Postgraduate training programs in veterinary clinical pathology in the United States and Canada (1998 to 2002)

Background: Residency and graduate programs in veterinary clinical pathology provide specialized training for board certification and are important pathways to careers in clinical pathology diagnostics, teaching, and research. Information about training opportunities is useful for assessing disciplinary needs, outcomes, and changes, garnering program support, and providing objective data for program evaluation by faculty, trainees, and prospective applicants. Objectives: The goals of this study were to 1) compile detailed information on the number and types of postgraduate training programs in veterinary clinical pathology in the United States and Canada, 2) describe the goals, activities, strengths, and weaknesses of the programs, 3) assess the desirability of program accreditation and program standards, 4) identify supplemental training opportunities, and 5) evaluate changes in programs, trainees, and faculty 4 years later. Methods: In July 1998, the American Society for Veterinary Clinical Pathology Education Committee sent a survey to representatives at the 31 schools and colleges of veterinary medicine in the United States and Canada and 31 diagnostic laboratories, private hospitals, and pharmaceutical companies. Survey data were compared with updated information obtained from training program coordinators in November 2002. Results: Survey response rate was 94% for universities, 39% for nonuniversity institutions, and 66% overall. In 1998, there were 20 clinical pathology training programs, including residencies (n=10) and graduate programs combined with residency training (n=10), with 36 total training positions. In 2002, there were 25 training programs (14 residencies, 11 combined), with 52 total positions. The median faculty: trainee ratio was 2.0 in both years. Of 67 faculty members involved in training in 1998, 57 (85.1%) were board‐certified in clinical pathology and 53 (79.1%) had DVM/PhD degrees. Net faculty numbers increased by 17 (25.4%) but the median per institution remained at 3.0. Primary program goals were 1) eligibility for and successful achievement of board certification in clinical pathology by the American College of Veterinary Pathologists, 2) proficiency in laboratory diagnostics, and 3) contemporary basic or applied research training. Many programs cited research opportunities, caseloads, and training in hematology and cytology as strengths. Program weaknesses included insufficient funding, too few faculty, and limited training in clinical chemistry and laboratory operations/quality assurance. Trainees completing programs within the past 5 years (n=70) were employed in academia (28.6%), diagnostic laboratories (32.9%), and industry (18.6%). For trainees completing programs between 1999 and 2002 (n=38), these percentages were 52.6%, 21.1%, and 7.9%, respectively. Most (62.5%) respondents supported program standards and accreditation, and 76% supported board review sessions for trainees. Conclusions: Opportunities for postgraduate training in veterinary clinical pathology increased between 1998 and 2002, with 5 new programs and 16 new training positions. These additions and the increased emphasis on diagnostic proficiency, efforts to strengthen training in clinical chemistry and quality assurance, and continuation of combined PhD‐residency programs will help address the perceived need for increased numbers of qualified clinical pathologists in academia, diagnostic laboratories, and industry.     

The European College of Veterinary Pathologists (ECVP): the professional body for European veterinary pathologists

The European College of Veterinary Pathologists (ECVP) was established in 1995 with the aim of advancing veterinary pathology and promoting high standards within the specialty in Europe. The ECVP is one of 21 European colleges recognized by the European Board of Veterinary Specialisation (EBVS), which represents a quality-assurance system for European veterinary specialists. Until the ECVP was founded, there was no unified European system recognizing the specialty of pathology, and many European countries followed their own qualification systems, which varied in form and standard. The ECVP provides an annual certifying examination, the passing of which is required to gain membership (diplomate status) in the college. This qualification is now accepted on equal terms by the well-established American College of Veterinary Pathologists (ACVP). In line with EBVS requirements, the ECVP has also established a standard continuing professional development (CPD) and re-registration system for its membership. Furthermore, it has promoted and unified European post-graduate training in veterinary pathology by setting up requirements for residency training programs and making registration and monitoring of these programs by the ECVP a prerequisite for approval of an institution as a training facility. The concurrent establishment, together with the European Society of Veterinary Pathology, of an annual summer school that trains residents for the certifying examination has further fostered European post-graduate training. Within 10 years, the ECVP has succeeded in establishing common standards and a unified approach to veterinary pathology throughout Europe. This article describes the evolution and organization of the ECVP.     

Developing and fostering a dynamic program for training in veterinary pathology and clinical pathology: veterinary students to post-graduate education

Recent reports project a deficiency of veterinary pathologists, indicating a need to train highly qualified veterinary pathologists, particularly in academic veterinary medicine. The need to provide high-quality research training for veterinary pathologists has been recognized by the veterinary pathology training program of the Ohio State University (OSU) since its inception. The OSU program incorporates elements of both residency training and graduate education into a unified program. This review illustrates the components and structure of the training program and reflects on future challenges in training veterinary pathologists. Key elements of the OSU program include an experienced faculty, dedicated staff, and high-quality students who have a sense of common mission. The program is supported through cultural and infrastructure support. Financial compensation, limited research funding, and attractive work environments, including work-life balance, will undoubtedly continue to be forces in the marketplace for veterinary pathologists. To remain competitive and to expand the ability to train veterinary pathologists with research skills, programs must support strong faculty members, provide appropriate infrastructure support, and seek active partnerships with private industry to expand program opportunities. Shortages of trained faculty may be partially resolved by regional cooperation to share faculty expertise or through the use of communications technology to bridge distances between programs. To foster continued interest in academic careers, training programs will need to continue to evolve and respond to trainees' needs while maintaining strong allegiances to high-quality pathology training. Work-life balance, collegial environments that foster a culture of respect for veterinary pathology, and continued efforts to reach out to veterinary students to provide opportunities to learn about the diverse careers offered in veterinary pathology will pay long-term dividends for the future of the profession.     

Resident and graduate training in veterinary nutrition

Training programs for veterinarians seeking board certification by the American College of Veterinary Nutrition (ACVN) are structured in one of two ways: (1) as programs similar to specialty training in other clinical disciplines or (2) as graduate programs leading to advanced degrees combined with clinical training. Residency training occurs through a variety of approaches, including didactic coursework, case-based and applied learning, clinical training, teaching, research, and self-study. Challenges to successful residency and graduate training include low numbers of diplomates, particularly at veterinary schools; low numbers of applicants; small numbers of funded programs; and faculty promotion systems that do not reward residency or graduate training and program development. The mentoring of individuals seeking both board certification and a graduate degree presents additional considerations, including recruitment of individuals motivated in research and structuring a combined program that facilitates completion of both tasks in a timely fashion.     

Future directions in training veterinarians for careers in toxicological pathology in the United Kingdom

There is currently a global shortage of veterinary pathologists in all sectors of the discipline, and recruitment of toxicological pathologists is a particular problem for the pharmaceutical industry. Efforts to encourage veterinarians to consider alternative career paths to general practice must start at the undergraduate level, with provision of structured career guidance and strong role models from pathology and research disciplines. It is also imperative that both the importance of biomedical research and the role of animal models be clearly understood by both university staff and undergraduates. Traditionally, much post-graduate training in toxicological pathology is done "on the job" in the United Kingdom, but completion of a residency and/or PhD program is recognized as a good foundation for a career in industry and for successful completion of professional pathology examinations. New models of residency training in veterinary pathology must be considered in the United Kingdom to enable a more tailored approach to training toward specific career goals. A modular approach to residency training would allow core skills to be maintained, while additional training would target specific training requirements in toxicological pathology. Exposure to laboratory-animal pathology, toxicology, research methodology, and management skills would all be of benefit as an introduction to a career in toxicological pathology. However, long-term funding for UK residencies remains a problem that must be resolved if future recruitment needs in veterinary pathology are to be met.     

The value of biomedical research training for veterinary anatomic and clinical pathologists

Veterinary pathologists traditionally have been actively engaged in research as principal investigators and as collaborators. Pathologists frequently obtain advanced training in research; however, it appears that in the last 10 years there has been a reversal of a previous trend toward increasing numbers of pathologists obtaining PhD degrees. This has arisen despite an established shortage of veterinarians engaged in research. This article evaluates the benefits of research training for individual pathologists, including a wide spectrum of professional opportunities and additional skill development beyond that usually provided by diagnostic pathology training alone. Various training models are discussed, including combined and sequential diagnostic residency and research degree training as well as the nondegree research fellowship programs more commonly pursued in human medicine. Best-practice recommendations for program infrastructure, mentorship, time management, and a team approach to research and research training are advocated to facilitate the development of successful programs and to encourage a continued emphasis on integrated training for pathologists as both clinical diagnosticians and experimentalists. This article is intended to help prospective and active pathology trainees, their mentors, and educational administrators optimize opportunities to ensure the future vitality of veterinary pathologists, and their contributions, in basic and applied research.     

Guidelines for resident training in veterinary clinical pathology. III: cytopathology and surgical pathology

The Education Committee of the American Society for Veterinary Clinical Pathology has identified a need for improved structure and guidance of training residents in clinical pathology. This article is the third in a series of articles that address this need. The goals of this article are to describe learning objectives and competencies in knowledge, abilities, and skills in cytopathology and surgical pathology (CSP); provide options and ideas for training activities; and identify resources in veterinary CSP for faculty, training program coordinators, and residents. Guidelines were developed in consultation with Education Committee members and peer experts and with evaluation of the literature. The primary objectives of training in CSP are: (1) to develop a thorough, extensive, and relevant knowledge base of biomedical and clinical sciences applicable to the practice of CSP in domestic animals, laboratory animals, and other nondomestic animal species; (2) to be able to reason, think critically, investigate, use scientific evidence, and communicate effectively when making diagnoses and consulting and to improve and advance the practice of pathology; and (3) to acquire selected technical skills used in CSP and pathology laboratory management. These guidelines define expected competencies that will help ensure proficiency, leadership, and the advancement of knowledge in veterinary CSP and will provide a useful framework for didactic and clinical activities in resident‐training programs.     

Residency training programs in veterinary clinical pathology: a comparison of experiences at two institutions

Two institutions with different residency training formats in clinical pathology are compared with respect to application procedures, learning and teaching opportunities, learning resources, research training, publication requirements, and assessment methods of the program and trainees. The University of Florida and Purdue University programs are both based on an emphasis in morphologic recognition and interpretation of disease processes as well as training in basic science and applied research principles. The progress of trainees through each program is carefully monitored to meet individual needs as well as to meet the training requirements to allow candidates to sit for the certifying examination in clinical pathology. Periodic mock board exams are a critical tool to assess trainee progress and learning. The differences in format focus on coursework and publication requirements as well as on program assessment tools. While one program provides training in the form of 75% clinical diagnostic service, the other uses a mixture of 50% coursework and 50% clinical diagnostic training. Despite the contrast between a pure residency training program and one combining residency training with an MS degree, both institutions provide a solid program structure, ample learning resources, and adequate faculty mentorship to produce a high pass rate of board-certified specialists, the major focus for both programs. Numbers of post-training employment positions for both institutions are similar for those selecting faculty positions at veterinary schools. During the period studied, however, the combined residency and MS graduate program at Purdue University produced more graduates employed in pharmaceutical and biotechnology companies, while the residency program at the University of Florida produced more graduates employed by diagnostic laboratories.     

Establishment of the European College of Veterinary Clinical Pathology (ECVCP) and the current status of veterinary clinical pathology in Europe

After 5 years of development, the European College of Veterinary Clinical Pathology (ECVCP) was formally recognized and approved on July 4, 2007 by the European Board of Veterinary Specialisation (EBVS), the European regulatory body that oversees specialization in veterinary medicine and which has approved 23 colleges. The objectives, committees, basis for membership, constitution, bylaws, information brochure and certifying examination of the ECVCP have remained unchanged during this time except as directed by EBVS. The ECVCP declared full functionality based on the following criteria: 1) a critical mass of 65 members: 15 original diplomates approved by the EBVS to establish the ECVCP, 37 de facto diplomates, 7 diplomates certified by examination, and 5 elected honorary members; 2) the development and certification of training programs, laboratories, and qualified supervisors for residents; currently there are 18 resident training programs in Europe; 3) administration of 3 annual board-certifying examinations thus far, with an overall pass rate of 70%; 4) European consensus criteria for assessing the continuing education of specialists every 5 years; 5) organization of 8 annual scientific congresses and a joint journal (with the American Society for Veterinary Clinical Pathology) for communication of scientific research and information; the College also maintains a website, a joint listserv, and a newsletter; 6) collaboration in training and continuing education with relevant colleges in medicine and pathology; 7) development and strict adherence to a constitution and bylaws compliant with the EBVS; and 8) demonstration of compelling rationale, supporting data, and the support of members and other colleges for independence as a specialty college. Formal EBVS recognition of ECVCP as the regulatory body for the science and practice of veterinary clinical pathology in Europe will facilitate growth and development of the discipline and compliance of academic, commercial diagnostic, and industry laboratories in veterinary clinical pathology. Future needs are in developing sponsorship for resident positions, increasing employment opportunities, increasing compliance with laboratory, training, and continuing education standards, and advancing relevant science and technology.     

Future directions in training zoological medicine veterinarians

The American College of Zoological Medicine (ACZM) is dedicated to excellence in furthering the health and well-being of both captive and free-ranging wild animals. Currently there are 14 ACZM-approved residency programs in zoological medicine. In addition, eight non-approved residencies and 15 internships in North America provide training opportunities in this field. This article outlines some of the training opportunities for both veterinary students and graduate veterinarians that would best position them for entry into a zoological medicine training program. Although there is a growing number of opportunities for individuals to serve in captive and free-ranging wildlife health positions, existing training programs are inadequate to meet these needs. It is also acknowledged that there is an increasing number of veterinary students entering veterinary schools with an interest in zoological medicine and that the job market is still limited. However, positions and opportunities in zoological medicine are available for those individuals with the drive, dedication, and passion to succeed.     

Academic and private practice partnerships in veterinary radiology residency training

As veterinary radiologists devote greater time to telemedicine consultation, residency training must evolve to reflect the skills of these services. The contribution of private practice/consultant radiologists to residency training has traditionally been minimal but academic and private practice partnerships in education and research can provide the framework for a well‐rounded residency. These partnerships can also lessen the impact of workforce shortages in academia and provide financial compensation to academicians through external consultation. The purpose of this commentary is to review existing collaborative interactions between academic and private practice veterinary radiologists; with a focus on ways to sustain, improve, and cautiously increase the number of veterinary radiology training programs.     

If you build it,they will learn: A review of models in veterinary surgical education

Surgical skills are learned through deliberate practice, and veterinary educators are increasingly turning to models for teaching and assessing surgical skills. This review article sought to compile and review the literature specific to veterinary surgical skills models, and to discuss the themes of fidelity, educational outcomes, and validity evidence. Several literature searches using broad terms such as “veterinary surgery model,” “veterinary surgical model,” and “veterinary surgical simulator” were performed using PubMed, CAB abstracts, and Google scholar. All articles describing a model created and utilized for veterinary surgical training were included. Other review articles were used as a source for additional models. Commercially available models were found using review articles, internet browser searches, and communication with veterinary clinical skills educators. There has been an explosion of growth in the variety of small animal surgical task trainers published in the last several decades. These models teach orthopedic surgery, ligation and suturing, open celiotomy and abdominal surgery, sterilization surgeries, and minimally invasive surgeries. Some models were published with accompanying rubrics for learner assessment; these rubrics have been noted where present. Research in veterinary surgical models is expanding and becoming an area of focus for academic institutions. However, there is room for growth in the collection of validity evidence and in development of models for teaching large animal surgery, training surgical residents, and providing continuing education to practitioners. This review can assist with evaluation of current surgical models and trends, and provide a platform for additional studies and development of best practices.     

Training satisfaction and well-being among veterinary anaesthesia residents: time for action

ObjectiveTo explore the satisfaction and well-being experienced by anaesthesia residents during their training, and to investigate factors that may have influenced their experiences.Study designCross-sectional online anonymous voluntary survey.Sample populationA total of 150 (of approximately 600 canvassed) former veterinary anaesthesia residents.MethodsParticipants were invited to complete an internet-based survey regarding the satisfaction and well-being experienced during their residency. Multiple choice, categorical, dichotomous, Likert-type rating scales and slider questions were used to investigate five domains (demographic, working conditions, educational environment, training satisfaction, well-being). Sampling adequacy, questionnaire reliability and participant responses were investigated by Kaiser-Meyer-Olkin (KMO) indices, Cronbach’s α and standard statistical techniques, respectively (p < 0.05).ResultsThe questionnaire demonstrated good sampling adequacy (median KMO index 0.74; range 0.51–0.89) and high item ‘reliability’ (α = 0.82–0.94). Of the 150 responders, (25% participation rate) 62% were satisfied, 14% were neutral and 24% were dissatisfied with their residency training; 60.6% would do the residency again, 39.3% would not or were unsure. Sex and age did not correlate with training satisfaction (p > 0.05). Salary/stipend was considered inadequate by 70% of responders; 66% received no on-call supplement. Greater supervisory input, a good working environment and extra income when on-call were positively correlated with training satisfaction (p < 0.01). The majority (94.6%) of trainees suffered from at least one medical condition during their residency, with fatigue, sleep disturbance or anxiety reported by > 62%.ConclusionsAlthough a quarter of responders were dissatisfied with their residency, several modifiable factors were identified, particularly with respect to supervisors’ input, working environment and pay, which could inform improvements for future residency programmes. Most trainees experienced negative health impacts; however, this parallels the general situation in both the medical and veterinary professions, which requires greater attention from the supervisors, trainees and colleges.     

Historical perspective and future directions in training of veterinary pathologists with an emphasis on zoo and wildlife species

This article discusses the history of the field of zoo and wildlife pathology, training opportunities for veterinary students and graduate veterinarians, and current and future job opportunities. The niches occupied by veterinarians in this field and their contributions to animal and human health are also highlighted. The field of zoo and wildlife, or "non-traditional" species, pathology has its roots in comparative anatomy, zoology, wildlife biology, and medical pathology in the mid- to late nineteenth century. The initial emphasis was on comparisons between animal and human diseases or on management of game animals. Veterinarians became increasingly involved during the twentieth century, gradually changing the emphasis to improvement of conservation strategies, captive care, and elucidation of diseases of concern for the animals themselves. Currently there are several zoos and wildlife agencies in the United States employing full-time veterinary pathologists. Private and government diagnostic laboratories, veterinary schools, and other academic institutions in the United States with pathology departments are other employers. The field requires post-DVM training by means of a residency program leading to board certification, graduate school (MS or PhD degrees), or both. Veterinary students can gain valuable experience in the field through externships and, at some schools, through elective courses in the curriculum. Current concerns about ecosystem health, bioterrorism, and the recognition that captive and free-ranging wildlife can serve as sentinel species will increase the demand for veterinary pathologists choosing this very rewarding career path specializing in non-traditional species.     

Behavioral medicine opportunities in North American colleges of veterinary medicine: A status report

In 1999, 8 of 27 (29.6%) US veterinary schools had a full-time behaviorist. A survey was conducted in the summer of 2007 to obtain information about the availability of behavioral medicine educational opportunities in colleges of veterinary medicine in North America. Twelve of 32 (37.5%) veterinary colleges have a veterinary behaviorist on staff, and 9 (28.13%) support residency programs. Fourteen (43.75%) have a normal animal behavior course, 12 (37.5%) an abnormal/clinical behavior course. Nine universities (28.13%) have a combined normal/abnormal animal behavior course in lieu of separate normal and abnormal behavior courses. Seven have officially recognized student chapters of the American Veterinary Society of Animal Behavior. Four have no behavioral medicine presence in the form of faculty, behavior courses, interested staff, or a student club. Inclusion of behavioral medicine into the curricula of North American colleges of veterinary medicine has been slow in the 14 years since the recognition of the specialty by the AVMA's American Board of Veterinary Specialties. Each year, behavior problems account for a large number of deaths, by euthanasia, of otherwise healthy pets. Increasing opportunities in behavioral medicine at the university level would have a considerable trickle-down effect by affecting the perception by owners and the comfort level of practitioners in identifying, managing and treating behavior problems in pets.     

The American College of Veterinary Surgeons The First Twenty-Five Years

The American College of Veterinary Surgeons (ACVS), founded in 1965 and recognized by the AVMA in 1970, maintains high standards for surgical training programs and administers rigorous certifying examinations. It provides educational outreach to the veterinary medical profession by presenting scientific programs at ACVS annual meetings, sponsoring the Veterinary Surgical Forum in the USA and Europe, and publishing a refereed journal, Veterinary Surgery. The ACVS offers research grants and other awards to surgical residents, and encourages its members to pursue original investigations and contribute to the veterinary literature. In its silver anniversary year, it is appropriate to recall the aspirations and accomplishments of this forward-looking specialty organization.     

Guidelines for resident training in veterinary clinical pathology. II. Hematology

BACKGROUND: The Education Committee of the American Society for Veterinary Clinical Pathology (ASVCP) identified a need for improved structure and guidance in training residents in clinical pathology. To begin to meet this need, guidelines for training in clinical chemistry were published in 2003. OBJECTIVE: The goal of this report is to define learning objectives and competencies in hematology, including coagulation and immunohematology. METHODS: These guidelines were developed and written with the input of ASVCP Education Committee members and peer experts. RESULTS: The primary objectives of training in hematology are: 1) to accrue a thorough, extensive, and relevant knowledge base of the types, principles, and properties of hematology tests and concepts of pathophysiology in animals; 2) to develop abilities to reason, think critically, communicate effectively, and exercise judgment in hematologic data interpretation and investigative problem-solving; and 3) to acquire technical and statistical skills important in hematology and laboratory operations. We also provide options and ideas for training activities and identify hematology resources useful for clinical pathology faculty and staff, training program coordinators, and residents. CONCLUSIONS: The guidelines define expected competencies that will help ensure proficiency, leadership, and the advancement of knowledge in veterinary hematology and provide a useful framework for didactic and clinical activities in resident-training programs. The learning objectives can readily be adapted to institutional and individual needs, interests, goals, and resources.     

Guidelines for resident training in veterinary clinical pathology. I. Clinical chemistry

Background: The Education Committee of the American Society for Veterinary Clinical Pathology identified a need for improved structure and guidance of clinical pathology resident training in clinical chemistry.
Objectives: The committee's goal was to develop learning objectives and competencies in knowledge, abilities, and skills in clinical chemistry; provide options and ideas for training activities; and identify clinical chemistry resources useful for clinical pathology faculty, training program coordinators, and residents.
Methods: Guidelines were developed and written with the input of Education Committee members and peer experts.
Results: The primary objectives of clinical chemistry training are: 1) to accrue a thorough, extensive, and relevant knowledge base of the types, principles, and properties of clinical chemistry tests and concepts of pathophysiology in animals; 2) to develop abilities to reason, think critically, and exercise judgment in clinical chemistry data interpretation, investigative problem-solving, and hypothesis-driven research; and 3) to acquire technical and statistical skills important in clinical chemistry and laboratory operations.
Conclusions: These guidelines define expected competencies that will help ensure proficiency, leadership, and the advancement of knowledge in veterinary clinical chemistry and provide a useful framework for didactic and clinical activities in resident training programs. The learning objectives can readily be adapted to institutional and individual needs, interests, goals, and resources.     

Financing the Delivery of Animal Health Services in Developing Countries: A Case Study of Ghana

Inadequate financing for the delivery of animal health services in many developing countries has been blamed for lack of efficiency and effectiveness of veterinary services. There are no reports of how the delivery of veterinary services in Ghana is financed. The aim of this paper is to provide information on the funding of veterinary services in Ghana to help in decision making on resource allocation.Various indicators and measures were used in assessing the adequacy of financing and resource allocation from 1990 to 1995. These measures were the veterinary budget as proportions of the national budget, GDP and AGDP; the proportions of the veterinary budget allocated to salaries; the ratios of salaries to non-staff expenditure and of non-staff expenditure to veterinary livestock units and technical staff; coefficient of efficacy; and R- ratio. These generally declined or worsened over the period, deviating from recommended norms where such norms exist. This confirmed the paucity of financing and resource allocation for the delivery of veterinary services. Revenue generation from cost recovery over the 1993–95 period was a potential source of funding, exceeding 100% of non-staff expenditure for 1993 and 1994. However, the revenue generated was not channelled back to veterinary services but went to the national coffers. This served as a disincentive.There is an urgent need to review how veterinary services are financed in Ghana, if the delivery of services is to improve in efficiency and effectiveness.     

Future directions in reptile medical education

Reptile medicine has emerged as a specialty area within the broader field of zoological medicine. It encompasses the medical needs of approximately 7,500 vertebrate species. This vertebrate class is highly diversified, having biological and medical peculiarities that differ both between and within major groups. Historically, veterinarians who have become recognized specialists with reptiles have had limited formal training in their medical management. The pet reptile trade is a multi-million-dollar business, and the popularity of reptiles as pets has resulted in a need for more veterinarians with training in their medical management. While few private practices have high volumes of reptile cases, many small-animal practices will have the opportunity to see a significant number of reptiles on an annual basis. Most practitioners with reptile medical expertise have merged their experiences as reptile pet owners with the principles of veterinary medicine taught in veterinary college. Several North American veterinary colleges have reptile medicine courses, and most have didactic and clinical courses in exotic and zoo animal medicine that include lectures and practical experience. Most accredited zoological medicine residency training programs include training in reptile medicine. The case load and interest in reptile medicine will probably never be sufficient to lead the average veterinary college to develop much more than what is currently offered. Consequently, those few colleges having more extensive course offerings, both didactic and clinical, will serve as educational centers for this discipline. Future Web-based teaching programs in reptile medicine will allow students nationally and internationally to have access to instructional material that can be continually updated.