RISE AND FALL OF VETERINARY COLLEGE CURRICULUM

As an old retired veterinary educator, I am puzzling over the definition of profession as it relates to the definition of technician. I have the veterinary profession in mind but also the human medical profession as it relates to the nature of their college education. A recent change in the curriculum in their College of Veterinary Medicine at what had been one of the major universities is what stimulated my concern. I wrote to the Dean of that college and told him I was concerned that the college was no longer teaching professional but was training veterinary technicians. He demonstrated he had no concept of what I was talking about in his answer. What was I saying and what did I mean?

We all know we have veterinary technician verses professional veterinarians and the more widely known physician verses nurses. We refer to nursing as a profession but also to medical doctors as a profession but there are clear differences. What is the difference? We glibly say a doctor knows everything but a nurse can do everything. Nurses are the technical experts. There are many gradations but in the end, it is “professional” verses “technician”.

On of my most burning memories was after spending many hours studying acid-base balance regulation as it relates to cardiopulmonary pathophysiology, putting together lecture notes, and having discussion with small groups of students, I was shocked. About an hour after my last discussion with a group, that particular group, I overheard an emergency room/intensive care veterinarian talking to the same students. The student was explaining in detail to him how they decided when to treat a patient in a way I was proud to hear. He cut them short by remarking that you do not have to know all that. He told them to subtract the bicarbonate on the lab report from the normal and calculate how many milligrams of bicarbonate to inject. They expressed surprised at how simple it was. Students idolize clinicians, so I am sure that is how they treated patients from then on.

While I was living on an island off the coast of Belize, a cat owner presented her cat for diagnosis and treatment for fleas to a veterinary technician. I just happened to be visiting the home where they met and made the remark that it wasn’t fleas but they should treat it for fleas. The tech was offended that I disagreed with her. She retorted rather acidly to the cat owner as well as the family who lived in that house where we were that the bite lesions were in a pattern that is typical for fleabites; therefore it was fleas—they looked impressed at her knowledge. I said nothing; I did not point out that neither she, the owner, nor I could find fleas or evidence of fleas on the cat. The truth is that a species of mite can live in follicles but attacks cats in the same pattern as fleas. The drug that kills fleas kills the mite.

A professional knows the subject of health and disease in depth. As time goes on, the amount of basic science knowledge is skyrocketing. That was what caused the medical professions to abandon apprenticeship programs years ago; there is no way everything that had to be leaned could be leaned by experience. With that as background, the headline to the article reporting the curriculum change sent chills down my spine; over the four-year curriculum, lecture time will decrease 21 percent while laboratory contact time will increase by 10.8 percent; how can that make sense? It doesn’t, but what are the forces at work? What happened to the missing 10.2 percent? The answer is that it was given to the area practitioners as cheap student labor. Who did the giving? Without looking, it was predictable clinicians had dominated the curriculum development committee that made the final decisions.

Four forces at play are 1) Student pressure; 2) Practitioner Pressure; 3) Faculty pressure; and finally; 4) Basic science verses clinical science competition. Student pressure is complex. It involves that strange thing called professional interest; students seem to think know what they have to learn to be veterinarians. They see veterinarians treating disease and doing surgery; what they see is what they want to learn.  What they cannot see is what is going on in the head of the professional. Deciding when is it appropriate to treat with bicarbonate, administer a certain drug over another drug, or call for surgery is not something they can see.  That is what makes a professional a professional; giving the drug or doing surgery is really the technical aspect, which of course requires skill but it is not the same thing. To give bicarbonate when it is contraindicates is mal practice. In addition, students do not want to learn about hundreds of exotic diseases and condition, which professors can only teach in long boring lectures. Students want hands on experience just like “real” veterinarians. When the clinic door opens and a case of flea bit dermatitis or canine distemper enters, even the kennel help can make that diagnosis. However, when an animal with an animal with an exotic disease show up it takes a profession to know how to recognized the disease is exotic and how to diagnose that disease. These student concerns are directly addressed in the quoted statement given above but at the expense of professionalism.

Practitioners want students to be “practice ready” the day they graduate. This means when a student graduates the tied worn out practitioner can drop the keys to their clinic in the student hands on day one and go on vacation. They expect to hire a new graduate for next to nothing but expect him or her to work like an experienced practitioner and pressure colleges to teach them that way. Veterinary colleges cannot and should not aim to do that—that is the job of practitioners. Colleges are academic institutions and not a glorified practice. Practitioners are a powerful political force in state politics; thus they have influence. Not only that, the concept of a new graduate being practice ready is the impression the populations has of what a college does.

College administrators force faulty members to do research, that is write grants to bring in research dollars. Colleges are ranked by the research dollars they bring in and not by what they teach. Unfortunately, majority faculty vote allots money and space within colleges. It takes one professor to lecture to an entire basic science class but it takes one surgeon to teach one student surgery. Obviously, faculties are clinician top heavy. Consequently, basic science resources suffer.

The consequence of all of this is a curriculum of the kind mentioned. Colleges are training highly skilled technicians. Maybe that is all they can do with the prevailing time and economic constraints. I worry about what the future will bring for my once great profession. Maybe the profession is like the Rome Empire, which rose up to greatness but was doomed to fall.  I am too old to wait to see what will arise out of the ashes.  

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