An Explosion of Vet Schools

Will the profession be able to absorb this sudden expansion?

Rendering of the new proposed vet school in New Jersey

A recent JAVMA news article discussed the huge number of planned veterinary schools coming to the US in the near future:

“Nearly a dozen newly proposed veterinary colleges have been announced in the past two years, which represents a sizeable potential increase to the existing 33 U.S. veterinary colleges. Some universities have already secured site visits from the [AVMA Council on Education] COE while others are just in the discussion stage.”

The short list so far:

• Ana G. Méndez University (Puerto Rico)

• Arkansas State University*

• Chamberlain University (Georgia)*

• Clemson University (South Carolina)

• Lincoln Memorial University-Orange Park (Florida)*

• Lyon College (Arkansas)*

• Rowan University (New Jersey)

• Utah State University

• University of Maryland Eastern Shore*

• Rocky Vista College (Campuses in CO, UT, and CO)*

• Murray State University (Kentucky)

*School would represent at least the second vet school in that state; most other states on list already have contracts to send their residents to existing programs

Even as someone in the profession who has followed rumblings about these schools popping up, I was surprised by the sheer number of 11 schools in the works, on top of 3 that just opened since 2020. Eleven programs may not sound like a lot, but when you consider that there are currently a total of thirty-three AVMA-accredited veterinary schools in the US, that would represent a whopping 33% increase! While the number of new seats in each program will likely vary, and may disrupt the student body at existing schools (more on that later), it is reasonable to assume this would represent a substantial increase in the number of veterinarians graduating annually.

To proponents of these new schools, that is a feature, not a bug! Their argument goes like this: Growth of new DVMs has not kept pace with US population growth, a strengthening human-animal bond for pet owners, shortages in sectors like rural care and emergency medicine, and recent shocks like spiking veterinary demand in 2020-2021 prove we’re behind the curve. Folks like the lawyer Mark Cushing have advocated this view for years, and he has been a consultant to many of the new vet colleges and supported them in litigation when they hit road blocks.

Have We Fallen Behind Producing New Vets?

Let’s look at what the data shows. The American Association of Veterinary Medical Colleges (AAVMC) tracks application and enrollment data for all of the US veterinary colleges. Here is the latest data on enrollment from their 2023 report:

Does this look like we’re not keeping up? Not to me! You could make a plausible argument that we had a flatline from the late 80s to the early 2000s, but from the late 'Aughts on we’ve seen an unmistakable upward march in attendance that dwarfs the previous expansion of multiple new vet colleges (like Tufts and NC State) in the early 80s. In fact, we have almost doubled the number of annually enrolled vet students since 2000, despite a much smaller increase in US population during this time.

There are several reasons for this. First, the graduation of the first DVM class at Western University in 2007 and its subsequent accreditation in 2010 (disclaimer, I graduated from WesternU in 2012) opened the door to a number of other schools using the community “distributive model” for the clinical portion of their education, such as Lincoln Memorial University. While I believe distributed education can and does work, it undoubtedly lowered the cost and logistical barriers to opening a new vet college relative to having to build a large teaching hospital on site. Schools outside the US such as Ross University and St. George rely on traditional teaching hospitals in mainland schools for 4th year rotations.

At the same time, many US vet schools started expanding class size. Nominally, this was to address the claimed shortage of veterinarians (especially in rural areas), although many of them predominantly increased “at-large” seats, meaning out-of-state students who pay very high tuition, as opposed to subsidized in-state tuition (see below). While no one says it out loud, it certainly has the appearance of working to drive up tuition revenue to account for decreases in funding from other sources (I.e. state legislature funding, federal research grants, etc).

Proponents of new schools claim we have huge demand for veterinary seats. To me, the data tells a different story:

While there is a moderate increase in total applicants from around 2015/2016 to 2020, it appears this is plateauing recently. When you look at the applicant-to-seat ratio (a measure of the number of unique applicants per total nationwide slots, which normalizes for students applying to many schools at once through the common application), it has been hovering around 2.0, and after a slight increase, it has been dropping since 2020. This is not surprising when you consider a flat pool of applicants, expansion of class sizes, and the addition of new programs. This decreasing ratio will likely continue as we increase the number of available seats, and may plummet if we see a continued decrease in vet school applicants. A low applicant-to-seat ratio is worrisome because it could portend schools admitting less qualified students who would have previously been rejected just to fill spots and stay open.

This also raises the risk that the new schools could cannibalize existing CVM enrollment, jeopardizing their viability. For one example, Kentucky currently contracts with Auburn in Alabama, and many AU students hail from the pre-vet program at Murray State, which is one of the new proposed schools. For another, Utah employs a “2+2” program where students do two-years of pre-clinical coursework at Utah State followed by 2 years of clinical rotations at Washington State, which would obviously go away if USU becomes its own independent program.

Who’s Going to Teach These Students?

I have written before about the ongoing shortage of faculty at vet schools. You can see that in the AAVMC data for total number of faculty here:

Despite a significant uptick in DVM student enrollment, faculty numbers have been essentially flat for the past decade. There are hundreds of currently open faculty job postings for CVMs as highly indebted new grads choose to go where the money is: companion animal medicine in private practice ER and specialty care. Furthermore, the limited pool of residencies and long training period (3+ years) makes it harder to patch the gap in specialists than generalists.

Hundreds of unfilled vet school faculty positions on Indeed.com and HigherEdJobs. You can find a similar story on most CVM career pages

With the imminent addition of double digit new colleges, teaching staff will be stretched even thinner as they compete for a small and shrinking pool of talent. It begs the question: Who exactly is going to educate all of these kids??? Short of some type of shared resource agreement or massively increasing faculty via immigration, the only other answers are “no one” or “under-qualified individuals".

How Will This Impact These New Students?

If history is any guide—lots of debt. This figure shows median educational debt of all students (including those with no debt) and students with loan balances:

Notice anything? The schools with the top five most indebted graduates (Midwestern, Ross, WesternU, Lincoln Memorial, and St. George) are all private, and all recently accredited. The next two, UPenn and Tufts, are older legacy schools, but also private. Ross and St. George are also both for-profit entities, while all of the others are incorporated as not-for-profit entities.

This interesting figure from the 2023 AVMA Economic State of the Profession report tracks the specific level of indebtedness of all graduating DVM students:

Notice that the largest single category of debt level is students with no debt, representing almost 1 in 5 vet students. Data from the AAVMC shows this proportion has been increasing over several years. How is this possible? Based on the high tuitions charged across the board and increasing living expenses, this is unlikely due to anyone working student jobs or getting scholarships; virtually all “financial aid” in professional school consists of loans, and the few grants and scholarships that exist are too small to close the gap completely.

While the data doesn’t get this granular, it is highly likely that this represents a shift in applicants and enrollees to those who are already financially well-off and can afford to pay the skyrocketing cost of vet school out of pocket. An increasingly wealthy student body does not bode well for the profession, which already lacks socioeconomic and demographic diversity.

Along these lines, it is worth considering where these students come from and where they say they want to practice:

Unsurprisingly, about 80% of vet students are from urban or suburban environments and want to practice in that setting. The amount of people from rural areas or who want to practice there has remained unchanged for years at around 20%. This means that one of the key arguments for expanding vet school enrollment—helping to fill rural shortages—is highly specious; if you are expanding the pool of candidates, but 80% of them (at a minimum; students may be motivated to express an interest in rural medicine to boost their admission chances) want to work on dogs and cats in the cities, you aren’t going to make much headway.

Finally, one of the core talking points to argue that we do indeed have a shortage of vets is that salaries are going up, which would seem to indicate increasing pay to attract and retain scarce talent. However, take a look at this graph from the 2023 AVMA Economic State of the Profession report:

While absolute or nominal salaries are indeed going up (even though they remain substantially lower than dentists, physicians, nurse practitioners, and other allied health professionals), real income (inflation-adjusted) has actually gone down, and in fact real income in 2022 is lower than in 2000. Note that real incomes were decreasing years before the great post-covid inflation surge. This means most or all of this increase is simply a mirage caused by inflation, and vets are no better off today than they were more than 20 years ago, which is obviously not a good situation!

How Do We Move Forward from Here?

The issue of vet shortages and opening new schools is very controversial and has resulted in arguments and shouting matches at several recent veterinary conferences. Broaching the topic is always tricky because a lot of the people advocating for increases in veterinary academic enrollment stand to benefit financially one way or another, while those who raise concerns often use it as an excuse to grind their personal axes, like attacking corporations, diversity initiatives, or the specific faculty and graduates of these new schools. I remember literally being told “Western is a garbage school” by the private practice preceptors I was paying for an education during 3rd and 4th year rotations. That kind of hurtful BS is never OK, and I want to make it clear I am not attacking folks at any specific institution.

These are systemic problems and they require systemic solutions. I’m proceeding from the assumption that we all want what’s best for animals, pet owners, and employees in vetmed, and simply have good faith disagreements about the data and implications. My hope is that this article at least introduced some doubt and curiosity in people who may not agree with me.

What are my proposed solutions? I’m not an economist, but I have a few ideas…

Reconsider Some of These New Programs

Nobody wants to see veterinary medicine go the way of law school, where huge numbers of young lawyers at all but the top-tier schools are over-indebted and under-employed or unemployed. The legal market is complicated, but a key driver is undoubtedly a proliferation of law schools that charge top dollar but provide questionable career prospects. A similar situation can be seen in a number of international veterinary markets, such as Brazil and Italy, where a greater number of per-capita vet students than the US means many earn a subsistence income, and the brightest often head to America for specialty residency training to earn a better living.

I think there is a good argument for pausing development of some of these new programs to see how the market changes in the next few years. We are still wrestling with the labor market and economic aftershocks of the COVID-19 pandemic, and basing long term decisions like creation of new vet schools on a few years of data seems risky. After all, it is basically impossible to put the genie back in the bottle and shut down a program once it is up and running with students…

We should ask of each of these new programs:

• Does this make sense for the state or region? In my opinion, there is a better argument to opening a first vet school in New Jersey, a state of just under 10 million residents near multiple huge urban markets than opening TWO vet schools in Arkansas, a state with a population less than a third of NJ

• Does this program offer anything uniquely valuable? One of the key arguments of the founding faculty at WesternU was their unique Problem-Based Learning (PBL) curriculum was not being adopted by the legacy schools, and their new model represented necessary disruptive innovation

• Does this program have a viable plan for training? Having a distributive school in a highly urbanized area like Southern California (Western) or the NYC area (Long Island University) obviously provides a higher density of practices to rotate through than rural areas where veterinarians may be hamstrung by financially limited clients. Programs like Ross and St. George simply use the existing academic veterinary teaching hospital model, which works as long as those institutions can accommodate the added students

• Is this program a cost-effective option for students? Many of these programs claim to allow cheaper training, including shorter programs. However, the data speaks for itself, and the newer schools tend to charge the highest tuition, and in general have the most severely indebted graduates

Expand Contracts First

If one does believe that we need more veterinarians, many states already employ contracts to send residents to specific veterinary programs for agreed-upon discounted rates. It seems obvious that expanding these contracts would be less expensive than opening a new college from scratch. Furthermore, these contracts could be configured in a way such that as a condition of enrollment, students have to return to practice in their state, or a specific sector (such as food animal safety in a rural area). Indeed, West Virginia was a state that was considering building a new vet school and recently decided against it in favor of expanding state contracts:

Montgomery stressed the cost-effectiveness of this method: "We have about the same retention rate with our contract students that the average vet school has with their in-state students, so financially, it makes the most sense. We get the best bang for our buck by supporting the programs that are currently ongoing, and we get to continue with established programs that we know are successful and work."

Expand Public-Private Partnerships

One possible way to address faculty shortages is partnerships between private specialty practices and veterinary colleges. Some programs are piloting such arrangements, where for example, a board-certified surgeon might practice in a private clinic 50% of the time and teach/research at the vet school for 50% of the time. While these are relatively new, I anticipate they may be an attractive way to entice specialists who yearn for some teaching and research activities to break up their normal routine, but want to earn a better wage and also avoid some of the frustrations of full-time tenured faculty.

Focus on Low Costs and Loan Repayment Options

I am not one of those DVMs who grouchily tells any young person “Never become a vet, it’s terrible!” I love my profession, and it’s hard to imagine doing anything else. I do want to see us be good stewards and make sure it is sustainable. I would tell any prospective vet student to think of higher education as a business (because in some ways it unfortunately is) and to be smart about where they apply. Not all schools carry the same debt load (see the AAVMC figure above), and going to an affordable school as an in-state resident is still the best deal around. I have a cousin who moved to a state in the southeast for a year so he could get residency and save a lot of money; in retrospect that looks pretty smart, and I should have considered that!

Ask tough questions during school visits and interviews about costs (including any hidden fees) and financial aid, how their graduates do in the job market, etc. Remember that they want YOUR business and you are entitled to ask anything you might need to know to make an informed purchase.

There are also some attractive forgiveness options. Look into programs such as Public Service Loan Forgiveness (PSLF) and the Veterinary Medicine Loan Repayment Program (VMLRP). These can be great options for people interested in food animal medicine, rural practice, public health, research, and more. Also, while it’s not for everyone, the US military does pay for some people to attend veterinary school in return for a commitment to service afterwards. Finally, some companies are also starting to offer loan payment bonuses as an incentive for hiring and retention.

Maybe It Will All Work Out After All

I want to close on a semi-optimistic note by saying there is a lot of uncertainty here. On the one hand, I don’t want to be a Pollyanna and “hope is not a plan,” but on the other, many previous economic predictions of doom and gloom did not come to pass. Perhaps the surging enrollment at vet schools will be balanced out by the massive retirement wave of Baby Boomers. Maybe AI and other technology will increase productivity to the point that better efficiency allows vets to earn a better wage. It’s possible that the continued trend of Millennials and Gen Z to embrace pet ownership over children could be a tailwind for the veterinary profession.

While I wouldn’t bank on these problems magically solving themselves, a good scientist always has to be open to the null hypothesis. As the physicist Niels Bohr said:

“It is difficult to make predictions, especially about the future."

What do you think? Is there a veterinary shortage? If so, how would you address it? Do you think the veterinary profession can or should rapidly expand the number of vet schools and students? Let us know below 👇