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.     

THE CAREER PATH CHOICES OF VETERINARY RADIOLOGISTS

Concerns of a shortage of board certified specialists willing to work in academia have shadowed the medical and veterinary communities for decades. As a result, a number of studies have been conducted to determine how to foster, attract, and retain specialists in academia. More recently, there has been a growing perception that it is difficult for academic institutions to hire board certified veterinary radiologists. The objective of this study was to describe the career paths (academia vs. private sector) of veterinary radiologists and to determine what factors influenced their career path decisions. A mixed mode cross‐sectional survey was used to survey ACVR radiologists and residents‐in‐training, 48% (255/529) of which responded. There was a near unidirectional movement of radiologists from academia to the private sector: 45.7% (59/129) of the respondents who began their careers in academia had switched to the private sector while only 8% (7/88) had left the private sector for academia. If a shortage of academic radiologists exists, then perhaps the issue should be framed as a problem with retention vs. recruitment. The most influential factors in the decision to leave academia were remuneration (wages and benefits), lack of interest/enjoyment in research, geographical location, and family considerations. It is salient that average salaries increased by twofold after leaving academia for the private sector.     

The scientific component of residency training

This article focuses on the role of veterinary teaching hospitals (VTHs) at public and private colleges and universities in the growth and nurturing of today's veterinary clinician scientists, who will assume the ranks of tomorrow's veterinary academic faculty. Virtually all residency programs offer some level of scientific education and training concurrently or sequentially with professional clinical training; approximately half (51%) include, or at least offer, the opportunity to obtain advanced scientific degrees (MS/MSc and/or PhD). If veterinary schools and colleges are the gatekeepers for the veterinary profession, then VTHs are the gatekeepers for the profession's scientific development, defining the future role of veterinary medicine in society. Although struggling to find their place in a financially challenging and competitive environment fueled by the demand for more and better clinical services, VTHs are in a potentially strong position to capitalize on the uniqueness of their faculty and academic resources and thus make an unparalleled contribution to the scientific evolution of the veterinary profession.     

Pharmacists in veterinary education: bridging the gap

Veterinary patients stand to benefit greatly from the collaboration of pharmacy and veterinary medicine, and there are many ways pharmacy and veterinary medicine can work in concert. The best efforts to revise and remodel veterinary and pharmacy education to fit an evolving world of clinical practice are grounded in an understanding of each profession. Veterinary education should impart to its students and residents the skills necessary to critically evaluate drug therapy, select therapies based on facts from drug information sources, and operate a veterinary practice that abides by the legal, regulatory, and operational requirements necessary to maintain and dispense drugs. The academic training environment of each profession must include information on the other, in order to better prepare professionals for a realistic practice environment. When armed with an understanding of what pharmacists can provide their patients, veterinarians can demand these skills where appropriate. With the ultimate goal of producing an optimal learning environment, veterinary curricula should allow both pharmacy and veterinary medicine to work together to build a path to quality patient care and educational superiority.     

A comparison of the surgical caseloads of selected companion animal hospitals and a veterinary academic hospital in South Africa

Educational institutions should be aware of the frequency of surgical procedures in private practice, to assist both the student and the lecturer in evaluating the relative importance of procedures and to structure training programmes accordingly. The surgical caseload for 1 year at a veterinary academic hospital and 13 private companion animal hospitals registered with the South African Veterinary Council were compared. Surgical records were entered into a spreadsheet and sorted according to 96 selected surgical procedures to facilitate comparisons. Surgical procedures were in turn grouped according to date, species, degree of difficulty and frequency of occurrence. Feline procedures were more commonly performed in private hospitals. The academic hospital's caseload was dominated by major and advanced procedures while the private hospitals carried out more minor procedures. At the private hospitals more general surgery, and ear, nose and throat surgery as well as dental procedures were performed, while at the academic hospital more ophthalmic, orthopaedic, thoracic and neurosurgical procedures were carried out. The most commonly performed procedures at the academic hospital differed from those at the private hospitals. No seasonal trends were evident.     

EXPERT INTERPRETATION COMPENSATES FOR REDUCED IMAGE QUALITY OF CAMERA‐DIGITIZED IMAGES REFERRED TO RADIOLOGISTS

We compared the accuracy of five veterinary radiologists when reading 20 radiographic cases on both analog film and in camera‐digitized format. In addition, we compared the ability of five veterinary radiologists vs. 10 private practice veterinarians to interpret the analog images. Interpretation accuracy was compared using receiver operating characteristic curve analysis. Veterinary radiologists' accuracy did not significantly differ between analog vs. camera‐digitized images (P=0.13) although sensitivity was higher for analog images. Radiologists' interpretation of both digital and analog images was significantly better compared with the private veterinarians (P<0.05).     

Response of a veterinary college to career development needs identified in the KPMG LLP study and the executive summary of the Brakke study: a combined MBA/DVM program, business certificate program, and curricular modifications

In the present market, veterinarians with a strong background in career development, practice management, and business skills have a clear advantage in achieving financial success. Although there is ample evidence that the scientific and clinical skills of veterinary college graduates are high, there are also data that suggest that additional capabilities in the business realm may promote greater economic success. As noted in the KPMG executive summary, the field of veterinary medicine must make changes in its "current business practices and attitudes" to be successful in the future. Furthermore, the KPMG study found that 36% of industry employers reported that some jobs within their companies had specific job requirements that were not met by a veterinarian with only a veterinary medical degree. The areas of additional training most often cited included business, administration, personnel management, sales and marketing, and financial skills. Yet, Lewis and Klausner found that veterinarians reported challenges in the business realm, such as "how business works and how business goals are translated into action. This challenge held true for veterinarians in industry, academia, government, and private practice." The present gender trends in the field of veterinary medicine provide additional impetus to make career development and business skills training more prevalent. Presently, women comprise >65% of the veterinary student population and approximately 45% of all practicing veterinarians. In some areas of practice, the rate is much higher. For example, in 2002, women comprised 48.2% of all small animal exclusive private practitioners. Unfortunately, the KPMG study found that female veterinarians in private practice report lower self-evaluation of business management and financial skills, compared with their male cohorts. Female veterinarians in nonprivate practice report lower self-evaluation in communication, personnel management, business management, and marketing skills than that reported by males. As a result of these pressing needs, CSU CVMBS has undertaken a major initiative to improve the veterinary practice management and business skills training of veterinary students by offering a variety of options to gain this knowledge: a combined MBA/DVM degree program, a Business Certificate Program for Health Professions, and core curriculum courses. In this way, students can select the amount of focus they want to place on career development and business skills as they earn their DVM degree, to best ensure that they become successful veterinarians.     

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.     

R(X) for recruitment and retention of veterinarian scientists: money, marketing, mentoring

Veterinary medicine is failing both to sustain its academic base and to meet national needs for research in the fields of comparative medicine (translational research), public health, and food production. The basis for the shortage of veterinarians with research expertise is multi-factorial and related to the substantial commitment of time and money required to obtain both a DVM and advanced training, as well as the lack of motivation among veterinary students to engage in biomedical science. Effective strategies for increasing the number of veterinarian scientists must address these issues using a balanced combination of money, marketing, and mentoring. Success will require not only that we increase and improve opportunities for research training, but also that we create and sustain veterinary college environments that attract, foster, and reward dedication to research. The 'research pipeline' needs to be transformed into a 'research manifold' with multiple portals for entry and re-entry of trainees. Age-appropriate educational and mentoring programs should be implemented at K-14, baccalaureate, veterinary college, post-graduate, and junior faculty levels to promote recruitment, training, and retention of veterinarian scientists. New initiatives are especially needed to attract students with primary interests in science and biomedical research to the veterinary profession and to facilitate transition of motivated veterinary graduates from private practice to research careers. Specific examples of such programs are presented and future directions are discussed.     

Venomous Snake Restraint and Handling

Venomous snakes may be maintained as captive animals and are commonly exhibited in both zoos and private zoological collections. Veterinarians who treat reptile species may be asked to provide medical care to venomous snakes. The addition of venomous snakes to the practice can be exciting and rewarding. Training and experience handling venomous snakes are required before treating these animals in a veterinary practice. Both training and experience with handling venomous snakes are important not only to protect hospital personnel but the owner and patient as well. Veterinarians who wish to provide care for venomous snakes need to be familiar with the many tools used to make restraint and handling venomous animals as safe as possible.     

North American veterinary pathology residency training programs: an overview of where they are today and where they were five years ago, with an analysis of trends

An e-mail/telephone survey of all active North American residency training programs in veterinary pathology was conducted in September 2005. The purpose of this survey was to determine current numbers of trainees, their program length and type, and salaries; to compare current numbers to five years earlier; and, finally, to gauge interest in expanding current programs. All 41 training institutions contacted responded to the survey. Briefly, the survey found that there are currently 235 veterinary pathology residents, for a mean of 5.7 residents per training program. The number of residents currently in training programs and the number of applicants for these programs has increased compared to five years earlier. There is widespread interest in further expanding capacity in these programs, and the coalition of the American College of Veterinary Pathologists and the Society of Toxicologic Pathology is a well-known source of possible funding for additional residents. This survey report further documents the numbers of combined residency/PhD programs, average starting salaries for new residents, outside sponsorship effects on pathology training programs, and some of the common concerns regarding veterinary pathology training programs voiced by the respondents. While residency training capacity has expanded in the last five years, and there is widespread desire to further expand these training programs, a shortage of veterinary pathologists for future market needs will need to be addressed by increased funding from as yet unspecified sources.     

Veterinary pathology in the United Kingdom: past, present, and future

This article presents a historical perspective on veterinary anatomic pathology in the United Kingdom from the late nineteenth century to the present. Prior to World War II, the specialty was a rather general one that also included bacteriology and parasitology and was only slightly affected by strong Germanic developments in cell and tissue pathology. The few notable figures of this era include John McFadyean, Sidney Gaiger, and J.R.M Innes. The specialty developed strongly in the second half of the twentieth century, led by a small number of individuals, and was greatly aided by the development of specialist colleges and residency training. Key individuals of this era include W.F. Blakemore, Ernest Cotchin, R.J.M. Franklin, W.F.H. Jarrett, A.R. Jennings, and A.C. Palmer. A remarkable feature of this period has been the increased employment of veterinary pathologists in biomedical industry and in private diagnostic laboratories. While standards of pathology practice have benefited from the college initiatives, there are major financial constraints on the availability of funded training posts in the United Kingdom, and there remain considerable shortages in the supply of pathologists trained to contemporary standards. The acknowledged professional and scientific importance of veterinary pathology needs to be translated into effective financial support for the training that underpins competence in this specialty. Further developments seem likely to be dominated by advances in the technology of tissue handling, applications of molecular biology to pathology, and greater use of telepathology in teaching, in quality assurance, and in continuing professional development.     

The future of training for aquatic animal health veterinarians

This article describes educational approaches for training veterinary students, veterinary graduates, and practicing veterinarians in the area of aquatic animal health and lists a range of general research, training, internship/residency, and continuing-education resources.     

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.     

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.     

Teaching veterinary students using shelter animals

Veterinary teaching hospitals (VTHs) are experiencing case-load trends that have negatively affected efforts to prepare students for entry-level veterinary practice, particularly in the area of technical skills training. This article examines the clinical training available to veterinary students through a variety of collaborative shelter models. Benefits and potential problems related to initiating a collaborative shelter clinical training program are reviewed. Collaborative efforts between animal shelters and veterinary schools can provide crucial opportunities for outreach teaching initiatives, particularly for teaching medical and surgical skills.     

Educating the next generation of swine veterinarians: needs and strategies

The education of future swine veterinarians will require a team approach from academic institutions, private practitioners, and the pork industry Students will need to be active participants in their education. University and college administration, faculty, industry, government, professional organizations, and private practitioners will all need to provide the leadership and financial framework to support the future of veterinary education related to swine.     

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.     

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.     

A SURVEY OF VETERINARY RADIATION FACILITIES IN THE UNITED STATES DURING 2001

A survey of veterinary radiation therapy facilities in the United States was done in 2001 to determine the type of equipment available, radiation protocols used, case load, tumor types irradiated, as well as other details of the practice of radiation oncology. A total of 42 sites were identified and included 17 (40%) academic institutions, and 25 (60%) private practice external beam radiation facilities. The overall response rate was 79% (33/42 responded). Based on this survey there is substantial variation between facilities in all aspects ranging from equipment and personnel to radiation protocols and caseloads. American College of Veterinary Radiology boarded radiation oncologists direct 76% of the radiation facilities at academic institutions and 60% of the private practice facilities. Three facilities had orthovoltage radiation units only, and 30 facilities had mega-voltage equipment: cobalt 60 or linear accelerator. A total of 18 facilities had linear accelerators with three of these off site at a human radiation facility. Patient load information was available from 31 sites (74% of the radiation facilities in the United States), and based on the responses 2790 dogs and 1081 cats were irradiated in 2001. Canine mast cell tumors were the most frequently irradiated tumor. This represents the first survey of veterinary radiation facilities in the United States and provides information on the specialty of veterinary radiation oncology.