Question of workforce demand echoes long-standing issue in U.S.
Dr. Kenji Murakami is one of five doctors at the Nakasorachi Veterinary Clinic in Furano, a town in Hokkaido, the northernmost of Japan’s main islands and the source of half of the country’s milk supply and a fifth of its beef.
Each morning, Murakami sets out on daily rounds to treat cows and steer at dairy farms and ranches scattered across the region. He drives through a valley that is carpeted with lavender blooms in spring and attracts skiers to its surrounding mountains in winter. After spending 16 years in the veterinary profession, Murakami makes the equivalent of about US$80,000 a year, a decent living in a rural area.
It’s a good life, Murakami said. Except, that is, when one of the doctors at the clinic quits. Then, the remaining four doctors have to fill in for as long as two years — up to a year to hire a veterinary school graduate, and another year to train the person. Murakami said clinics like his almost always hire graduates straight out of veterinary school because it is difficult to find large animal veterinarians willing to move from another job.
Murakami’s concerns seem a world away from the storm of controversy that accompanied the launch in April of Japan’s first new veterinary school in 52 years, but they are very much at the heart of a debate about whether it makes sense to open a new school at a time when Japan has a shrinking population of people, livestock and pets.
One of the key reasons the Japanese government has given for opening the new veterinary school in Imabari — located at the opposite end of the Japanese archipelago from Hokkaido — is that rural areas face a shortage of veterinarians. Of the 17,569 veterinarians in private practice, 13,400 work with small animals and 4,165 work with large animals, according to a 2013 report by the Japan Veterinary Medical Association (JVMA).
The new program in Imabari is the first veterinary school to be established on the island of Shikoku, a largely rural area. The veterinary program is a department of Okayama University of Science, which is run by the for-profit Kake Educational Institution. (The Kake-owned university is unrelated to Okayama University, a public institution in Okayama Prefecture.)
The new veterinary school was built on 40 acres of land worth 3.7 billion yen (US$34 million) donated by the city of Imabari and with ¥9.6 billion ($88 million) in public money, much of it designated for revitalizing Japan’s rural economy. The school received applications from 2,185 students and accepted 147, according to Yoshiya Yoshimi, a communications official in the school admissions office.
Veterinary schools in Japan, as with its medical and dental schools, take students straight from high school into a six-year program. The Imabari school charges ¥2.5 million ($23,000) in the first year and ¥2.43 million ($22,300) in succeeding years for a total cost of ¥14.65 million ($134,400) for the full six years, high by Japanese standards. Public veterinary school in Japan costs ¥817,800 in the first year and ¥535,800 in succeeding years, for a total of about ¥3.5 million ($32,000), according to the website of a prep school for students interested in studying veterinary medicine.
The school at Imabari has promised to offer an “international standards” curriculum that supplements traditional book and lab work with more clinical training in both small and large animals.
Yoshimi said he couldn’t elaborate on what will distinguish the curriculum because school leaders have not yet determined what that will be. “We are just in the process of reviewing the curriculum for future years,” Yoshimi said, speaking by telephone in Japanese. He said that any innovation in the curriculum wouldn’t come until the fourth year, when students begin to specialize.
Yoshimi said the program's leaders aspire to make the school more globally connected, and has accepted nine foreign students, mostly from Asia, to the first-year class. Their hope is that the connections that Japanese students make with their foreign-born classmates will lead to future collaborations. For example, Yoshimi said, “Influenza can happen anywhere. If students have international connections, they can work collaboratively with people overseas to address those issues.”
Planned innovations notwithstanding, many in Japan's veterinary community long have opposed establishing any new veterinary schools. The JVMA pointed out in a statement last June that the country already had 16 veterinary schools, while European countries average four to eight. The association acknowledged that there are shortages in some areas, such as agriculture and public health, but that “from a national point of view, there is no shortage of veterinarians.” The statement also expressed concern that any new school would worsen an existing shortage of veterinary-school professors.
The debate is similar to one in the United States that began years ago and continues to flare today. Texas Tech University, for example, is on a quest to open a new veterinary school in a state that has an established program at Texas A&M University in the eastern half of the state. Advocates for the new school say large animal veterinarians are in short supply in the western part of the state.
Advocates for the two newest veterinary schools in the United States — Midwestern University in Arizona and Lincoln Memorial University in Tennessee, both of which opened in 2014 — also cited a need for more practitioners in rural communities.
Others in the veterinary community argue that, to the extent some rural areas need more veterinarians, the problem isn't a numerical shortage of practitioners but the economics of those regions. "... [T]hey can’t make ends meet; that’s why these areas are underserved,” Dr. Alan Kelly, a dean emeritus at the University of Pennsylvania School of Veterinary Medicine, told the VIN News Service in 2015. Kelly chaired a committee that published a U.S. veterinary workforce study in 2013.
Political scandal intensifies the controversy
Dr. Takuo Ishida, medical director of the Akasaka Animal Hospital in Tokyo and president of a professional-education organization called the Japanese Board of Veterinary Practitioners, tells a tale of political scandal and intrigue behind the new veterinary school. Relaying a narrative widely reported in the press, said the government approved the new school against the advice of Japan’s veterinary community because Japan’s prime minister, Shinzo Abe, is a close friend of Kotaro Kake, chairman of the Kake Educational Institution, and son of the school’s founder. The two met while studying as exchange students at the University of Southern California.
“It is well known that Abe and Kake have long been friends,” Ishida related by email. “There are pictures all over the media of the two having dinner, doing a BBQ and playing golf.”
Kihei Maekawa, former vice minister of education, said at a press conference last year that he had seen documents stating that it was “the prime minister’s will” that Kake be allowed to establish the new school. Maekawa had earlier told the Asahi Shimbun, one of Japan’s most prestigious newspapers, that “It would be untrue if I said the education ministry didn’t feel pressured by those words.”
Abe reportedly has denied intervening to push for special approval of the school.
Beyond the political outrage, worries about an oversupply of veterinarians in Japan spring from trends in the population of people and pets alike. The number of dogs fell to 8.9 million in 2017, from 11.9 million in 2010, according to the Japan Pet Food Association, while the number of cats remained largely flat at about 9.5 million. Japan’s rapidly aging population also means more households are giving up their dogs because they no longer can care for them properly, for example, by taking them on regular walks. The number of livestock in Japan also has declined by 10 percent over the past decade, according to the Asahi Shimbun.
Even as the number of animals needing care declines, the number of veterinarians continues to soar. “Since veterinarians continue to work even as they age, their total number has climbed to more than 39,000, up 8,000 since a decade ago,” the Asahi Shimbun reported last year.
For these reasons, Dr. Kisho Miyoshi, CEO of Matsuyama-Hojo Veterinary Clinic, located about 25 miles from Imabari, believes concern about an oversupply is justified. “In Japan, the population [of people] is declining, as well as the number of dogs and cats,” Miyoshi said in a phone interview. “Yet the number of animal hospitals keeps increasing, so competition is high.”
The nation’s 16 veterinary schools graduate 930 new veterinarians each year, with the 11 public schools graduating about 30 students each, and five private schools graduating about 120 each, according to the JVMA report. The school in Imabari will add another 140 to 147 graduates a year beginning in 2024, when the first class graduates, said Yoshimi, the school-admissions representative.
Said Miyoshi: “Many veterinarians are worried that the number of veterinarians will increase so much, there won’t be enough good work for everyone.”
Even so, Miyoshi said many of his friends in the region, both veterinarians and non-veterinarians, support the new school because of the positive impact they perceive it will have on the local economy, and because of the local shortage of veterinarians. “In rural areas like Ehime, [where Imabari is located] it’s difficult to hire [veterinarians],” he said.
Miyoshi said he has visited the new school and was impressed by its modern facilities. “They are trying to take a different approach with more practical training, but it’s too early to tell what the results will be,“ he said.
Yoshimi, the admissions representative, said the school is not concerned about a possible oversupply of veterinarians because graduates can take positions available at rural agricultural cooperatives, government agencies and pharmaceutical and medical-instrument companies.
Educational quality and curriculum questioned
Another concern among Japanese veterinarians is the quality of education that the new school will provide. Kake Educational Institution, the company behind the new school, also owns two other universities, two vocational schools, a high school, a junior high and a kindergarten. Those schools generally are not regarded to be among Japan’s more competitive schools.
Universities operated by Kake “are easy to get into if you have enough money,” Ishida said. Citing information from the prep school that serves students interested in veterinary medicine, Ishida said the SAT-equivalent scores, called hensachi, are relatively low at the Okayama University of Science. (High school teachers in Japan use schools' scores to guide their students in choosing colleges.)
Okayama University of Science has a heavy focus on engineering and informatics and a longer history in those fields than in the life sciences. It added a department of medical science in 2002, a department of life science in 2004 and a department of zoology in 2008.
If a new veterinary school had to be established, Ishida maintains, it should have gone to Kyoto Sangyo University, a well-respected school doing strong research in important subjects such as zoonosis. Kyoto Sangyo attracts talented students with high test scores and has long sought permission from the Japanese Ministry of Education, Culture, Sports, Science and Technology to add a new veterinary school, Ishida said.
Kyoto Sangyo withdrew from consideration last summer, in part, because the government added a condition requiring that any new school be established in a region that didn’t already have a veterinary school.
Dr. Seigo Ogasawara believes there is a clear need for reform in Japan’s veterinary-education system. Ogasaware is a clinical pathologist at Idexx Laboratories, has trained in veterinary studies both in Japan and the United States, and frequently travels Japan lecturing at conferences and seminars.
During an interview while attending the American College of Veterinary Internal Medicine conference in Seattle this month, Ogasawara, speaking in Japanese, explained: “Whereas American students have clinical rounds and get a chance to work with animals, students in Japan are assigned to work in a professor’s research labs so they can complete the thesis the Ministry of Education requires to become a veterinarian.”
Professors like the system, Ogasawara said, because the students studying in their labs help them with their research. Because of the effort that research takes, however, students don’t have time to do clinical rounds and seldom learn even the basics of practicing veterinary medicine.
“Most students in Japan will graduate without ever having learned how to spay a dog,” he said. Because the curriculum of Japanese veterinary schools is determined by the Ministry of Education, Ogasawara doubts leaders of the new school in Imabari will be able to do much to change it.
Extensive on-the-job training required
Owing to the lack of opportunities to gain practical experience in school, new graduates typically require years of additional training before they can work independently. Consequently, there is an extensive system of online services, conferences and evening seminars to address the continuing education of veterinarians.
Miyoshi, in addition to running his veterinary clinic, runs an online school for continuing education called Veterinary Services Japan. He offers a variety of courses, tapping experts who have trained in the United States. He said he plans soon to add a class to help veterinarians learn to better manage their practices.
The lack of such management experience, Miyoshi said, is one reason that 65 percent of the clinics in Japan have only one veterinarian. Because competition between clinics is intense, many veterinarians end up focusing more attention on marketing than improving animal care, he believes.
A lack of clinical and business skills, he said, also is a reason many veterinarians move to cities to practice: They believe city hospitals will be in a better position to train them.
Murakami in Hokkaido agrees that students need more practical training at veterinary school. He recalled having had only one opportunity to do surgery on an animal in his six years in school. “When we get veterinarians straight from vet school they are pretty useless,” he said bluntly. “I learned virtually everything I know after I got out of school.”
At the same time, Murakami doubts the school in Imabari will make much headway in training students in large animals. “Where are they going to find the people to teach the courses?” he asked rhetorically. “There is already a severe shortage of professors trained in large animals.”
Yoshimi, the school-admissions representative, said he doesn’t believe the school will have trouble hiring professors to teach about large animals but wouldn’t say from where those professors will come.
Even if students coming out of Okayama University of Science are properly trained, Murakami said, historically, only about a quarter of the veterinarians who start out working with large animals stay on the farm long-term. “After a few years, the rest of them go into small animal practice or to drug companies where the offices are more modern and high-tech.”
He fears that no matter how good the training is at the new school, he will continue to lose veterinarians to the cities and have trouble finding their replacements.
This article has been changed from the original to reflect veterinary-school application figures provided by the Okayama University of Science after the article was published. The article previously stated, citing a Japanese media report, that more than 600 students paid a fee equivalent to about $300 to apply.