Confidence and competence of recent veterinary graduates — Is there a problem?

During my presidential year, I have had the privilege to meet, and talk to, a large number of veterinary colleagues in Canada. These conversations soon turn to the attributes of recent veterinary graduates and the profession's view that they lack confidence, competence, or both, upon entry into the profession. Similarly, graduating veterinary students at the college where I teach frequently tell me that they have a strong preference for employment in veterinary practices that are willing to provide close mentoring and oversight in the early employment period, because they lack confidence in their skills and abilities. Many of our graduates seek postgraduate internships for the same reason.

Concerns about the confidence and competence levels of recent veterinary graduates were aired by participants at the 2002 Summit Meeting of the Canadian Veterinary Medical Association (CVMA), where they considered the report of the CVMA Task Force on “Education, Licensing, and Expanding the Scope of Veterinary Practice” (1). Summit participants included members of the CVMA; the presidents and registrars of provincial veterinary medical associations; deans of the veterinary colleges; representatives of the Canadian Food Inspection Agency and the Veterinary Drugs Directorate; and presidents of a number of international veterinary associations; as well as 38 others, representing veterinary and industry interests. In a recent CVMA member opinion survey, which generated over 800 responses (17% rate of return), 76% of respondents indicated that lack of confidence, competence, or both, of new veterinary graduates was a moderately serious to extremely serious problem (2).

Such findings raise the following questions in my mind: Why is there a mismatch between employer expectations of entry level competence and the actual competence of recent veterinary graduates? Why is there a perception that new veterinary graduates lack confidence? Does this perception arise because the employers of entry level veterinarians are unable to recall what they knew when they graduated, or because modern veterinary education does not equip entry level graduates with the competencies required by employers and society?

The generation of new knowledge and understanding in veterinary medicine is accelerating on all fronts. Veterinary practitioners are coping with this phenomenon by focussing along species or discipline lines, such as swine, equine, or feline practice; ophthalmology; or radiology (3). Competence and confidence develop through focussing, or through having an in-depth understanding. Veterinary curricula, which have been described as being a “mile wide and inch deep,” generally provide great breadth but little depth (4). This poses the questions: Could the competence and confidence of new veterinary graduates be improved by providing them with in-depth elective courses after exposing them to a broad-based core curriculum? Is it possible to diversify their education in this way, so that they are able to acquire the specific knowledge and skills required by the marketplace?

In contrast to private practice, where most care is primary, and the focus is on prevention rather than intervention, the academic teaching hospital environment is generally dominated by secondary and tertiary care responsibilities. In private practice, graduates must demonstrate team skills, leadership, and business acumen; topics that may not be adequately addressed in academia. This mismatch in academic and private practice environments is probably a contributor to the the lack of confidence and competence of recent graduates in veterinary practice. Perhaps this situation can be improved through greater collaboration between academia and private practice. Current externship experiences could be modified or lengthened, or cooperative educational programs could be established to serve as a bridge between academia and private practice. Cooperative programs already exist in other disciplines, such as business and computer science. Although these programs would lengthen the time required to obtain a professional degree, they would be affordable, because students would earn an income during that program.

Over the years, veterinary colleges have greatly decreased the use of live animals in teaching. This has been driven primarily by changes in societal views about the use of animals, including the views of faculty and students. Extensive live animal laboratories have largely been replaced by cadaver labs, spay-neuter laboratories, and skills models. This trend is not likely to change. Could these practices also be responsible for the lack of practical competence and confidence of recent graduates? If so, this situation may also be rectified through revised externships and cooperative programs between academia and private practices.

Mismatches between the expectations of employers and the competence/confidence levels of recent graduates are probably multifactorial. It is, of course, possible, that some employers have unrealistic expectations of new veterinary graduates, and it is equally possible that some veterinary graduates have inherently low self-esteem. However, it does appear likely that veterinary education is at least partially culpable for the lack of confidence and confidence of recent graduates.