Featured Article
Wanted: Country Vets
by Nicole Kitchener | 2009 Canadian Horse AnnualIf the trend towards urban and small animal practices continues, who will look after our rural horses?
Rural and large-animal veterinarians are disappearing. They aren’t simply going “poof” or being abducted by aliens while on country rounds; but their numbers are decreasing and, from the looks of it, won’t be on the rise any time soon.
In fact, the problem is not exclusive to rural vets; the veterinary profession overall can’t keep up with demand and figures indicate the situation will only worsen – but it is more acutely felt in rural areas.
The American Veterinary Medical Association (AVMA) estimates that although more veterinarians will enter the profession from the 28 vet schools in the US and five in Canada than ever before, shortfalls are still expected because the number of positions that will have to be filled will increase significantly. In recent years, however, it has become clear how important vets are on many societal fronts. Far from just being the friendly James Herriot-type who tends with care to ailing animals, vets play a major role in providing critical surveillance, monitoring, reporting and research in areas of rising concern such as globalization of travel, food supply and other trade, environmental issues, manmade and natural disasters and emerging diseases, each of which has the potential to effect devastating social and economic consequences. In many cases, rural vets are on the frontline when it comes to these issues (consider outbreaks of animal-borne illnesses such as Mad-Cow Disease and Avian Influenza, for instance).
Foot and mouth disease outbreaks, response to animal care during natural catastrophes such Hurricane Katrina, even the spread of West Nile Virus, indicate that horses can be front and centre of significant crises, health or otherwise.
The horse industry in Canada is more robust than ever before and shows no signs of slowing. Clearly, therefore, it is not immune to the veterinary human resource shortfall. With all that is going right for the industry right now, how will it cope with fewer vets?
First, we need to find out what why there are fewer rural vets than ever before and how come the trend looks like it will continue.
Large vs. Small Animals
The majority of vet school graduates, even those originally intending to work in large-animal medicine, decide to enter small animal practice for a variety of interwoven reasons that are mainly lifestyle driven. The life of a small-animal vet, while challenging and intensive, generally offers greater benefits, fewer hours, a better environment, is less physically demanding and poses less risk. Meanwhile, rural vets are generally on call 24-7, they face physical hardships, work in all weather conditions, deal with large, often dangerous animals and many work alone in expansive regions.
Dr. Alastair Cribb, Dean of the Faculty of Veterinary Medicine at the University of Calgary, says the expectation of how many hours a vet wants to work has changed since he graduated from vet school in the early 1980s. Having to work weekends and nights, “was just part of being in the societal fabric of a small town,” he says. Currently, with so many opportunities in large centres, it is possible to practice and not have to do any emergency calls.
Wages are better for urban vets, which is a major draw for recent graduates who face monster student loans (often well over $100,000.) The Canadian Veterinary Medical Association does not track starting wage figures for equine practitioners, but 2008 AVMA numbers showed that its members entering equine practice typically earn less than small animal veterinarians in the early years – $42,000 versus a baseline starting salary of more than $65,000 for graduates entering a exclusively small animal practice. (Although within five years, income for equine vets surpasses that of small animal vets by more than $10,000 a year.)
Nowadays, a more urban-based student population enters veterinary programs. Unfamiliar with large animals and the realities of rural living, graduates from cities tend to opt for work in cities. And, as cities continue to gobble up countryside and urban-centre populations boom, young vets simply don’t envision a future for rural practice. Statistics Canada census data shows that, between 2001 and 2006, Canada’s population grew by more than 1.6 million people and that nearly
90 per cent of the population growth was concentrated in 33 “Census Metropolitan Areas.” More people in these areas means more companion animals, which, in turn, leads to more opportunities for vets seeking jobs in urban and suburban centres.
In 2007, for the first time ever, more women than men practiced veterinary medicine according to the AVMA. This is significant because, typically women enter the mixed- or small-animal professions. It is easier for females to obtain part-time employment, work flexible hours and receive support of other vets in sharing of workloads in urban practice, allowing them to juggle other responsibilities such as family.
As well, the physical nature of working with large animals might not suit some women.
Expanding and Changing the Role of Rural Vets
Although a variety of demographic shifts are at the root of the declining number of rural vets, many experts say it is a situation that has been brewing for decades but both the profession and its educational institutions have been slow to respond.
Some suggestions to improve the outlook include:
• having rural practices also deliver public services that are currently overseen by government or its agencies;
• developing team practice approaches by hiring animal health technologists and administrative professionals to undertake business-management duties;
• creating multi-person practices and species-specific practices with more than one veterinarian;
• organizing networks of veterinarians for peer mentoring and support on health and business matters
• establishing cooperative approaches in which vets can centralize certain practice elements – i.e. a clinic with a surgery could become the main location for examination and treatment for all vets in a particular rural region.
Alterations to Education
In 2002, the CVMA established a task force on “education, licensing, and the expanding scope of veterinary practice” in response to concerns that development of the veterinary profession had become limited. It suggested that the profession itself and its educational facilities don’t properly prepare students for the diverse range of career offerings available. One of the ideas offered was a movement away from creating “jackof-all-trade” veterinarians, in favour of specialists.
In the equine model, for example, those who want to become specialists enter into post-graduate internships or residencies to further their training. Specialization in all aspects of veterinary medicine in Canada is recognized by the AVMA’s board system of 20 disciplines or species-specific specialty boards/colleges. Becoming board certified usually requires three to ten years of clinical experience, mentoring and examination. Of the AVMA-recognized American Board of Veterinary Practitioners’ 88 equine Diplomates, two practice in Canada. Other specialties equine-interested vets can pursue include: theriogenology, internal medicine, surgery and radiology.
New means of producing specialists can be achieved in a number of ways, many of which require major shifts in education and licensing. Outreach and awareness programs are key. Sessions such as “Opportunities in Equine Practice,” an annual seminar organized by private practitioners, industry sponsors and the American Association of Equine Practitioners, allows North
American veterinary students to discover what the career entails directly from industry professionals.
It has also been suggested that the profession take the lead in recruiting prospective students from all walks of society through public relations campaigns. In addition, early targeting and mentoring of high school students who show the aptitude and willingness to enter the field is advocated, as is creating outreach programs between equine youth groups such as Pony Club and 4-H and vet colleges, agriculture departments and equine vets.
Large-animal veterinarians identify a lack of hands-on experience as a major shortcoming in the education process.
“The way we teach and deliver the veterinary programs has evolved over time,” says Cribb, explaining that sometimes when graduates enter a rural environment, “they are in a smaller practice with fewer numbers of people and they have to do a lot of different things.”
For many students who have had less hands-on experience than they perhaps might have had years ago, “it’s quite a transition to all of a sudden be doing everything,” says Cribb.
Hands-on learning can be accomplished through the vet faculties themselves or internship programs. For instance, Alberta Agriculture and Rural Development offers a work experience program for veterinary students who seek summer employment. Preference is given to employers whose practice is at least 50 percent livestock work (including equine) and a mentorship program, funded by Saskatchewan Agriculture and Food and the Saskatchewan Veterinary Medical Association, is available to vet students who have completed their first or second year of studies and who want exposure to rural mixed- or food-animal practices.
Vet schools can also evaluate program applicants for interest in rural or specialty practice and offer them acceptance preference, perhaps even supporting them with scholarship and paid internships.
In terms of licensing, there a couple of suggestions. One is the creation of post-graduate internships that would follow a generalized undergraduate education and become part of a graduated program toward specialization in a particular type of practice. Another is having vet colleges choose an area of professional focus (i.e. equine) to aid in developing more focused education geared toward licensing and recognizing competency in that particular concentration.
Impact on the Horse Industry
The equine veterinary practice’s landscape is somewhat different than other areas of animal medicine. It can cross several practice areas and, as Cribb explains, the type of horses and clientele “vary widely across the country.”
By definition, the Canadian Veterinary Medical Association (CVMA) categorizes equine vets as large-animal practitioners. Equine vets work in a wide range of professions, such as:
• specialized practice focusing only on horses;
• large-animal practice in which vets solely treat large animals;
• mixed practice in which large and small animals are treated;
• government – research, regulation, public and animal health;
• private corporations – pharmaceutical, agribusiness, nutrition companies;
• universities and colleges – involved in teaching and research.
“When I graduated it was difficult to find an equine-only position,” explains Dr. Norm Wirth, a 1991 graduate who is an associate with Calgary’s Equine Services Ltd. “Now, the situation is completely different. I know that a lot of equine veterinary practices are looking for help at this point in time,” he says, mentioning that the four-veterinarian Equine Services itself is currently seeking an associate.
Wirth calls the problem “widespread” and adds, “More horse owners are expecting a level of professional expertise that only a specialty practice provides.”
Cribb says, “We could certainly use more highly-trained equine veterinarians – those who are able to provide the more advanced veterinary care that the equine industry, as opposed to the individual horse owner, require.”
Equine practices that most often serve high-end equine clientele are based out of urban centres because that is where the greatest concentration of horses and expertise is found. “There is no doubt that veterinary care required for horses in Calgary jumping at Spruce Meadows is different than what is required for pleasure horses,” Cribb says.
And, although large farms are disappearing, the number of “lifestyle” or “hobby” farms, in which half or more of the farm’s income is derived off property, is on the rise, coinciding with an increase in horses and horse owners.
Statistics Canada reports that more than half of the farms in the country are considered “small,” meaning they earn less than $50,000 a year. Yet hobby farm owners could be considered well off, with an average income of $96,000 per year.
In many cases, these smaller operations are home to horses and are also located in suburban, “semi-rural” areas surrounding major urban centres such as Ontario’s Greater Toronto Area or the outskirts of Calgary. Typically, these horse owners expect optimum results and advice from their vets and are willing to pay for services.
“The more rural you get, you find the density of horses can’t support an equine-only practice,” says Wirth.
However, the importance of rural vets who work with horses mainly in large-animal or mixed practices shouldn’t be underestimated when it comes to the overall health of the horse population. “It’s no good just having veterinary service for large concentrations of horses when you’re talking about diseases that can spread,” says Cribb. “You need to have veterinarians in all these locales.”
Canadian Veterinary Statistics
According to the Canadian Veterinary Medical Association’s (CVMA) 2008 member database, based primarily on information from its provincial organizations, there are 10,138 veterinarians in the country with the following statistical breakdowns:
• Gender breakdown: male: 5,456; female 4,680
• Field of practice: Large animal (horses, cattle, pigs, etc) = 980; Companion animal = 4,698; Mixed animal = 2,319; Other (research, teaching, government, industry, retired) = 2,141
• Number of practices: 2,717 (large animal: 311; companion animal: 1,585; mixed animal: 821)
The association’s national database does not currently track equine-specific statistics on its members.
Calgary’s New Vet School
Canada’s fifth veterinary school, the Faculty of Veterinary Medicine at the University of Calgary (UCVM), now operating in its inaugural year with 34 students, is mandated to produce veterinarians that will serve in rural Alberta and the province’s agri-food industries. “Rural practice permeates everything we do,” says the faculty’s Dean, Alastair Cribb.
The school offers several elective opportunities including equine emphasis focusing on population and individual health and medicine; preparing veterinarians to meet the needs of the horse industry.
Cribb says it has been a priority to ensure the Alberta equine industry is well served by the school. “There is a clear need for that,” he says.
All students take a core elective program, which offers a general veterinary education. “It really focuses on making sure the students are highly competent to do the things they need to do when they graduate,” says Cribb. “We do a lot of practical, hands-on stuff right from the very beginning of the program and the students get a lot of exposure not only to the veterinary community but also the animal-owning communities. Many forget that veterinary medicine is also about the people.”
The faculty does not host a teaching school. Instead, private veterinary practices throughout the province will be organized into a Distributed Veterinary Learning Community of institutional and private partners.
The fourth year of the program entails working with veterinarians in the field. “That’s important because it shows students the things they really need to be able to do. They get a high case load and it exposes them to the environments in which they will work,” says Cribb.
Students will do rotations with every domestic animal species and then pick an area of emphasis. If they choose equine, for example, they will have to carry mandatory rotations and experiences related to the field. Electives will allow them to further focus on their specialty so that when they graduate, “they will be much more skilled than the average graduate in equine medicine,” says Cribb.
Also the faculty has established links with the University of Alberta Faculty of Agricultural, Life and Environmental Sciences, Olds College, the Western College of Veterinary Medicine (WCVM), among other educational institutions and faculties, to provide further opportunities for students and graduates.
