Journal of Veterinary Medical Education, Vol 35, Issue 2, 231-234
DOI: 10.3138/jvme.35.2.231
Copyright © 2008 by Association of American Veterinary Medical Colleges
Public-Health Training for Veterinarians |
Public-Health Instruction Necessary to Supplement the Veterinary Professional Curriculum: The DVM/MPH Coordinated-Degree Program at Auburn University
James G.W. Wenzel•
Kenneth E. Nusbaum•
James C. Wright•
Dugald C.A. Hall
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ABSTRACT
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To meet long-term needs, many veterinary colleges and schools are participating in dual-degree DVM/MPH programs. Auburn University's College of Veterinary Medicine and the School of Public Health at the University of Alabama at Birmingham have developed a coordinated-degree curriculum in which the DVM and the MPH are not necessarily awarded simultaneously. Other opportunities at Auburn include Public Health Careers Day, trips to the Centers for Disease Control and Prevention, several elective courses related to veterinary epidemiology, and online access to the Emerging and Exotic Diseases of Animals course available from the Veterinary Information Network. We have been able to increase our students’ exposure to the role of the veterinarian in public health and to develop a program to augment their training in public practice.
Key Words: curriculum structure • public health • disease control • zoonotic medicine • veterinary public health education • federal veterinary accreditation
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INTRODUCTION
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The need for an adequate veterinary public health (VPH) workforce in the post-9/11 world has been re-emphasized by several disease events: the incursion and spread of West Nile virus in North America; the 2001 outbreak of foot-and-mouth disease in the United Kingdom; postal anthrax attacks; and introduction and spread of monkey pox in the United States.1 Yet a shortage of more than 500 veterinary personnel in the US Department of Agriculture (USDA) alone was predicted to occur by 2007.2 Veterinary schools and colleges in the United States have been working to improve veterinary workforce training in public health by increasing the availability of combined, dual, or coordinated training programs in veterinary medicine and public health. Auburn University's College of Veterinary Medicine (AUCVM) has developed a program in conjunction with the School of Public Health at the University of Alabama at Birmingham (UAB).
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MODEL PUBLIC-HEALTH CURRICULA
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The American College of Veterinary Preventive Medicine (ACVPM) has proposed that colleges of veterinary medicine include 164 contact hours of required coursework and 49 hours of optional material to enhance training in public health (see Table 1).3 This proposed curriculum includes subject areas in common with those identified in the Association of Schools of Public Health (ASPH) Master of Public Health degree (MPH) Core Competency Development Project (see Table 2):4 environmental health, epidemiology, statistics, health policy, and zoonoses and food safety (under "public health biology" in the ASPH competencies). Only two areas—foreign animal diseases in the veterinary curriculum and social and behavioral sciences in the MPH core competencies—are unique to one model (see Table 3). However, the coverage of even the common subject areas by veterinary curricula is often superficial compared to the typical dedicated (approximately) two-year MPH program of study.
Recently published reports on European veterinary curricula also provide data to which American training may be compared. Among various accounts of European veterinary training programs, two estimate contact hours in courses addressing public health and related areas. These reports estimate the number of contact hours for Danish curricula at 2705 and for Polish curricula at 345.6
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SHORTFALLS IN US VETERINARY PROFESSIONAL CURRICULA
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Veterinary students in the United States are exposed to a great deal of information on basic vertebrate and pathogen biology and on the pathogenesis of disease. Veterinary students at AUCVM must earn five semester credits (representing approximately 75 contact hours) in parasitology and four credits (approximately 60 contact hours) in principles of infectious disease. Judged against the suggested contact hours in the ACVPM model, however, they fare poorly with only 60 total contact hours for public-health topics such as epidemiology, zoonoses, and food safety. Independent assessments of the total number of contact hours related to public health in US veterinary curricula have put the maximum number of hours at any US veterinary school or college at 120, which falls short of the ACVPM-recommended 164 hours for core topics alone. Riddle et al.7 report a range of 30 to 120 public-health-oriented contact hours among various schools, and Wenzel8 found a range of 41 to 120 hours in a review of 25 curricula. In 2003, only five of 28 schools (18%) had required clinical rotations dedicated to public practice, while five others offered such rotations as electives.
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SOLUTIONS FOR SHORTFALLS IN THE VPH WORKFORCE
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Although the ACVPM model does not specify time allotted to USDA-related (regulatory) training, students must be instructed in such activities and functions, such as animal identification, inspection, control of movement, and disease control and surveillance, including foreign animal diseases. Shortfalls in addressing regulatory veterinary medicine and foreign animal diseases in professional veterinary curricula must be countered with continuing education8,9 or other training. Proposed continuing education for reaccreditation indicates an awareness of the need for a reserve cadre of veterinarians skilled in disease control and other regulatory functions. A supplement to reaccreditation for emergency response may be "just-in-time training" (JITT): information and skills imparted to otherwise qualified personnel shortly before they are needed in practice.10 This disease-specific training ideally would be immediately available, portable, and convenient in format. Skills useful in cattle and poultry outbreaks are predictable and could apply to almost any outbreak: sampling, diagnosis, disinfection, vaccination, euthanasia, and tracing. For traditionally or broadly trained veterinarians, JITT materials would enable the recapture of skills learned during professional training.
In an apparent response to the anticipated long-term need for additional veterinarians with public-health training, the Web sites of at least 18 of the 28 veterinary schools and colleges in the United States describe master's-level training programs in public health, epidemiology, or related areas. Nine of these programs appear to offer only post-graduate training; seven offer dual DVM/MPH (or equivalent) programs, and two offer dual-degree programs in planning.11 Before the advent of these programs, veterinarians traditionally obtained post-graduate training in public health at institutions not necessarily associated with veterinary schools, often broadening their perspective of epidemiology across the health professions. The number and online availability of training programs has increased, such that MPH training is now available for virtually any veterinarian. Certificate programs in various specific subject areas are also available.
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THE COORDINATED-DEGREE PROGRAM AT AUCVM AND UAB
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Auburn University's College of Veterinary Medicine and UAB have developed a DVM/MPH coordinated-degree program. The professional and MPH degrees will not necessarily be awarded simultaneously. Candidates will receive training within the veterinary curriculum in infectious diseases, parasitology, and public health; UAB will provide online instruction in biostatistics, epidemiology, environmental health, health behavior, and public-health systems. An additional 12 credit hours are required in a selected area of special emphasis: epidemiology, environmental health, health behavior, or health care organization and preparedness. Other applicable credits for the coordinated-degree candidate, available from UAB online or during summer sessions, may include courses or other training in environmental disasters; disaster and emergency management; communications issues in disaster preparedness; public-health politics and policy; prevention of and response to agro-terrorism events; and public-health law. Six credit hours of internship and integrative experience are also required.
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INTEGRATING PUBLIC HEALTH INTO AUCVM
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For three years, Auburn has hosted a Public Health Careers Day, featuring AUCVM graduates employed in public practice from the USDA, the Centers for Disease Control and Prevention (CDC), our state veterinarian's office, and the military. This program gives veterinary students opportunities for personal contact, often with recent graduates who are very nearly their peers, for frank and insightful discussions about public-practice careers. Approximately 10% of first- and second-year veterinary students have attended this event. The Public Health Careers Day not only allows students to talk with individuals in nontraditional practice areas but also helps to identify those students with interests in public practice. Several elective courses are also available to veterinary students at Auburn, including courses in foreign animal diseases, disaster medicine (including Community Emergency Response Team training), and the great plagues, as well as a clinical rotation in agricultural emergency response training at the Center for Domestic Preparedness of the Department of Homeland Security in Anniston, Alabama. Students at AUCVM also have access online to the Emerging and Exotic Diseases of Animals course available from the Veterinary Information Network. Portions of this course are required for AUCVM's Infectious Diseases and Public Health courses.
Extramural experiences also provide additional training opportunities. Examples include the USDA-sponsored Smith-Kilborne Fellowship; the Merck-Merial Summer Research Fellowship; and internships at the CDC, the USDA, the Alabama Department of Public Health, and the Alabama Department of Agriculture and Industries. The Smith-Kilborne Fellowship is designed to acquaint students with foreign animal diseases and is conducted at Cornell University and the Plum Island Animal Disease Center. Students who receive Merck-Merial Summer Fellowships spend time in the laboratories of faculty to learn about research being conducted at the college. In addition, 26 Auburn students attended "CDC Day," through the support of the college's three departments and the Office of the Dean and the Office of Research and Graduate Studies in 2006; through our corporate sponsors, 10 students attended in 2008.
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POSTSCRIPT
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Two important questions remain about the veterinary profession's push toward public-health education: Will the predicted shortfall in VPH personnel actually result in jobs, and will those jobs offer salaries commensurate with the level of training achieved, and the level of indebtedness borne, by our students? Current salaries for public-health veterinarians are inadequate to lure our best students into the public sector; other rewards of those jobs are only theoretical in the face of substantial student loans and indebtedness. Although we have been able to increase our students’ exposure to the role of the veterinarian in public health, the effort and expense of additional training must be justified.
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Footnotes
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AUTHOR INFORMATION
James G.W. Wenzel, DVM, PhD, Dipl. ACT, Dipl. ACVPM (Epidemiology), is an associate professor in the Department of Clinical Sciences, Vaughan Large Animal Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, AL 36849 USA. E-mail: wenzejg{at}auburn.edu.
Kenneth E. Nusbaum, DVM, PhD, Dipl. ACVM, is an associate professor in the Department of Pathobiology at Auburn University, Auburn, AL 36849-5519. He teaches Virology in the Infectious Disease sequence in the veterinary curriculum and will serve as Chair of the AAVMC Public Health Committee for 2007/2008.
James C. Wright, DVM, PhD, Dipl. ACVPM, is an associate professor in the Department of Pathobiology, Auburn University, Auburn, AL 36849-5519 USA. He teaches public health and disaster medicine and conducts research in pre-harvest food safety.
Dugald C.A. Hall, PhD, is a research associate at the South Central Center for Public Health Preparedness, University of Alabama at Birmingham, RPHB 445, 1530 3rd Avenue South, Birmingham, AL 35294-0022 USA
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REFERENCES
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- Wright JC. The challenges of veterinary education in a post 9/11 world. Atlanta, GA,: Paper presented at the Joint Symposium on Veterinary Public Health, 2007. April 23–24.
- US Department of Agriculture [USDA]. Department of Agriculture Skills Gap Analysis. USDA, 2004.
- American College of Veterinary Preventive Medicine [ACVPM]. Proposed Model Veterinary Public Health/Preventive Medicine Curriculum. ACVPM, 2000.
- Association of Schools of Public Health [ASPH]. MPH Core Competency Development Project. Washington, DC: ASPH, 2006. <http://www.asph.org/document.cfm?page=851>. Accessed 03/27/08.
- Jensen AL. The new veterinary curriculum at the Royal Veterinary and Agricultural University, Denmark. J Vet Med Educ 33: 209–213, 2006.[Free Full Text]
- Kita J, Klucinski W. Structure and teaching of the Faculty of Veterinary Medicine, Warsaw Agricultural University, Poland. J Vet Med Educ 33: 223–227, 2006.[Free Full Text]
- Riddle C, Mainzer H, Julian M. Training the veterinary public health workforce: A review of educational opportunities in US veterinary schools. J Vet Med Educ 31: 161–167, 2004.[Abstract/Free Full Text]
- Wenzel JGW. Public health and veterinary education in the United States. Leadership in Public Health 7(2):3–11, 2006.
- Wenzel JGW. Assessment of Training for Veterinary Accreditation and Foreign Animal Disease Recognition at U.S. Colleges and Schools of Veterinary Medicine, 2004. [CD]. USDA contract # 53-6395-3-C004. Riverdale, MD: USDA-APHIS-VS.
- Nusbaum KE. Coupling credentialing with just-in-time training for the animal epidemic workforce. Atlanta, GA: Paper presented at the Joint Symposium on Veterinary Public Health, 2007. April 23–24.
- Association of American Veterinary Medical Colleges [AAVMC]. Students and Admissions: Member Institutions. Washington, DC: AAVMC, 2006. <http://www.aavmc.org/students_admissions/vet_schools.htm>. Accessed 03/27/08.
| AAVMC APPRECIATES THE SUPPORT OF OUR TWO PATRONS, HILL'S PET NUTRITION AND BAYER ANIMAL HEALTH, WHO IN COMBINATION ARE FULLY SUPPORTING THIS SITE. |
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THE COORDINATED-DEGREE PROGRAM...
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