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Feature
Feature
Veterinary Record 125 years
education
Taking a history on veterinary education In this article, another in the series marking 125 years of Veterinary Record, Andrew Gardiner and Susan Rhind consider some common themes in the history of veterinary education. They look at how veterinary teaching and education have evolved over time and discuss what may happen in years to come. In 1887, the National Veterinary Association decided that ‘the time has arrived for the profession to be represented by a weekly scientific journal’. The Veterinary Record was the result, its aim being to unite the different arms of the profession under the banner of progress and education, ‘by holding the balance fair, supporting no clique and fostering no individual pretensions’. With reference to medicine, the first editorial also told its readers, ‘we have too long accustomed ourselves to a respectful following of our sister profession’ (Hunting 1888). In 1888, the year of the Veterinary Record’s first issue, British veterinary colleges were already reasonably well established. Organised and continuous veterinary education in Britain, as elsewhere in Europe, had been a product of the Enlightenment and represented a coming together of comparative anatomy/medicine and agriculture, set alongside the 18th century ideals of rationalism and improvement. The reference to ‘clique’ and ‘individual pretensions’ in the journal’s first editorial, however, indicated the lively nature of British veterinary politics in the 19th century (Fisher 1993). This period featured privately owned veterinary colleges presided over by independently minded individuals, not all of whom agreed with each other! On the continent, by contrast, veterinary education was often founded, funded and primarily organised by the state. Table 1 shows the historical background
Andrew Gardiner, BVM&S, Cert SAS, MSc, PhD, MRCVS, Susan Rhind, BVMS, PhD, FRCPath, FHEA, MRCVS, Veterinary Medical Education Division, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG, UK e-mail: [email protected]
Veterinary Record is 125 years old this year. To celebrate, we are publishing an article each month focusing on a key topic. Each article aims to look at what the challenges have been, how the topic has developed and what the future might hold. Articles published so far are listed in the box on p 393. The pictures on the right compare the first issue of Veterinary Record, published on July 14, 1888, with how it looks today
and institutional development of the British veterinary colleges existing in 1888. This general situation remained until the addition of two new veterinary schools in 1949, at the universities of Bristol and Cambridge, when major changes in veterinary education followed the government’s Loveday Reports of 1938 and 1944, and a new Veterinary Surgeons Act in 1948, which replaced the first Act of 1881. Any long view of British veterinary education in the years since Veterinary Record began suggests several overarching themes. We have used these to bring together what can only be a very brief synopsis on such a large, diverse and often hotly debated topic.
Beginnings
In one sense, British veterinary education is repeating history. We are currently in a phase of new veterinary schools opening without restriction, with all the debate that this prompts as to what is best for the students, the profession, the animals and the public. In the 19th century, veterinary schools could open (and close) with impunity. In 1888, three of the UK’s four veterinary colleges were located in Scotland (see Table 1). In addition to the college opened by William Dick in 1823, Edinburgh had two New Veterinary Colleges. One was started by John Gamgee in 1857, which
January 12, 2013 | Vol 172 No 2
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transferred to Bayswater, London, in 1865, where it became known as the Albert Veterinary College, before closing in 1868 for financial reasons. The second Edinburgh ‘New Veterinary College’ was opened by William Williams in 1873 and moved to Liverpool in 1904, where it became the first department (later faculty) of veterinary medicine within a university. There was also a Polish veterinary college in Edinburgh during the Second World War. Glasgow Veterinary College opened after founder James McCall disagreed with his employer William Dick on one of the most contentious medical issues of the day – the cause of cattle plague (rinderpest), which regularly wreaked havoc on European economies. McCall felt so strongly that he moved to Glasgow and set up his own college. As the nation’s capital, and a city full of horses, London was perhaps an obvious location for Britain’s first veterinary college, but why was Edinburgh so prominent? One explanation may be the city’s key role in the 18th century as a focus of comparative anatomy, a subject that created the same excitement that genomics (also strongly associated with Edinburgh) elicits today. Historically, Scotland and France had been politically close, and comparative anatomy was a French ‘invention’, promoted by
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Feature Table 1: Background and institutional development of the British veterinary colleges existing in 1888*, the year of the first issue of Veterinary Record London
Edinburgh
Glasgow
Edinburgh/Liverpool
Founded
1791
1823
1862
1873/1904 †
Founder/Principal
Saint Bel
Dick
McCall
Williams
Until 1866
Until 1909
Until 1904
1911
1927
1904
Privately owned
N/A
University degree
1906
Incorporated into university
1949
1951
1949
1904
Faculty status
N/A ‡
1964
1968
1952
‡
* Bristol and Cambridge university veterinary schools were opened in 1949 and marked the post-Loveday phase of British veterinary education (see main text) The Department of Veterinary Science at Liverpool university began as New Veterinary College, Edinburgh, in 1873, and moved to Liverpool in 1904 ‡ The Royal Veterinary College (RVC) was never owned by a single individual. It originated with subscribers and a board of governors. After university incorporation, the RVC retained its own Royal Charter and federal structure within the University of London (which still persists today) †
the palaeontologist Georges Cuvier. The first veterinary college opened at Lyons in 1762, and early discussions about teaching in Edinburgh, even before William Dick opened his college, enthusiastically referred to Cuvier and to a future of comparative medicine (Gardiner 2007).
‘The veterinary student is more likely to be successful if he comes from the farm or is the son of a practising veterinary surgeon than if he is town bred. [. . .] We could not justify expenditure of public money on the training of women for work among dogs and cats; the number of women admitted by the schools should be small’ — Loveday Report (1938) By the 19th century, there was no control of the number of veterinary colleges opening nor of the students enrolling. This free market in veterinary education reflected the general laissez faire attitude in British politics of the time, which tended to limit state involvement in public life. Initially unregulated, a major development in British veterinary education was that the profession obtained a Royal Charter in 1844, and subsequently developed a ‘single portal’ system of licence to practise (Pattison 1984, 1991, Hall 1994). The single portal was the qualifying diploma exam administered by the RCVS, which was designed to set a comparable standard across all veterinary colleges. This meant that the colleges taught the courses, but that the RCVS examined for membership and applied a consistent standard (rather than individual colleges issuing their own, internally examined diplomas). The single portal harmonised veterinary education and provided a welcome, steadying force for the 19th century profession. The system was admired by the General Medical Council, which tried to impose a similar format on medical education, but this was repeatedly thwarted by the Royal Colleges of Physicians and Surgeons – an instance of veterinary medicine innovating in advance
of the much larger ‘sister profession’. There will still be some older veterinarians who qualified under the MRCVS diploma system. Their post nomials are ‘MRCVS’, without any university degree abbreviations (such as BVSc, BVMS, BVM&S, BVetMed, etc). Until the second Veterinary Surgeons Act of 1948, a veterinary degree was an optional extra; the MRCVS diploma was mandatory. When veterinary colleges entered universities, and degrees themselves conferred the right to practise, there were great fears that multiple portals of entry to the practising profession would lead to a slip in standards. However, others argued that standards would be improved when universities took over examination – there had been criticisms that the rather small pool of RCVS examiners were out of touch with new developments in knowledge and teaching. As always in British veterinary life, it was a spirited debate (Adami 1920, Whitehouse 1944, Kraft 2004a, b).
Post-1948
The two Loveday Reports (Ministry of Agriculture and Fisheries and Department of Agriculture for Scotland 1938, 1944), and the second Veterinary Surgeons Act of 1948, which the Loveday Reports informed, defined veterinary education for most of the 20th century. The post-war report basically accepted much of the 1938 version, but added urgency to the need for educational reform following wartime concerns about national food security. The Atlantic blockade had highlighted the fact that the UK was not self-sufficient in food production, and that much livestock agriculture was inefficient and hampered by chronic disease problems and low productivity – problems to be tackled by a modernised profession. Each of the traditional colleges subsequently conformed to the Loveday model of what a modern universitybased veterinary education should look like. One key feature was an emphasis on preclinical science underpinning the clinical studies. This had become a notable feature of medical curricula, following the
highly influential Flexner Report (Flexner 1910). In many ways, Loveday was the British veterinary profession’s equivalent to Flexner. Other recommendations were the inclusion of field stations and working farms within each veterinary school, as well as extensive on-site clinical facilities. There was investment in staff and infrastructure, but also a government-derived quota placed on veterinary student intake, based on forecasted employment needs. Loveday makes interesting reading even today, and many of the educational concerns and themes are recurring ones, albeit in a different context. ‘History doesn’t repeat itself, but it does rhyme’ – this quote, often attributed to Mark Twain, seems very true of veterinary education. Transformative though it was, the Loveday Report was proved dramatically wrong in two key areas: the intended role and purpose of the post-war profession, and its gender balance. Confidently forecasting a future for the veterinarian as the ‘physician of the farm’ and suggesting that work would mainly take place in the territory where animal and public health overlapped (Hardy 2003), the report did not predict the explosion that was to take place in companion animal practice from the 1950s and 60s, which by the turn of the century would make this sector the dominant area of veterinary practice. The report was also deeply prejudiced against women and its attempts to socially engineer the gender balance of the profession would be seen as highly inappropriate today. ‘The veterinary student is more likely to be successful if he comes from the farm or is the son of a practising veterinary surgeon than if he is town bred. [. . .] We could not justify expenditure of public money on the training of women for work among dogs and cats; the number of women admitted by the schools should be small’ (Loveday Report 1938).
New schools and models
The opening of Nottingham veterinary school in 2006, the first for more than 50 years, heralded a new approach to clinical teaching by using a ‘distributed’ model where clinical rotations take place October 26, 2013 | Veterinary Record | 389
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her wording seems to emphasise ‘masculine’ personality traits. These debates about skills and competences, whether pre-existing in the student because of their gender or social background, or acquired during their education, surfaced and resurfaced throughout the 20th century. The Loveday idea of having functioning clinics within veterinary schools, the equivalent of the human teaching hospital, was just one attempt to address the problem, but it is really only within the past 10 years or so that we have seen the structured introduction and embedding of clinical, professional and communication skills teaching and assessment throughout the curriculum. The RCVS Day 1 Competences (RCVS 2013), first published over 10 years ago (and FIG 1: Model patient: in this clinical skills lab, the students learn how currently under review), greatly to carry out jugular blood-sampling on a dog manikin. This patient assisted curriculum developers always stays perfectly still and students can practice as many times in emphasising the importance as they wish. This increases the chance of success when students of general professional skills/ first have to do it ‘for real’ in clinics – a positive for animal welfare attributes and specific practical and student confidence alike competences, in addition to the underpinning scientific knowledge change in species emphasis, questions and understanding necessary for clinical were increasingly asked about what a practice. The subsequent development veterinary surgeon should be, where they of the Year 1 competences and the Changes in teaching should come from, how they should be Professional Development Phase, which In the early 1930s, there were concerns selected for entry, and how they should became mandatory in 2007, further served that veterinary training was becoming be trained. Could women do the work? to emphasise the importance of lifelong too theoretical. Those in practice often It seemed that a number of women learning. bemoaned the fact that veterinary colleges wished to enter veterinary courses, and While clinical skills facilities are now were turning out new veterinarians to undertake the full range of veterinary part of the teaching infrastructure in most without proper training in animal work, despite calls that, if they did study, veterinary schools, many veterinary handling and practical, clinical skills. they should concentrate on species surgeons in practice will not have One correspondent to The Veterinary Record appropriate to them, such as poultry and experienced a clinical skills lab during blamed student selection procedures, cats. An elliptical ‘compliment’ was paid in their own student days. These facilities considering that the colleges were ‘largely an editorial in the special Ladies’ Number provide safe and animal welfare-friendly filled with . . . unregenerate, pallid and of The Veterinary Record, published in April environments for students to practice key studious sons of suburbia, with a sprinkling 1934: ‘Eminent men research workers find procedures, such as suturing, basic surgery, of virile and competent women’ (Anon particularly that when the need arises to blood sampling and rectal examination, 1934). exploit their original ideas and preliminary using a variety of specific models and The 1930s was an era of great anxiety investigations so that a great deal of simulators (Fig 1). Different learning speeds about the future of the profession, painstaking and tedious collection of and styles are easily accommodated. whose totemic animal, the horse, was further detail has to be undertaken, women A parallel focus on professional and disappearing from the streets. Up to are invaluable collaborators’ (Anon 1934). communications skills reflects a growing this point, everything about veterinary Faced with such blatant discrimination, desire to ensure that students are well education had been equine-centric. it is amazing that women continued prepared for the challenges of dealing with Colleges largely provided ‘courses for to apply, but they did, and they often the general public, and of being part of a horses’, with other species being given graduated with high honours. business. Teaching in all of these skill areas far less attention. The horse – a noble ‘Qualified veterinary surgeon, BVSc, now tends to begin in the early years of and useful animal – in turn suggested a (woman), desires position as Assistant in the curriculum, with a general move away noble and useful veterinary profession. As large mixed practice. Is highly recommended from the Loveday-inspired ‘preclinical’, a result of this virtual horse cult within as “excellent surgeon, obstetrician, observant ‘paraclinical’ and ‘clinical’ phases. Alongside veterinary medicine, some economically and sound diagnostician in horse, cattle these developments, there is also a trend important species, such as poultry, were and small animals” and as “strong, active, away from the lecture as the dominant mode completely off the radar, and before the keen, commands respect with all clients”. of teaching. Instead, more small-group, 1950s, veterinary surgeons who specialised Motorist.’ problem-based and self-directed approaches in small animals seemed to have been This is an advert placed in The Veterinary to learning are used. However, such changes considered morally dubious – in the words Record, December 14, 1935, by a female bring with them significant implications in of one editorial in the Veterinary Journal, they veterinary graduate. It is interesting that she terms of staff development, acceptability were ‘below the salt’ (Anon 1947) . had a degree (optional), that she appears to and cost (Dale and others 2008). In this anxious time, caused by a want to work in mixed practice, and that in associated practices, rather than within teaching hospitals as part of the school’s own on-campus infrastructure. Although this approach had been used previously, notably in some newer North American schools, it represented a significant shift from the traditional Loveday model in the UK, and was viewed with much interest. This model will underpin clinical delivery in the newest veterinary school opening at Surrey university, where the first student cohort is due to arrive in 2014. As in the 19th century, the RCVS still has a key role in maintaining standards, through its system of veterinary school inspections, and any new veterinary programme requires validation by the RCVS before the qualification can act as automatic membership of the RCVS. However, the RCVS itself has no say in the number of veterinary schools opening – it only inspects them once they are up and running. Existing veterinary schools are also inspected regularly – a throwback to the RCVS’s historic role as the examining body in the single portal system.
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Feature
FIG 2: Extract from an OSCE sheet for a typical small animal clinical skill assessment. Supplied by John Mosley, Royal (Dick) School of Veterinary Studies
With changes in curriculum content and structure, assessment practices have also adapted to align with the new skills and attributes being taught. A detailed discussion of assessment methods in veterinary schools is beyond the scope of this article; however, one major change over the past 10 years or so has been the move towards a more thorough and rigorous assessment of skills. Most veterinary schools now include some form of Objective Structured Clinical Examination (OSCE) as part of their standard ‘assessment armoury’ (Fig 2). This import from medical education (Harden and Gleeson 1979) aims to ensure an appropriate level of reliability and fairness using a form of skill assessment that is far more structured than the traditional ‘viva’ that many of us may recall from our own undergraduate days. Such assessment changes reflect broad shifts in educational theory and practice, which are being applied within the veterinary curriculum,
often heavily informed by developments in medical education.
E-learning
When the Royal Dick Veterinary College moved to its newly completed premises at Summerhall in 1925 (the official opening had taken place in 1916), one of the features of the purpose-designed building was a lecture room equipped for the showing of lantern slides. This use of such vivid imagery would no doubt have made a great impact on the teaching of visual subjects, such as anatomy and pathology – perhaps it even stopped some students falling asleep in the darkened room! An equivalent technological development today is the use of e-learning. Those of us graduating before the 21st century have lived through a huge change in terms of the technology present in our everyday lives – the same change has happened within the walls of our veterinary schools. E-learning is just another teaching
strategy: good teachers tend to be good teachers regardless of the methods they choose to use; however, appropriate use of technology can greatly enhance learning. New learning technologies are perhaps best suited to providing more readily available access to resources – most notably videos, recorded lectures, interactive images, and so on. Two excellent examples of e-learning on a national and international scale in veterinary education are Wikivet and the Online Veterinary Anatomy Museum (OVAM) projects. Wikivet is a worldwide collaborative venture that ultimately aims to cover the entire undergraduate curriculum. The linked OVAM project is a collection of anatomy resources organised into categories according to the species, system and region covered (Fig 3). Both projects harness the power of the internet to allow collaboration between students and staff across institutions.
Tracking and specialisation – two contentious issues In one important sense, veterinary education has always ‘tracked’ and specialised, by species. Nineteenth and early 20th century veterinary teaching focused on the horse. Following the Second World War, great emphasis was placed on the dairy cow (Woods 2007), before companion animal subjects expanded considerably. Historically, however, the British veterinary profession has tended to resist formal division of its expertise (as in medicine), because flexibility provided for a variety of veterinary careers in a numerically small profession (Gardiner and others 2011). Great growth in veterinary knowledge, together with expansion in the size of the profession, has prompted debate on whether veterinary medicine should become more formally tracked, to allow vets to graduate in more restricted areas of practice, but with higher level
Photograh: OVAM
Photograph: Library, University of Edinburgh
FIG 3: Getting to grips with anatomy, a perennial challenge for any veterinary student. (left) An interactive 3D visualisation created as part of the OVAM project that a current student may pull up for learning and revision. (right) A student’s drawing from the1930s
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FIG 4: Overall number of publications with ‘veterinary education’ as a subject heading since the late 1970s, broken down into five-year blocks (obtained by searching the CAB abstracts database). Although a crude measure, this is consistent with a significant increase in research activity over the past 20 years
competences. There are also real concerns in connection with content overload and the effect this has on general educational experience/development and also on overall student wellbeing on such an intense programme as veterinary medicine (Reisbig and others 2012). Full-blown tracking would be a considerable change and would impact on the veterinary labour market in new ways; however, several schools have already implemented, or are in the process of implementing, partial tracking options to allow students to focus on primary and secondary areas of interest, while still retaining broad-based cross-species training and the RCVS Day 1 competences.
Veterinary education as a ‘new’ academic discipline
Before the 21st century, the main fora for discussing veterinary education were either during species-specific conferences, such as BSAVA and BEVA, or at the Association of Veterinary Teachers and Research Workers (AVTRW) annual conference. Historically, the subject has always aroused great interest and sometimes heated debate within the profession’s journals; however, a problem has been the generally low evidence base applied to matters of veterinary pedagogy.
‘Between animal and human medicine there is no dividing line – nor should there be. The object is different but the experience obtained constitutes the basis of all medicine’ — Rudolf Virchow In 2004, the association Veterinary Education Worldwide (ViEW) was established by a group of veterinary educators who had attended the large medical educational conference held by the Association for Medical Education in Europe.
The aim of ViEW is to promote and support excellence in veterinary education through an annual meeting and by developing a network of veterinary educators internationally. In the UK, the VetEd symposium (established in 2009) rotates annually around the veterinary schools and also attracts a national and international audience. Consistent with this emergence of a vibrant research community, there has been a rapid rise in the number of publications in the field of veterinary education (Fig 4). This rise has coincided with the appearance of departments or groups of individuals whose main research interest is in veterinary education itself, rather than the more traditional biomedical sciences. Looking again to our ‘sister profession’, such units in medical schools are now commonplace (Davis and others 2005).
Prognosis . . .
Going by the quality, enthusiasm and commitment that veterinary students continue to bring to their studies, the future of veterinary education should be exciting. However, like any profession, veterinary medicine is subject to wider structural changes operating within society; these may affect human-animal relations in diverse and hard-to-predict ways and are bound to impact on future veterinary education. Current debate has tended to focus on the issues of oversupply of veterinarians (and the linked issue of the opening of new veterinary schools), student debt and changing models of practice. These are all areas that demand close scrutiny. In particular, student debt has risen considerably within the past 20 to 30 years and is a serious concern affecting wellbeing and prospects for veterinary students. The profession should attract able students from across the socioeconomic
spectrum if it is to fulfil all of its social role and purpose. One of the benefits of history is that one can easily reach for that most useful of diagnostic instruments – the retrospectoscope. No such instrument exists for looking into the future apart, perhaps, from the crystal ball – but the evidence base there is somewhat lacking. However, one phrase we hear a lot of today, ‘one health’ (and its close relations, ‘one medicine’ and ‘one wellbeing’) has a long historical pedigree (Michell 2000). Veterinary medicine is uniquely placed to exploit the huge comparative and mutually beneficial opportunity that Rudolf Virchow (18211902) – physician, scientist, politician and philosopher – first identified: ‘Between animal and human medicine there is no dividing line – nor should there be. The object is different but the experience obtained constitutes the basis of all medicine.’ If the profession can do this, the future for veterinary education should be bright.
Acknowledgements
The authors would like to thank the following colleagues for their help in preparing this article: Clare Boulton, Sue Bradley, Glen Cousquer, Gemma GaitskellPhillips, Julie Hipperson, John Mosley and Claire Phillips.
Speaking personally . . . capturing life in practice Visit the following link to hear retired members talk about their own veterinary education ( http://knowledge.rcvs.org. uk/capturing-life-in-practice/education/). These extracts are taken from fulllength veterinary life stories recorded for the Capturing Life in Practice oral history project, a collaboration between RCVS Knowledge, the Centre for Rural Economy at Newcastle University and the British Library (archive partner). Speakers include Mary Brancker (qualified 1938), Alistair Clarke (1948), Carl Boyd (1953) and Dick Lane (1953).
References
ANON (1934) Women and the veterinary profession. Veterinary Record 14, 362-363 ANON (1947) The clinician is important. Veterinary Journal 103, 155 ADAMI, G. (1920) The position of veterinary science. The Times June 11, 1920. p 17 DALE, V. H. M., SULLIVAN, M. & MAY, S. (2008) Adult learning in veterinary education: theory to practice. Journal of Veterinary Medical Education 35, 581-588 DAVIS, M. H., KARUNATHILAKE, I. & HARDENS, R. M. (2005) AMEE education guide no. 28. The development and role of departments of medical education. Medical Teacher 27, 665-675 FISHER, J. R. (1993) Not quite a profession: the aspirations of veterinary surgeons in the mid-nineteenth century. Historical Research lxvi, 284-302 FLEXNER, A. (1910) Medical education in the
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Feature United States and Canada: a report to the Carnegie Foundation for the Advancement of Teaching. The Carnegie Foundation for the Advancement of Teaching GARDINER, A. (2007) Elephants and exclusivity: an episode from the ‘pre-Dick’ history of veterinary education in Edinburgh. Veterinary History 13, 299-309 GARDINER, A., LOWE, P. & ARMSTRONG, J. (2011) Who or what is a veterinary specialist? Veterinary Record 169, 354-356 HALL, S. A. (1994) Charter 150. The struggle for the charter of the Royal College of Veterinary Surgeons, 1844. Veterinary Record 134, 536-540 HARDEN, R. M. & GLEESON, F. A. (1979) An assessment of clinical competence using an objective, structured clinical examination (OSCE). Medical Education 13, 39-54 HARDY, A. (2003) Professional advantage and public health: British veterinarians and state veterinary services. Twentieth Century British History 14, 1-23 HUNTING, W. (1888) Editorial notes. Our position. Veterinary Record 1, 1 KRAFT, A. (2004a) Breaking with tradition: the reform of British veterinary education 1900-20. History of Education 33, 317-336 KRAFT, A. (2004b) Liverpool veterinary school: the first 100 years. Veterinary Record 155, 620-624 MICHELL, A. (2000) Only one medicine: the future of comparative medicine and clinical research. Research in Veterinary Science 69, 101-106 MINISTRY OF AGRICULTURE AND FISHERIES
AND DEPARTMENT OF AGRICULTURE FOR SCOTLAND (1938, 1944) Report (and Second Report) of the Committee on Veterinary Education in Great Britain (Loveday Committee). HMSO PATTISON, I. (1984) The British Veterinary Profession 1791-1948. J. A. Allen PATTISON, I. (1991) Two hundred British veterinary years. Veterinary Record 128, 470-474 REISBIG, A. M. J., DANIELSON, J. A., WU, T-F., MCARTHUR, H., Jr, KRIENERT, A., GIRARD, D. & GARLOCK, J. (2012) A study of depression and anxiety, general health, and academic performance in three cohorts of veterinary medical students across
the first three semesters of veterinary school. Journal of Veterinary Medical Education 39, 341-358 RCVS (2013) Day and year one competences. www. rcvs.org.uk/document-library/day-and-year-one-competences/. Accessed October 2, 2013 WHITEHOUSE, A. C. (1944) Veterinary education in Great Britain. Nature 153, 227 WOODS, A. (2007) The farm as clinic: veterinary expertise and the transformation of dairy farming, 1930-1950. Studies in History and Philosophy of Biological and Biomedical Sciences 38, 462-487
doi: 10.1136/vr.f6273
Articles published in Veterinary Record’s 125th anniversary series so far have considered: n Cattle lameness (VR, January 26, 2013, vol 172, pp 92-95) n Dermatology in companion animals (VR, February 23, 2013, vol 172, pp 201-207) n Articular disorders in dogs (VR, March 30, 2013, vol 172, pp 332-335) n Equine surgery (VR, April 27, 2013, vol 172, pp 442-446) n Imaging (VR, May 25, 2013, vol 172, pp 546-551) n Cardiology (VR, June 29, 2013, vol 172, 678-682) n Parasitology (VR, July 27, 2013, vol 173, 89-91) n Equine infectious diseases (VR, August 31, 2013, vol 173, 186-189) n Companion animal obesity (VR, September 28, 2013, vol 173, 287-291)
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Taking a history on veterinary education Andrew Gardiner and Susan Rhind Veterinary Record 2013 173: 388-393
doi: 10.1136/vr.f6273 Updated information and services can be found at: http://veterinaryrecord.bmj.com/content/173/16/388
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Feature
Feature
Veterinary Record 125 years
education
Taking a history on veterinary education In this article, another in the series marking 125 years of Veterinary Record, Andrew Gardiner and Susan Rhind consider some common themes in the history of veterinary education. They look at how veterinary teaching and education have evolved over time and discuss what may happen in years to come. In 1887, the National Veterinary Association decided that ‘the time has arrived for the profession to be represented by a weekly scientific journal’. The Veterinary Record was the result, its aim being to unite the different arms of the profession under the banner of progress and education, ‘by holding the balance fair, supporting no clique and fostering no individual pretensions’. With reference to medicine, the first editorial also told its readers, ‘we have too long accustomed ourselves to a respectful following of our sister profession’ (Hunting 1888). In 1888, the year of the Veterinary Record’s first issue, British veterinary colleges were already reasonably well established. Organised and continuous veterinary education in Britain, as elsewhere in Europe, had been a product of the Enlightenment and represented a coming together of comparative anatomy/medicine and agriculture, set alongside the 18th century ideals of rationalism and improvement. The reference to ‘clique’ and ‘individual pretensions’ in the journal’s first editorial, however, indicated the lively nature of British veterinary politics in the 19th century (Fisher 1993). This period featured privately owned veterinary colleges presided over by independently minded individuals, not all of whom agreed with each other! On the continent, by contrast, veterinary education was often founded, funded and primarily organised by the state. Table 1 shows the historical background
Andrew Gardiner, BVM&S, Cert SAS, MSc, PhD, MRCVS, Susan Rhind, BVMS, PhD, FRCPath, FHEA, MRCVS, Veterinary Medical Education Division, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG, UK e-mail: [email protected]
Veterinary Record is 125 years old this year. To celebrate, we are publishing an article each month focusing on a key topic. Each article aims to look at what the challenges have been, how the topic has developed and what the future might hold. Articles published so far are listed in the box on p 393. The pictures on the right compare the first issue of Veterinary Record, published on July 14, 1888, with how it looks today
and institutional development of the British veterinary colleges existing in 1888. This general situation remained until the addition of two new veterinary schools in 1949, at the universities of Bristol and Cambridge, when major changes in veterinary education followed the government’s Loveday Reports of 1938 and 1944, and a new Veterinary Surgeons Act in 1948, which replaced the first Act of 1881. Any long view of British veterinary education in the years since Veterinary Record began suggests several overarching themes. We have used these to bring together what can only be a very brief synopsis on such a large, diverse and often hotly debated topic.
Beginnings
In one sense, British veterinary education is repeating history. We are currently in a phase of new veterinary schools opening without restriction, with all the debate that this prompts as to what is best for the students, the profession, the animals and the public. In the 19th century, veterinary schools could open (and close) with impunity. In 1888, three of the UK’s four veterinary colleges were located in Scotland (see Table 1). In addition to the college opened by William Dick in 1823, Edinburgh had two New Veterinary Colleges. One was started by John Gamgee in 1857, which
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transferred to Bayswater, London, in 1865, where it became known as the Albert Veterinary College, before closing in 1868 for financial reasons. The second Edinburgh ‘New Veterinary College’ was opened by William Williams in 1873 and moved to Liverpool in 1904, where it became the first department (later faculty) of veterinary medicine within a university. There was also a Polish veterinary college in Edinburgh during the Second World War. Glasgow Veterinary College opened after founder James McCall disagreed with his employer William Dick on one of the most contentious medical issues of the day – the cause of cattle plague (rinderpest), which regularly wreaked havoc on European economies. McCall felt so strongly that he moved to Glasgow and set up his own college. As the nation’s capital, and a city full of horses, London was perhaps an obvious location for Britain’s first veterinary college, but why was Edinburgh so prominent? One explanation may be the city’s key role in the 18th century as a focus of comparative anatomy, a subject that created the same excitement that genomics (also strongly associated with Edinburgh) elicits today. Historically, Scotland and France had been politically close, and comparative anatomy was a French ‘invention’, promoted by
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Feature Table 1: Background and institutional development of the British veterinary colleges existing in 1888*, the year of the first issue of Veterinary Record London
Edinburgh
Glasgow
Edinburgh/Liverpool
Founded
1791
1823
1862
1873/1904 †
Founder/Principal
Saint Bel
Dick
McCall
Williams
Until 1866
Until 1909
Until 1904
1911
1927
1904
Privately owned
N/A
University degree
1906
Incorporated into university
1949
1951
1949
1904
Faculty status
N/A ‡
1964
1968
1952
‡
* Bristol and Cambridge university veterinary schools were opened in 1949 and marked the post-Loveday phase of British veterinary education (see main text) The Department of Veterinary Science at Liverpool university began as New Veterinary College, Edinburgh, in 1873, and moved to Liverpool in 1904 ‡ The Royal Veterinary College (RVC) was never owned by a single individual. It originated with subscribers and a board of governors. After university incorporation, the RVC retained its own Royal Charter and federal structure within the University of London (which still persists today) †
the palaeontologist Georges Cuvier. The first veterinary college opened at Lyons in 1762, and early discussions about teaching in Edinburgh, even before William Dick opened his college, enthusiastically referred to Cuvier and to a future of comparative medicine (Gardiner 2007).
‘The veterinary student is more likely to be successful if he comes from the farm or is the son of a practising veterinary surgeon than if he is town bred. [. . .] We could not justify expenditure of public money on the training of women for work among dogs and cats; the number of women admitted by the schools should be small’ — Loveday Report (1938) By the 19th century, there was no control of the number of veterinary colleges opening nor of the students enrolling. This free market in veterinary education reflected the general laissez faire attitude in British politics of the time, which tended to limit state involvement in public life. Initially unregulated, a major development in British veterinary education was that the profession obtained a Royal Charter in 1844, and subsequently developed a ‘single portal’ system of licence to practise (Pattison 1984, 1991, Hall 1994). The single portal was the qualifying diploma exam administered by the RCVS, which was designed to set a comparable standard across all veterinary colleges. This meant that the colleges taught the courses, but that the RCVS examined for membership and applied a consistent standard (rather than individual colleges issuing their own, internally examined diplomas). The single portal harmonised veterinary education and provided a welcome, steadying force for the 19th century profession. The system was admired by the General Medical Council, which tried to impose a similar format on medical education, but this was repeatedly thwarted by the Royal Colleges of Physicians and Surgeons – an instance of veterinary medicine innovating in advance
of the much larger ‘sister profession’. There will still be some older veterinarians who qualified under the MRCVS diploma system. Their post nomials are ‘MRCVS’, without any university degree abbreviations (such as BVSc, BVMS, BVM&S, BVetMed, etc). Until the second Veterinary Surgeons Act of 1948, a veterinary degree was an optional extra; the MRCVS diploma was mandatory. When veterinary colleges entered universities, and degrees themselves conferred the right to practise, there were great fears that multiple portals of entry to the practising profession would lead to a slip in standards. However, others argued that standards would be improved when universities took over examination – there had been criticisms that the rather small pool of RCVS examiners were out of touch with new developments in knowledge and teaching. As always in British veterinary life, it was a spirited debate (Adami 1920, Whitehouse 1944, Kraft 2004a, b).
Post-1948
The two Loveday Reports (Ministry of Agriculture and Fisheries and Department of Agriculture for Scotland 1938, 1944), and the second Veterinary Surgeons Act of 1948, which the Loveday Reports informed, defined veterinary education for most of the 20th century. The post-war report basically accepted much of the 1938 version, but added urgency to the need for educational reform following wartime concerns about national food security. The Atlantic blockade had highlighted the fact that the UK was not self-sufficient in food production, and that much livestock agriculture was inefficient and hampered by chronic disease problems and low productivity – problems to be tackled by a modernised profession. Each of the traditional colleges subsequently conformed to the Loveday model of what a modern universitybased veterinary education should look like. One key feature was an emphasis on preclinical science underpinning the clinical studies. This had become a notable feature of medical curricula, following the
highly influential Flexner Report (Flexner 1910). In many ways, Loveday was the British veterinary profession’s equivalent to Flexner. Other recommendations were the inclusion of field stations and working farms within each veterinary school, as well as extensive on-site clinical facilities. There was investment in staff and infrastructure, but also a government-derived quota placed on veterinary student intake, based on forecasted employment needs. Loveday makes interesting reading even today, and many of the educational concerns and themes are recurring ones, albeit in a different context. ‘History doesn’t repeat itself, but it does rhyme’ – this quote, often attributed to Mark Twain, seems very true of veterinary education. Transformative though it was, the Loveday Report was proved dramatically wrong in two key areas: the intended role and purpose of the post-war profession, and its gender balance. Confidently forecasting a future for the veterinarian as the ‘physician of the farm’ and suggesting that work would mainly take place in the territory where animal and public health overlapped (Hardy 2003), the report did not predict the explosion that was to take place in companion animal practice from the 1950s and 60s, which by the turn of the century would make this sector the dominant area of veterinary practice. The report was also deeply prejudiced against women and its attempts to socially engineer the gender balance of the profession would be seen as highly inappropriate today. ‘The veterinary student is more likely to be successful if he comes from the farm or is the son of a practising veterinary surgeon than if he is town bred. [. . .] We could not justify expenditure of public money on the training of women for work among dogs and cats; the number of women admitted by the schools should be small’ (Loveday Report 1938).
New schools and models
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her wording seems to emphasise ‘masculine’ personality traits. These debates about skills and competences, whether pre-existing in the student because of their gender or social background, or acquired during their education, surfaced and resurfaced throughout the 20th century. The Loveday idea of having functioning clinics within veterinary schools, the equivalent of the human teaching hospital, was just one attempt to address the problem, but it is really only within the past 10 years or so that we have seen the structured introduction and embedding of clinical, professional and communication skills teaching and assessment throughout the curriculum. The RCVS Day 1 Competences (RCVS 2013), first published over 10 years ago (and FIG 1: Model patient: in this clinical skills lab, the students learn how currently under review), greatly to carry out jugular blood-sampling on a dog manikin. This patient assisted curriculum developers always stays perfectly still and students can practice as many times in emphasising the importance as they wish. This increases the chance of success when students of general professional skills/ first have to do it ‘for real’ in clinics – a positive for animal welfare attributes and specific practical and student confidence alike competences, in addition to the underpinning scientific knowledge change in species emphasis, questions and understanding necessary for clinical were increasingly asked about what a practice. The subsequent development veterinary surgeon should be, where they of the Year 1 competences and the Changes in teaching should come from, how they should be Professional Development Phase, which In the early 1930s, there were concerns selected for entry, and how they should became mandatory in 2007, further served that veterinary training was becoming be trained. Could women do the work? to emphasise the importance of lifelong too theoretical. Those in practice often It seemed that a number of women learning. bemoaned the fact that veterinary colleges wished to enter veterinary courses, and While clinical skills facilities are now were turning out new veterinarians to undertake the full range of veterinary part of the teaching infrastructure in most without proper training in animal work, despite calls that, if they did study, veterinary schools, many veterinary handling and practical, clinical skills. they should concentrate on species surgeons in practice will not have One correspondent to The Veterinary Record appropriate to them, such as poultry and experienced a clinical skills lab during blamed student selection procedures, cats. An elliptical ‘compliment’ was paid in their own student days. These facilities considering that the colleges were ‘largely an editorial in the special Ladies’ Number provide safe and animal welfare-friendly filled with . . . unregenerate, pallid and of The Veterinary Record, published in April environments for students to practice key studious sons of suburbia, with a sprinkling 1934: ‘Eminent men research workers find procedures, such as suturing, basic surgery, of virile and competent women’ (Anon particularly that when the need arises to blood sampling and rectal examination, 1934). exploit their original ideas and preliminary using a variety of specific models and The 1930s was an era of great anxiety investigations so that a great deal of simulators (Fig 1). Different learning speeds about the future of the profession, painstaking and tedious collection of and styles are easily accommodated. whose totemic animal, the horse, was further detail has to be undertaken, women A parallel focus on professional and disappearing from the streets. Up to are invaluable collaborators’ (Anon 1934). communications skills reflects a growing this point, everything about veterinary Faced with such blatant discrimination, desire to ensure that students are well education had been equine-centric. it is amazing that women continued prepared for the challenges of dealing with Colleges largely provided ‘courses for to apply, but they did, and they often the general public, and of being part of a horses’, with other species being given graduated with high honours. business. Teaching in all of these skill areas far less attention. The horse – a noble ‘Qualified veterinary surgeon, BVSc, now tends to begin in the early years of and useful animal – in turn suggested a (woman), desires position as Assistant in the curriculum, with a general move away noble and useful veterinary profession. As large mixed practice. Is highly recommended from the Loveday-inspired ‘preclinical’, a result of this virtual horse cult within as “excellent surgeon, obstetrician, observant ‘paraclinical’ and ‘clinical’ phases. Alongside veterinary medicine, some economically and sound diagnostician in horse, cattle these developments, there is also a trend important species, such as poultry, were and small animals” and as “strong, active, away from the lecture as the dominant mode completely off the radar, and before the keen, commands respect with all clients”. of teaching. Instead, more small-group, 1950s, veterinary surgeons who specialised Motorist.’ problem-based and self-directed approaches in small animals seemed to have been This is an advert placed in The Veterinary to learning are used. However, such changes considered morally dubious – in the words Record, December 14, 1935, by a female bring with them significant implications in of one editorial in the Veterinary Journal, they veterinary graduate. It is interesting that she terms of staff development, acceptability were ‘below the salt’ (Anon 1947) . had a degree (optional), that she appears to and cost (Dale and others 2008). In this anxious time, caused by a want to work in mixed practice, and that in associated practices, rather than within teaching hospitals as part of the school’s own on-campus infrastructure. Although this approach had been used previously, notably in some newer North American schools, it represented a significant shift from the traditional Loveday model in the UK, and was viewed with much interest. This model will underpin clinical delivery in the newest veterinary school opening at Surrey university, where the first student cohort is due to arrive in 2014. As in the 19th century, the RCVS still has a key role in maintaining standards, through its system of veterinary school inspections, and any new veterinary programme requires validation by the RCVS before the qualification can act as automatic membership of the RCVS. However, the RCVS itself has no say in the number of veterinary schools opening – it only inspects them once they are up and running. Existing veterinary schools are also inspected regularly – a throwback to the RCVS’s historic role as the examining body in the single portal system.
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Feature
FIG 2: Extract from an OSCE sheet for a typical small animal clinical skill assessment. Supplied by John Mosley, Royal (Dick) School of Veterinary Studies
With changes in curriculum content and structure, assessment practices have also adapted to align with the new skills and attributes being taught. A detailed discussion of assessment methods in veterinary schools is beyond the scope of this article; however, one major change over the past 10 years or so has been the move towards a more thorough and rigorous assessment of skills. Most veterinary schools now include some form of Objective Structured Clinical Examination (OSCE) as part of their standard ‘assessment armoury’ (Fig 2). This import from medical education (Harden and Gleeson 1979) aims to ensure an appropriate level of reliability and fairness using a form of skill assessment that is far more structured than the traditional ‘viva’ that many of us may recall from our own undergraduate days. Such assessment changes reflect broad shifts in educational theory and practice, which are being applied within the veterinary curriculum,
often heavily informed by developments in medical education.
E-learning
When the Royal Dick Veterinary College moved to its newly completed premises at Summerhall in 1925 (the official opening had taken place in 1916), one of the features of the purpose-designed building was a lecture room equipped for the showing of lantern slides. This use of such vivid imagery would no doubt have made a great impact on the teaching of visual subjects, such as anatomy and pathology – perhaps it even stopped some students falling asleep in the darkened room! An equivalent technological development today is the use of e-learning. Those of us graduating before the 21st century have lived through a huge change in terms of the technology present in our everyday lives – the same change has happened within the walls of our veterinary schools. E-learning is just another teaching
strategy: good teachers tend to be good teachers regardless of the methods they choose to use; however, appropriate use of technology can greatly enhance learning. New learning technologies are perhaps best suited to providing more readily available access to resources – most notably videos, recorded lectures, interactive images, and so on. Two excellent examples of e-learning on a national and international scale in veterinary education are Wikivet and the Online Veterinary Anatomy Museum (OVAM) projects. Wikivet is a worldwide collaborative venture that ultimately aims to cover the entire undergraduate curriculum. The linked OVAM project is a collection of anatomy resources organised into categories according to the species, system and region covered (Fig 3). Both projects harness the power of the internet to allow collaboration between students and staff across institutions.
Tracking and specialisation – two contentious issues In one important sense, veterinary education has always ‘tracked’ and specialised, by species. Nineteenth and early 20th century veterinary teaching focused on the horse. Following the Second World War, great emphasis was placed on the dairy cow (Woods 2007), before companion animal subjects expanded considerably. Historically, however, the British veterinary profession has tended to resist formal division of its expertise (as in medicine), because flexibility provided for a variety of veterinary careers in a numerically small profession (Gardiner and others 2011). Great growth in veterinary knowledge, together with expansion in the size of the profession, has prompted debate on whether veterinary medicine should become more formally tracked, to allow vets to graduate in more restricted areas of practice, but with higher level
Photograh: OVAM
Photograph: Library, University of Edinburgh
FIG 3: Getting to grips with anatomy, a perennial challenge for any veterinary student. (left) An interactive 3D visualisation created as part of the OVAM project that a current student may pull up for learning and revision. (right) A student’s drawing from the1930s
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FIG 4: Overall number of publications with ‘veterinary education’ as a subject heading since the late 1970s, broken down into five-year blocks (obtained by searching the CAB abstracts database). Although a crude measure, this is consistent with a significant increase in research activity over the past 20 years
competences. There are also real concerns in connection with content overload and the effect this has on general educational experience/development and also on overall student wellbeing on such an intense programme as veterinary medicine (Reisbig and others 2012). Full-blown tracking would be a considerable change and would impact on the veterinary labour market in new ways; however, several schools have already implemented, or are in the process of implementing, partial tracking options to allow students to focus on primary and secondary areas of interest, while still retaining broad-based cross-species training and the RCVS Day 1 competences.
Veterinary education as a ‘new’ academic discipline
Before the 21st century, the main fora for discussing veterinary education were either during species-specific conferences, such as BSAVA and BEVA, or at the Association of Veterinary Teachers and Research Workers (AVTRW) annual conference. Historically, the subject has always aroused great interest and sometimes heated debate within the profession’s journals; however, a problem has been the generally low evidence base applied to matters of veterinary pedagogy.
‘Between animal and human medicine there is no dividing line – nor should there be. The object is different but the experience obtained constitutes the basis of all medicine’ — Rudolf Virchow In 2004, the association Veterinary Education Worldwide (ViEW) was established by a group of veterinary educators who had attended the large medical educational conference held by the Association for Medical Education in Europe.
The aim of ViEW is to promote and support excellence in veterinary education through an annual meeting and by developing a network of veterinary educators internationally. In the UK, the VetEd symposium (established in 2009) rotates annually around the veterinary schools and also attracts a national and international audience. Consistent with this emergence of a vibrant research community, there has been a rapid rise in the number of publications in the field of veterinary education (Fig 4). This rise has coincided with the appearance of departments or groups of individuals whose main research interest is in veterinary education itself, rather than the more traditional biomedical sciences. Looking again to our ‘sister profession’, such units in medical schools are now commonplace (Davis and others 2005).
Prognosis . . .
Going by the quality, enthusiasm and commitment that veterinary students continue to bring to their studies, the future of veterinary education should be exciting. However, like any profession, veterinary medicine is subject to wider structural changes operating within society; these may affect human-animal relations in diverse and hard-to-predict ways and are bound to impact on future veterinary education. Current debate has tended to focus on the issues of oversupply of veterinarians (and the linked issue of the opening of new veterinary schools), student debt and changing models of practice. These are all areas that demand close scrutiny. In particular, student debt has risen considerably within the past 20 to 30 years and is a serious concern affecting wellbeing and prospects for veterinary students. The profession should attract able students from across the socioeconomic
spectrum if it is to fulfil all of its social role and purpose. One of the benefits of history is that one can easily reach for that most useful of diagnostic instruments – the retrospectoscope. No such instrument exists for looking into the future apart, perhaps, from the crystal ball – but the evidence base there is somewhat lacking. However, one phrase we hear a lot of today, ‘one health’ (and its close relations, ‘one medicine’ and ‘one wellbeing’) has a long historical pedigree (Michell 2000). Veterinary medicine is uniquely placed to exploit the huge comparative and mutually beneficial opportunity that Rudolf Virchow (18211902) – physician, scientist, politician and philosopher – first identified: ‘Between animal and human medicine there is no dividing line – nor should there be. The object is different but the experience obtained constitutes the basis of all medicine.’ If the profession can do this, the future for veterinary education should be bright.
Acknowledgements
The authors would like to thank the following colleagues for their help in preparing this article: Clare Boulton, Sue Bradley, Glen Cousquer, Gemma GaitskellPhillips, Julie Hipperson, John Mosley and Claire Phillips.
Speaking personally . . . capturing life in practice Visit the following link to hear retired members talk about their own veterinary education ( http://knowledge.rcvs.org. uk/capturing-life-in-practice/education/). These extracts are taken from fulllength veterinary life stories recorded for the Capturing Life in Practice oral history project, a collaboration between RCVS Knowledge, the Centre for Rural Economy at Newcastle University and the British Library (archive partner). Speakers include Mary Brancker (qualified 1938), Alistair Clarke (1948), Carl Boyd (1953) and Dick Lane (1953).
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doi: 10.1136/vr.f6273
Articles published in Veterinary Record’s 125th anniversary series so far have considered: n Cattle lameness (VR, January 26, 2013, vol 172, pp 92-95) n Dermatology in companion animals (VR, February 23, 2013, vol 172, pp 201-207) n Articular disorders in dogs (VR, March 30, 2013, vol 172, pp 332-335) n Equine surgery (VR, April 27, 2013, vol 172, pp 442-446) n Imaging (VR, May 25, 2013, vol 172, pp 546-551) n Cardiology (VR, June 29, 2013, vol 172, 678-682) n Parasitology (VR, July 27, 2013, vol 173, 89-91) n Equine infectious diseases (VR, August 31, 2013, vol 173, 186-189) n Companion animal obesity (VR, September 28, 2013, vol 173, 287-291)
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Taking a history on veterinary education Andrew Gardiner and Susan Rhind Veterinary Record 2013 173: 388-393
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