Veterinary physician

Veterinary physician
A vet conducts a routine spaying operation on a domestic cat

A veterinary physician, colloquially called a vet, shortened from veterinarian (American English) or veterinary surgeon (British English), is a professional who treats disease, disorder and injury in animals.

In many countries, the local nomenclature for a vet is a protected term, meaning that people without the prerequisite qualifications and/or registration are not able to use the title, and in many cases, the activities that may be undertaken by a vet (such as animal treatment or surgery) are restricted only to those people who are registered as vet. For instance, in the United Kingdom, as in other jurisdictions, animal treatment may only be performed by registered vets (with a few designated exceptions, such as paraveterinary workers), and it is illegal for any person who is not registered to call themselves a vet or perform any treatment.

Most vets work in clinical settings, treating animals directly. These vets may be involved in a general practice, treating animals of all types; may be specialised in a specific group of animals such as companion animals, livestock, zoo animals or horses; or may specialise in a narrow medical discipline such as surgery, dermatology or internal medicine.

As with healthcare professionals, vets face ethical decisions about the care of their patients. Current debates within the profession include the ethics of purely cosmetic procedures on animals, such as declawing of cats, docking of tails, cropping of ears and debarking on dogs.

Contents

Etymology and nomenclature

The word veterinary comes from the Latin veterinae meaning "working animals". "Veterinarian" was first used in print by Thomas Browne in 1646.[1]

The term veterinarian is used in North America and other countries using predominantly American English, whereas in the United Kingdom, and countries which are formerly part of the British Empire or are part of the Commonwealth of Nations tend to use the term veterinary surgeon.

Roles and responsibilities

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Vets are primarily required to treat disease, disorder or injury in animals, which includes diagnosis, treatment and aftercare. The scope of practice, speciality and experience of the individual vets will dictate exactly what interventions they perform, but most will perform surgery (of differing complexity).

Unlike in adult human medicine, vets must rely on clinical signs, as animals are unable to vocalise symptoms as a human would (and in that respect is similar to medicine on human children). In some cases, owners may be able to provide a medical history and the vet can combine this information along with observations, and the results of pertinent diagnostic tests such as x-rays, CT scans, blood tests, urinalysis or other diagnostics.

As with human medicine, much veterinary work is concerned with prophylactic treatment, in order to prevent problems occurring in the future. Common interventions include vaccination against common animal illnesses, such as distemper or rabies. This may also involve being involved in owner education so as to avoid future medical or behavioural issues.

Unlike in most human medicine, vets will often consider the appropriateness of euthanasia ("putting to sleep") if a condition is likely to leave the animal in pain or with a poor quality of life.

Employment

The majority of vets are employed in private practice treating animals (75% of vets in the United States, according to the American Veterinary Medical Association).

Small animal vets typically work in veterinary clinics or veterinary hospitals, or both. Large animal vets often spend more time travelling to see their patients at the primary facilities which house them, such as zoos or farms.

Other employers include charities treating animals, colleges of veterinary medicine, research laboratories, animal food companies, and pharmaceutical companies. In many countries, the government may also be a major employer of vets, such as the United States Department of Agriculture or the State Veterinary Service in the United Kingdom. State and local governments also employ veterinarians.[2][3]

Focus of practice

Vets and their practices may be specialised in certain areas of veterinary medicine. Areas of focus include:

  • Exotic animal veterinarian - Generally considered to include reptiles, exotic birds such as parrots and cockatoos, and small mammals such as ferrets, rabbits, chinchillas, and degus.
  • Conservation medicine - The study of the relationship between animal and human health and environmental conditions.
  • Small animal practice - Usually dogs, cats, and other companion animals/household pets such as hamsters and gerbils. Some practices are canine-only or feline-only practices.
  • Laboratory animal practice - Some veterinarians work in a university or industrial laboratory and are responsible for the care and treatment of laboratory animals of any species (often involving bovines, porcine species, felines, canines, rodents, and even exotic animals). Their responsibility is not only for the health and well being of the animals, but also for enforcing humane and ethical treatment of the animals in the facility.
  • Large animal practice - Usually referring to veterinarians that work with, variously, livestock and other large farm animals, as well as equine species and large reptiles.
  • Equine medicine - Some veterinarians are specialists in equine medicine. Horses are different in anatomy, physiology, pathology, pharmacology, and husbandry to other domestic species. Specialization in equine veterinary practice is something that is normally developed after qualification, even if students do have some interest before graduation.
  • Food animal medicine - Some veterinarians deal exclusively or primary with animals raised for food (such as meat, milk, and eggs). Livestock practitioners may deal with ovine (sheep), bovine (cattle) and porcine (swine) species; such veterinarians deal with management of herds, nutrition, reproduction, and minor field surgery. Dairy medicine practice focuses on dairy animals. Poultry medicine practice focuses on the health of flocks of poultry; the field often involves extensive training in pathology, epidemiology, and nutrition of birds. The veterinarian treats the flock and not the individual animals.
  • Food safety practice - Veterinarians are employed by both the food industry and government agencies to advise on and monitor the handling, preparation, and storage of food in ways that prevent foodborne illness.
  • Wildlife medicine - A relatively recent branch of veterinary medicine, focusing on wildlife. Wildlife medicine veterinarians may work with zoologists and conservation medicine practitioners and may also be called out to treat marine species such as sea otters, dolphins, or whales after a natural disaster or oil spill.

Veterinary specialities

Veterinary specialists are in the minority compared to general practice vets, and tend to be based at points of referral, such as veterinary schools or larger animal hospitals. Unlike human medicine, veterinary specialities often combine both the surgical and medical aspects of a biological system.

Veterinary specialities are accredited in North America by the AVMA through the American Board of Veterinary Specialties, in Europe by the European Board of Veterinary Specialisation and in Australasia by the Australasian Veterinary Boards Council. While some vets may have areas of interest outside of recognized specialities, they are not legally specialists.

Specialities can cover from general topics such as anaesthesiology and dentistry to organ system focus such as cardiology or dermatology. A full list can be seen at veterinary specialties

Salary

The mean salary for new graduates in the United States during 2010 was US$48,674 including nearly 50% going on to advanced study programs.[4] Those not continuing their studies made US$67,359 at first.[4], whereas vets in the United Kingdom earned slightly less with new graduate wages at an average of £25,000.

The average income for private practice in the United States rose from $105,510 in 2005 to $115,447 in 2007. These increased values exceed those of public practice including uniformed services and government.[5]

Education and regulation

In order to practice, vets must complete both an appropriate degree in veterinary medicine, and in most cases must be registered with the relevant governing body for their jurisdiction.

Veterinary science degrees

Degrees in veterinary medicine culminate in the award of a veterinary science degree, although the title varies by region. For instance, in North America, graduates will receive a Doctor of Veterinary Medicine (DVM or VMD) whereas in the United Kingdom or India they would be awarded a Bachelor's degree in Veterinary Science, Surgery or Medicine (BVS, BVSc, BVetMed or BVMS), and in Ireland graduates receive a Medicina Veterinaria Baccalaureate (MVB).

The award of a bachelor's degree was previously commonplace in the United States, but the degree name and academic standards were upgraded to match the 'doctor' title used by graduates.

Comparatively few universities having veterinary schools that offer degrees which are accredited to qualify the graduates as registered vets. In the United States, only 28 universities offer a degree meeting American Veterinary Medical Association (AVMA) standards,[6] in Canada, only 5 veterinary schools offer a vet qualifying course and in the United Kingdom only 7 universities offer a suitable degree.

Due to this scarcity of places for veterinary degrees, admission to veterinary school is highly competitive and requires extensive preparation. The likelihood of acceptance is not in favour of the applicant. In the United States in 2007, approximately 5,750 applicants competed for the 2,650 seats in the 28 accredited veterinary schools, with an acceptance rate of 46%.[7]

With high levels of competition, many schools may place heavy emphasis and consideration on a candidate's veterinary and animal experience. Formal experience is a particular advantage to the applicant, often consisting of work with veterinarians or scientists in clinics, agribusiness, research, or some area of health science. Less formal experience is also helpful for the applicant to have, and this includes working with animals on a farm or ranch or at a stable or animal shelter and basic overall animal exposure.[8]

In the United States, approximately 80% of admitted students are female. In the early history of veterinary medicine of the USA, most veterinarians were males. However, in the 1990s this ratio reached parity, and now it has been reversed.


Registration and licensing

Following academic education, most countries require a vet to be registered with the relevant governing body, and to maintain this licence to practice.

Dependent on where the vet practices (or wishes to practice), they may have to complete an examination or test in order to complete this registration. For instance, in the United States, a prospective vet must receive a passing grade on a national board examination, the North America Veterinary Licensing Exam. This exam must be completed over the course of eight hours, and consists of 360 multiple-choice questions, covering all aspects of veterinary medicine, as well as visual material designed to test diagnostic skills.

Postgraduate study

The percentage electing to undertake further study following registration in the United States has increased from 36.8% to 39.9% in 2008. About 25% of those or about 9% of graduates were accepted into traditional academic internships. (2008 -696 graduates accepted a position in advanced study, 89.2% (621) accepted an internship (private practice, 74.5%; academic, 25.3%; and other internship, 0.2%). An additional 6.0% (42) accepted a residency). Approximately 9% of veterinarians eventually board certify in one of 20 specialties.[9][10]


Curriculum comparison with human medicine

The first two year curriculum in both veterinary and human medical schools are very similar in the course names, but very different in the content. First two year curriculum usually include Biochemistry, Physiology, Histology, Anatomy, Pharmacology, Microbiology, Epidemiology, Pathology and Hematology.[11] Some veterinary school uses the same biochemistry, histology, and microbiology books as human medicine students; however, the course content is greatly supplemented to include the varied animal diseases and species specific differences. Many veterinarians were trained in pharmacology using the same text books as human physicians. As the specialty of veterinary pharmacology develop, more schools are using pharmacology textbooks written specifically for veterinarians. Veterinary Physiology is more complex, as intestinal physiology of animals is complex (Rumen Physiology), different renal physiology (especially in the Equine Species, Fish, Reptiles and Poultry), and of course, different pulmonary physiology (Avian vs. Fish vs. Mammals). Histology is essentially the same for most organs, with the additional differences in the tissues of ruminant intestinal tract and pilo-sebaceous differences in birds, reptiles, and fish. Anatomy is exceedingly complex with the anatomy of the dog most focused upon; ruminant anatomy, with particular focus on intestinal surgical approaches; and equine anatomy, with focuses on musculoskeletal anatomy of the limbs, and intestinal surgical anatomy. Microbiology and particularly, virology, of animals share the same foundation as human microbiology, however, with grossly different disease manifestation and presentations. Epidemiology is focused on herd health and prevention of herd borne diseases, and foreign animal diseases. Pathology, like microbilogy and histology, is very diverse and encompasses many species and organ systems. Most veterinary school have courses in small animal and also large animal nutrition, often taken as electives in the clinical years or as part of the core first two year curriculum.

The last two year curriculum of the two fields are similar only in their clinical emphasis.[11] A veterinary student must be well prepared to be fully functional animal physician on the day of graduation - competent in surgery and medicine at the same time, and willing to practice on as many as 5 or more common animal species. Most veterinarians are trained to perform orthopaedic surgery, gynaecological and obstetrical surgeries, intestinal surgeries, minor urologic surgery, oral surgeries, and even minor cardio-thoracic surgeries. The accumulation of skills in the last two years of veterinary school encompasses what many human doctors acquire after 3 or 5 years of post-doctoral residency. In fact, it is impossible for a human doctor to independently perform ALL the surgical procedures a veterinarian is trained to do in one residency alone. The graduating veterinarian must be able to pass medical board examination and be prepare to enter clinical practice on the day of graduation, while most medical doctors for human in the USA complete 3 to 5 years of post-doctoral residency before practising medicine independently, usually in a very narrow and focused speciality.

Impact on human medicine

Some veterinarians pursue post-graduate training and enter research careers and have contributed to advances in many human and veterinary medical fields, including pharmacology and epidemiology. Research veterinarians were the first to isolate oncoviruses, Salmonella species, Brucella species, and various other pathogenic agents. Veterinarians were in the forefront in the effort to suppress malaria and yellow fever in the United States. Veterinarians identified the botulism disease-causing agent, produced an anticoagulant used to treat human heart disease, and developed surgical techniques for humans, such as hip-joint replacement, limb and organ transplants.

In popular culture

Well-known depictions of a veterinarian at work are in James Herriot's All Creatures Great and Small, made into a BBC series.

Doctor Dolittle is a series of children's books, one of which was turned into a 1967 movie. The movie was remade in 1998 with Eddie Murphy as Dr. Dolittle.

US-based cable network Animal Planet, with animal-based programming, frequently features veterinarians. Two notable shows are Emergency Vets and E-Vet Interns, set at Alameda East Veterinary Hospital in Denver, Colorado.

The song Grandma Got Run Over by a Reindeer, performed by the husband and wife duo "Elmo & Patsy", is a song performed by a veterinarian, Elmo Shropshire, DVM.

Fictional character veterinarians in TV series include Steve Parker in Neighbours; Jim Hansen in Providence, and Vincent Ventresca in the horror film Larva

The Garfield comic has a vet named Liz.

Veterinary Malpractice

Most states in the US allow for malpractice lawsuit in case of death or injury to an animal from professional negligence. Usually the penalty is not greater than the value of the animal. For that reason, malpractice insurance for veterinarians usually is well under $500 a year, compared to an average of over $15000 a year for a human doctor.[12] Some states allow for punitive penalty, loss of companionship, and suffering into the award, likely increasing the cost of veterinary malpractice insurance and the cost of veterinary care. Most veterinarian carry much higher cost business, worker's compensation, and facility insurance to protect their client and worker's from injury inflicted by animals.

Criticisms

Concerns about the role of veterinary surgeons in helping health threats survive and spread have been raised by several commentators, particularly with respect to pedigree dogs. Koharik Arman (2007) reached the following conclusion for example: "Veterinarians also bear some responsibility for the welfare situation of purebred dogs. In fact, the veterinary profession has facilitated the evolution of purebred dogs. ‘Breeds’ that would not normally be sustainable are propagated by the compliance of veterinarians to breeder wishes.” [13] A finding that was echoed by Sir Patrick Bateson in his Independent Review of Dog Breeding following the broadcast of the BBC documentary Pedigree Dogs Exposed: "Its only the ready availability of modern veterinary medicine that has permitted some conditions…to become widespread.”[14] Before one criticizes the veterinary profession on these issues, one needs to understand the make up of the veterinary profession. Veterinarians are as diverse as the general population. Some veterinarians work for and represent the animal industry, some are involved in research using animal as models for human diseases, and some are actively working in protest against the animal industry and facilities that use animals for research. All veterinarians strive to work to improve animal welfare. However, not all veterinarians are all in agreement on all issues concerning animal research, animal husbandry, and animal rights.

Practice by country

  • Veterinary medicine in the United Kingdom

See also

Further reading

  • Freyberger, P. (2009). Vetting: The Making of a Veterinarian. PJF Publishing.
  • Gutkind, L. (1998). The Veterinarian's Touch: Profiles of Life Among the Animals. Holt Paperbacks.
  • Herriot, J. (2004). All Creatures Great and Small. St. Martin's Griffin.

References

  1. ^ Oxford English Dictionary, Oxford University Press.
  2. ^ http://www.bls.gov/oco/ocos076.htm
  3. ^ http://www.goarmy.com/amedd/vet/index.jsp?bnrcd=C490-ITBP-MCAU-04012008-NA-8021-TEXTAD
  4. ^ a b www.avma.org/1 year employment
  5. ^ Burns, Katie. "AVMA Survey Measures Income Trends to 2007." AVMA Journals (1 January 2009): Javma News. American Veterinary Medical Association. 2 Mar. 2009 <http://www.avma.org/onlnews/javma/jan09/090101a.asp>.
  6. ^ http://www.aavmc.org/students_admissions/vet_schools.htm
  7. ^ Griel, Lester C. "Advising Notes." Division of Undergraduate Studies. 7 Apr. 2008. The Pennsylvania State University. 2 Mar. 2009 <http://www.psu.edu/dus/anvet.htm>.
  8. ^[dead link]"Occupational Outlook Handbook, 2008-09 Edition: Veterinarians." Bureau of Labor Statistics. 18 Dec. 2007. United States Department of Labor. 2 Mar. 2009 <http://www.bls.gov/oco.ocos076.htm>
  9. ^ "Market research statistics". AVMA. http://www.avma.org/reference/marketstats/. 
  10. ^[dead link]"Specialties". AVMA. http://www.avma.org/press/profession/specialties. 
  11. ^ a b http://cvm.msu.edu/student-information/dvm-program/dvm-curriculum
  12. ^ http://www.medicalnewstoday.com/articles/43147.php
  13. ^ Arman, Koharik (September 2007). "A new direction for kennel club regulations and breed standards". Canadian Veterinary Journal 48: 953–965. PMC 1950109. PMID 17966340. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1950109. Retrieved 9 December 2009. 
  14. ^ Bateson, Patrick (14 January 2010). "Independent Inquiry into Dog Breeding". http://dogbreedinginquiry.com/publication-of-the-inquiry-report/. Retrieved 16 January 2010. 

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