Reply to An 'Open Letter to the Veterinary Community About COE Standards'

JAVMA editor-in-chief Kurt J. Matushek, DVM, MS, Dipl. ACVS, responds.

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The original letter here: Viewpoint: An Open Letter to the Veterinary Community About COE Standards

Even the most casual reader of the Journal of the American Veterinary Medical Association knows that the journal has not shied away from publishing a wide diversity of views, including views that disagree with those of the AVMA. As editor-in-chief of the largest veterinary medical journal in the world—and one of the largest biomedical journals—I take quite seriously the journal’s mission “to promote the science and art of veterinary medicine and provide a forum for discussion and dissemination of ideas important to the profession.”AVMA. As editor-in-chief of the largest veterinary medical journal in the world—and one of the largest biomedical journals—I take quite seriously the journal’s mission “to promote the science and art of veterinary medicine and provide a forum for discussion and dissemination of ideas important to the profession.”

The truth is that very, very few letters submitted to JAVMA are rejected. As editor-in-chief, I do, however, demand that letter writers maintain a certain level of professionalism and, as indicated in our instructions, will not publish letters containing defamatory, libelous or malicious statements or letters representing attacks on or attempts to demean others. I also will not publish letters containing false or clearly misleading statements.

Whenever possible, I work with authors to modify their letters as necessary so that they meet the journal’s publication criteria. At times, however, this is not possible, as was the case with the letter by Brinster et al. In that letter, for instance, the authors insult former members of the AVMA’s Council on Education by claiming that those members voted to accredit “schools that do not meet Council on Education (COE) standards.” 

Colleges of veterinary medicine are accredited by the COE only after careful review of extensive documentation and site visit reports supporting a judgment that all 11 standards have been met. While Brinster et al. may disagree with that judgment or may wish the standards were more stringent, to simply state that certain schools do not meet the standards is a terrible insult not just to the COE members who devote their time reviewing those schools but also to the hundreds of faculty members who work to ensure they meet the standards and the thousands of veterinarians who have graduated from them.

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In addition, while advocating for an independent accrediting body for colleges of veterinary medicine, Brinster et al. convey a false impression about the relationship between the Liaison Committee on Medical Education (LCME), which accredits medical colleges, and its sponsoring organizations, the American Medical Association (AMA) and Association of American Medical Colleges (AAMC). Contrary to Brinster et al.’s claim that the LCME is wholly autonomous and independent, the AMA and AAMC each appoint a co-secretary to administer the activities of the LCME; the LCME secretariats are located at AMA headquarters in Chicago and the offices of the AAMC in Washington, D.C.; and the AMA and AAMC each appoint members of the LCME, similar to the situation for the COE. In fact, following the changes made in recent years, the structure of the COE closely reflects that of the LCME.

Brinster et al. also misleadingly state that “the COE violates [U.S. Department of Education] requirements that it function autonomously and independently,” when, in fact, the COE is exempt from those requirements and thus cannot possibly be in violation of them. Note, however, that the Council for Higher Education Accreditation, which also recognizes the COE as an accrediting body, has independence requirements similar to those of the U.S. Department of Education and has continuously found the COE to be in compliance with them.

Finally, in railing against colleges that “utilize a distributive, often chaotic and poorly monitored, model for clinical education,” Brinster et al. suggest that much of their criticism of the COE arises from their belief that colleges of veterinary medicine that use a distributive model for clinical education of veterinary students are inferior to colleges that incorporate a traditional veterinary teaching hospital. Currently, the Western University of Health Sciences College of Veterinary Medicine is the only U.S. veterinary college that has had students complete their clinical education by means of a distributive model. Given that Western has graduated over 1,000 veterinarians since it was first accredited, it should be possible to compare the outcome of those students with the outcome for students who graduated from colleges with a more traditional clinical education structure. As scientists, Brinster et al. surely know that expert opinion is the very lowest tier of the evidence pyramid. It doesn’t seem too much to ask that, even in a letter, they provide evidence to back up their opinions, nor does it seem surprising that a letter that cannot provide such evidence would be rejected.

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Since 1946, the COE has been working to raise the standards of veterinary education here in the United States and around the world. Are there things it could be doing better? Certainly. And, as the JAVMA editor-in-chief, I will gladly publish letters discussing ways the COE could improve or advocating changes to the accreditation process. But, I will continue to insist that those letters remain respectful of the views of others and not contain false or misleading information.

Kurt J. Matushek, DVM, MS, Dipl. ACVS 
Journal of the American Veterinary Medical  Association 

Originally published in the June 2016 issue of Veterinary Practice News. Did you enjoy this article? Then subscribe today! 

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