AVMA task force to review merits of foreign accreditation

Resolution stripped of economic language on advice of AVMA lawyer

Published: July 20, 2011
By Jennifer Fiala

The American Veterinary Medical Association (AVMA) plans to create a task force to study how accrediting foreign veterinary medical programs might impact the U.S. profession and its quality of standards.

The charge comes from a resolution passed by the AVMA House of Delegates, which met July 15-16 in St. Louis. While the task force exists as a mere recommendation from the House, the final go-ahead from the AVMA Executive Board is a formality; the board has publicly expressed support for the initiative.   

At an estimated cost of $25,000, the task force will review procedures of the Council on Education (COE), the AVMA’s accrediting arm charged by the United States Department of Education to ensure quality veterinary education in America.

Resolution 5 — brought by several state veterinary medical associations — calls for evaluating the merits of foreign school accreditation by answering seven questions:

  • What is the logistical burden in time and expense required by the AVMA and COE in accrediting foreign schools, now and for the next 10 years?
  • How will the continued accreditation of foreign schools impact the financial viability of the veterinary profession in the United States?
  • What is the impact on U.S. standards resulting from the increasing accreditation of foreign schools?
  • What are the potential adverse effects on standards in the U.S. by waiving the certification test (ECVFG or PAVE) for graduates of foreign schools?
  • What concerns are anticipated from international pressure on the COE to have their schools accredited?
  • How does the accreditation of foreign schools serve the needs and interests of the U.S. public?
  • How does the accreditation of foreign schools serve the needs and interest of AVMA’s membership?

What the task force won’t explore: Any effect that the COE’s foray into foreign accreditation might have on the economic viability of U.S. veterinarians, the vast majority of whom are AVMA members. Notably absent from the resolution is the question: “How will the continuation of accrediting foreign schools influence the ongoing veterinarian workforce concerns in the United States?”

That’s per the advice of AVMA legal counsel Isham Jones. Gathered in closed session before the start of the House of Delegates meeting, Jones purportedly warned delegates that throttling back on foreign accreditation to protect the economic health of U.S. practitioners might run afoul of U.S. antitrust laws. The talk resulted in a resolution altered from its original and stripped of language pertaining to the economic environment.

Once a foreign program earns AVMA accreditation, graduates of that program are on equal footing with graduates of U.S.-based schools. Specifically, accreditation allows a foreign program’s graduates to bypass equivalency tests designed to assess competency and sit for the same licensing examinations posed to graduates of U.S.-based programs.

Critics contend that extending accreditation to foreign schools eliminates the equivalency exam hurdle, thereby better positioning the foreign graduates to enter the U.S. workforce. These concerns climaxed early this year with the accreditation of the National Autonomous University of Mexico (UNAM), the first veterinary program in Latin America that the COE has considered. To date, the COE accredits 11 foreign veterinary schools worldwide. Most received the council’s nod during the past decade, as part of the AVMA’s self-imposed charge to become the “premier” global accrediting authority.

Efforts to spread U.S. accreditation internationally are lauded by many who believe the AVMA has a duty to raise global standards for veterinary medicine. Yet an increasingly vocal faction of veterinarians question whether the AVMA's international accreditation efforts might be burdensome to the volunteer-based COE and whether its seal of approval can truly ensure that accredited foreign programs churn out graduates practicing medicine at the same level as their U.S.-based counterparts. Additionally, critics believe that the COE is, in fact, too closely guided by the AVMA's leadership, considering that the group is supposed to act autonomously.

Another objection to the AVMA's role on the international scene comes via concerns that extending accreditation to foreign programs could result in a surge of veterinarians entering the United States, which could increase competition for American practitioners who already are saddled with low starting salaries and heavy educational debt. While these concerns manifested with the accreditation of UNAM, which graduates some 350 veterinarians annually, they are amplified by news that a second Mexican-based program is vying for a COE site visit — an initial step in the accreditation process.

In response, the AVMA released figures to delegates showing that 160 veterinarians from U.S. accredited foreign programs and 500 veterinarians from non-accredited foreign programs entered the U.S. workforce in 2010. Roughly 2,460 veterinarians graduate from U.S.-based programs annually.

“The overriding question is, will the profession and the AVMA best be served by the AVMA continuing to accredit foreign schools by other countries … or best be served by assisting and supporting efforts to accredit their own schools? That's the question that must be answered,” stated Dr. Billy Martindale, Texas delegate to the House.

The Texas Veterinary Medical Association (TVMA) has been at the forefront of efforts to scrutinize the AVMA’s mission to accredit internationally. During the House of Delegate’s meeting in January, the TVMA proposed a resolution calling for the AVMA Executive Board to assign a task force to determine the impact, via risk-benefit analysis, that accrediting internationally might have on the U.S. profession. The resolution failed and resulted in a backlash, with one delegate publicly stating that the measure smelled of prejudice and discrimination.

This time around, the same type of accusations surfaced. Brigadier General Timothy Adams, a veterinarian and delegate representing Uniformed Services of the United States, called Resolution 5 “exclusionary” and “phobic.”
Dr. Katherine Knutson, a delegate representing the American Animal Hospital Association, concurred: “We’re using this resolution as a way to deal with the fact that many of us believe that there are too many veterinarians in the United States, that there’s an oversupply of them and perhaps one of the ways to get rid of that would be to have everyone take some sort of test."

Dr. William DeWitt, a delegate representing Alabama, responded: “We’re producing enough veterinarians here, more than we probably need. This push to accredit foreign schools is going to bring more veterinarians in. It is going to bring down the compensation for veterinarians. Yes they will be competing with us. That being an aside, they’re still my colleagues.”

Amid vocal opposition to the resolution, a watershed moment came with a speech from Dr. Orlando Garza, TVMA president. Though Garza is not a House member, he spoke to delegates about concerns he hears from practitioners in his area.

“What effect will foreign school accreditation have on AVMA members, I don’t know,” he said. “But I think it’s way too important of an issue to sweep under the carpet. The AVMA has too many workers in the field to ignore this.”

On the House floor, Montana delegate Dr. John Beug reiterated the grassroots impetus for the resolution and made light of any notion that it might be exclusionary in its intent.

"We're just asking that a task force be made to look at the process and see how it impacts us in the United States," he said. "I'm not worried about a foreign veterinary student taking my job. I'm getting ready to retire anyway."

In related news on accreditation, AVMA Executive Board Chair Dr. John Brooks stood before the House and in a call for “fiscal responsibility,” suggested that the delegation dismantle Resolution 6 — a proposal to create a task force to conduct a cost-benefit analysis of the association’s involvement in global affairs — in favor of asking AVMA staff to come up with a report on the topic.

The resolution was proposed by California and Arizona veterinary medical associations and essentially expanded the foreign accreditation review mapped by Resolution 5 to include all global activities. Supporters of the Resolution 6 noted that the task force easily could be the same one assigned to explore Resolution 5, which would lessen and possibly even negate its $25,000 price tag.

Resolution 6, however, ultimately failed.

Shortly after Brooks’ call to exercise fiscal restraint, the Executive Board presented their own resolution — this one reviewing how the association’s governance structure operates — for $45,000. The measure passed.

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