August-aout 1977

No. 8

PROBE '77 SONDAGE "Sondage '77" fait partie d'un programme parraine par le chapitre de Guelph de l'Association canadienne des I:tudiants veterinaires. Cette annee, le comite d'organisation se composait de: B. Mills, J. Seguire et R. G. Thomson. On pria les conf6renciers de remettre les textes de leurs communications et R. G. Thomson les a remanies en tenant compte des exigences de la Revue veterinaire canadienne. LE REDACTEUR

Probe '77 is part of a yearly program sponsored by the Guelph Chapter of the Canadian Veterinary Students Association. The organizing committee for this year was composed of B. Mills, J. Seguire and R. G. Thomson. Written submissions were requested from the speakers and these were prepared in the format of the Journal by R. G. Thomson. THE EDITOR

SPECIALTY IN VETERINARY MEDICINE R. B. Altman* 1. American College of Veterinary


who limits his professional endeavor to a specific discipline and develops an expertise in this area. The three classifications of veterinary specialists are board certified, board eligible and individuals who have developed a specific competence in a field not acknowledged as an "organized" specialty. Board certified individuals must undergo formalized training including an internship and residency (or equivalent qualifying experience in the field), have fulfilled the other criteria required for their specific board and passed the examination which qualified them as diplomats of that speciality. A diplomat is the only individual permitted by the American Veterinary Medical Association to advertise his expertise as a specialist. The American College of Veterinary Pathologists were the first official group to receive board status in 1948. The currently recognized speciality groups are:

Pathologists 2. American Board of Veterinary Public Health 3. American College of Laboratory Animal Medicine 4. American College of Veterinary Radiology 5. American College of Veterinary Microbiologists 6. American College of Veterinary Surgeons 7. American Board of Veterinary Toxicologists 8. American College of Veterinary Ophthalmologists 9. American College of Theriogenologists 10. American College of Veterinary Preventive Medicine 11. American College of Veterinary Internal Medicine -

Cardiologists b. American College of Veterinary Dermatologists c. American College of Veterinary Neurologists

'Practitioner, Franklin Square, New York 11010. Adjunct Assistant Professor, University of Pennsylvania, School of Veterinary Medicine. 101 CAN. VET. JOUR., vol. 18, no. 8, August, 1977

affiliates -

a. American College of Veterinary


Those desiring certification in cardiology, dermatology, or neurology must first qualify for internal medicine before further pursuing their own specific area. Board eligible specialists are those who meet all the criteria for board certification but have not taken or passed the qualifying examination. A specialist in any other discipline is one who has, through his own interest, gained recognition for his expertise and earned the recognition of his colleagues. Some of the specialists included in this category are those such as zoo animal and exotic animal medicine, urology and endocrinology. These individuals and board eligible specialists cannot present themselves to the public or the profession as specialists but can get referrals from their colleagues. Because of the enormous volume of scientific information that is being disseminated and because of the growing public expectations for quality veterinary service, the need for speciality veterinary practice has never been more evident. However, the position of the specialist today is still very limited in scope. Let us examine the areas in which specialists are practicing today. The vast majority of the clinical specialists are in institutions such as the universities and the few chartered, nonprofit animal centers such as the Animal Medical Center, Angel Memorial Hospital and others scattered throughout the United States. Most of the nonclinical specialists are employed by the teaching colleges, the federal government and state and municipal governments. A minority of veterinary specialists are in private speciality practice. Some are practicing general medicine in conjunction with their specialty and some limit their practice to their specific field of expertise. Those involved in general medicine are practicing in private hospitals. The few in a exclusively specialty field, practice out of one or more general hospitals or are involved in a specialty hospital in which no general medicine is practiced but functions strictly on a referral basis. Today there are many more graduates interested in formal internships and residencies than there are institutions making these positions available. In fact, because of the tight economic bind in which most of these institutions find themselves, these programs are being reduced or even dropped. In 1976 the Animal Medical Center had 16 interns and in 1977 the program will be reduced to 11 positions. Many of the schools are also in jeopardy of reducing their teaching programs. Competition for these openings is very keen and

class standing has become a very important factor. One of the inconsistencies in veterinary specialty as compared to human specialty practice is the economic remuneration after successfully completing a speciality program. The investment in time and money is considerable and the income differential while engaged in the program amounts to many thousands of dollars. In human medicine this income differential is compensated by the increased income derived after entering the speciality field. In veterinary specialty medicine, the majority of the practitioners are employed by the universities and institutions which do not offer the economic remuneration that private practice affords. However, successful private specialty practice is extremely difficult to pursue when not tied into a general practice. The reason for this of course is primarily economic. Veterinary medicine today is expensive and the majority of people cannot afford the additional cost of specialty medicine since the fees incurred are "out of pocket money" and not supported, even in part, by insurance. Another problem which is changing in concept but is still a limiting factor is that an exclusive specialty is dependent upon referral. Many general practitioners are reticent to refer cases because of loss of personal income, fear of loss of the client and inability to determine when a case should be referred. This is particularly true when the specialist is involved with a general practice. Another drawback of private specialty practice, as compared to institutional practice, is the loss of liaison with the academic, comparative and research aspects of medicine. In summary, the situation today appears to be one of increased interest in specialty medicine with more qualified people than there are available positions. This fact, however, is basically good for veterinary medicine in general because many of the qualified specialty people today are finding their way to general private practice, thus upgrading the quality of veterinary medicine. A graduate of veterinary school today who wishes to pursue a specialty discipline must be truly dedicated since he must spend several years in this pursuit and then be able to qualify. If successful, he must then pursue this endeavor in a field in which there are limited opportunities. What does specialty practice have to look forward to in the future? It is unlikely that the economic situation will change appreciably in the next decade. One factor of importance would be the introduction of a good medical202


surgical insurance program, but to date all attempts have ended in failure. I feel that veterinary medicine will follow a trend in the future toward central hospital facilities in which specialists can exclusively engage in their own private specialty practice. This type of practice offers interaction with other specialty disciplines as well as the opportunity for limited teaching programs. These institutions are beginning to make inroads throughout the country today and though their suc-

'77 cess cannot yet be clearly determined, the trend seems to be in this direction. Some of these facilities have failed and some have changed in concept from their original plan, but more attempts at this type of function are being made. Though economics are still a major factor in their success, I personally feel that this will be the trend for the future and that this concept is in the best interests of veterinary medicine and good veterinary service.




changes have taken place within the animal industry. The number of individual farm units keeping livestock and poultry have dropped rather significantly; the average size of those remaining and the productivity level per animal, have increased. For example, in Ontario today, we note a reduction of 16,190 dairy farmers, 18,000 pork producers and 3,500 poultry producers in the last decade. In spite of this, the total production of most of our animal products has remained fairly constant and, in fact, in some cases increased. These trends will not hold true across all regions of Canada but the general picture for the country as a whole falls into this type of pattern. Will they continue at the same slope for several years and then level off? Will the rates of decrease in number of animal units and the increase in size and productivity begin to slow and possibly reach a fairly constant level? One cannot be absolutely certain of what will definitely happen but we believe the likely occurrence is reasonably clear. We anticipate a continuation of the decline in the number of farm units with livestock and poultry, but in certain cases this decline will be rather modest. The average size of operation will continue to grow but not into extremely large operations. For example, we would expect to see more "100 cow dairy herds" but we fail to see much growth in the

*Executive Director, Education, Research and Special Services, Ontario Ministry of Agriculture and Food. 203

number with 200 plus milking head. The productivity level per animal unit will continue to increase, although in certain areas, like egg production with an average of 250 eggs per layer per year, one wonders if, in fact, we are reaching a physiological limit. In summary, there will be fewer, but larger animal units to service with each producing at a higher level of productivity than today. The top managed herds and flocks will be finely tuned with persons in charge having considerable advanced education in agricultural production. In recent years there has been a very significant increase in the number of students returning to primary agriculture from, (a) colleges of agricultural technology with diplomas in agriculture and (b) from universities with degrees in agricultural science. What now of the future? Considering the type of animal agriculture you will have to deal with, we are convinced that the role of the veterinarian will become of greater importance although we foresee a possible shift in function over time. Diagnosis and treatment have been major components of veterinary medicine since the beginning of the profession and will continue to be important but an increasing emphasis will be placed on preventive medicine. Considering the type of animal managers who will be in charge of operations and the size of many of these, it becomes imperative that more effort goes into preventing disease and other problems from occurring rather than to go merrily along day by day with fingers crossed hoping that nothing will happen until

Specialty in veterinary medicine.

THE CANADIAN VETERINARY JOURNAL LA REVUE VETERINAIRE CANADIENNE Volume 18 August-aout 1977 No. 8 PROBE '77 SONDAGE "Sondage '77" fait partie d'un p...
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