Foreign veterinarians struggle with equivalency program

Advocate who navigated ECFVG years ago is ousted by AVMA from oversight panel

May 11, 2023 (published)
Photo courtesy of Dr. Andrei Tarassov
Raised in Ukraine and trained in Russia, Dr. Andrei Tarassov has practiced in Utah for 17 years. He now advocates for people who, like him, didn't attend a school accredited by the American Veterinary Medical Association but want to practice in the U.S.

Gazing at the spring sky over the American Veterinary Medical Association headquarters in suburban Chicago, Dr. Andrei Tarassov awaited his fate as an advocate for foreign veterinarians looking to practice in the United States.

Down the hall from his seat at a lobby window, his colleagues on the Educational Commission for Foreign Veterinary Graduates joined AVMA attorney Isham Jones in a conference room. After hours of deliberation on March 27, they voted to remove Tarassov, a practice owner in Utah, from the meeting. The reason: He had publicly criticized the ECFVG program and spoken to candidates about their experiences, many of them with stories of utter frustration.

"What happened to free speech? I thought this was America," Tarassov fumed after the vote, speaking by phone from his hotel. "I'm not going to sit quiet."

The ECFVG is a program of the AVMA that enables veterinarians who have graduated from schools not accredited by the AVMA to qualify to take the North American Veterinary Licensing Examination. Passing the NAVLE is required of all veterinarians who wish to practice in the United States or Canada. Most veterinarians with degrees from unaccredited schools — all from foreign countries — take the NAVLE after they complete at least three of the ECFVG's four steps: credential verification; an English proficiency exam; the Basic and Clinical Veterinary Sciences (BCVS) exam; and the hands-on Clinical Proficiency Exam (CPE). 

The ECFVG program, which can cost a candidate upwards of $10,000 to complete, has a reputation for long waits, dense bureaucracy and lax communication. Frustrations among applicants have grown so pervasive in recent years that complaints litter social media groups, and an online petition asks the AVMA to "stop discriminating against foreign veterinarians."

The AVMA says the issues stem from the pandemic shutdown, which required CPE sites to temporarily close and created a backlog that has been compounded by increased demand. At the same time, the program remains successful, the AVMA maintains, pointing out that 168 ECFVG certificates were awarded last year to graduates of more than 102 veterinary schools in 41 countries, approaching pre-pandemic numbers. More than 7,000 candidates have successfully completed the ECFVG program since its inception in 1973, the AVMA reports — an average of 140 per year. 

In brief

"ECFVG helps to make it possible for foreign-educated and -trained veterinarians to realize the dream of licensure in the United States," the AVMA told the VIN News Service in a written statement. "The process for carrying out this essential work is thoughtful, thorough and collaborative."

Judging from complaints on social media, candidates are struggling to navigate the program. They report that: Test results take longer than the promised turnaround of 20 business days or fewer. The requirement to transcribe and notarize transcripts is difficult and costly. Emails and voice messages routinely go unanswered. And it can take a year or more to secure a seat to take the CPE, the final step in the program.

The CPE is administered over three days at two venues: Mississippi State University College of Veterinary Medicine and Viticus Center, a clinical training facility in Las Vegas. The testing site in Mississippi can seat eight candidates four times a year; the Las Vegas venue can accommodate 18 or so candidates 10 times a year. Both also take some candidates who repeat portions of the exam. Seventy-five percent of all first-time candidates fail one or more of the CPE's seven sections and must get back in line to retake the assessment.

The fee for the CPE is more than $7,600, not including lodging and transportation. Retakes cost $1,450 per section. Fees go toward costs related to the program, which is not a revenue-generator for the association, the AVMA said. 

CPE seats are so sought-after, Tarassov said, that he's seen posts on the internet from people offering to pay those with a coveted spot to give it up, though he doesn't believe such exchanges truly are possible. In response to demand, the AVMA told VIN News that it aims to add more CPE test dates to better accommodate candidates but did not say when that might happen.

Candidates will be "informed of all new opportunities to continue their progress," the association said by email. 

Tarassov is one of the 7,000-plus veterinarians who have made their way to practice in the United States via the ECFVG. Born in Germany, he grew up in Ukraine and studied veterinary medicine in Russia before moving to the U.S., where he obtained a professional license after completing the ECFVG program in 2008. A decade later, he gained a seat on the ECFVG committee. Since the war in Ukraine began nearly 15 months ago, he has helped veterinarians from the region emigrate to the United States. Mentoring them through the ECFVG process, he's had a front-row seat to their travails.

Tarassov said he was motivated to join the ECFVG committee — a volunteer position — to voice candidate concerns. He's incensed that he was kicked off for having contact with the very people the organization serves.

"Who can control who you speak to and who you don't? We're not communists," he said incredulously.

The committee vote was a recommendation; the final call was made by the AVMA Board of Directors eight days later. Tarassov received the news in a letter dated April 4 from AVMA CEO Dr. Janet Donlin. Without specifying the reasons, she stated that the board supported the committee's decision after "careful consideration." The letter closes: " ... your removal is effective immediately."

In a statement to VIN News, AVMA officials expanded on why they took action: "Some of the factors that led to the Board's conclusion that removing Dr. Tarassov from the ECFVG was necessary include his failure to understand and comport with his neutral and unbiased role as a Commission member in assessing candidates, and his unfounded and public criticism of the Commission on which he served.

"Dr. Tarassov's statements accusing the AVMA of mistreating foreign-trained veterinarians are simply untrue and undermine his ability to effectively serve as a colleague with his fellow ECFVG members," the statement continued. "His statements and activities also undermine the public and stakeholder trust and confidence in the ECFVG process, program, operations and work product — all of which are key to AVMA and its mission and integrity."

AVMA view on the ECFVG process

The AVMA board action, however, is not the end of it. While the AVMA says there's no option to appeal the decision, supporters of Tarassov have turned to the Utah Veterinary Medical Association and, more recently, the Utah Veterinary Physicians Licensing Board, which is scheduled on May 18 to consider exploring other options for licensing veterinarians who've graduated from foreign programs. 

Easing employment barriers for immigrants with professional skills isn't a new strategy in Utah. Last year, Gov. Spencer Cox signed SB 43, which allows trained immigrants to obtain licenses and certifications from the Utah Division of Professional Licensing without additional hurdles; however the new law does not pertain to veterinary practice. Cox signed a second licensing law in April, this time for trade workers who hold licenses from another state or country. Under the new rules, nine regulatory departments are authorized to extend licenses to foreign-trained applicants so long as they meet one of two conditions: They have at least one year of experience in the licensed occupation and skills that demonstrate competency, or their license was obtained from a foreign agency with requirements similar to Utah's.

'We deserve respect'

Lauren Beheshti, a research and policy consultant with the state Division of Professional Licensing who advocated for both bills, is expected to consult veterinary regulators on the prospect of expanding access to licensing in their field. Publicly, she has characterized such efforts thus far as a "win for our state, our economy and our immigrant and refugee neighbors and friends." 

Drawing from experience

Tarassov said change is long overdue. In a letter he sent to the AVMA Board of Directors on March 30 and later shared with VIN News, he said foreign veterinarians are being treated unfairly. 

Candidates, he wrote, are not given reasonable and accurate timeframes for the steps in the program. They are assessed more for how they navigated the system than their clinical skills, hanging in limbo and at the mercy of ECFVG staff. To help fix the system, Tarassov endeavored to join the ECFVG as a committee member. In 2019, he got the only seat reserved for a non-native English-speaking clinical practitioner holding an ECFVG certificate. His term would have expired in 2025.

Just one other seat on the 11-member committee is held by a veterinarian with first-hand experience navigating the ECFVG. Dr. Amanda Fiser, born in Texas, graduated in 2009 from Ross University School of Veterinary Medicine in the Caribbean, before it was accredited in 2011. Fiser did not respond to a message from VIN News requesting her perspective on the ECFVG program.

Tarassov points out that ECFVG candidates from the U.S. have advantages over foreign veterinarians who emigrate to America. Typically, they're native English speakers whose transcripts need no translation. They aren't limited to the constraints of U.S. visas, and often do not incur the expenses of overseas travel and accommodations. 

"When I became a volunteer at ECFVG, I saw that all the issues I dealt with were still in place; the program barely changed," Tarassov said. ECFVG candidates, he said, are still required to take an English language proficiency examination that's unrelated to health care terminology. And they are required to get every page of their transcripts translated to English, and each page must be notarized, which can cost a candidate hundreds of dollars, in addition to stress and time.

"There are constant delays in the first steps of the program, and the candidates cannot move forward without resolving these issues," he said.

Frustrated candidates have come to him for help. He explained in his letter to the AVMA: "I always disclosed that I am being contacted by the ECFVG candidates about their issues. I lectured in Russia and Ukraine extensively in the past years, and I am well known as a doctor who obtained veterinary license and practicing in the U.S. for several years. By the word of mouth, many other people from different countries from all over the world contacted me. … I never disclosed any confidential information to any person and never given any advice about any tests that candidates must take. I collect the concerns and bring them to the ECFVG committee. That is part of my duty as ECFVG member holding ECFVG certificate."

The issues he's relayed to the ECFVG since becoming a commission member in 2019 have never resulted in action, Tarassov continued, including calls to add staff, particularly when a key employee of nearly nine years left the organization. "I asked at meetings at least every year if ECFVG needs to ask AVMA about increasing funding for staff, to hire additional people, but every time I was told that the staffing is adequate," Tarassov wrote to the board. "Last October, Vicky Wragg resigned and the situation became critical. Many candidates could not get any response from the ECFVG from October up to now. How can such a delay be in the benefit of candidates ...?" 

VIN News could not reach Wragg, former ECFVG program coordinator. She now works at the University of Illinois at Urbana-Champaign, according to her LinkedIn profile.  

The AVMA filled the coordinator position in late February. At present, the ECFVG is run by two staff members, a part-time administrator and two AVMA directors, one of whom divides time with the Council on Education, the AVMA's accrediting body. Improvements are "always a goal for the ECFVG," the AVMA said in a followup statement to VIN News, noting that it's "working to streamline" each of the four steps of the program — a process that's "ongoing and in development." 

Clock ticks for immigrants

Candidates' frustrations about ECFVG waiting and processing times often are compounded by a race to complete the program and take the NAVLE before their visas expire.

Dr. Andrei Albul, a foreign-trained veterinary neurologist, faces that prospect.

He moved from Russia last year after authorities arrested him for protesting the war in Ukraine. Then he was drafted. Rather than fight, he made his home in the U.S. Now he works as a veterinary technician at Tarassov's practice near Salt Lake City, where he lives with his wife, also a veterinarian, and their young daughter. 

Albul initiated the online petition, which has garnered 126 signatures. He said he posted it while discouraged and stressed. Albul's work visa expires in March, and he's so concerned about finding a CPE test date that while he sleeps at night, his mother, who lives nine hours ahead in St. Petersburg, spends her days monitoring the test scheduling portal in hopes of finding an open examination date for her son.

"She refreshes it every hour," Albul said. "We decided that if she sees an open date, she will call and wake me up. I sleep with my phone next to my head, just in case."

So far, she's had no luck. Competition is fierce. Albul's goal is to finish the ECFVG in time to schedule the NAVLE in November, the only chance he'll have to take the exam before his visa expires. 

"I only have a year until my visa is finished," he said, exasperated. "And I can't be sure I can take these tests before my visa is gone. Until I do this, I have no actual reason to go to the U.S. Embassy and ask for a visa extension, and I want my family to stay in this country. My daughter loves her school; she's happy. We are comfortable here."

Some believe the AVMA has a responsibility to better manage candidate expectations. 

"It would be nice to share timeframes at the point of registration, so every foreign doctor registering in the program knows how long (approximately or potentially) the whole process might take, due to long reply times, long document processing times and extremely long waiting for the CPE, since there are few available seats," said another veterinarian who left Russia when the war began and is in the U.S. 

Because her situation is vulnerable, she spoke on condition of anonymity.

"When you are reading ECFVG explanation articles on their website, it is very easy to think you can finish the whole process in under a year ... and that is simply very far from reality," she said. "It would be just nice of them to warn people to be ready for indefinite waiting times, since many of the foreign veterinarians have families and might be tight on funds and would really like to be able to somehow plan their lives during this process." (The AVMA website notes that candidates can complete the ECFVG in four to six months, depending on CPE availability; others may take longer, up to two-and-a-half years.)

Recently, however, she's noticed an uptick in response times from the ECFVG. Early on, it took months to get feedback, she said. But lately, replies have been coming within the span of a week. Right now, she's waiting on the translation of her diploma, which initially was not done in accordance with ECFVG instructions. "My fault," she readily admits. Once it's accepted, she can work on scheduling the CPE and NAVLE, possibly for this fall. 

The prospective timeline is a victory, she said, as she'd been "prepared to wait for years already." Officials had a difficult time verifying the veterinary program she attended, she said, because many Russian websites are inaccessible.

"My university was not on the AVMA list of schools, and it took many months for the ECFVG to verify it, but they finally did it!" she said. "So I cannot really complain right now." 

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