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Dr. Mary Beth Leininger is appealing the COE's decision last spring to remove her as a council member. She was accused of harboring unspecified conflicts of interest after publicly expressing concerns about the COE's efforts to accredit foreign programs. Her appeal rests before the AVMA Board of Governors.

That plea, delivered by Dr. Mary Beth Leininger, was the height of a two-hour meeting dubbed a "listening session," hosted on Jan. 18 by the American Veterinary Medical Association’s Council on Education, or COE. Upwards of 50 veterinarians attended during the North American Veterinary Conference in Orlando, with a dozen or so making impassioned speeches regarding their concerns and complaints about how the nation’s sole accreditor of veterinary education operates.

Four of the COE’s 20 volunteers — public member Nicole Roberts and Drs. John Pasco, Ronald Gill and Patrick Farrell — were present. 

No one spoke in the COE’s favor, though the number of known supporters in the audience rivaled the number of known critics.

Leininger, a former AVMA president, was kicked off the COE last spring after she publicly expressed concerns about the accrediting body’s efforts to evaluate foreign programs — a topic that draws heavy debate among veterinarians.

“Why are we here?” Leininger asked rhetorically. “It’s because NACIQI had directed the council that they must drive toward wide acceptance by the veterinary community. They must do that by the time they go before NACIQI again.”

NACIQI is the National Advisory Committee on Institutional Quality and Integrity, an 18-member oversight panel within the U.S. Department of Education (USDE). Last month, NACIQI members reprimanded the COE for failing to reach out to practitioners who believe veterinary accreditation is plagued by cronyism, a lack of transparency and conflicts of interest. 

The COE’s hearing before NACIQI marked the second time since 2012 that the agency has tried but failed to gain re-recognition as a programmatic accreditor of domestic veterinary education, a status it’s held since the 1950s. Such re-recognition reviews typically are conducted every five years. 

For now, NACIQI has granted the COE a temporary extension with six to 12 months to:

• Demonstrate wide acceptance among practitioners. 
• Correct a disparity whereby COE standards heed North American Veterinary Licensing Exam test scores, but the exam is not widely taken by students at foreign accredited programs. 
• Systematically review standards rather than doing it piecemeal. 
• Solicit feedback from all relevant constituencies in the review, and afford them meaningful opportunity to provide input. 
• Ensure that the COE is compliant with written policies for the revision of accreditation standards. 
• Establish clear and effective controls against conflicts of interest.

“I’m happy the council seems to seriously be looking at what’s going on in the world around them. But from my perspective, this is just the first tiny step …” Leininger said in conclusion.

Her words were met with a round of applause. So were those of Dr. Eric Bregman, a past president of the New York State Veterinary Medical Society. As a one-time member of the AVMA Task Force on Foreign Veterinary School Accreditation, he’s long been critical of the COE’s efforts to accredit foreign programs.

During the listening session, he also laid out concerns about the COE’s acceptance of the distributive model, which allows fledgling programs to forgo building traditional teaching hospitals that cost tens of millions of dollars. Instead, such programs construct smaller versions of on-campus hospitals and contract with private practices where students can develop their clinical skills.

The result, he said, is less research and oversight of students’ learning. What’s more, removing the burden of building a teaching hospital has resulted in an influx of new veterinary schools, some of which are for-profit institutions. 

Bregman's also wary of the private practices through which students are rotating: “I question the education that students receive when they’re sent out to private practices that operate for a profit,” he said.

Dr. Greg Nutt, a practitioner from Canton, Georgia, spoke of conflicts of interest and fears that the AVMA isn’t being truthful with members about the state of accreditation. Since the COE's hearing before NACIQI in December, many veterinarians have questioned whether COE Chairman Dr. Fred Derksen's description of the meeting as “routine" was disingenuous. 

“I remember being told by the AVMA that there are standards in place to maintain the integrity of the veterinary degree and these standards are rigorous,” he said. But now that he’s read a recent USDE report reviewing the COE, “It is glaringly obvious that is not the case.” 

Nutt questioned why the COE must exist under the AVMA umbrella given that the arrangement has long spurred concerns about a lack of autonomy and exposure to the influence and politics of AVMA leaders. What's more, accreditation does not align with the focus of a membership-based organization, he said. 

“... I don’t see anywhere that this was a member-mandated issue for the COE to exist within the AVMA,” he said. “I believe the two ought to be separate. If the AVMA is taking my dues, I ought to be the No. 1 priority.”

Dr. Frank Walker, a former COE member from North Dakota, concurred, stating that the “AVMA is a professional trade organization, which serves the needs of the membership.

“This relationship of the AVMA and the (COE) is a conflict,” he said, resulting in a “culture that promotes undue influence …”

Dr. Carl Darby, a practitioner from Seneca Falls, New York, said the fact that the COE must host a listening session is a sign of deep disconnection between the AVMA and its members.

“It’s taken veterinarians from around the country to bring these issues to the floor,” he said. “If the AVMA truly is going to advocate for the profession, it seems clear to me, and even clearer to me now, that there needs to be a separation.”

Dr. Paul Pion, co-founder of the Veterinary Information Network (parent of the VIN News Service), urged AVMA and COE members to solve the accreditation problems in order to move forward.

“The biggest thing that I want to add to this is that we have to find a resolution,” he said. “As a profession, we’re wasting too much time fighting this one issue." 

The COE plans to host additional listening sessions during next month's Western Veterinary Conference in Las Vegas and at the AVMA annual meeting in July in Boston.