The American Veterinary Medical Association Council on Education (AVMA COE) has 12 months to become more transparent and consistent and to create firewalls against conflicts of interests or face possible suspension as the nation's sole accreditor of veterinary education.   

The order came Wednesday with the National Advisory Committee on Institutional Quality and Integrity (NACIQI)'s unanimous ruling to demand significant changes in how the COE operates. NACIQI's 18-member board based its decision on the results of a federal audit as well as public complaints about how the COE functions.  

NACIQI is a panel of the U.S. Department of Education (USDE) charged with advising the Secretary of Education on higher-education accreditors. The COE, a 20-member volunteer body, has been USDE-recognized to accredit veterinary education since 1952. Every five years, the organization goes before NACIQI to petition to maintain that recognition.   

Previously, COE's appeals for re-recognition passed with little fuss. That changed this year, when at least a dozen high-profile veterinarians wrote to NACIQI to protest COE activities. The criticisms ranged from the COE's efforts to take its accreditation program global to accusations that it inappropriately relaxed its standards, largely for political reasons, and is overtly guided by AVMA executives.  

USDE auditors identified a lack of transparency as one of the COE's core problems. A 24-page report by USDE recommends that the COE: 

• Increase the transparency of its decisions, including by publicizing negative accreditation outcomes.  
• Rework COE policies and procedures so they are less confusing for both university officials and the COE members who apply the standards to programs.   
• Publicize COE actions in media outlets that reach the general public, not just AVMA members.   
• Weed out conflicts of interest within COE ranks by overhauling the way members are elected to the council.   
• Ensure that those who are on site-visit teams don't make up the majority of members who vote on a program's accreditation status.   

"The agency has some significant work to do," USDE staff analyst Jennifer Hong-Silwany testified before NACIQI, implying that the COE does not operate in full compliance with federal guidelines. Still, she did not advocate that the committee immediately suspend its recognition of the COE as an accreditor; instead, she suggested giving the organization a year to improve how it operates.  

"... There's a spirit and willingness to listen to third-party commenters," Hong-Silwany said, referring to AVMA and COE leaders.  

Some veterinarians disagree. Testimony from some high-profile veterinarians exhibited long-held frustrations with the COE's foray into international accreditation and the alleged relaxing of standards that permitted Western University of Health Science's (Western U) controversial veterinary medical program to earn accreditation.   

Dr. Paul Pion, co-founder of the Veterinary Information Network (parent of the VIN News Service), Dr. Robert Marshak, dean emeritus of the University of Pennsylvania's veterinary school and two former COE members — Drs. Frank Walker and William Kay — were among speakers who aired complaints before the NACIQI panel. Some called the COE's new mission to accredit international programs irresponsible, predicting that it might feed an already oversupplied market of small animal veterinarians in the United States. 

Others focused on a concern that the COE has relaxed its standards to allow subpar programs to earn accreditation. Western U was given as an example, with Marshak noting that unlike in most other programs, veterinary students there are expected to develop their clinical acumen by rotating through private practices rather than a traditional veterinary medical teaching hospital.   

Given that Western U contracts with upwards of 700 private practices, it's impossible for academicians to monitor what students are learning, if anything, Marshak said. What's more, now that building an expensive teaching hospital no longer is required for accreditation, several new Western-like programs are emerging across the United States.  

By accrediting Western U, the COE "ensnared themselves in a trap," Marshak testified. "How do you turn down the next crummy school without being sued?"  

He added: "This is tearing down the profession ... we're going to be a trade organization, not a profession."  

Despite the impassioned testimony of those who warned that COE actions fuel a looming veterinary surplus, back-breaking student indebtedness, unchecked tuition hikes and a lagging job market, NACIQI members agreed that it's not within the agency's purview to consider market demands or an accreditation body's endeavors in foreign countries.

Moreover, it is not the COE's responsibility to act as a workforce gatekeeper, the panel agreed. Still, some NACIQI members found the level of criticism directed at the COE surprising and disconcerting.   

"With all this discontent, is there a means by which the council interacts with the community to address concerns? How is it that there could be so much unhappiness?" NACIQI member William Kirwan asked of the AVMA's Dr. David Granstrom, director of education and research, and Dr. Sheila Allen, former COE chairwoman and dean of the University of Georgia's veterinary college.  

Allen responded that those with criticisms are misguided. She referenced a letter signed by administrators at 22 of the nation's 28 veterinary medical programs supporting the COE's continued recognition as an accrediting body.   

"The commenters (who are critical) are not representing the institutions where they were previously employed," she said. "We have interactions with AAVMC (Association of American Veterinary Medical Colleges) leadership, the administrators of all the colleges, we attend their meetings, we distribute the COE newsletter ... we also have lots of communications on our websites."   

Allen explained the criticism of foreign accreditation and Western U's program this way: "There is a fair amount of resistance to evaluating different models of delivering veterinary education — I'm sure you've had that happen before — and there's a fair amount of resistance to accrediting schools outside North America."   

That didn't deter Kirwan, however, from continuing to question the AVMA about the COE's inner workings.  
   
"I am quite troubled by a number of the findings, and I think there are real deficiencies," he said. "If you do move forward and come back in 12 months, (I hope) the critics will come back and assess whether the agency's response addressed their concerns."  

Within the next year, however, veterinary accreditation could be overhauled. AVMA officials noted during the hearing that they're in talks with the AAVMC on developing a joint accrediting body, much like the model that's employed to accredit medical schools.

"The COE has already met with AVMA and AAVMC leadership to set the groundwork for change," Allen said. She noted that the Liaison Committee on Medical Education, an accrediting authority for medical education sponsored by the Association of American Medical Colleges and the American Medical Association, has been asked to present how its model works during the 2013 Deans Conference in January.