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Isham Jones, the AVMA's general counsel, advised delegates during a Jan. 11 meeting to avoid considering workforce issues when mulling the future of foreign accreditation. Doing so might raise the potential for litigation or invite scrutiny from the U.S. Federal Trade Commission, he said. That doesn't mean the AVMA is compelled to continue accrediting foreign schools. "I think the AVMA can stop the activity if it wants to do it. Is there a litigation risk? That depends on the reason why the AVMA chooses to stop this activity if that’s what you decide to do. That’s the critical issue," Jones said.

For the third time in as many years, veterinarians sought last weekend to end the American Veterinary Medical Association (AVMA) foray into international accreditation.

Like previous attempts, their efforts were defeated. The showdown between foreign accreditation advocates and those critical of the AVMA’s efforts to evaluate overseas programs occurred Jan. 10-11 in Chicago during the House of Delegates meeting.

The House — the AVMA’s primary policymaking body — rejected a resolution Saturday that called on the AVMA’s Council on Education (COE) to stop using its finite resources to assess veterinary education in foreign countries and instead turns its eye to domestic programs, which are proliferating at a rapid pace. 

The COE is the AVMA’s accrediting body, comprised of 20 volunteers. The U.S. Department of Education recognizes the COE as the nation’s accreditor of colleges and schools of veterinary medicine in the United States. The federal government does not oversee the AVMA's international accreditation program; the association leadership initiated and drives the evaluations of schools abroad.

The resolution sought to stop the AVMA from accrediting internationally by the end of the decade.

Dr. Eric Bregman, a practice owner near Manhattan and member of the AVMA Task Force on Foreign Veterinary School Accreditation, spoke on behalf of the New York State Veterinary Medical Society, which sponsored the measure. He countered the AVMA’s assertion that international accreditation is needed to keep an eye on emerging diseases and overseas food safety, pointing out that the AVMA accredits only preeminent foreign programs, mostly in Europe and Australia.

“We do not accredit schools in countries like India, China and Brazil,” he said in a speech before delegates. “If we’re talking about food supplies and global health, we should be doing it in countries (like that).”

AVMA officials countered that the COE foreign accreditation efforts have been a staple since the 1970s, starting with the accreditation of Utrecht University in the Netherlands. After that, the next accreditation of a foreign program came during the late 1990s, when the AVMA resolved to “raise the bar” of veterinary education internationally. Today, the COE recognizes 13 veterinary medical programs outside of the United States and Canada.

Dozens of veterinarians debated the resolution during committee meetings and on the House floor, with most voicing support for maintaining the foreign accreditation program.

“There’s no question that through the accreditation of foreign schools, the AVMA has had a positive influence on the standards of veterinary education throughout the world,” said Dr. Link Welborn, a delegate representing the American Animal Hospital Association. “We should take pride in that.”

Dr. Andy Abbo, the interim alternate delegate from Massachusetts, agreed: "I feel very strongly that on a world stage, the AVMA has been the gold standard in accreditation across the board. We’d be taking a very big step backward by not allowing schools to pursue our accreditation."

The COE's foreign accreditation activity has attracted attention from AVMA members due to a surge of overseas approvals. Seven of the 13 foreign programs accredited by the AVMA earned the distinction during the past decade.

Some critics believe that the United States is becoming saturated with veterinarians due, in part, to a proliferation of domestic veterinary schools and growing numbers of accredited foreign programs that cater to American students.

AVMA General Counsel Isham Jones warned delegates during the meeting that workforce issues cannot play a role in whether foreign programs are considered by the COE. Doing so could generate legal action or be viewed by the U.S. Federal Trade Commission as protectionism, he stated.

While the resolution made no mention of trying to control veterinary workforce numbers, Dr. Steven Wills said he "could see us in litigation" if it passed.

"I do believe the process does bring up standards," added Wills, Kentucky's alternate delegate.

Dr. Rick Baum, Vermont's alternate delegate, was unconvinced: "These schools that we are accrediting are the well-endowed schools. (Accreditation) does nothing to raise the bar for those who need our help the most."

Dr. Mary Beth Leininger, a COE member and former AVMA president, said the assertion of officials that the COE has been accrediting foreign schools for 30-some years is misleading.

“If you go back to Utrecht, it was accepted, not accredited,” she stated before delegates. “I don’t know when the change in phraseology happened."

She added, “I think every time we use the words ‘gold standard’ … we sound a little arrogant."

Leininger noted that overseas programs already are accredited by esteemed evaluating agencies such as the Royal College of Veterinary Surgeons, European Association of Establishments for Veterinary Education and the Australasian Veterinary Board Council.

"We’re using our volunteer resources ... frittering them away by giving them to the foreign schools," she said, noting that five of the 12 programs to be assessed this year by the COE this year are based on foreign soil. In 2013, the ratio was 3-to-10. "I believe the educational process in the United States is so troubled right now that unless a body that has clout with schools starts addressing some of the problems … we'll be in trouble."

Leininger did not spell out her concerns for domestic veterinary education. However, it's widely acknowledged that rising tuition rates are outpacing students' ability to pay, leaving them burdened with heavy student loan debts post graduation. At the same time, U.S. veterinary institutions have been dealing with deep cuts in funding from state legislatures.

"The one body that drives change in veterinary education in the United States is the Council on Education," Leininger stated. Speaking to the idea that AVMA leaders are free to put a stop to foreign accreditation, she added: "They are the ones who got us into the process to begin with ... and they can take it away."

Before the vote, AVMA President Dr. Clark Fobian implored delegates to not believe information that discredits AVMA foreign accreditation. Much of the talk, he said, is circulating among those who don’t have the right facts about foreign accreditation.

“I see our membership in a sense as being like one of our clients,” he said. “They don’t have the access to the information and the knowledge that we have. They do not have the insights that hopefully many of you have developed, sitting on this board. They look to us — just like our clients look to us — to make the right decision.”

With that, he urged delegates to “do what’s best for the members” by voting to defeat the accreditation measure.

Nearly 80 percent of the House followed his suggestion.