The veterinary profession enjoys broad public support and veterinarians continue to be ranked among the most trusted members of society. However, there is no guarantee that this trust will be sustained. There is little doubt that societal needs and expectations will change significantly in the middle of this century, just as they did in the mid 1900s. If the veterinary profession fails to adapt to these changing needs, we will assuredly become less relevant to the society we serve.

The Association of American Veterinary Medical Colleges (AAVMC) recently conducted a long-range planning study to prepare for the inevitable changes needed to educate veterinarians. The study objective was to determine a direction for academic veterinary medicine that will prepare veterinarians for opportunities and possibilities that may emerge within the next 20 years. The process of foresight technology was used to help study participants consider various plausible future scenarios affecting veterinary medicine over a 20-to 25-year horizon. The study report concluded that it is imperative to change the way we educate tomorrow’s veterinary medical students.

The report considered the following future scenarios:

• A world in which pandemic zoonoses are persistent, and conversely, an era in which such disease threats are largely overcome.
  
• A world in which the genome of animal species is explored and tapped for animal modification, cloning, drug development, genetically created novelty pets, and in vitro development of animal-based food supplies.
  
• A world in which global warming and its consequences for domestic and wild animal populations dramatically change health care requirements and food supply and result in the emergence of new animal diseases.

A more rapid response will be required by the profession if it is to continue to be relevant at the interface of human and animal health. For example, various sectors of the profession are expected to provide expertise in food safety from production to consumption; leadership in regard to animal husbandry and welfare concerns; executive-level knowledge about economics, business, and personnel management; fundamental client communication and media skills; and ethical and moral guidance in the care and use of animals. Are today’s graduates adequately prepared to meet these challenges? And, do they understand these expectations, even if the appropriate learning opportunities are not available in the curriculum?

New graduates are expected to be knowledgeable and able to function effectively in a changing environment. They are challenged with many emerging issues including:

• new diagnostic technology.
  
• rapidly changing pharmaceutical modalities.
  
• antimicrobial resistance to drugs and transference of resistance.
  
• an expanding range of health care options, from primary entry-level services to those requiring secondary or tertiary referral.
  
• regulations and policies pertaining to drug residues.
  
• restrictions on use of agents for products being prepared for natural or organic foods and those intended for export.
  
• diagnosis, prevention, and control of emerging and reemerging infectious diseases.
  
• application of state-of-the-art therapeutic and surgical procedures that owners discover on the Internet or elsewhere.

The necessity for veterinary medical students to study specifically for general licensing examinations is limiting the creative expansion of learning opportunities within the veterinary school curricula.

Licensing examinations should not limit the progress and development of curricula to prepare veterinarians to meet societal needs and expectations. While veterinarians generally may be reluctant to accept so-called "limited licensure," constructive dialog about strategies to accomplish these emerging needs should be encouraged. Perhaps the term "enhanced licensure" could be adopted, whereby a general examination would be administered to reflect competence in core areas of veterinary medical knowledge, and the "enhancement" notation added to indicate completion of training in a particular area of professional focus. This might be accomplished by simply adding the notation of major emphasis to the degree or by use of a certifying examination.

It is important to understand that licensing is not designed to protect veterinarians’ options, but rather exists to assure the public of competency in providing health care services. But, does our current system provide such public assurance? Consider the example of veterinarians working for years in a purely administrative capacity but maintaining licenses to practice in several states, and complying with their continuing education requirements. They would clearly not be competent to practice medicine and surgery. Similarly, consider a longtime practitioner in equine medicine who, for reasons of health or injury, wants to change to small animal practice. This practitioner would undoubtedly need to pursue continuing education to prepare to manage situations such as diabetic dogs and cats, and to diagnose and treat gastric dilatation-volvulus, before offering services to clients. The public protection in this example is fulfilled by the integrity of the practitioner, not the license. However, the current licensing structure does not protect the public from this individual practicing without the appropriate small animal experience. Thus, current veterinary licenses imply that all practitioners are qualified to practice on all species.

Providing for greater licensing flexibility would allow for greater flexibility of curriculum development. The foresight study report recommendations called for an "acceptance that veterinary licensure will recognize competence in selected areas of professional focus, and will lead to public assurance of competency in a selected area of veterinary medicine." This has already happened in two states for poultry practitioners. The profession and the public should engage in discussion about this issue.

In considering proposed curricular models, other issues arise such as the need for change in admission and residency standards, and accreditation standards. Despite the difficulties and inertia that such needs present, to continue on our present path places the veterinary profession at risk of becoming mediocre and perhaps irrelevant in some areas of professional focus. The veterinary medical curriculum must change now to ensure the future respect and value of the profession in society.

Reference: Excerpted from Thomason, Flatland, and Calvert, Vet Med 9:588-598, 2007.