MU college expanding amid dire vet shortage

Vicky Kasten always enjoyed diagnosing and treating her menagerie of pets while growing up in suburban St. Louis, and she often compared notes with her veterinarian aunt in Texas. So it was natural that she enrolled at the University of Missouri’s College of Veterinary Medicine.

But in October, right after donning her white coat in a ceremony marking the class of 2011’s move into clinical training, Kasten didn’t work on cats and dogs. She headed down to Versailles to treat large farm animals in a rural area north of Lake of the Ozarks.

“It’s hard, physical labor,” Kasten said. For example, she spent hours one night in bad weather helping a cow deliver a calf by wrapping chains around the front hooves of the 80-pound animal and pulling.

But she learned to love working with dairy farmers while helping out a veterinarian in Union during breaks at Missouri Baptist University, where she earned her undergraduate degrees in chemistry and biology.

“They are just such good, hard-working people,” Kasten said. She and the farmers were “working together to try to figure out what to do better to care for their herds.

“To me, veterinary medicine is like a murder mystery,” she said. “You’re given all these clues, and you work together to try to treat the animal and hopefully save the client money at the same time.”

But there’s a larger mystery that the MU vet school is helping to solve: How will the U.S. meet what Dean Neil Olson calls the “current and looming” shortage of veterinarians in most areas, particularly those who treat food animals rather than pets and those involved in public health?

This fall, Missouri’s sole veterinary school admitted the largest freshman class in its history: 110 students. In 2007, when Olson became the new dean, 76 students were admitted.

Olson’s long-term goal is to admit 125 students a year and create more tuition revenue to boost programming resources. But that will take more space in an already crowded facility. His 10-year plan calls for a new academic building and renovation of current buildings to meet the space shortages as well as to accommodate the additional students.

Billion-dollar industry’s widespread impact

Veterinary medicine is a $1 billion industry in Missouri, Olson said, and every dollar spent for veterinary education and services generates $2.42 in economic impact to the state.

“But it potentially goes way beyond that” in its contribution to the state’s well-being, Olson said.

It’s well-known, he said, that “animal agriculture is very vulnerable to bioterrorism.” Having a strong veterinary college and well-supported veterinary medicine system in the state protects animals and the state’s No. 1 industry — agriculture.

Animal health and safety also helps safeguard the No. 2 industry — tourism — from the losses that would ensue if something like the foot-and-mouth disease outbreak in the United Kingdom happened close to the Interstate 70 corridor, which would require massive slaughtering of animals and the shut-down of highways, airports and more.

Day to day, MU veterinary medical extension specialists, through herd health management consultation and medical care, are directly responsible for increasing the efficiency of the Missouri’s food animal production. According to university estimates, every 1 percent productivity increase in the state’s $2.5 billion livestock industry results in an increase of $25 million more sales for the state’s producers. But that scenario requires a sufficient number of large-animal veterinarians.

Luring large-animal docs

At MU’s veterinary teaching hospital, there is a stark difference in activity on the floor where students treat small animals, with the cacophony of barking dogs and the packed waiting room, and the floor where students treat livestock.

The surroundings are quiet when Dusty Nagy, an assistant professor and doctor of veterinary medicine, leads a gaggle of students — five women and one man — on her rounds at the food animal clinic.

Although veterinary medicine used to be a male-dominated industry, that 5-to-1 ratio is now typical at the vet school at MU and elsewhere. About 80 percent of the MU applicants and the admitted students are women. And Kasten is one of a very few of those women who will enter a practice whose main clients are cattle, hogs, horses and, occasionally, goats; only three to five female graduates go into large-animal practices each year, according to Olsen.

Kasten has tried to spread her passion for large-animal work. She helped revive the vet college’s Swine Club and worked with the Bovine Club to introduce more students to hands-on experience with cattle.

While spending six weeks in dairy practices in Wisconsin this past summer as an “externship,” Kasten got first-hand insight into the demand for large-animal practitioners. “There is definitely a shortage,” she said. At a goat-care conference, “I was swarmed by people all day saying, ‘You need to come here.’”

She’s also realistic about the barriers she might face in her chosen field. “There still is some animosity against women as large-animal veterinarians,” she said. She recounts stories of women buying existing practices, then seeing large-animal clients pulling out because they don’t think a woman can do the job.

Kasten, who’s 5 foot 9 inches tall and strong from her clinical work, said she’s confident she’ll handle the job.

Olson acknowledges that “there’s a stereotype that’s out there, and it’s unfortunate. You can’t just flip a switch. Attitudes have to change over time.” He also said that with proper use of restraints, lifting mechanisms and other specialized equipment, for most procedures “you don’t have to have brute strength, male or female.”

Olson looks at the gender shift in applicants and graduates as part of a larger “feminization of the health professions” going on in medical and dentistry schools as well. “Here in veterinary medicine, we’ve been the most dramatically impacted,” he said. He emphasizes that it has been a gradual change as women have become more interested in pursuing mathematics, science and engineering.

“The real question we should be asking,” Olson said, “is this: Where are the male applicants?”

He believes a key factor is less-than-desirable starting salaries for new veterinarians facing an average of $115,000 in debt load at graduation after so many years in school. A colleague at the med school tells him the average student debt there is $150,000, but starting salaries are disproportionately greater. Veterinarians can look forward to significant increases in income once a practice is established or after obtaining additional specialty training, but he said it’s those first few years out that get people’s attention.

In 2009, the average veterinary school graduate going into private practice started at a salary of $65,165.

As an incentive for students to stay in Missouri to practice large-animal veterinary medicine, a new federally funded loan program provides six MU students with $20,000 for living and educational expenses per academic year. The loans are forgiven, provided the students practice large animal veterinary medicine in a defined area of need — one year for each year they received the scholarship.

Easing the growing pains

MU’s College of Veterinary Medicine has graduated more than 3,000 veterinarians since its founding in 1946. The annual entering class number hovered around 30 for the first two decades, moved up to 65 to 70 in the late ’60s and early ’70s and only recently moved above 70.

After admitting 110 students this year, the college’s long-term goal is to phase in classes of up to 125 a year, for an eventual total student population of 500.

Until this year, MU’s class size ranked 24th or 25th out of 28 veterinary colleges in the United States.

“We will still be at about the national average because other schools will increase, too,” Olson said. “We’ll go from being one of the smallest in terms of class size to being right in the middle.”

But the MU vet school ranks near the bottom — 25th out of 28 schools — in state funding.

Why grow? Two major reasons, Olson said. The first is to reduce the severity of the shortage of veterinarians. The second is “to generate more revenue.”

Olson said “going to 110 really stretches us.” One way of coping this year was to divide the histology lab course into two sections; others were to consolidate exam schedules and give exams as early as 7 a.m. The auditorium seats 190 students, so it works for larger lectures.

“But our curriculum is not like a traditional curriculum,” he said. “Everyone in a class has to take the same thing at the same time each year. So bringing in a larger class sends ripples in terms of how we schedule other courses.”

Why care about the veterinarian shortage?

As the only health professionals trained in multi-species comparative medicine, veterinarians serve the public in myriad ways, some of which make the headlines regularly: investigating animal and human disease outbreaks such as food-borne illnesses (think E. coli), the H1N1 influenza pandemic (inappropriately named “swine flu”) and zoonotic (animal-borne) illnesses (rabies, West Nile viral encephalitis); working in the Food and Drug Administration to evaluate the safety of everything from pet foods to food additives; protecting the U.S. from bioterrorism by serving in the U.S. Army Veterinary Corps and the Department of Homeland Security.

Many of the 24 federal entities with veterinarian workforces told the General Accounting Office they are concerned about current and future shortages. The Food Safety and Inspection Service fell 15 percent short of its 2008 hiring goal for veterinarians who inspect meat and poultry. Just to satisfy current needs, 500 of the 2,500 new graduates each year need to enter the public arena. To make matters worse, 27 percent of the veterinarians at key USDA agencies will be eligible to retire in fewer than three years.

MU began a joint Doctor of Veterinary Medicine-Master of Public Health degree program two years ago; it now has 17 students enrolled — some as a dual degree, others started the program with their D.V.M in hand. “It will be very desirable for veterinarians of the future to have a public health background,” Olson said.

The shifts needed to staff up for the future will take time. Olson said it’s natural for incoming students to apply to veterinary school to emulate someone they admire — most often a private practitioner whom they have shadowed or who cared for their animals. The trend to small-animal practice is starting to level off, he said; students such as Vicky Kasten are rediscovering the satisfaction of large-animal care.

Kasten drew inspiration from her aunt, a companion-animal veterinarian in Texas who challenged her to learn how to diagnose and treat animals rather than just take care of them.