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Volume 21, Number 2 Fall, 1994

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WORKSHOP--QUALITY ASSURANCE IN ADVANCED TRAINING PROGRAMS

Leader: Leon Potgieter, DVM, PhD
Rapporteur: John Galland, PhD


This workshop focused its attention on problems related to assuring the quality of the educational experience within three types of programs: non-degree (residency), degree, and combined residency/degree programs. While there are some issues unique to each of the three programs, other issues were considered to be involved in all three areas. Problems common to all program types included mentoring, establishment of clear programmatic goals, and monitoring outcomes.


Nondegree (Residency) Programs

There is a lack of clearly stated measurable objectives and outcomes that are communicated to students and faculty before training begins. Students experience time management difficulties when their attention must be divided between clinical service and research as a result of ill-defined training requirements.

Inconsistency in mentoring and availability of relevant clinical cases makes it difficult to meet program objectives. Trainees are either too busy or not busy enough. Faculty are often unavailable to fulfill their mentor roles.

Inadequate evaluation of program and trainees occurs and there is a lack of consistent and regular evaluation of training programs, including both internal and external review. Such evaluations should supplement information from the diplomate examinations or job success of the trainees.

Degree Programs

There are no national board examinations for persons completing MS or PhD degrees to help assure quality education and outcome. Quality assurance for the MS and PhD degrees is entirely the responsibility of the University and/or graduate programs within University departments or programs. Recommendations by members of this symposium may be useful in stimulating universities to review their quality assurance efforts.

Administrators, faculty in disciplines outside veterinary medicine, and even members of the veterinary profession, have the perception that acquiring a PhD in veterinary medicine is less rigorous than acquiring a PhD in other disciplines. The following table illustrates the dilemma of a veterinarian aspiring to a research career.

Trainee           21-22 years old       26-27 years old       30 years old          
Research Track    BS                    PhD                   2 Post Docs           
Veterinary        BS                    DVM                   PhD                   
Track                                                                               

The research track individual can focus on his/her research specialty at 21-22 years of age, whereas with the veterinary track individual this focus is difficult to achieve and, at the earliest, occurs 5 to 6 years later than for the former. Furthermore, few veterinarians with a PhD enter into postdoctoral training programs. There is a need for more consistent monitoring of program content and mentoring to ensure students are receiving appropriate quality programs.

The goals of degree programs should be defined. Consensus exists that degree programs should emphasize research. Acquiring a degree has become a stepping stone for achieving any faculty status in all preclinical disciplines and may be becoming a factor for candidates in clinical disciplines aspiring to academic careers. However, many veterinary faculty, although scholarship is an essential component of their assignment, are not in a position to compete for major extramural funding.

Often, training is inappropriate for a research degree and too much formal coursework is required. Flexibility should be sought to allow for training appropriate to the individual's goals.

Clinical departments should promote high-quality, controlled, clinical research. A need exists to develop and validate the knowledge base in clinical medicine. Vigorous quality control on experimental design must be in place.

Inconsistent mentoring, inadequate monitoring of comprehensive examinations, and inadequate rigor of thesis defense may exist in some degree programs. The following recommendations should be considered:

Combined Residency and Degree Programs

The conflicting objectives, divided responsibilities, time constraints, and conflicting demands of combined programs may adversely affect the quality of these programs. In general, parallel programs should be discouraged because of conflicting objectives, divided responsibility, and time constraints. Sequential or separate programs can allow adequate time and focus and thereby promote improved quality training. However, Masters' degree (especially, the nonthesis masters degree option) can be done in parallel with a residency. This can be facilitated if some residency activities (seminars, training experiences, etc.) are given graduate credit.

Combined programs may devalue or diminish DVM, MS, PhD and board certification programs or give the perception thereof. Maintaining the historical value of the earlier degree (DVM) is difficult as credential requirements continue to increase.

There were some topics which were considered by the workshop group that pertained to two or more of the type programs discussed. These topics are presented below with some commentary for each.

Student Selection

Evaluation of background and credentials of incoming students sometimes is difficult, especially for international students when veterinary degrees from different institutions may not be equivalent. Although most residency programs require an internship or practice experience before residency, some students entering the programs are inadequately prepared. Social (animal rights) and financial issues may adversely affect the experience veterinary graduates have before entering residency programs. Only high-quality students should be admitted into a program. Minimal GPA and GRE scores and other appropriate criteria should be established for the admissions process.

Oversupply and Credentials Inflation.

Too many specialists in certain disciplines may be graduating from residency training programs. Do programs have a responsibility to students not to create an oversupply of graduates who cannot be supported by the job marketplace? The job marketplace (supply and demand) cannot be ignored by instructors and programs. A program must add value for the student and make the student more marketable for employment and to enhance his/her professional competence. An oversupply of qualified individuals means more credentials may be needed to become employable, especially at academic institutions.

Inadequate Funding and Support.

Universities and other sponsoring institutions must have the necessary budget, instrumentation, facilities, patients, type of patients, and technology to support the training program either in basic or clinical sciences. The budget should support enough residents or graduate students for the necessary critical mass to optimize instruction.

Difficulty in Defining Competency

Board certification appears to be the only means to define competency legally.


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