Global Perspectives of Veterinary Education
Reflections on the Trends in Education and Research in Small Animal Reproduction in Europe Heriberto Rodríguez-Martínez
ABSTRACT An open questionnaire-based survey was performed among 86 institutions of veterinary education in 32 European countries: 15 within the European Union (EU) and 17 outside the EU, in Central and Eastern Europe and the European Free Trade Association (EFTA). The survey aimed to provide a view of the general status of education and research in small animal reproduction (SAR) in Europe. It further aimed to disclose whether ongoing trends in organization (e.g., from the classical animal reproduction discipline orientation [DO] toward a species-oriented [SO] organization) among veterinary colleges responsible for undergraduate education and research in SAR have affected the provision of clinical services, continuing professional development (CPD), specialization, post-graduate education, and research. Response rates reached 80% among EU institutions and 48.4% in other countries (overall response rate = 68.6%). A clear, significant majority of institutions (> 60%) were DO, with a well-defined comparative subject in the veterinary curriculum. No differences were reported for either orientation in their ability to provide undergraduate education or clinical services in SAR. However, more DO institutions reported active research in SAR than their SO counterparts. Similar (and stronger) differences were seen for post-graduate education, CPD, and participation in specialization programs (national or European). Finally, more DO than SO institutions provided assisted reproductive technologies (ARTs), such as AI with frozen semen, to customers. The analysis of the data emanating from the respondents’ perceptions, supports the advantages of the more classical, DO-based approach. The results highlight the need for caution when institutions abandon the comparative benefits of the classical DO animal reproduction subject for a SO approach, which tends to prioritize clinical specialized service rather than research and research education. In the author’s opinion, in the absence of the data generated by comparative research and used in research education and the development of new technologies in SAR, there is a risk that sound science-based academic preparation for undergraduates and candidates for post-graduate research education is constrained. To counteract these negative trends, SAR must be recognized as a very important branch of the department of animal reproduction. Access to resources, personnel for teaching and research, and curriculum space should be made available in order to provide the basis for relevant post-graduate training, specialization, and research. INTRODUCTION
New, exciting programs in veterinary education are being established in conjunction with the scrutiny and consequent revision of curricula in European institutions of veterinary education, both in the European Union (EU) and elsewhere. This evaluation process has been overseen by the European Association of Establishments of Veterinary Education (EAEVE) since 1986; more recently it evolved into a voluntary joint evaluation system between the EAEVE and the Federation of Veterinarians of Europe (FVE). Furthermore, the associate countries for integration into the internal market of the EU (i.e., candidates for eventual entry into the EU) are assisted with regard to professional activities, including training, legislation, and activities, by the Technical Assistance Information Exchange Office (TAIEX), under contract to the European Commission. The ultimate goal of these assistance systems is to help the European Commission to ensure a consistently high standard of veterinary training throughout the EU. Since mutual recognition of veterinary diplomas was established by law within the EU by Directives 78/1026/EEC and 78/1027/EEC in 1978, the surveillance of EU requirements has been a pillar for a slow but consistent improvement of veterinary education throughout Europe. Some of the new programs of undergraduate veterinary education recently installed in various European countries endeavor to train undergraduates by using a combination of basic education and elective terms, while others have focused training in species-oriented tracks. Although in 1
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either case the aim is to individualize undergraduate education, the two types of programs differ in the extent of this individualization. These curricular changes have not been merely organizational but have also been accompanied by the application of modern pedagogical concepts to cope with the growing bulk of information produced by research and technical development, as documented by the Pew Report and discussed extensively within the EU. The changes have caused concern among veterinary institutions as a result of under-financing of the high costs of veterinary training and the demographic changes reflected in the newly recruited veterinary students, whose expectations differ from those of previous generations in terms of employment possibilities, personal interests, and experiences. Moreover, with a veterinary market showing sustained changes worldwide, there is a call for diversity and flexibility on the part of professionals toward the demands of service to society, requiring knowledge updates through continuing professional development (CPD) or reaching more advanced levels of knowledge and skills in a particular discipline through specialization. Both CPD and specialization are strongly recommended in the EU; as a result, the European Board for Veterinary Specialization (EBVS) was established. Between its creation in 1992 and 2000, the EBVS has approved 15 European colleges of veterinary specialization, and, most probably, more are to come. An example of an area of the veterinary profession that has grown steadily is small animal practice, which, in many 8
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industrialized countries, occupies the vast majority of licensed veterinarians in private practice (e.g., the United States, Australia, Japan, and Europe ) and has led to the design of tracking systems to encourage earlier diversification of professional activities. Some of these systems have been criticized for not taking into consideration the need to strengthen the general professional education of undergraduates. Animal reproduction (or, to use the North American term, “theriogenology”) has been a major area of active research and education within European veterinary medicine, bringing together fields such as obstetrics, gynecology, and andrology, among others. The subject has benefited from a strong comparative spirit and a discipline-oriented core. However, the strong links, methodological and otherwise, between animal reproduction and other classical disciplines, such as medicine and surgery, have always led to discussions as to whether animal reproduction should be discipline oriented (DO) or species oriented (SO). Small animal reproduction (SAR) is a growing field within theriogenology whose development accompanies the growth in companion animal clinics over the past years; it is often seen in connection with the inherent interest of the new students enrolling in veterinary schools and colleges worldwide. Questions have obviously arisen when education plans are revisited or new curricula are under development, for example: How and where should reproduction of companion animals (pets, small animals) be taught within the curriculum? Should it be taught at small animal clinics (both surgical and medical services?) with a strong species- or sub-discipline-oriented profile? Or should it continue to be taught in an animal reproduction department, within a strong comparative environment? Veterinary practice is based on scientific grounds and proven experience. Therefore, it is important, in this discussion about where to conduct undergraduate training, to consider where research and research education, pillars of sound undergraduate teaching and CPD (and, particularly, specialization), are best done. A basic requirement for taking a position in such a debate is, obviously, to know how a subject such as SAR is taught among the various institutions of veterinary education in Europe. Moreover, consideration of the provision of clinical services is essential for the training of undergraduates and professionals, as is providing a place where new methods for therapy and breeding technologies (e.g., assisted reproductive technologies, or ARTs) can be offered to clients. This article intends to provide a personal view, supported by recent data gathered thorough an open questionnaire survey, of how ongoing trends related to organizational changes among the institutions of veterinary education responsible for undergraduate education and research in SAR in Europe have affected the provision of clinical services, CPD, specialization, and post-graduate education. 13
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MATERIALS AND METHODS
An open questionnaire was sent via e-mail, fax, or airmail to individuals (i.e., department heads, deans, associate deans and instructors directly involved in SAR, depending on the author’s connection to a particular college) in 86 institutions of veterinary education in 32 countries, 15 from the EU and 17 from non-EU countries (associated/applicant countries JVME 31(1) © 2004 AAVMC
from Central and Eastern Europe as well as European Free Trade Association [EFTA] countries). Table 1 gives the list of institutions. The questionnaire, distributed in English only, contained the following questions (1–6): Which department (institute, section, or unit) carries out and/or provides (yes/no), and to what level, the following services: 1. undergraduate veterinary teaching 2. active research 3. research (post-graduate) education (to MSc, PhD or Doctorate degree) 4. CPD and/or specialization 5. clinical services 6. assisted reproductive technologies (ARTs, AI, freezing of semen, IVF, etc.) services in companion animal reproduction (small animal reproduction, SAR)? The survey then requested that each institution clarify, in question #1, whether it was discipline oriented or species oriented. The answers were received and categorized as follows: 1. Discipline-oriented (DO), species-oriented (SO), or mixed (e.g., a single clinical institute with subsections or services) (M). 2. Yes/no 3. Yes/no 4. Yes/no 5. Yes/no 6. Yes/no, level of ART (description of the techniques offered). Whenever answers were not sufficiently clear, a second contact was made with the respondent (often the person responsible for the activity in question) for clarification and proper categorization. Following categorization and tabulation, frequency distributions were statistically compared using the χ test (p values less than 0.05 were considered statistically significant). 2
RESULTS
Response Rates
As Table 1 shows, 27 of 32 countries (15/15 EU, 12/17 nonEU) responded to the survey within the time frame scheduled for the survey. Those countries that did not return the survey were Croatia, the Czech Republic, Macedonia, Russia, Slovenia, Ukraine, and Yugoslavia; I have no indication of their reasons for not responding. Fifty-nine of 86 institutions of veterinary education responded to the questionnaire (44/55 EU, or 80.0%; 15/31 non-EU, or 48.4%), constituting, in total, a response rate of 68.6%. Response rates by country were as follows: Austria 1/1; Belgium 4/4; Bulgaria 1/2; Denmark 1/1; Estonia 1/1; Finland 1/1; France 3/4; Germany 5/5; Greece 1/1; Hungary 1/1; Ireland 1/1; Italy 8/14; Latvia 1/1; Lithuania 1/1; Netherlands 39
One of the responding institutions—Antwerp, Belgium— recently initiated its program of veterinary education (finishing the pre-clinical years) and was therefore not included in the display of results; 57 of the 58 responses were therefore analyzed and are presented here.
1/1; Norway 1/1; Poland 1/4; Portugal 3/5; Romania 2/3; Slovakia 1/1; Spain 8/10; Sweden 1/1; Switzerland 2/2; Turkey 3/7; United Kingdom 6/6.
Table 1: Institutions of veterinary education, by country, to which the survey was sent
Country
Faculty
Country
Faculty
Country
Belgium
Ghent* Liège* Antwerp* Louvain* Stara Zagora* Sofia Zagreb
Hungary
Budapest*
Romania
Ireland
Dublin*
Russia
St. Petersburg
Italy
Slovakia
Kosice*
Czech Republic Denmark
Brno
Latvia
Bari* Bologna* Camerino* Messina* Milan* Naples Padua* Parma Perugia Pisa* Sassari Teramo Turin Udine* Jelgava*
Slovenia
Ljubljana
Copenhagen*
Lithuania
Kaunas*
Spain
Estonia Finland
Tartu* Helsinki*
Macedonia The Netherlands
Skopje Utrecht*
Sweden Switzerland
France
Alfort* Nantes* Toulouse Lyon* Berlin* Giessen* Hannover* Leipzig* Munich*
Norway
Oslo*
Ukraine
Barcelona* Caceres* Cordoba Las Palmas* Leon* Lugo* Madrid* Murcia* Valencia Zaragoza* Uppsala* Berne* Zurich* Kiev
Poland
Lublin* Olsztyn Warsaw Wroclaw
Yugoslavia
Belgrade
Austria
Bulgaria Croatia
Germany
Vienna*
Greece
Thessaloniki*
Portugal
Faculty
Lisbon* Castelo-Branco Evora Porto* Vila Real* Bucharest* Cluj-Napoca Timisoara*
* Institution responding to the survey and included in the survey results
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Table 2: Organization profile of European institutions of veterinary education Profile of SAR Institutions in
Subject- or Discipline-Oriented (DO) (%)
Species-Oriented (SO) (%)
Mixed Character (M) (%)
All European countries (n = 57)
68.9
18.9
12.2
European Union countries (n = 43)
62.8
23.3
13.9
Table 3: Percentages (%) of establishments (a) providing undergraduate education, (b) offering clinical services, (c) conducting research, (d) providing post-graduate education (MSc or PhD degrees or equivalent), and (e) ensuring (organizing and/or participating in) continuing professional development (CPD) or facilitating specialization of veterinarians in small animal reproduction (SAR) Institutions of Veterinary Education in All European Countries (n = 58)
European Union Countries (n = 43)
Activity
DO
SO/M
DO
SO/M
(a) undergraduate education
100
100
100
100
(b) clinical services
090.0
094.4
081.3
092.6
(c) research
090.0
050.0
088.9
050.0
(d) postgraduate education (MSc, PhD, or equivalent degrees)
082.5
022.2
092.6
018.8
(e) CPDs
072.5
027.8
074.1
025.0
Favoring Different Orientations for SAR
Of the 58 institutions that responded to the survey, a clear, significant (p < 0.01) majority have a discipline-oriented (DO) Department of Animal Reproduction, with a comparative subject construction enclosed in the curriculum (68.9%, 40/58). The remaining institutions (31.1%, 18/58), for various reasons, have abandoned this comparative subject construction for a species-oriented (SO) organization (18.9%, 11/58) or a mixed organization, that is, a single clinical department with species-oriented units or subdivisions of disciplines mixed with species-oriented clinical services (12.2%, 7/58) (see Table 2). Among institutions located in countries belonging to the EU (Table 2), this organizational trend was maintained, with a vast majority (62.8%, 27/43, p < 0.01) still organized in DO Departments of Animal Reproduction, covering SAR within the department. The other establishments (37.2%, 16/43) carried out SAR activities either in SO clinics (23.3%, 10/43) or within an organization of mixed character (13.9%, 6/43). Teaching SAR in Europe
All respondents (100%, NS) reported that their institutions maintain undergraduate teaching programs in SAR, independent of the type of department or clinical service organization that they had at the time of the survey (see Table 3(a)). Although details of the extent of their training were not requested in the survey questionnaire, most institutions explained that they provide adequate theoretical and practical training, complying either with EEC directives 78/10264 JVME 31(1) © 2004 AAVMC
and 78/10275 (EU countries and institutions in non-member countries listed as approved by the ACVT/European Commission after inspection by EAEVE/FVE) or with the prevailing national regulations (most candidate countries, EFTA, and countries from Central and Eastern Europe). Provision of Clinical Services in SAR
Clinical services in SAR were provided by more than 80% of the institutions responding to the survey (Table 3(b)). There was a slight (non-significant) difference between those institutions classically organized as Departments of Animal Reproduction (DO) and those organized as species-oriented (SO) clinics or services, in favor of the latter. This difference became significant (p < 0.05) among institutions within the EU. Although this information was not requested in the questionnaire, the SO/mixed (SO/M) organizations made it clear that they covered both medical and surgical aspects of reproductive disorders. Surgical disorders were often not covered by the classical Departments of Animal Reproduction (data not shown). Research Activities in SAR
Central to most European universities is the conduct of research, both basic and applied (and/or clinical). Based on the survey responses, the extent to which research is carried out by the different organizations surveyed appears to vary significantly. As can be seen in Table 3(c), more DO than SO/M institutions (p < 0.01) reported that they conduct active research in SAR, with only half of SO/M institutions reporting that they perform research activities in SAR. No 41
significant differences existed between EU and non-EU countries. However, it should be remembered that the survey did not document either the extent or the quality of such research. Post-graduate Education in SAR The presence of post-graduate education in SAR topics was directly related to the presence of research in the same establishments (see Table 3(d)). Compared to their SO/M counterparts, a significantly (p < 0.01) higher percentage of DO institutions (more than 80%) reported that they provide post-graduate education (at various levels, from MSc to doctoral/PhD degrees). The percentages did not differ (NS) between institutions in all countries and those in EU countries. However, the survey did not quantify the number of graduates or the quality of these degrees. Only anecdotal information was available in the questionnaires, which were answered by individuals. Provision of CPD and/or SAR Specialization In this category, too, there were significant (p < 0.01) differences between DO and SO/M institutions.About 75% of the DO establishments provided CPDs and/or were involved in SAR specialization, against about 25% of the SO/M institutions (see Table 3(e)). No significant differences were present between the data for all institutions and those for EU countries. Once again, the survey lacks information about the character (institutional or national), duration, and quality of the CPDs or of the specialty, whether at national or EU-college levels. Provision of Assisted Reproductive Technologies (ARTs) in SAR A large proportion of establishments with DO in animal reproduction (> 90%) reported providing various types of ARTs – significantly (p < 0.05) more than their SO/M counterparts (40–50%) (see Figure 1). Comparisons between establishments within Europe did not show significant differences (NS). However, based on the survey results, it appears that institutions with different organizational orientations (DO vs. SO/M) do not differ significantly in their rates of providing basic ARTs, such as the use of artificial insemination (AI) using liquid (dog) semen. This service was provided to a statistically similar degree by all institutions. The differences in the ART provision are clear, however, from an examination of the reported use of other technologies, such as freezing semen for semen banks, AI using frozen semen, or the use of IVF technologies for diagnostic or experimental purposes (see Figure 1). Discrimination for this “upper level” indicates that more DO than SO/ M institutions provided these more complex ARTs. Interestingly, the numbers for all countries did not differ significantly from those for the EU countries alone (NS) in the provision of ARTs. However, the survey did not take into account the extent (amount) or quality (success rates, repeatability, etc.) of the ART in question.
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Figure 1: Percentages of establishments offering assisted reproductive technologies (ARTs) in small animal reproduction (SAR), grouped as “All European countries” (left bar pair, n = 58) or as those within the European Union (right bar pair, n = 43) DISCUSSION
Veterinary education in animal reproduction has classically been discipline oriented, with a clear-cut comparative profile; based on the results of the present survey, this is how it is still practiced in the majority of the establishments of veterinary education in Europe at present. The response rate was high enough to indicate that the results accurately express the situation perceived by the respondents within the EU. The response rate from institutions outside the EU, however, barely reached the 50% level, and therefore these results should be treated as informative, but not conclusive. Nevertheless, no significant differences emerged from a comparison of the distribution of DO versus SO/M institutions within the EU countries and within all responding countries (EU + non-EU). The discipline- (or subject-) oriented profile has been built using knowledge from basic, pre-clinical subjects and substantial clinical training, often alongside relevant research. This research has often been first-class, even cutting-edge: discoveries in, for instance, artificial reproduction techniques are examples of this development. However, reflecting greater opportunities for experimentation, more research has been done on farm animals than on individual animals of equine or companion animal species. More often than not, these gains in research have translated into teaching, following the concept that veterinary education aims to produce academically trained professionals, irrespective of the species considered. The results of the survey support the idea that there is an advantage to the more classical, discipline-based approach for reproduction in domestic animals. It clearly indicates that there are no differences in the ability of either organizational orientation to provide undergraduate education or clinical services in SAR, and students largely benefit from both of these programs. However, there was a difference, both in EU and in non-EU countries, in the proportion of institutions that reported conducting active research in SAR, with the advantage going to the DO institutions. Similar differences, with even stronger significance, were seen for the provision of post-graduate education, CPD, and spe6, 18
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cialization programs (at national or European levels). Finally, more DO institutions were able to provide complex ARTs than SO counterparts. On the other hand, basic ARTs, such as canine AI with liquid semen, a rather widespread technology at present, were provided equally by both orientations. As mentioned above, SAR is an expanding field within theriogenology worldwide. Clinics for companion animals have grown dramatically in recent years, both in connection with the interests of the new students enrolling in institutions of veterinary medicine worldwide and because such clinics expand the labor market for graduating veterinarians. As a result of this scenario, expectations have also grown among teachers and researchers in SAR for opportunities to develop this area of knowledge within the departments of animal reproduction, an issue that has not been properly considered elsewhere. Therefore, some specialists in SAR have concluded that their subfield is more adequately recognized within surgical and medical clinics for companion animals. However, these specialists should consider that research in animal reproduction will always benefit, in the long run, from the classical comparative environment of the discipline. This approach will always facilitate the selective extrapolation of methods and results obtained in other species to SAR, and vice versa, thus increasing our ability to interpret species differences from methodological variation. Such examples exist and speak for themselves, as in the cases of andrology, manipulation of the estrous cycle, or biotechnology. There is a risk that a separation into species-oriented activities not only forgoes the above-mentioned gains in comparative research but also makes undergraduate training less effective, focusing on skills training rather than on sound scientifically based academic preparation. It is the firm conviction of this author that training students in reproduction using a comparative approach is far more efficient in preparing these future colleagues for lifelong learning than a shallow teaching of general concepts followed by a second teaching (often of the same concepts) in various clinics. Early diversification, as launched in only a few colleges at present, may weaken the basis for clinical education, converting the undergraduate into an operator rather than an academically trained veterinarian whose basic education is founded on the proven experience and scientific grounds that will guarantee the future of a sound veterinary education. However, not all students recognize the values of comparative training in animal reproduction until later in their professional lives, often because of their intrinsic interest in one particular species or species group. As already mentioned, small animal practice absorbs the majority of veterinary professionals in the developed world. There is a growing interest in in-depth studies and specialization in this area and, concomitantly, in SAR. Therefore, it is of the utmost importance that SAR be recognized as a very important branch of animal reproduction. Access to resources, teaching and research personnel, and curriculum space must be provided so that this area receives the necessary recognition within reproduction departments in charge of post-graduate training, specialization, and research. 7, 11, 13, 15
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CONCLUSIONS
Analysis of the present survey, albeit based on the perceptions of the respondents, suggests that institutions of veterinary education should be cautious about giving up the classical comparative approach of teaching animal reproduction. A separation into species-oriented activities, by early diversification, for instance, may make undergraduate training less effective and focused on skills training rather than on a sound scientific preparation. Academic education, post-graduate training, and research in animal reproduction are better nurtured by a comparative, subject-oriented environment. In order to avoid this trend, SAR must receive the necessary recognition and be allowed access to proper resources, teaching and research personnel, and curriculum space to ensure that its share of post-graduate training, specialization, and research develops satisfactorily. ACKNOWLEDGMENTS
This paper is based on a plenary speech at the 3rd European Congress on Reproduction in Companion, Exotic and Laboratory Animals of the European Veterinary Society for Small Animal Reproduction (EVSSAR), Liège, Belgium, May 10–12, 2002. I am grateful to all my colleagues in the various colleges, schools, and faculties of veterinary medicine in Europe who so kindly took their precious time to respond to the present survey. Without their collaboration, this study, which I hope will open a fruitful debate, would not have been possible. REFERENCES
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AUTHOR INFORMATION
DVM, MSc, PhD, Dipl. ECAR, is Professor of Reproductive Biotechnology and Vice-Dean (Research) in the Centre for Reproductive Biology, Department of Obstetrics and Gynecology, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences (SLU), Box 7039, SE750 07 Uppsala, Sweden. E-mail:
[email protected]. Heriberto Rodríguez-Martínez,
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