At the end of my career, it is perplexing to look back 60 years—with what passes for the wisdom of old age—to make comparisons with the contemporary scene. To be sure, during my lifetime the veterinary profession achieved major scientific and technological progress, and survived several episodes of political and economic uncertainty. Yet, who can say there may not be worse to come? In my view, the most serious threat to the long-term prosperity of the veterinary profession is the damage now being caused by out-of-control educational costs and student debt. We seem to have lost our moral compass. By the numbers Incurring a moderate amount of educational debt to achieve a professional degree is a worthy investment; however, veterinary education has become prohibitively expensive. According to the 2018-2019 Association of American Veterinary Medical Colleges’ (AAVMC’s) annual report,1 the national median tuition for in-state veterinary students is $31,900 and for out-of-state students it is $52,600. The mean veterinary educational debt is $174,000. With starting salaries averaging in the low $70s, the debt-to-income ratio is approximately 2.4:1 (double the 1.2:1 figure of just a decade ago). One hesitates to invoke the hyperbole of “crisis;” however, student debt is an enormous drag, not only jeopardizing the personal lives of veterinarians, but also limiting the college applicant pool and thus threatening the profession’s future.2 As the debt-income gap continues to grow, many qualified students—particularly those from lower-income families, underrepresented groups, and those more financially astute—will decide against veterinary education simply because they can’t afford it. Will losing them diminish the profession’s fragile diversity?1 Does debt discourage graduates from practicing in rural areas? (Urban practice pays more.) How many young veterinarians might be willing to take a lower-paying position but can’t because they have massive loans to pay off? When faced with budget shortfalls, universities simply choose the easy way out: more cash. Thus, as public funding decreases, veterinary colleges expand enrollment and increase tuition. Efficiency measures (program restrictions) are contentious: it is easy to reject them just because they are hard. The national system for financing higher education is a food chain.3 The most important members of the chain—students—are at the bottom supplying the “nutrients.” The federal government feeds voraciously at the top while handing out more easy-to-get, high-interest student loans. (It takes money to make money.) Colleges and universities are foraging opportunistically in between. In other words, veterinary education is prospering on the rich pickings from government-backed student debt. In my opinion, this raises moral and ethical questions. The American Veterinary Medical Association (AVMA) is advocating for lower interest loans, loan forgiveness, financial literacy education, and programs to promote personal well-being.4 The Veterinary Information Network (VIN) offers workshops on loan repayment planning. Without question, such support systems are vitally important; however, they tend to enable student loan use, rather than avoid it. When shall we start talking about cutting education costs and reducing students’ need to borrow money in the first place? Prevention is the preferred path to lowering student debt. The impediments to change are systemic, and bold institutional leadership will be required if we are to avoid serious consequences. A major step would be the formal establishment of a six-year curriculum from high school to the DVM degree (i.e. two years’ undergraduate and four years’ veterinary education). The benefit is substantial: an estimated $150,000 to $200,000 (i.e. saving two years’ tuition and personal expenses, and gaining two years’ employment as a veterinarian). This figure is comparable to the veterinary graduates’ average debt load. The AVMA Council on Education has fully accredited similar curricular structures at 10 prestigious veterinary colleges worldwide, and U.S. and Canadian colleges currently accept students with only two years’ undergraduate experience. There is no obvious reason why a six-year curriculum could not become the standard veterinary education model in North America. Less talk, more action Despite these undergraduate-level cost savings, significant student expenses would remain in the veterinary curriculum itself. Expanding private fund-raising is already critical to providing scholarships and tuition discounts. However, as the public financing of higher education continues its relentless decline, it is simplistic—and potentially dangerous—to imply philanthropic gifts could solve the tuition-debt problem.5 Colleges will need to consider trimming their operating expenses as well. This could include: reducing administrative services; cutting faculty and staff hiring to only essential needs; increasing faculty teaching loads and requiring residents, interns, graduate students, and post-docs to teach more; merging or eliminating some disciplines or specialties; offering some courses online; sharing educational resources among colleges; and partnering with private and corporate practice for clinical education. The list goes on—each alone offers modest gains, but if combined would be significant. The above ideas are neither intended to be all-inclusive nor are they offered as a universal recipe. Instead, they are presented for consideration and adaptation among the individual institutions making up the veterinary education community. I am well aware the suggestions contain nothing new: the debt question has been debated extensively for years.2,3,5,6 However, success will require more than talk and good intentions; it will be measured by what we do, not what we say. Of course, it is possible we will stumble forward without intervention. Yet, even if we get lucky and the “market” somehow checks the student debt problem, what would our failure to act say about the moral character of our profession? I do not suppose everyone will agree with what I have said. (Too much agreement could be a sign the suggestions do not go far enough.) Neither do I pretend the proposed changes can be undertaken without risk and inconvenience, even if the outcome is for the better. In my experience, major change often does not come until folks have to deal with the consequences of their inaction or mismanagement. However, changes are needed now to anticipate the circumstances that are beginning to alter the practice of veterinary medicine, and that today’s veterinary students will confront in the future. Peter Eyre, DVM&S, BVMS, BSc, PhD, is professor-and-dean emeritus at the Virginia-Maryland College of Veterinary Medicine, Virginia Tech in Blacksburg, Va. He can be contacted via email at cvmpxe@vt.edu. References Mattson K. The Veterinary Student Population by the Numbers. J Am Vet Med Assoc 2019;254:1128. Larkin M. Pulling Together to Lower the Debt-to-Income Ratio. J Am Vet Med Assoc 2016;248:1312-1325. Eyre P. Tuition Cash Won’t Last. Vet Practice News December 2016. VMLRP Enhancement Act introduced in House. Vet Practice News May 2019. Maccabe AT. Additional thoughts on debt and tuition (lett) J Am Vet Med Assoc 2018; 253:1241-1242. Dicks MR. A Short History of Veterinary Workforce Analysis. J Am Vet Med Assoc 2013;242:1051-1060.
