Photo by Dr. Liz Norby

Dr. Liz Norby's 4-year-old daughter Olivia enjoys playing the veterinarian. If Olivia grows up to want passionately to be a veterinarian like her mom, Norby says she'll support her daughter's decision. But Norby and many other practitioners worry that swelling educational debt coupled with stagnant incomes make veterinary medicine a tough livelihood to enter.

Playing veterinarian is a happy pastime for Dr. Liz Norby’s daughter Olivia. At age 2, the tot wore miniature scrubs stitched by her grandma. For her 4th birthday, Olivia got from her other grandma a veterinarian kit complete with surgeon’s outfit, stethoscope and toy puppy patient. This Halloween, Olivia wants to be “Dr. Norby.”

Olivia is young to be deciding her life’s work, although veterinarians commonly say that they knew what they wanted to do from the time they were small.

As for Olivia’s mom, she’s flattered that her daughter wants to be like her. But underlying her pride is worry.

The financial position of new veterinarians has gone downhill markedly since Norby joined the profession in 2001. Back then, the average starting salary for full-time work was $44,378 (excluding pay for veterinarians working toward advanced degrees, who typically earn less); the average educational debt was $67,819.

Today, the income-debt imbalance is steeper still. According to the latest statistics from the American Veterinary Medical Association, nine out of 10 veterinary school students graduated with a mean debt of $151,672 in 2012. That being an average, some start their careers owing much more.

While tuition and debt continue to climb, wages are stagnant at best, and slipping against inflation. The mean starting salary for full-time work was $65,404 last year. Not including an inflation adjustment, that's 1.6 percent less than the year before. It is less than half the average educational debt-load — an income-to-debt ratio most financial advisers consider precarious.

Yet demand for veterinary-school admission continues to rise. In response, schools are adding seats to existing programs and opening new ones. Two veterinary schools are set to debut in 2014, bringing the number of U.S. veterinary schools in the United States to 30 and fanning concerns among practicing veterinarians of a market oversupply.

The financial squeeze facing new and aspiring veterinarians is causing anguished discussions among colleagues at all points in their careers. They wonder how best to respond when faced with young people — perhaps their own offspring — who want to be veterinarians, too. Should they encourage or try to dissuade them?

“I cringe at how much … debt has climbed over the past 10 years for new grads,” Norby wrote on a message board of the Veterinary Information Network (VIN), an online community for the profession. “I honestly don’t know if I could provide the same level of financial support to my little girl that my parents gave me.”

Norby, who practices in Illinois, elaborated on her concern in an interview. She spoke of young veterinarians she knows with upwards of $250,000 in student loans to repay. “I can’t fathom how they will be able to support themselves,” she said. Harder still to imagine, she said is how a debt-laden veterinarian wishing to start a family can manage a mortgage, food, day care and automobile expenses on top of school loans.

Moreover, educational debt isn’t the only economic pressure point on today’s private-practice veterinarians. Competition for pet health care is converging on multiple fronts, drawing business from traditional animal hospitals. “Between Dr. Google and what the pet-shop kid says and vaccine clinics,” Norby said, “will (new veterinarians) be paid enough to support this kind of educational debt?”

Dr. Megan Tremelling thinks not. Tremelling would discourage her children from following her footsteps “partly because I love my critters, my kids love their critters, and I want my kids to be able to expect to make enough money to comfortably provide their own pets with optimal medical care,” she wrote on the VIN message board.

She wasn’t speaking hypothetically. Tremelling told the VIN News Service by email: “My dog has needed her teeth cleaned and X-rayed for the past three years, and she’s not getting it done any time soon because I can’t afford it. I love my job but … c’est la vie.” (Providing the dental care herself is not an option because Tremelling works in a Wisconsin referral hospital that doesn’t perform routine dentistry.)

Dr. Hillary Olin Smith, a practitioner in Texas who graduated in 2009, reported feeling similarly strapped, with a yearly salary less than half of what she owes for school. She wrote on VIN that she “got lucky” because her husband makes a good living and her parents have lent support. But were she single, younger and without parental help, Olin Smith said, “I would not want to be in this field.”

In an interview by email, Olin Smith said that if she had it to do over, she wouldn't choose a different livelihood but she'd approach the schooling differently. "I would have tried to get a decent job in another field (perhaps living at home for some time) for a few years, in order to save a decent amount of money before attending school," she said "That way, I wouldn't have had to borrow quite as much, and maybe the debt/salary mismatch wouldn't be so striking."

As it was, she wrote on VIN: “I was not at all informed about … what it really meant to shoulder a $135,000 debt load when your starting salary is half or less than half that. … So, while I love veterinary medicine and can’t see myself ever doing anything else, I can’t in good conscience pump it up as a great career choice for my girls if they want to have a decent standard of living.”

Passions too strong to stem?

While many veterinarians say they, too, would try to steer their children and other young people away from veterinary medicine, some believe the attempt is futile.

That’s Dr. Marylou Visco’s view. “When you have a passion to do it, no one’s going to talk you out of it. No one could have talked me out of it,” Visco said in an interview.

Visco’s husband also is a veterinarian; together, they own Dravosburg Veterinary Hospital in suburban Pittsburgh. When their daughter made plans to become a veterinarian, too, Visco said her husband raised the issue of expense and debt, hoping to dissuade her.

It didn’t work.

Their daughter now is in her fifth semester at Ross University and more passionate about the work than ever, Visco said. “It’s great. I’m so proud of her,” she said.

Visco said she and her husband assist their daughter with some living expenses, but loans cover tuition and other bills. Visco estimates her daughter's debt upon graduation will be $150,000. Where she’ll work is an open question; her mom hopes she’ll pursue a specialty, but there’s talk of her joining the family practice.

Asked whether Visco and her husband as clinic owners could afford to pay their daughter what she’ll need to service the debt and live comfortably, Visco paused before answering. “As a detached employer or as her parents?” she said. “That’s the kicker.”

Like Visco’s daughter, Dr. Lisa Whitney, a practitioner in Vermont, resisted advice to choose another career. “I still remember when I was getting ready to apply to vet school and my sister trying to talk me out of it,” said Whitney, who graduated in 1999. “She tried to push me into podiatry or dentistry (she is a dentist). Hindsight being 20:20, I completely appreciate why she said it. At the time, it infuriated me that she would suggest that I not follow my dreams.”

Lori Kogan is intrigued by the idea that no amount of warning will deter some of the people drawn to veterinary medicine.

Kogan is a counseling psychologist and faculty member at Colorado State University College of Veterinary Medicine and Biomedical Sciences. In that capacity, she’s become familiar with what makes veterinary students tick.

Observation and experience tell her that many aspiring veterinarians feel a lifelong calling to the profession. “If you look at most veterinary students and their (school) applications, they’ve wanted to be a vet since they were 5,” Kogan said.

Psychologically, the longer people travel down a particular path, the more likely they are to find confirmation that they’re on the right path, and filter out information to the contrary, she said.

“Say you go out on a couple of dates with somebody and you determine that you really like them a lot,” she said by way of example. “Then you go out on more dates, and you get alternative information that runs counter to your initial hypothesis. We almost immediately start filtering data to support what we want to believe. We highlight what’s good about the person. …

“I think that’s what’s happening in veterinary medicine,” she said. “People since they were 5, they’ve shaped their entire lives — school, volunteer, work experience — toward becoming veterinarians. Even when this new information comes in that says, ‘Hmm, perhaps this isn’t the right thing,’ they use all their coping and denial skills to say, ‘It’s not going to be me’ and they entrench deeper.”

It’s also hard for most young people to imagine the effects of big debt on their future lives. “It’s difficult to project yourself 15 years down the road — having children, a spouse and a lot of debt — what your day-to-day life is going to be,” said Dr. Andrew Roark, a practitioner in South Carolina who often counsels aspiring veterinarians.

Choosing cheaper schools

If would-be veterinarians aren’t easily deterred from their career choice, warnings about heavy debt may be influencing, at least, their choice of schools.

That’s the case for Sarah Kooy. A biology major entering her senior year this fall at Furman University in Greenville, S.C., Kooy has heard enough about debt to know that if she follows her childhood dream of going to veterinary school to become a large animal veterinarian, she must pay attention to affordability.

She knows that a year’s tuition at the veterinary program in her home state of Minnesota, for example, is some $20,000 less for residents than out-of-state students.

So the University of Minnesota College of Veterinary Medicine is one option Kooy is considering. She also might try to establish residency in another state with a veterinary school.

What isn’t a factor, she said, is a program’s prestige. “It’s a lot different from undergraduate (school), where the name kind of helps you get into the graduate program,” Kooy said. “People aren’t going to come to you (for veterinary care) just because you graduated from Cornell.” (Cornell University College of Veterinary Medicine came out on top in the most recent ranking of veterinary programs by U.S. News and World Report.)

The main determinant, Kooy has resolved, is cost. “That is a huge deciding factor,” Kooy said. “Do I want to come out of school with $100,000 in debt or $200,000?”

Asked how much debt would make a veterinary degree not worth pursuing, Kooy replied: “That’s a good question. I’ve never really thought about that. It’s always been my goal.”

She paused, pondering. “I’ve never really thought about it that way, like how much makes it unobtainable,” she said finally. “I don’t know if I have an answer.”

Paulynne Bellen is another aspiring veterinarian for whom cost is an overriding consideration in choosing a school. In fact, Bellen decided against her first choice because the price was too steep.

Photo courtesy of Paulynne Bellen

Paulynne Bellen rejected her dream school due to cost. She made a decision based on affordability.

An avid hiker, Bellen’s original No. 1 pick was Colorado State University. That was before she realized that as a non-resident, she’d have to pay an extra $27,000 a year. She estimated that the full cost for four years of veterinary school would be $340,000.

“It was unreasonable,” she concluded.

Fortunately, Bellen had other options. Of 15 schools to which she applied, she was accepted at eight. (She was invited to interview at two more but had already spent $9,500 in application fees and on-site visits and couldn’t afford further travel.)

Once she let go of her dream school, Bellen made the decision purely on economics. “Which one can I go to so I have the lowest loan?" she said. "Simple."

Among the resources Bellen tapped was a graphical online tool developed by the VIN Foundation, a philanthropic arm of VIN dedicated to supporting new veterinarians. The tool compares costs of 31 veterinary programs in the United States and Caribbean.

The winner was The Ohio State University. Although Ohio is not the least-expensive under the VIN Foundation analysis, it worked out that way for Bellen for a few reasons: She received a recruitment scholarship; she’ll be able to convert to resident tuition after a year; and the region’s cost of living is relatively low.

Bellen estimates she’ll finish owing between $220,000 and $250,000, including money borrowed for living expenses. “I have some savings, but it’s not going to sustain me for four years,” she explained.

The most affordable school for Bellen still carries a breathtaking price. “A week ago, I had to sign my promissory note,” she said. “It was daunting. $25,000 at 7.9 percent (interest) was heart-wrenching. (Another) $40,500 was at 6.8 percent. How can this education be more expensive than a mortgage? But I had to do it.”

Bellen has wanted to be a veterinarian since she was young. She grew up in the Philippines, where such a career isn’t viable: “Most people are poor, let alone have enough funds to support animal welfare and medical care,” she said.

After earning an undergraduate degree, Bellen moved to the United States, where she worked for more than 10 years in corporate human resources. During off hours, she would volunteer in animal shelters.

At age 30, Bellen divorced. Her life upheaved, Bellen sought healing by working with animals. With the international aid organization World Vets, Bellen traveled to Latin America, assisting veterinarians in providing free medical care in developing nations.

The urge to become a veterinarian became more insistent. Bellen returned to school for prerequisite courses. She started part-time, squeezing classes around her full-time job.

She enrolled first in subjects she most feared. “It was a way of checking myself, of finding out if it was something I really wanted,” Bellen said. “I took chemistry because I hated the class and I wanted to scare the life out of myself. I took it before biology.”

She gave herself many such tests. “I wanted to be exposed to animals that are not cute and fluffy,” Bellen continued. “I wanted to see animals that are really sick and in really bad shape. That’s why I chose to go to South America. I wanted the gruesome. I wanted to scare myself to see how committed I was.”

After that, the scariest part was figuring out her financial situation: “Being on my own, no family, no parents, and going back to school, setting up the finances all over again without going back to work full-time. But,” she found, “it’s doable. You streamline your lifestyle, you live simply.”

Poised to begin veterinary school in three weeks, Bellen already envisions the kind of a veterinarian she’ll be after graduation and how to manage her debt. Stimulated by the scientific research aspects of veterinary medicine, she’s leaning toward public health. She knows that if she goes into government service, she may be able to discharge her debt after 10 years under a federal program known as Public Service Loan Forgiveness.

“I am counting on that to make my life easier,” Bellen said. “In fact, I’m even going for my Master of Public Health conjointly with my DVM to give me an edge for that 10-year forgiveness program. So that’s my plan.”

Informing without discouraging

Taking practical steps to stay financially sound is what Dr. Joey Gaines, a practitioner in Nebraska, espouses to her children. But deterring their dreams? No way.

“I have five kids, and if any of them wants to go into veterinary medicine, I will be supportive,” Gaines said. “I think it’s a great profession. I love it. I love going to work every day — well, most days. There’s always something new.”

Her eldest child, age 13, has his eye on becoming a large animal veterinarian. He’ll select the least-expensive education possible if his mother has anything to say about it.

“My expectation for my kids would be to go to in-state school for undergrad … not to go to a private school, not to go out of state,” Gaines said. “I would expect them to work all through undergraduate school and summers and live frugally through school. And then vet school, same thing. … It’s not about where you go, it’s about being able to make ends meet when you graduate.”

Helping aspiring veterinarians understand what they’re getting into financially makes a lot of sense to Roark, the practitioner in South Carolina. But telling young people all the ways in which the profession is failing — that’s just unproductive negativity, he said.

“These young doctors, they’re being told, ‘You’re in so much trouble. You are totally screwed.’ Someone told me that!” said Roark, who graduated five years ago.

The grousing inspired Roark to write an essay to counter the complaints. In “Three reasons veterinarians are not doomed,” published in May in DVM 360, Roark concluded: “… There’s a reason most of us take out big loans to fund our education. This is a profession where you can lay hands on an animal and save both that pet and the spirit of its owner. While that reality can slip from view underneath piles of bills and paperwork from time to time, it’s still very real. It’s a life with purpose, and that’s wonderful.”

Attempting to present a realistic picture of the profession without being unduly dark, the VIN Foundation recently posted online a brochure titled “I Want To Be A Veterinarian” that addresses questions such as “Is becoming a veterinarian worth it?”

The goal is to inform, said foundation president Dr. Richard Headley.

“We don’t want to discourage anybody at all,” Headley said. “We still all think this is a pretty good profession, but the problems that we’ve seen with some of these young people coming out of school with literally six figures of debt, and coming to work for a $50,000-a-year job, is disturbing. It’s going to be 20 years before they are out of poverty.

“So the VIN Foundation developed this brochure as one tool to give to high school students, pre-vet students and early veterinary school students to basically lay things on the line. Let them come into this with their eyes open, not thinking they’re going to get through school and suddenly be healthy, wealthy and doing something they love,” he said, adding: “One or two out of three ain’t bad.”