WORKSHOP--RESIDENT vs. DEGREE PROGRAMS: PARALLEL OR SEQUENTIAL?
Discussion Leaders: Anthony Schwartz, DVM, PhD; Jan Bartels, DVM, PhD
Rapporteurs: James Creed, DVM, MS; Edward Mather, DVM, PhD
Because of the level of interest, two workshop groups meeting in parallel discussed this topic. Issues or problems which were identified and solutions or conclusions from the 2 groups were nearly identical. The following represents a consensus statement on issues and conclusions.
Responsibility of Academic Veterinary Institutions to Provide Postgraduate Training
In considering the mix of research and clinical residency training, academic veterinary institutions must consider that they have the collective responsibility to provide graduate veterinarians with the opportunity to develop credentials meeting needs in several niches. Each of the following niches may require a different level, type, length and intensity of research training:
- Specialty/private practice
- Academia -- performing nationally competitive research
- Academia -- performing clinical practice/teaching/research
- Government (public practice)
Research training provided to residents, parallel or sequential (or some combination thereof) to a clinical training program, can be variable and will reflect student, institutional and job market factors. We conclude, therefore, that the structure of training programs must be flexible and customized, according to those factors. Institutions operate under a multiplicity of regulations and constraints, including differing levels of available internal and external financial and other resources. There is inadequate involvement, by institutions, of private practices, industry, the military, and producer/commodity groups in clinical specialty and research training efforts. Utilizing such external resources can add further flexibility to residency/degree programs, and increase teamwork, synergism, new educational opportunities and financial support.
Many schools have both parallel and sequential residency/research training programs; in some instances a program combines both approaches. There is substantial variation in the amount of sequencing and parallelism, and the quantity, level and intensity of research performed, between the extremes of nondegree residencies and residency-PhD programs. As noted above, this variation facilitates satisfying differing trainee, institutional and market needs.
We believe that research training during the residency program is important, but we do not consider the presence of an associated graduate degree to be a necessarily critical factor. That is, learning scientific method should be the goal. It is critical, however, that there be a proper balance of components, which minimizes the degree to which research interferes with clinical training, and vice versa. Combined (especially parallel) residency/degree programs are viewed as being more likely to create such programmatic interference (which suggests the need for greater administrative oversight of such programs) than residency programs with more modest research expectations.
Two Factors Influencing the Nature and Balance of Training Programs
- Specialty board guidelines may have impact on the ability to offer a substantial research experience, as clinical and other experiential requirements may preclude sufficient time for research.
- The number of clinical accessions and time required to manage the increasing complexity of clinical case management in contemporary academic veterinary medical practice may affect negatively the ability to perform research.
Influence of the Job Market on Training
The job market for future trainees might influence the type and research/clinical mix of programs selected by trainees and offered by institutions, however the following also should be considered:
- The intellectual interest of the student in a specific training program, or varied opportunities for training, should not be suppressed solely because of market pressures.
- Adequate advice should be presented to applicants, prior to their entry into a program, to ensure that they are aware of current estimates and future projections of available positions.
- Institutional philosophy and resources (such as faculty, clinical case accessions, financial support and physical plant) influence the menu of training program offerings.
- Institutions should respond collectively to consumers' needs as they consider continuing existing programs or developing new ones (e.g., new methods of training for species specialization in a food animal discipline, including management as a major component).
- Veterinary medicine should think regionally, nationally and internationally, as decisions are made concerning the market for trainees and training program offerings.
The Quality of Programs is Important and is Influenced by a Number of Factors
- The quality of the resident
- The quality of the faculty
- An appropriate intellectual environment
- Adequate facilities, clinical case accessions and support personnel.
- Focus and emphasis of the institution
- The mentoring ability and enthusiasm of the faculty. (The quality of postveterinary professional education is enhanced by improved mentoring. Mentors should be selected carefully and trained well. During the residency program, time must be provided for the mentoring process.)
Measures of the Quality of a Program Include:
- Trainees' achievement of board certification,
- Trainees' achievement of graduate degrees and/or postdoctoral positions,
- Perhaps most importantly, evidence of trainees' sustained productivity, and contributions and leadership in their discipline or field of study.
Institutions are encouraged to make available such information about their former trainees, to allow applicants to make an informed selection of a training program.
Are National Standards Needed for Training Programs?
It is felt that standards for excellent training programs are established to an adequate degree by the American Board on Veterinary Specialties (ABVS) and the various specialty colleges. It should be left to institutions, however, to implement those standards, without undue interference from outside organizations.
Are Residency and Associated Research Programs Cost-Effective?
While most residency programs may not be self-supporting financially, residencies and associated research training are viewed as enhancing the overall quality of clinical, educational and research programs of the colleges.
Integration of Basic and Clinical Sciences in Residency Training
A greater effort is needed to integrate the efforts of basic and clinical science faculties in residents' research. This approach provides added resources and initiates cooperative scholarship, thereby benefiting all participants.
Faculty Credit for Residency Training
The residency program is itself a mechanism for enhancing clinical excellence, and must be recognized by college and university administrations, graduate faculties and promotion and tenure committees, as an important entity in postveterinary professional education. This recognition is necessary to permit participating faculty and mentors to be properly rewarded for their efforts, and to further justify the use/expenditure of precious resources.