Paraveterinary workers

Paraveterinary workers are those people who assist a veterinary physician in the performance of their duties, or carry out animal health procedures autonomously as part of a veterinary care system. The job role varies throughout the world, and common titles includeveterinary nurse, veterinary technician, veterinary assistant and veterinary technologist, and variants with the prefix of 'animal health'.

The scope of practice varies between countries, with some countries allowing suitably qualified paraveterinary workers a scope of autonomous practice, including minor surgery, whilst others restrict their workers to simple assisting of the veterinarian.

Nomenclature

Veterinary nurse and technician

In the majority of anglophone countries, paraveterinary workers with a formal scope of practice, and a degree of autonomy in their role, are known as a veterinary nurses. The primary exception to this is in North America, where both the United States and Canada refer to these workers as veterinary (or animal health) technicians or technologists.

Human nursing associations have often claimed rights over the term 'nurse' and in some countries, this is protected by law. This was the case in the United Kingdom until 1984, where veterinary nurses were referred to as 'registered animal nursing auxiliaries', in line with the naming convention at the time for less qualified assistants in human nursing, called 'nursing auxiliaries'.

This is still the case in the United States, where the American Nursing Association and some state nursing associations have claimed proprietary rights to the term 'nurse'. Some veterinary technicians argue that as they spend approximately 90% of their time performing nursing tasks, they should be allowed to use the title of veterinary nurse, like their counterparts in other countries. Some argue that this is especially valid as their skill set is often greater than their human nursing counterparts, with the addition of skills such as radiology, laboratory work, pharmacy and more. Unofficially, many people (including vets and technicians) refer to these workers as veterinary nurses in conversation, as it is a succinct description of the role.

Veterinary assistant

In most countries, a veterinary assistant is a person with fewer or no formal animal health qualifications, who has no autonomous practice, but who is designated to assist a vet and act under their direct instruction.

Training programmes are often workplace-based, and no formal licence or certification is required to perform the role.

Local laws may restrict what activities a veterinary assistant may perform, as some procedures may only be legally completed by a registered practitioner, such as a vet or a veterinary nurse.

History

Veterinarians have had assistance from staff throughout their existence of the profession, but the first organised paraveterinary workers were the canine nurses trained by the Canine Nurses Institute in 1908, and announced in the magazine 'The Veterinary Student'. According to the founder they would "carry out directions of the veterinary surgeon, meet a genuine need on the part of the dog owners, and at the same time provide a reasonably paid occupation for young women with a real liking for animals".

In 1913, the Ruislip Dog Sanatorium was founded, and employed nurses to care for unwell dogs and in the 1920s, at least one veterinary surgery in Mayfair employed qualified human nurses to tend the animals. In the mid-1930s, the early veterinary nurses approached the Royal College of Veterinary Surgeons for official recognition, and in 1938 the Royal Veterinary College had a head nurse appointed, but the official recognition was not given until 1957, first as veterinary nurses, but changed within a year to Royal Animal Nursing Auxiliaries (RANAs) following objection from the human nursing profession.

In 1951, the first formal paraveterinary role was created by the United States Air Force who introduced veterinary technicians, and this was followed in 1961 by a civilian programme at the State University of New York (SUNY) Agricultural and Technical College. In 1965 Walter Collins, DVM received federal funding to develop model curricula for training technicians. He produced several guides over the next seven years, and for this work he is considered the "father of veterinary technology" in the United States.

In 1984, the term veterinary nurse was formally restored to paraveterinary workers in the United Kingdom.

Role and responsibilities

United States veterinary technician's oath

I solemnly dedicate myself to aiding animals and society by providing excellent care and services for animals, by alleviating animal suffering, and promoting public health. I accept my obligations to practice my profession conscientiously and with sensitivity, adhering to the profession's Code of Ethics, and furthering my knowledge and competence through a commitment to lifelong learning

Midland College "Veterinary technician's oath". Midland College.

The scope of practice for paraveterinary workers varies by jurisdiction, and by qualification level. In some places, more than one grade of paraveterinary worker exists. For instance, in the United Kingdom there are both veterinary nurses, who are qualified professionals with a protected title, and veterinary assistants, who do not have a single level of qualification which they must attain, and whose title is not protected. Furthermore, job roles may be divided further into roles such as Veterinary Surgical Technician, Veterinary Emergency and Critical Care Technician, Veterinary Technician Anesthesia Specialist, etc.

At the higher levels, veterinary nurses or technicians may be able to practice skills autonomously, including examinations and minor surgery on animals, without the direct supervision of a veterinarian.

Paraveterinary workers are likely to assist the vet, or perform by themselves on behalf of the vet, medical skills such as observations (e.g. taking and recording pulse, temperature, respiration etc.), wound and trauma management (e.g. cleaning and dressing wounds, applying splints etc.), physical interventions (e.g. catheterizations, ear flushes and venipuncture) and preparing and analysing biological samples (e.g. performing skin scrapings, microbiology, urinalysis, and microscopy).

Dependant on their scope of practice and training, they may also be called upon to operate diagnostic screening equipment, including electrocardiographic, radiographic andultrasonographic instruments, including complex machines such as computed tomography, magnetic resonance imagers and gamma cameras. In veterinary hospitals, veterinary technicians can perform complete blood counts, differential counts, and morphologic examinations of blood.

Paraveterinary workers would commonly assist veterinarians in surgery by providing correct equipment and instruments and by assuring that monitoring and support equipment are in good working condition. They may also maintain treatment records and inventory of all pharmaceuticals, equipment and supplies, and help with other administrative tasks within a veterinary practice such as client education.

Client education plays a key role of the veterinary technician's responsibilities to effectively communicate sometimes complex medical instructions in a positive and understandable way, and to facilitate the patient's care as an intermediary between the doctor, hospital and the patient. In this way, open lines of communication are established that can benefit the patient and hospital.

Education and qualification

The level of education of a paraveterinary worker will depend on the role they are performing, and the veterinary medico-legal framework for the area in which they are working. Many areas employ veterinary assistants, who have a simple role to directly assist the vet under direction, and may hold no formal qualification or training, or have been trained on the job.

Higher level paraveterinary workers, such as veterinary nurses, veterinary technicians or veterinary technologists, who have a scope of autonomous practice which they are expected to perform without instruction, are likely to have both formal qualifications and in many jurisdictions will also require a formal registration with a monitoring body.

In countries where the role of paraveterinary workers is most advanced, the qualification required is likely to be based in higher education, such as in the United States or Canada where veterinary technicians must normally gain an associate degree at an institution recognised by the American Veterinary Medical Association or Canadian Veterinary Medical Association, and can choose to study for an extended period to gain a bachelor's degree (which in America may confer the title 'technologist', rather than 'technician'), or the United Kingdom, where veterinary nurses enter the profession through either a two-year diploma programme or through completion of a foundation degree or honours degree.

In almost all cases, regardless of the level of formalised training, a high level of practical experience is usually required prior to a student being fully qualified, which may be completed as part of their course, or during a post-qualification period. This may require maintenance of a log of all work completed, which may need to be signed by a supervising professional (such as the vet or senior member of the paraveterinary staff) to indicate competence. In some cases, such as in the United States, video records may be required of some procedures, which may then be examined by the awarding or registration body.

Many countries, including the United Kingdom, Canada, and parts of the United States, restrict some elements of practice, and may restrict use of the recognised name, to those people currently registered with an appropriate licensing body, meaning that it would be illegal for any person not on the register to represent themselves as a paraveterinary worker, or to perform some of the procedures that a licensed professional could. The precise details of these restrictions vary widely between legal areas, and neighbouring areas may have different policies, as is the case in the various states of the US.

This licensing body may have its own requirements for maintaining a registration, and those who hold the requisite academic qualification may still have to complete a further range of exams or tests to become registered. For instance, in the United States, most areas use the Veterinary Technician National Exam, and this will be used by the state licensing authority (such as a state veterinary medical association) to qualify an applicant to become a registered veterinary technician.

In some cases, those people who qualified before the introduction of formal academic qualification requirements may still be working as paraveterinary workers, and may still be entered on a required register through the use of grandfather rights. For instance, in some states of the US, people with a set number of years or hours of experience assisting a veterinarian could sit for the Veterinary Technician National Exam, however this route was phased out in 2011, and future candidates must have an academic qualification.

Specialty certification

Beyond credentialing as a veterinary technician specialty certification is also available to technicians with advanced skills. To date there are specialty recognitions in: emergency & critical care, anesthesiology, dentistry, small animal internal medicine, large animal internal medicine, cardiology, oncology, neurology, zoological medicine, equine veterinary nursing, surgery, behavior, nutrition, clinical practice (canine/feline, exotic companion animal, and production animal sub-specialties) and clinical pathology. Veterinary Technician Specialists carry the additional post-nominal letters "VTS" with their particular specialties indicated in parentheses. As veterinary technology evolves more specialty academy recognitions are anticipated.

Global presence

Attempts at professional solidarity resulted in the creation of the International Veterinary Nurses and Technicians Association (IVNTA) in 1993. Its members currently include Australia, Canada, Denmark, Finland, France, Germany, Ghana, Hong Kong, Ireland, Japan, Malta, Nepal, New Zealand, Norway, South Africa, Spain, Sweden, Switzerland, Thailand, Turkey, the United Kingdom, and the United States.^[10] In 2007 the Accreditation Committee for Veterinary Nurse Education (ACOVENE) was established in an attempt to standardize veterinary technology education throughout the European Union and to allow movement of veterinary nurses educated in one member nation to employment in another.^[11] On the specialty front, the Swiss-based organization VASTA (Veterinär Anästhesie Schule für TechnikerInnen und ArzthelferInnen -- Veterinary Anaesthesia School for Technicians and Assistants) is a six module year-long program that is approved by the Association of Veterinary Anaesthetists (AVA), the European College of Veterinary Anaesthesia and Analgesia (ECVAA), the International Veterinary Academy of Pain Management (IVAPM), and that has applied for RACE (Registry of Approved Continuing Education) approval in the United States ("Assistants" in the VASTA title refers to assistant or junior veterinarians and not to unqualified veterinary assistants). Its instructors include diplomates of the ECVAA, nurse anesthetists from the human medical field, neurologists, and veterinary physical therapists. It is currently offered in Germany, Austria, and the German-speaking regions of Switzerland. It has previously been offered in the French-speaking region of Switzerland but is currently on hiatus there due to low participation. Courses are planned for the US and the UK in 2012. Successful completion of the course results in the awarding of the post-nominal letters VAT (Veterinary Anaesthesia Technician).

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Veterinary medicine in the United States

Veterinary medicine in the United States is the performance of veterinary medicine in the United States, normally performed by licensed professionals, and subject to provisions of statute law which vary by state. Veterinary medicine is normally led by veterinary physicians, normally termed veterinarians or vets.

Veterinarians are often assisted by paraveterinary workers including veterinary technicians and veterinary assistants, and in some cases, these para-professionals may perform work on their own.

Dependent on the jurisdiction, other professionals may be permitted to perform some animal treatment, through either specific exemptions in the law or through a lack of prohibitive legislation. This can include manipulation techniques such as physiotherapy, chiropractic andosteopathy, or animal-specific professions such as horse and cattle hoof trimmers, equine dental technicians, and technicians who specialize in cattle artificial insemination.

Veterinarians

Veterinarian's Oat

The Veterinarian's Oath was adopted by the American Veterinary Medical Association's House of Delegates July 1969, and amended by the AVMA Executive Board, November 1999 and December 2010.

Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health and welfare, the prevention and relief of animal suffering, the conservation of animal resources, the promotion of public health, and the advancement of medical knowledge.

I will practice my profession conscientiously, with dignity, and in keeping with the principles of veterinary medical ethics. I accept as a lifelong obligation the continual improvement of my professional knowledge and competence.

Qualification

In order to practice, veterinarians must obtain a degree in veterinary medicine, followed by gaining a license to practice. Previously, veterinary degrees were available as abachelor's degree, but now all courses result in the award of a doctorate and are therefore awarded a Doctor of Veterinary Medicine (DVM) if the degree is awarded in English, or a Veterinariae Medicinae Doctor ("Doctor of Veterinary Medicine") (VMD) if the degree is awarded in Latin.

There is a high level of competition for admission to veterinary schools; there are currently only twenty eight veterinary schools in the United States which meet the accreditation standards set by the Council on Education of the American Veterinary Medical Association (AVMA), and five in Canada. Entrance requirements vary among veterinary schools, and various pre-professional degree programs have been developed to assist undergraduates in meeting these requirements. Such “pre-vet” programs are thus similar in concept to “pre-med” programs, and are often housed in Agricultural Biology, Animal Science, or Biological Science programs.

Following qualification from the doctoral degree, the prospective veterinarian must receive a passing grade on the North America Veterinary Licensing Exam. This exam is completed over the course of eight hours, and consists of 360 multiple-choice questions. This exam covers all aspects of veterinary medicine, as well as visual material designed to test diagnostic skills.

Salary

The mean salary for new graduates in 2010 was US$48,674 including nearly 50% going on to advanced study programs.^[5] Those not continuing their studies made US$67,359 at first.

The average income for private practice rose from $105,510 in 2005 to $115,447 in 2007. These increased values exceed those of public practice including uniformed services and government.

Veterinary specialties

As opposed to human medicine, general practice veterinarians greatly outnumber veterinary specialists. Most veterinary specialists work at the veterinary schools, or at a referral center in large cities. As opposed to human medicine, where each organ system has its own medical and surgical specialties, veterinarians often combine both the surgical and medical aspect of an organ system into one field. The specialties in veterinary medicine often encompass several medical and surgical specialties that are found in human medicine.

Veterinary specialties are accredited in North America by the AVMA through the American Board of Veterinary Specialties. While some veterinarians may have areas of interest outside of recognized specialties, they are not legally specialists.

Veterinary technicians

Veterinary technicians are the primary paraveterinary workers in the US and assist the veterinarian in the role of a nurse (and in most other anglophone countries, the equivalent role is called a veterinary nurse), providing trained support. The requirements for technicians vary by state, but in most cases, technicians are graduates of two or four year college-level programs and are legally qualified to assist veterinarians in many medical procedures.

Some states choose to license technicians, so that only people with appropriate qualifications are able to fulfill the role, but this is not the case in all jurisdictions.

History

Veterinary technology as an organized and credentialed career option is relatively young, only existing since the mid 20th century (although the seeds had been planted in 1908 when the Canine Nurses Institute was established in England, and as such is still struggling for recognition in many parts of the world. The first training program for technicians in the United States was established by the Air Force in 1951. The first civilian program was established ten years later in 1961 at the State University of New York (SUNY) Agricultural and Technical College at Delhi. In 1965 Walter Collins, DVM received federal funding to develop model curricula for training technicians. He produced several guides over the next seven years, and for this work he is considered the "father of veterinary technology" in the United States).

Role and duties

Technical skills include: venipuncture; collecting urine; performing skin scrapings; taking and processing radiographs; and performing routine lab procedures and tests in:hematology, blood chemistry, microbiology, urinalysis, and microscopy. They assist the veterinarian with physical examinations that help determine the nature of the illness or injury. Veterinary technicians also induce and maintain anesthesia, and administer medications, fluids and blood products as prescribed by the veterinarian. Tasks in patient care include: recording temperature, pulse and respiration, dressing wounds, applying splints and other protective devices, and dental procedures. They perform catheterizations – urinary, arterial, and venous; ear flushes; intravenous feedings and tube feedings. Equipment use includes operating various types of patient monitors and imaging devices to include electrocardiographic, radiographic and ultrasonographic equipment. Larger referral practices and teaching hospitals may also find veterinary technicians operating computed tomography equipment, magnetic resonance imagers, gamma cameras and other advanced medical devices. Veterinary technicians commonly assist veterinarians in surgery by providing correct equipment and instruments and by assuring that monitoring and support equipment are in good working condition. They may also maintain treatment records and inventory of all pharmaceuticals, equipment and supplies, and help with other administrative tasks within a veterinary practice such as client education. Unlike their more specialized counterparts among medical paraprofessionals, the veterinary technician is usually the only paraprofessional found in a veterinary practice and is thus often called upon to be a jack-of-all-trades.

Education and credentialing

To become a credentialed veterinary technician, one must complete a two-year or three-year AVMA credentialled degree, most of which result in the awarding of an associate of applied science degree in veterinary technology (those completing a four-year AVMA accredited school gain a bachelor's degree are considered veterinary technologists though the distinction is rarely made with the term technician being used generally.

The education a credentialed technician receives is in-depth and crucial for medical understanding and to give proper health care. The American Veterinary Medical Association(AVMA) is responsible for accrediting schools with either Associate's degrees or Bachelor's degrees, though in some states or provinces this is not necessary. The AVMA also accredits schools that offer distance education. As a requirement of AVMA-accreditation, all distance learning programs require a significant amount of practical clinical experience before the student will be allowed to graduate.

Specialty certification

Beyond credentialing as a veterinary technician specialty certification is also available to technicians with advanced skills. To date there are specialty recognitions in: emergency & critical care, anesthesiology, dentistry, small animal internal medicine, large animal internal medicine, cardiology, oncology, neurology, zoological medicine, equine veterinary nursing, surgery, behavior, nutrition, clinical practice (canine/feline, exotic companion animal, and production animal sub-specialties), and clinical pathology. Veterinary Technician Specialists carry the additional post-nominal letters "VTS" with their particular specialties indicated in parentheses. As veterinary technology evolves more specialty academy recognitions are anticipated.

Veterinary Technician Oath

"I solemnly dedicate myself to aiding animals and society by providing excellent care and services for animals, by alleviating animal suffering, and promoting public health. I accept my obligations to practice my profession conscientiously and with sensitivity, adhering to the profession's Code of Ethics, and furthering my knowledge and competence through a commitment to lifelong learning."

Veterinary assistants

Non-credentialed personnel who perform similar tasks to veterinary technicians are usually referred to as veterinary assistants though the term technician is often applied generously. In many states, a veterinary assistant cannot legally perform as many procedures as a technician. Veterinary assistants often have no formal education related to veterinary medicine or veterinary technology, however, NAVTA recently approved the designation of Approved Veterinary Assistant (AVA) for those successfully completing approved educational programs. In larger facilities with tiered hierarchies veterinary assistants typically assist veterinary technicians in their duties.

Veterinary Malpractic

Most states in the US allow for malpractice lawsuit in case of death or injury to an animal from professional negligence. Usually the penalty is not greater than the value of the animal. For that reason, malpractice insurance for veterinarians usually is well under $500 a year, compared to an average of over $15000 a year for a human doctor. Some states allow for punitive penalty, loss of companionship, and suffering into the award, likely increasing the cost of veterinary malpractice insurance and the cost of veterinary care. Most veterinarian carry much higher cost business insurance, worker's compensation, and facility insurance to protect their clients and workers from injuries inflicted by animals.

Need For Veterinarians in U.S.

There is a need for veterinarians in the United States. Veterinarians who specialize in research of infectious diseases and translational medical research are especially needed. This type of research would not only benefit those who own pets, but the entire human population. By researching translational medical research, scientists would know how to prevent the transmission of diseases from humans to animals and vice versa. There are many aspects to a veterinary career that could help increase the interest for prospective graduates. As of now however, the economy and related start up costs of a private practice appear as an unsurmountable task which scares graduates from opening a private practice.

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Veterinary medicine in the United Kingdom

Veterinary medicine in the United Kingdom is the performance of veterinary medicine by licensed professionals, and strictly regulated by statute law, notably the Veterinary Surgeons Act of 1966. Veterinary medicine is led by veterinary physicians, termed 'veterinary surgeons' (with a different meaning to how it is used in some other anglophone countries, where it denotes a surgical specialist), normally referred to as 'vets'.

Vets are often assisted by registered veterinary nurses, who are able to both assist the vet and to autonomously practice a range of skills of their own, including minor surgery under direction from a responsible vet.

Other professionals are also permitted to perform some animal treatment, through exemptions in the law, and these include manipulationtechniques such as physiotherapy, chiropractic and osteopathy. Other alternative medicine therapies, such as homeopathy, acupuncture,phytotherapy and aromatherapy may only be performed by a licensed veterinary surgeon.

The practice of veterinary medicine in the United Kingdom is regulated by the Royal College of Veterinary Surgeons (RCVS), who licence both veterinary surgeons and veterinary nurses.

Veterinary surgeons

Veterinary surgeons require both a degree in veterinary science or veterinary medicine, and must hold a current registration with the RCVS in order to practice. As of 5th March 2015, the RCVS has agreed that veterinary surgeons registered with the RCVS in the UK are entitled to use the courtesy title Doctor. This makes it the third clinical degree in the UK, after Medicine and Dentistry, to allow the use of the title Dr. The origins of veterinary surgeons parallel to human surgery are reflected in human medicine where qualified surgeons also drop their Dr designation and revert to their original title. The naming convention for veterinary surgeons has been debated, with some favouring the use of the Dr title for all vets.

Education

Veterinary medicine degree courses are usually five years in length, although Cambridge University's degree takes six, and in some cases, a four year accelerated course is available. There are a limited number of places on veterinary courses each year, with only eight British Universities offering the degree (Bristol, Cambridge, Edinburgh, Glasgow,Liverpool, Nottingham and the Royal Veterinary College, London, Surrey).

Continuing professional development (CPD) is a mandatory and key part of career development. The RCVS recommends a minimum of 105 hours CPD over a three-year period. The RCVS Professional Development Phase (PDP) that was launched for new graduates in 2007 provides a structured approach to guide the new graduate towards the professional competences they need to develop in either small animal, equine or production animal practice.

Specialism

Vets may choose to specialise in any of a number of areas of veterinary medicine, through certificate qualifications, modular certificates or diplomas, with each speciality taking around two years to complete. Certificates cover a wide range of areas, including small animal medicine, small animal surgery, large animal medicine, welfare ethics and law, public health, cardiology and orthopaedics. A certificate is also available in advanced veterinary practice (Cert AVP).

It is important to note that there is a large and confusing array of post-nominal titles in the UK veterinary profession, which have varying levels of credibility. In particular, Certificate level qualification does not qualify a veterinary surgeon as a specialist. With further training, extensive professional experience and by publishing articles in a particular subject area, it is possible to gain Royal College of Veterinary Surgeons (RCVS) Recognised Specialist Status. The RCVS is the regulatory body for veterinary surgeons in the UK. In 2012, the ruling council of the RCVS adopted a report from the Calman Committee into specialisation in the UK veterinary profession, accepting that only those veterinary surgeons recognised by the RCVS as specialists and placed on a register held by the RCVS could be truly held up as "Specialist". Members of the public looking for an appropriately accredited specialist veterinary surgeon in the UK should therefore primarily seek those that carry the post-nominal description of "RCVS Recognisd Specialist in..." after their name. No other accolade carries authority from the appropriate regulatory body.

Some vets also undertake the training to become Official Veterinarians, (OVs), which authorises them to carry out tasks on behalf of the Department for Environment, Food and Rural Affairs, such as testing cattle for tuberculosis or issuing of documentation for the export of animals and animal products.

Employment

Most veterinary surgeons work in private practice, either in a general practice, or specialising in one type of animal (small animal, equine, zoo animal etc.). Newly qualified veterinary surgeons usually work as assistants for some time before being offered the opportunity to become a partner or a principal. Becoming a partner involves increased responsibility, the need for more business and management skills and a financial input into the practice.

Some vets are also employed by animal welfare charities who offer treatment to the public, such as Royal Society for the Prevention of Cruelty to Animals (RSPCA), the People's Dispensary for Sick Animals (PDSA) and The Blue Cross.

There are also opportunities to work for government services, including APHA (the Animal and Plant Health Agency) who are responsible for the control and eradication of major notifiable diseases, animal welfare, promotion of international trade and certain public health functions related to residues in meat and investigation of food safety incidents,and scanning surveillance, or the Veterinary Medicines Directorate (VMD) who licence veterinary medicines.

It is also possible to pursue a research and/or teaching career within universities or research bodies.

Veterinary nurses

Veterinary nurses are the primary paraveterinary workers in the United Kingdom and assist vets in their work, and have a scope of autonomous practice within which they can act for the animals they treat, which can include minor surgery.

Registration

All veterinary nurses must be registered or listed with the Royal College of Veterinary Surgeons (RCVS). Registered or listed veterinary nurses have dispensations in law [the Veterinary Surgeons Act of 1966 amended in 2002)] to undertake certain procedures to include minor surgery on animals under veterinary direction. Registered veterinary nurses (RVNs) are bound by a code of professional conduct and are obliged to maintain their professional knowledge and skills through ongoing CPD. Those VN's listed after 2002 are automatically registered.

Education

RVNs train for the Register through either a two-year further education diploma programme or via a qualifying foundation or honours degree. All student nurses must complete a significant amount of work experience in general veterinary practice during their training.

RCVS badges are engraved with the nurse's personal badge number, however badges are a sign of having achieved a VN qualification and not of a person's current registered status.

Representation

UK veterinary nurses are represented by the British Veterinary Nursing Association (BVNA). VN's can further their formal training with a BVNA specialist course Certificate in Dentistry and/or by achieving the RCVS Diploma in Advanced Veterinary Nursing (DipAVN) by following a course of study in one or more of three pathways: Small animal nursing, Equine nursing, and Veterinary nursing education. The streamlined RCVS DipAVN replaced the DipAVN(Medical) and DipAVN(Surgical) formerly administered by the BVNA up until 2005. The DipAVN is offered through Myerscough College in Lancashire since 2007 and more recently through Harper Adams University, some modules are also available from the Royal Veterinary College in conjunction with the University of London.

Animal nursing assistants

Lay staff, without formal qualification or status may be called animal nursing assistants (the BVNA approved term) or veterinary care assistants. These lay staff have usually undertaken some basic veterinary nurse training but are limited by law as to the procedures they may undertake on animals. They work alongside qualified vets and veterinary nurses to provide care and support to animal patients and their owners.

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Veterinary physician

A veterinary physician, colloquially called a vet, shortened from veterinarian (American English, Australian English) or veterinary surgeon (British English), is a professional who practices veterinary medicine by treating disease, disorder, and injury in non-humananimals.

In many countries, the local nomenclature for a veterinarian is a regulated and protected term, meaning that members of the public without the prerequisite qualifications and/or licensure are not able to use the title. In many cases, the activities that may be undertaken by a veterinarian (such as treatment of illness or surgery in animals) are restricted only to those professionals who are registered as a veterinarian. For instance, in the United Kingdom, as in other jurisdictions, animal treatment may only be performed by registered veterinary physicians (with a few designated exceptions, such as paraveterinary workers), and it is illegal for any person who is not registered to call themselves a veterinarian or prescribe any treatment.

Most veterinary physicians work in clinical settings, treating animals directly. These veterinarians may be involved in a general practice, treating animals of all types; they may be specialized in a specific group of animals such as companion animals, livestock, zoo animals or equines; or may specialize in a narrow medical discipline such as surgery, dermatology or internal medicine.

As with other healthcare professionals, veterinarians face ethical decisions about the care of their patients. Current debates within the profession include the ethics of certain procedures believed to be purely cosmetic or unnecessary for behavioral issues, such as declawing of cats, docking of tails, cropping of ears and debarking on dogs.

Etymology and nomenclature

The word veterinary comes from the Latin veterinae meaning "working animals". "Veterinarian" was first used in print by Thomas Browne in 1646.

The term "veterinarian" is used in North America and other countries using predominantly American English, whereas in the United Kingdom, and countries which are formerly part of the British Empire or are part of the Commonwealth of Nations tend to use the term veterinary surgeon.

History

The first veterinary college was founded in Lyon, France in 1762 by Claude Bourgelat. According to Lupton, after observing the devastation being caused by cattle plague to the French herds, Bourgelat devoted his time to seeking out a remedy. This resulted in his founding a veterinary college in Lyon in 1761, from which establishment he dispatched students to combat the disease; in a short time, the plague was stayed and the health of stock restored, through the assistance rendered to agriculture by veterinary science and art.

The Odiham Agricultural Society was founded in 1783 in England to promote agriculture and industry, and played an important role in the foundation of the veterinary profession in Britain. A 1785 Society meeting resolved to "promote the study of Farriery upon rational scientific principles.”

The professionalization of the veterinary trade was finally achieved in 1790, through the campaigning of Granville Penn, who persuaded the Frenchman, Benoit Vial de St. Bel to accept the professorship of the newly established Veterinary College in London. The Royal College of Veterinary Surgeons was established by royal charter in 1844.

Veterinary science came of age in the late 19th century, with notable contributions from Sir John McFadyean, credited by many as having been the founder of modern Veterinary research.

Roles and responsibilities

Veterinarians treat disease, disorder or injury in animals, which includes diagnosis, treatment and aftercare. The scope of practice, specialty and experience of the individual veterinarian will dictate exactly what interventions they perform, but most will perform surgery (of differing complexity).

Unlike in human medicine, veterinarians must rely primarily on clinical signs, as animals are unable to vocalize symptoms as a human would. In some cases, owners may be able to provide a medical history and the veterinarian can combine this information along with observations, and the results of pertinent diagnostic tests such as radiography, CT scans, MRI, blood tests, urinalysis and others.

Veterinarians will sometimes consider the appropriateness of euthanasia ("putting to sleep") if a condition is likely to leave the animal in pain or with a poor quality of life, or if treatment of a condition is likely to cause more harm to the patient than good, or if the patient is unlikely to survive any treatment regimen.

As with human medicine, much veterinary work is concerned with prophylactic treatment, in order to prevent problems occurring in the future. Common interventions include vaccination against common animal illnesses, such as distemper or rabies, and dental prophylaxis to prevent or inhibit dental disease. This may also involve owner education so as to avoid future medical or behavioral issues.

Employment

The majority of veterinarians are employed in private practice treating animals (75% of vets in the United States, according to the American Veterinary Medical Association).

Small animal veterinarians typically work in veterinary clinics, veterinary hospitals, or both. Large animal veterinarians often spend more time travelling to see their patients at the primary facilities which house them, such as zoos or farms.

Other employers include charities treating animals, colleges of veterinary medicine, research laboratories, animal food companies, and pharmaceutical companies. In many countries, the government may also be a major employer of veterinarians, such as the United States Department of Agriculture or the State Veterinary Service in the United Kingdom. State and local governments also employ veterinarians.

Focus of practice

Veterinarians and their practices may be specialized in certain areas of veterinary medicine. Areas of focus include:

• Exotic animal veterinarian - Generally considered to include reptiles, exotic birds such as parrots and cockatoos, and small mammals such as ferrets, rabbits, chinchillas, and degus.
• Conservation medicine - The study of the relationship between animal and human health and environmental information.

• Small animal practice - Usually dogs, cats, and other companion animals/household pets such as hamsters and gerbils. Some practices are canine-only or feline-only practices.
• Laboratory animal practice - Some veterinarians work in a university or industrial laboratory and are responsible for the care and treatment of laboratory animals of any species (often involving bovines, porcine species, felines, canines, rodents, and even exotic animals). Their responsibility is not only for the health and well being of the animals, but also for enforcing humane and ethical treatment of the animals in the facility.
• Large animal practice - Usually referring to veterinarians that work with, variously, livestock and other large farm animals, as well asequine species and large reptiles.
• Equine medicine - Some veterinarians are specialists in equine medicine. Horses are different in anatomy, physiology, pathology,pharmacology, and husbandry to other domestic species. Specialization in equine veterinary practice is something that is normally developed after qualification, even if students do have some interest before graduation.
• Food animal medicine - Some veterinarians deal exclusively or primary with animals raised for food (such as meat, milk, and eggs). Livestock practitioners may deal with ovine (sheep), bovine (cattle) and porcine (swine) species; such veterinarians deal with management of herds, nutrition, reproduction, and minor field surgery. Dairy medicine practice focuses on dairy animals. Poultrymedicine practice focuses on the health of flocks of poultry; the field often involves extensive training in pathology, epidemiology, and nutrition of birds. The veterinarian treats the flock and not the individual animals.
• Food safety practice - Veterinarians are employed by both the food industry and government agencies to advise on and monitor the handling, preparation, and storage of food in ways that prevent foodborne illness.
• Wildlife medicine - A relatively recent branch of veterinary medicine, focusing on wildlife. Wildlife medicine veterinarians may work with zoologists and conservation medicine practitioners and may also be called out to treat marine species such as sea otters, dolphins, orwhales after a natural disaster or oil spill.
• Aquatic medicine - mostly refers to veterinary care of fish in aquaculture (like salmon, cod, among other species), but can also include care of aquatic mammals. For certain countries with high economic income from aquaculture, this is an important part of the veterinary field (like Norway, Chile). Other countries (particularly those who are landlocked), might have little or no emphasis on aquatic medicine.

Veterinary specialties

Veterinary specialists are in the minority compared to general practice veterinarians, and tend to be based at points of referral, such as veterinary schools or larger animal hospitals. Unlike human medicine, veterinary specialties often combine both the surgical and medical aspects of a biological system.

Veterinary specialties are accredited in North America by the AVMA through the American Board of Veterinary Specialties, in Europe by the European Board of Veterinary Specialisation and in Australasia by the Australasian Veterinary Boards Council. While some veterinarians may have areas of interest outside of recognized specialties, they are not legally specialists.

Specialties can cover general topics such as anesthesiology, dentistry, and surgery, as well as organ system focus such as cardiology or dermatology. A full list can be seen atveterinary specialties.

Salary

The mean salary for new graduates in the United States during 2010 was US $48,674, including nearly 50% going on to advanced study programs. Those not continuing their studies made US$67,359 at first, whereas veterinarians in the United Kingdom earned slightly less with new graduate wages at an average of £25,000.

The average income for private practice in the United States rose from $105,510 in 2005 to $115,447 in 2007. These increased values exceed those of public practice including uniformed services and government. In Australia, the profession wide average income was $67,000 in 2011 and this has declined compared to other professions for the past 30 years whilst graduate unemployment has doubled between 2006 and 2011.

Education and regulation

In order to practice, vets must complete both an appropriate degree in veterinary medicine, and in most cases must be registered with the relevant governing body for their jurisdiction.

Veterinary science degrees

Degrees in veterinary medicine culminate in the award of a veterinary science degree, although the title varies by region. For instance, in North America, graduates will receive a Doctor of Veterinary Medicine (DVM or VMD) whereas in the United Kingdom or India they would be awarded a Bachelor's degree in Veterinary Science, Surgery or Medicine(BVS, BVSc, BVetMed or BVMS), and in Ireland graduates receive a Medicina Veterinaria Baccalaureate (MVB).

The award of a bachelor's degree was previously commonplace in the United States, but the degree name and academic standards were upgraded to match the 'doctor' title used by graduates.

Comparatively few universities have veterinary schools that offer degrees which are accredited to qualify the graduates as registered vets. In the United States, only 28 universities offer a degree meeting American Veterinary Medical Association (AVMA) standards, in Canada, only 5 veterinary schools offer a vet qualifying course and in the United Kingdom only 7 universities offer a suitable degree.

Due to this scarcity of places for veterinary degrees, admission to veterinary school is competitive and requires extensive preparation. In the United States in 2007, approximately 5,750 applicants competed for the 2,650 seats in the 28 accredited veterinary schools, with an acceptance rate of 46%.

With competitive admission, many schools may place heavy emphasis and consideration on a candidate's veterinary and animal experience. Formal experience is a particular advantage to the applicant, often consisting of work with veterinarians or scientists in clinics, agribusiness, research, or some area of health science. Less formal experience is also helpful for the applicant to have, and this includes working with animals on a farm or ranch or at a stable or animal shelter and basic overall animal exposure.

In the United States, approximately 80% of admitted students are female. In the early history of veterinary medicine of the USA, most veterinarians were males. However, in the 1990s this ratio reached parity, and now it has been reversed.

Preveterinary courses should emphasize the sciences. Most veterinary schools typically require applicants to have taken one year equivalent classes in organic, inorganic chemistry, physics, general biology; and one semester of vertebrate embryology and biochemistry. Usually, the minimal mathematics requirement is college level calculus. Individual schools might require introduction to animal science, livestock judging, animal nutrition, cell biology, and genetics. However, due the limited availability of these courses, many schools have removed these requirements to widen the pool of possible applicants.

Registration and licensing

Following academic education, most countries require a vet to be registered with the relevant governing body, and to maintain this license to practice.

Dependent on where the vet practices (or wishes to practice), they may have to complete an examination or test in order to complete this registration. For instance, in the United States, a prospective vet must receive a passing grade on a national board examination, the North America Veterinary Licensing Exam. This exam must be completed over the course of eight hours, and consists of 360 multiple-choice questions, covering all aspects of veterinary medicine, as well as visual material designed to test diagnostic skills.

Postgraduate study

The percentage electing to undertake further study following registration in the United States has increased from 36.8% to 39.9% in 2008. About 25% of those or about 9% of graduates were accepted into traditional academic internships. (2008 -696 graduates accepted a position in advanced study, 89.2% (621) accepted an internship (private practice, 74.5%; academic, 25.3%; and other internship, 0.2%). An additional 6.0% (42) accepted a residency). Approximately 9% of veterinarians eventually board certify in one of 20 specialties.

Curriculum comparison with human medicine

The first two-year curriculum in both veterinary and human medical schools are very similar in the course names, but at certain subjects relatively different in content. Generally, the more basal the field of science is (for example: biochemistry, biophysics, cell biology etc.), the more similar it is. Later on when the courses get more clinically oriented, more significant differences arise. Where some things are completely different, and other things are about the same. Considering the courses, the first two-year curriculum usually include biochemistry, physiology, histology, anatomy, pharmacology, microbiology, epidemiology, pathology and hematology.

Some veterinary school uses the same biochemistry, histology, and microbiology books as human medicine students; however, the course content is greatly supplemented to include the varied animal diseases and species specific differences. Many veterinarians were trained in pharmacology using the same text books as human physicians. As the specialty of veterinary pharmacology develop, more schools are using pharmacology textbooks written specifically for veterinarians. Veterinary physiology, anatomy, and histology is complex, as physiology often varies among species. Microbiology and virology of animals share the same foundation as human microbiology, but with grossly different disease manifestation and presentations. Epidemiology is focused on herd health and prevention of herd borne diseases, and foreign animal diseases. Pathology, like microbiology and histology, is very diverse and encompasses many species and organ systems. Most veterinary school have courses in small animal and also large animal nutrition, often taken as electives in the clinical years or as part of the core curriculum in the first two years.

The last two year curriculum of the two fields are similar only in their clinical emphasis. A veterinary student must be well prepared to be a fully functional animal physician on the day of graduation, competent in both surgery and medicine. The graduating veterinarian must be able to pass medical board examination and be prepare to enter clinical practice on the day of graduation, while most human medical doctors in the USA complete 3 to 5 years of post-doctoral residency before practicing medicine independently, usually in a very narrow and focused specialty. Many veterinarians do also complete a post-doctoral residency, but it is not nearly as common as it is in human medicine.

Impact on human medicine

Some veterinarians pursue post-graduate training and enter research careers and have contributed to advances in many human and veterinary medical fields, including pharmacology and epidemiology. Research veterinarians were the first to isolate oncoviruses, Salmonella species, Brucella species, and various other pathogenic agents. Veterinarians were in the forefront in the effort to suppress malaria and yellow fever in the United States. Veterinarians identified the botulism disease-causing agent, produced an anticoagulant used to treat human heart disease, and developed surgical techniques for humans, such as hip-joint replacement, limb and organ transplants.

In popular culture

Well-known depictions of a veterinarian at work are in James Herriot's All Creatures Great and Small, made into a BBC series.

Doctor Dolittle is a series of children's books, one of which was turned into a 1967 movie. The movie was remade in 1998 with Eddie Murphy as Dr. Dolittle.

Hershel Greene from the popular series The Walking Dead, played by actor Scott Wilson is a veterinarian before turning his knowledge of medicine to treat human survivors and to study pathology of sick patients while in isolation during the time of the group's use of a prison as a fortified shelter.

US-based cable network Animal Planet, with animal-based programming, frequently features veterinarians. Two notable shows are Emergency Vets and E-Vet Interns, set atAlameda East Veterinary Hospital in Denver, Colorado.

The song Grandma Got Run Over by a Reindeer, performed by the husband and wife duo "Elmo & Patsy", is a song performed by a veterinarian, Elmo Shropshire, DVM.

Fictional character veterinarians in TV series and films include Steve Parker in Neighbours, Jim Hansen in Providence, and Vincent Ventresca in the horror film Larva.

In Beethoven, Dean Jones portrayed Dr. Herman Varnick, an evil veterinarian, with his associates Harvey and Vernon played by Oliver Platt and Stanley Tucci, who wanted all animals to be destroyed. They were foiled by the Newton Family and Beethoven. The Newton Family released other dogs from Dr. Varnick's captives.

Veterinary malpractice

Most states in the US allow for malpractice lawsuit in case of death or injury to an animal from professional negligence. Usually the penalty is not greater than the value of the animal. For that reason, malpractice insurance for veterinarians is usually under $500 a year. Some states allow for punitive penalty, loss of companionship, and suffering into the award, likely increasing the cost of veterinary malpractice insurance and the cost of veterinary care. Most veterinarians carry much higher cost business, worker's compensation, and facility insurance to protect their clients and workers from injury inflicted by animals.

Criticisms

Concerns about the role of veterinary physicians in helping health threats survive and spread have been raised by several commentators, particularly with respect to pedigree dogs. Koharik Arman (2007) reached the following conclusion for example: "Veterinarians also bear some responsibility for the welfare situation of purebred dogs. In fact, the veterinary profession has facilitated the evolution of purebred dogs. 'Breeds' that would not normally be sustainable are propagated by the compliance of veterinarians to breeder wishes." This finding was echoed by Sir Patrick Bateson in his Independent Review of Dog Breeding following the broadcast of the BBC documentary Pedigree Dogs Exposed: "It's only the ready availability of modern veterinary medicine that has permitted some conditions…to become widespread.

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