Veterinary medicine needs to critically assess workforce needs, watchdogs say

NATIONAL REPORT — With veterinary practice caseloads falling, some watchdogs in the profession are sounding the alarm on increasing veterinary school enrollments.

At the same time, leaders in veterinary education say new opportunities for DVMs will emerge outside of practice and it's up to veterinarians to carve new paths for themselves.

"I truly fear that we're looking at graduating way more people than the profession is going to be able to employ. The worst of it is that the debt levels are rising so fast it's almost becoming a bad investment to spend between $140,00 for residents and $260,000 for a nonresident or private school DVM education to enter an absolutely flat job market," says James F. Wilson, DVM, JD, a veterinary consultant who serves on the VetPartners Career Development Committee, Veterinary Pet Insurance's (VPI) Veterinary Advisory Board, and as national adviser for the Veterinary Business Management Association (VBMA).

The problem is there isn't enough hard data on what happens to students once they leave college with their DVM in hand, says Paul Pion, DVM, Dipl. ACVIM, co-founder of VIN. More students go through veterinary programs, but when they are done and can't find a job, they often have no one to look to for help. A shortage of veterinarians would increase the value of the profession, but smaller class size would increase veterinary student fees even more, Pion says.

"There's no one thing you can change here that will make it better," Pion says. "How do we increase the value of the degree these kids pay for and mortgage their future for?"

Loan forgiveness programs awarded to draw students into underserved areas are working, according Marguerite Pappaioanou, executive director of the Association of American Veterinary Medical Colleges (AAVMC), who says more students are entering veterinary school with an interest in shortage areas like rural or production medicine.

But there are problems on the other end that aren't being acknowledged, Pion counters. Students in Kansas told him recently that they had to return money they received through a loan repayment program because they couldn't find jobs in the "underserved" area they were needed to work in.

"We have to really look at what's happening overall, and we have to be really honest about what we're seeing and what are the drivers," Pion says.

(See related story, "There's no shortage of veterinarians in most areas of rural practice, AABP reports.") What the profession really needs is an overall plan that will increase the value of veterinary medicine and make it a viable choice for the next generation, Pion says.

"We're always reacting instead of planning," he says. "To me, it comes down to you have to lead from the top. We don't have to blame anybody but those who choose to be leaders, it behooves them to make the hard choices."

Hard choices are something many new veterinary graduates will have to face, with jobs being harder to find and student debt levels increasing.

"There are not many jobs out there," says Dr. Nan Boss, owner of Best Friends Veterinary Center in Grafton, Wis. "I think there's a lot of discouraged fourth- and fifth-year students."

While veterinary students used to have their first post-grad jobs lined up by early spring, Boss says many are still looking.

"It's very scary because these students have such overwhelming amounts of debt, and now they're not able to find jobs," she says. "It's all very regional. I think a lot of it's the economy, but it's also saturation in some markets."

Boss says there are plenty of students who want to practice in underserved areas like rural medicine, but find themselves so saddled with debt upon graduation, they choose to go into more lucrative fields like companion-animal medicine. But graduating veterinary school and working in a practice are two very different things to graduates, Boss says.

"Veterinary school is all taught by specialists, and most of the cases they see in clinicals are advanced cases. They're not practicing enough routine medicine," Boss says.

"Students are graduating feeling unprepared for general practice," Boss comments. So they take low-paying internships where they are "working like dogs and they're not learning anything."

Wilson says internships cost new DVMs between $50,000 and $60,000 for this added year of education, taking into account lost wages, interest accumulated on their mean $134,000 of student debt during the year and additional money some need to borrow to survive that year.

Most internships pay about $28,500 per year compared to the $68,000 mean starting salary for a new graduate associate veterinarian in 2010. There are about 1,000 internship openings each year compared with about 250 residencies, Wilson adds.

"That means that many of these people will not find residencies. In fact, it is not uncommon to find them doing two internships these days and still not getting into a residency," he explains.

While students who do internships in order to pursue a specialty may benefit despite the dollar loss, Pion says it's a shame some are interning in order to boost their confidence before practicing veterinary medicine professionally.

"There's not enough training in the bread and butter," Boss explains. Likewise, veteran practitioners aren't doing a good enough job of helping pet owners understand the value of veterinary medicine, she says. If practitioners did a better job of making the most out of every client—charging more appropriate fees and keeping up on maintenance care—they would bring in more revenue and therefore have more resources to hire associates.

Still, a shortage of job postings in some sectors of the profession does not mean veterinarians are saturating the market, cautions Pappaioanou.

"There's a lot of opinions out there right now," she says, adding veterinary job seekers can find a lot of opportunities outside standard practice in fields like research and public health, but they have to be creative. Not all positions will advertise for a veterinarian, but it is a job where a DVM would excel.

But practice owners who don't have the means to expand their own practices see things differently, she says.

"Some companion-animal folks are not looking at the bigger picture," she says. "We hear anecdotes of small-animal practitioners who are dissuading young people from pursuing veterinary medicine as a career. This is the antithesis of what we want."

But Wilson says that increasing enrollment among veterinary colleges to generate money to cover decreasing funding for financially taxed schools and to answer the profession's call for more veterinarians will only make matters worse. Off-shore and European veterinary colleges have been adding hundreds of more slots at their programs, and these are not counted in the American Veterinary Medical Association's or AAVMC's survey data. He estimates that enrollment increases in the past four years at U.S.-accredited veterinary colleges will produce almost 300 more students per year once all the students in the bigger classes matriculate.