014 and lectures frequently at local, regional, and national veterinary conferences on a variety of nutrition topics. Carlson was also the recipient of the NAVTA 2019 Technician of the Year award. Columnists’ opinions do not necessarily reflect those of VPN Plus+. Resources NAVTA. (July 2018). Policies and Procedures for NAVTA Recognition of Veterinary Technician Specialties. https://cdn.ymaws.com/www.navta.net/resource/resmgr/docs/CVTS_Guidelines_July_2018_fi.pdf NAVTA. Specialties – National Association of Veterinary Technicians in America. https://www.navta.net/general/custom.asp?page=specialties

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Tech Talk: A look at advanced degrees

Finding solutions for a profession in crisis

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