2 Adequacy of the Current Comparative Medicine Veterinary Workforce

Ideally, an analysis of the adequacy of the current comparative medicine veterinary workforce would be based on information such as time necessary to fill open job positions, the percentage of veterinarians entering the workforce that achieves appropriate faculty, research, managerial, or administrative positions, and the employment rate of this workforce. Similar analyses have evaluated the PhD and MD workforces in biomedical research (NRC, 2000). These detailed analyses were possible because the PhD workforce is the subject of national surveys sponsored by the National Science Foundation, and information on the MD workforce is collected by the American Medical Association.

However, because the comparative medicine veterinary workforce encompasses individuals with different educational backgrounds, professional experiences, and career pathways, data sets describing the entire veterinary workforce in biomedical research are not available. It is therefore difficult to estimate the veterinary workforce, as was acknowledged in the NRC report Addressing the Nation’s Changing Needs for Biomedical and Behavioral Scientists (NRC, 2000). The only unifying characteristics of the comparative medicine veterinary workforce are (1) that they have obtained a doctorate of veterinary medicine and (2) that they either directly perform biomedical research or support biomedical research in a professional capacity. While the AVMA membership would potentially include the veterinary workforce involved in biomedical research, this workforce is a very small minority of the membership (less than 1% of the AVMA



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National Need and Priorities for Veterinarians in Biomedical Research 2 Adequacy of the Current Comparative Medicine Veterinary Workforce Ideally, an analysis of the adequacy of the current comparative medicine veterinary workforce would be based on information such as time necessary to fill open job positions, the percentage of veterinarians entering the workforce that achieves appropriate faculty, research, managerial, or administrative positions, and the employment rate of this workforce. Similar analyses have evaluated the PhD and MD workforces in biomedical research (NRC, 2000). These detailed analyses were possible because the PhD workforce is the subject of national surveys sponsored by the National Science Foundation, and information on the MD workforce is collected by the American Medical Association. However, because the comparative medicine veterinary workforce encompasses individuals with different educational backgrounds, professional experiences, and career pathways, data sets describing the entire veterinary workforce in biomedical research are not available. It is therefore difficult to estimate the veterinary workforce, as was acknowledged in the NRC report Addressing the Nation’s Changing Needs for Biomedical and Behavioral Scientists (NRC, 2000). The only unifying characteristics of the comparative medicine veterinary workforce are (1) that they have obtained a doctorate of veterinary medicine and (2) that they either directly perform biomedical research or support biomedical research in a professional capacity. While the AVMA membership would potentially include the veterinary workforce involved in biomedical research, this workforce is a very small minority of the membership (less than 1% of the AVMA

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National Need and Priorities for Veterinarians in Biomedical Research membership in 2002 had board certification in laboratory animal medicine, and less than 2% had board certification in pathology), and demographic information specific to this subpopulation of veterinarians is not collected. Some professional societies, such as ACLAM and the American College of Veterinary Pathologists (ACVP), do obtain demographics of their membership to varying degrees; however, veterinarians who participate in biomedical research, with the exception of laboratory animal veterinarians, are generally following non-traditional career paths and there is little impetus among professional societies to investigate the demographics, supply, or demand for these individuals. For example, veterinarians participating in biomedical research as principal investigators or technical consultants are more likely to be affiliated with a professional research society (e.g., Society for Neuroscience) than a professional veterinary society. The committee was able to identify some data on various subpopulations of comparative medicine veterinarians, such as individuals who have obtained board certification in laboratory animal medicine or pathology. However, the authoring committee was unable to find any usable data on some subpopulations, such as veterinarians who are co-investigators, research scientists, or technical consultants. This lack of usable information prevented the committee from performing a detailed, quantitative analysis of the current workforce. Because the authoring committee was not commissioned to survey the workforce, they were forced to rely heavily on data collected by professional societies and NIH on three subpopulations of the workforce: laboratory animal medicine veterinarians, veterinary pathologists, and veterinary principal investigators. Data available on these three subpopulations of workforce are presented in the following sections. LABORATORY ANIMAL MEDICINE VETERINARY WORKFORCE As described by ACLAM, the professional society that administers specialty certification, laboratory animal veterinarians are veterinary medical specialists who are experts in the humane, proper, and safe care and use of laboratory animals. The majority of laboratory animal medicine veterinarians (as identified by membership in the American Society for Laboratory Animal Practitioners [ASLAP] or ACLAM) identified themselves as administrative, management, or clinical staff involved in the management of laboratory animal facilities (Weigler and Huneke, 2003). These individuals, acting as attending veterinarians, staff veterinarians, and facility directors, oversee the care and use of laboratory animals in biomedical research institutions, such as universities, hospitals, and biotechnical and pharmaceutical companies. Most of these institutions are subject to the Animal Welfare Act (AWA), which is enforced by the USDA and applies to any research institution utilizing warm blooded animals other than birds, rats of the genus

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National Need and Priorities for Veterinarians in Biomedical Research Rattus, or mice of the genus Mus; and/or to the Public Health Service (PHS) Policy, which is enforced by NIH through its assurance program and which regulates any research institution receiving federal funding through the PHS. Both the AWA and PHS Policy require that each research institution have a veterinarian with training or experience in laboratory animal medicine responsible for the activities involving animals at the institution, often defined as attending veterinarians. These individuals are the most visible subpopulation of the comparative medicine veterinary workforce, and more information and data were available on this subpopulation of the workforce than on any other. For these individuals, ACLAM board certification is considered the preferable standard of specialized training. ACLAM is the only US organization that establishes standards of education, training, experience, and expertise necessary to become qualified as a specialist in laboratory animal medicine and that recognizes achievement through board certification. Individuals who desire to sit for the certifying examination must have either 24 months of formal training in an ACLAM-accredited training program and a total of 4 years of training and experience; or, if they do not train in an ACLAM-accredited program, they must have 6 years of full-time experience in laboratory animal medicine. In addition to the training and experience requirements, a candidate must be the first author of a scientific article that has been accepted by a refereed journal on some phase of laboratory animal medicine. One indicator of the need for laboratory animal medicine veterinarians in biomedical research is the increased amount of NIH funding directed toward animal-related research. From 1990 through 2002, live, vertebrate animal-based research accounted for approximately 43% of the research grants competitively funded annually by NIH (Figure 2-1). However, since the mid-1990s, the total number of research grants has increased, resulting in a 31.7% increase in the number of competitive grants utilizing animals between 1995 and 2002. In essence, there were approximately 1,300 more competitive grants utilizing animals funded in 2002 than in 1995. Unfortunately, there is no way to estimate the additional burden of this increase in competitive research grants on veterinary care programs because there is no way to identify the number of animals that would be utilized in research funded by those grants. However, the USDA tracks the number of AWA-covered species used in research; between 1995 and 2001, the number of AWA-covered animals used in research decreased 11.3% from 1,395,463 to 1,236,903. From these data, it would appear fewer animals are used in biomedical research, except that AWA-covered species have been estimated to include less than 15% of vertebrate animals used in research (Goodrich et al., 2000). The AWA does not include rats, mice, or birds, and because rats and mice are the most commonly used species in biomedical research, it

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National Need and Priorities for Veterinarians in Biomedical Research FIGURE 2-1 Historical trends of animal use in NIH grant portfolio. NIH competing research grants from 1986-2002 were assessed for use of live, vertebrate animals (excludes research training, fellowship, construction, and medical library grants and R&D contract awards). Source: NIH Office of Laboratory Animal Welfare. is not expected that the USDA inventories accurately reflect changes in the numbers of animals utilized in research. Although 95% of rats and mice used in research are subject to PHS Policy and NIH oversight (Goodrich et al., 2000), accurate inventories of the number of rats and mice used in research are not kept, making it difficult to document changes in the utilization of rats and mice. Estimates are 12 to 15 million rats and mice were utilized for research in 1983 (US Congress, 1986) and 23 million in 1998 (Trull and Rich, 1999), with indications that mouse use alone will continue to increase by 10% to 20% annually over the decade 2000–2010 (Malakoff, 2000). If these predictions hold true over the next decade, by 2010 the US biomedical research enterprise could be utilizing more than 200 million rats and mice per year. A previous study of the supply of and demand for laboratory animal medicine veterinarians (Weigler et al., 1997) concluded that there would be no increase in the demand for laboratory animal medicine veterinarians from 1994 to 2005, based partially on the assumption that NIH funding of research involving vertebrate animals had reached a steady state. However, starting in 1997, there was an increase in the annual rate of growth of the

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National Need and Priorities for Veterinarians in Biomedical Research NIH budget along with a steady increase in the number of NIH competing grants that utilize animals. These increases coincided with legislators in 1997 calling for a doubling of the NIH budget over 5 years. This 5 year doubling was officially set in motion during the 1999 fiscal year appropriations cycle (Mervis, 1997) (Figure 2-2). Neither the dramatic increase in the NIH budget nor the increase in the total number of NIH grants utilizing animals was predicted when it was concluded that the laboratory animal veterinary workforce had reached a steady state. Nevertheless, although these data would suggest an increased demand for laboratory animal medicine veterinarians during the last 5 years, the current workforce may indeed be adequate if there was a concomitant increase in the number of laboratory animal medicine veterinarians. Examination of the ACLAM membership (Table 2-1) during this time period (1997-2002) reveals the annual rate of growth in the membership of active ACLAM diplomates was less than 3%. In total from 1997 to 2002, there was a 15% increase in the number of active ACLAM diplomates. Most positions of attending veterinarian or director of a laboratory animal facility FIGURE 2-2 Total budget for the National Institutes of Health, by fiscal year. Source: National Institutes of Health, Office of the Director.

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National Need and Priorities for Veterinarians in Biomedical Research TABLE 2-1 Active ACLAM Diplomates   1996 1997 1998 1999 2000 2001 2002 Active diplomates 564 579 597 620 633 643 666   Source: American College of Laboratory Animal Medicine. require or strongly encourage ACLAM board certification, although in the committee’s experience fewer positions for laboratory animal medicine veterinarians have required board certification in recent years because of the perceived lack of available ACLAM diplomate applicants. Taken together, the 30% increase in competitive grants utilizing animals and the 15% increase in ACLAM membership might suggest that there is not an adequate number of appropriately trained laboratory animal medicine veterinarians in the workforce. However, it is not possible to correlate these data directly because data on the total (competitive and noncompetitive) number of grants utilizing animals are not available. Another indication of continuing demand for laboratory animal medicine veterinarians is the growth in professional income. The estimated mean salary of laboratory animal medicine veterinarians over the period 1996 to 1999 increased from $86,236 to $99,095 (15% over 3 years). Even if extremes in salaries are eliminated, laboratory animal medicine veterinarian salaries outpaced inflation by 6.4% (Weigler and Slattum, 2001), suggesting that an imbalance in supply and demand could be driving the increase in laboratory animal medicine veterinarian salaries. Further evidence provides direct insight into the adequacy of the laboratory animal medicine veterinary workforce. Currently, an estimated 1,608 research institutions in the US* are USDA-registered and/or hold NIH assurances.† In contrast, only 666 individuals were active ACLAM diplomates in 2002. It should be noted that many research institutions register multiple research sites or campuses through the same registration or assurance, and this estimate of 1,608 research institutions would underestimate *   This estimate is an unpublished tabulation of all USDA-registered research facilities (as of December 11, 2002) and all NIH assured facilities (as of June 3, 2003), with duplicates removed. Domestic institutions include those within the 50 states and the US territories of Puerto Rico and Guam. For the purposes of this estimate, a facility was identified as a research organization based on its unique USDA certification number or NIH assurance number. This estimate does not include additional sites that may be registered or assured through a parent facility. †   Each research facility in the US that utilizes Animal Welfare Act-covered species (warm-blooded vertebrates other than rats of the species Rattus, mice of the species Mus, and birds) or utilizes live, vertebrate species at a facility that is supported by PHS funding must be registered with the USDA or hold an NIH assurance, respectively.

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National Need and Priorities for Veterinarians in Biomedical Research the number of facilities that would require a veterinarian to oversee the care of the laboratory animals. While it is recognized that attending veterinarians are not required to be ACLAM certified, these data suggest that there is a severe shortage of appropriately trained laboratory animal medicine veterinarians in the workforce. The large, unexpected increase in the number of competitive grants utilizing animals and the large discrepancy between the number of institutions that are required to be overseen by a laboratory animal medicine veterinarian and the number of ACLAM diplomates are reflected in the number of position announcements for laboratory animal medicine veterinarians advertised in the major trade journals (Figure 2-3). Publication of position announcements for laboratory animal medicine veterinarians has been documented in the past (NRC, 1982; Weigler et al., 1997), which FIGURE 2-3 Number of position announcements for laboratory animal medicine veterinarians, 1980-2001. Position announcements appearing in classified-advertisements sections of Journal of the American Veterinary Medical Association (JAVMA), Contemporary Topics in Laboratory Animal Science (Contemporary Topics), and Lab Animal were tallied. Data for 1980-1995 from Weigler et al., 1997. From 1980 to 1990, the classified advertisement section now found in Contemporary Topics was printed in the AALAS journal Laboratory Animal Science.

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National Need and Priorities for Veterinarians in Biomedical Research allowed the authoring committee to examine trends in position announcements for possible indications of demand for the position. Building on data gathered by Weigler et al. (1997), the number of position announcements for laboratory animal medicine veterinarians in three major journals from 1980 to 2001 was tallied (Figure 2-3). From 1995 to 2001 there was approximately a 250% increase in the number of position announcements from 56 announcements in 1995 to 199 announcements in 2001. It is not evident whether specific advertisements appearing in more than one journal or more than one issue of a journal represented turnovers in positions or multiple attempts to fill single positions. Thus, these data do not reflect the actual number of available laboratory animal medicine veterinarian positions, but rather may indicate an increased demand that may or may not have been adequately fulfilled. This large increase in position announcements could reflect a large increase in the total number of positions for laboratory animal medicine veterinarians, the retirement of large numbers of laboratory animal medicine veterinarians, an inability of employers to find qualified laboratory animal medicine veterinarians, a high turnover of laboratory animal medicine veterinarians, or a combination of these situations. Although it is impossible to determine the specific cause of the large increase in position announcements, these data support the suggestion that the increase in NIH-funded grants utilizing animals created an increased demand for laboratory animal medicine veterinarians. The small annual growth in the membership of ACLAM along with the large discrepancy between facilities that require a laboratory animal medicine veterinarian and the total membership of active ACLAM diplomates further support the conclusion that the current workforce of laboratory animal medicine veterinarians is inadequate. VETERINARY PATHOLOGISTS The subpopulation of the comparative medicine veterinary workforce composed of veterinary pathologists was recently surveyed by the American College of Veterinary Pathologists (ACVP, 2002). While this data set was the most comprehensive available to the authoring committee, the information was not derived exclusively from veterinary pathologists engaged in biomedical research, but included demographics on the entire veterinary pathologist workforce. The ACVP survey, undertaken during the summer of 2002, was commissioned to determine whether there currently was a shortage of veterinary pathologists. This survey determined that in 2002, there was an estimated deficit of 67 anatomic and clinical pathologists in the veterinary pathologist workforce (ACVP, 2002). This estimate was based on a survey of 279 employers of veterinary pathologists in the United States and Canada (60.0% response

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National Need and Priorities for Veterinarians in Biomedical Research TABLE 2-2 Active ACVP Diplomates   1997 1998 1999 2000 2001 2002 2003 Active diplomates 1119 1145 1194 1223 1236 1244 1268   Source: American College of Veterinary Pathologists. rate) and 58 veterinary pathologist training programs (67.2% response rate). Based on this survey, the total workforce of veterinary pathologists in the United States and Canada was approximately 1,897 veterinary pathologists in 2002.* The active membership of ACVP in 2002 was 1,244 (Table 2-2), suggesting that approximately one third of the veterinary pathologist workforce does not have board certification in veterinary pathology. The membership of ACVP (Table 2-2) reflected increases in growth similar to that seen in the ACLAM membership (Table 2-1). The active membership of ACVP increased by 13.3% from 1997 to 2003, with an average annual growth of 2.1%. The majority of survey respondents in the ACVP survey indicated that it took 7 or more months to fill an open position, and only one or two qualified individuals applied for each open position. More than 25% of respondents indicated that it took 13 to 18 months or more than 19 months to fill an open position. The majority of respondents also indicated that their primary barrier to recruiting qualified job applicants was a limited number of qualified pathologists, and approximately 80% of respondents indicated that a limited number of qualified pathologists was a factor in their struggle to recruit qualified job applicants (ACVP, 2002). While the results of the ACVP survey establish a need for veterinary pathologists, NIH has identified a specific need for mouse pathologists (NIH, 1998). This need was identified during the NIH workshop “Priority Setting for Mouse Genomics and Genetics Resources,” convened in March 1998 by then NIH Director Harold Varmus. During this workshop, a series of action items were outlined and included “a training program to support veterinary fellows in a two year fellowship in mouse pathology should be implemented” (NIH, 1998). In a subsequent follow-up meeting, NIH identified several types of training programs that were developed “to increase the number mouse pathobiologists” (NIH, 2000). These programs included *   An unpublished estimate based on the results of the ACVP survey. The estimated total workforce was calculated from the survey response rate, the percentage of organizations that employ an anatomic/clinical pathologist, and the average number of pathologists employed per organization. This estimate is based on the assumption that the percentage of organizations that employ an anatomic/clinical pathologist and the average number of pathologists employed per organization is similar in the respondent and nonrespondant organizations.

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National Need and Priorities for Veterinarians in Biomedical Research the Special Emphasis Research Career Award (SERCA) in Pathology and Comparative Medicine and the Mid-Career Investigator Award in Mouse Pathobiology (K26) award. In 1998, the SERCA award was expanded to include research on genetically modified animals; however, this award encompasses any type of comparative medicine research, with no special emphasis on pathology or mouse models. In contrast, the K26 award announcement states that “the NIH is especially interested in increasing the number of scientists trained to conduct high-quality mouse pathobiology research.” The objective of the award is to “encourage experienced, midcareer pathobiologists to . . . increase their mentoring of beginning investigators in mouse pathobiology to build up the pool of skilled mouse pathologists who can fill the growing need for trained professionals to contribute in the exciting discoveries being made using genetically altered mice for biomedical research.” NIH Support of Comparative Medicine Although the discipline of comparative medicine and the need for well-trained, experienced veterinarians stretch across the institutes of NIH, only the National Center for Research Resources (NCRR) Division of Comparative Medicine directly funds the research-training and career-development awards of veterinarians (except for K08 awards that are funded by individual institutes). Therefore, it is disappointing that due to policy priorities, the various divisions of NCRR have not benefited equally from the doubling of the NIH budget. As seen in Figure 2-4 from 1995 to 2002, NCRR’s budget increased by 204% while there was only a 42.9% increase in the Division of Comparative Medicine’s funding. VETERINARIANS AS PRINCIPAL INVESTIGATORS To examine the comparative medicine veterinary workforce that participates in biomedical research as principal investigators, the authoring committee used research project grant (RO1) funding both to identify this population and to measure its growth and success (Figure 2-5). During the period of the doubling of the NIH budget (1997-2001), the overall increase in the number of RO1 awards was 33%. The number of RO1 grants awarded to individuals with a DVM (DVM, DVM-PhD, or DVM-MD) during this period increased 103% from 127 in 1997 to 258 in 2001. DVM-PhDs in particular competed successfully during this time frame (1997-2001). The number of RO1s awarded to DVM-PhDs increased by 161%. However, the number of RO1s awarded to DVM-PhDs continues to be quite small: 154 RO1s awarded in 2001 compared with 3,071 awarded to MD-PhDs.

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National Need and Priorities for Veterinarians in Biomedical Research FIGURE 2-4 Annual budgets of NIH, NCRR, and NCRR Division of Comparative Medicine. From 1995 to 2002, NIH experienced a doubling in annual budget. From 1995-2001, the budget of NCRR increased 204% and the budget of NCRR Division of Comparative Medicine increased 42.9%. Source: National Institutes of Health, Office of the Director and National Center for Research Resources. The period 1997-2001 also reflected an increase of 11.8% in the number of RO1s awarded to DVM principal investigators, which was similar to the 11.5% increase in awards to MDs. However, the absolute number of RO1s awarded to DVMs was quite small: 76 in 2001 compared with 5,597 to MDs. A new category of veterinary principal investigators also became apparent during this time—that of the DVM-MD. DVM-MD principal investigators have received RO1 awards only since 1999; however, in 2001 there were 28 grants awarded to DVM-MDs. While it is evident that an increased number of veterinary principal investigators are successfully competing for RO1 funding, the total number of veterinarians with RO1 funding is still extremely small. In 2001, only 172 veterinary principal investigators were RO1 funded (some veterinary principal investigators are awarded multiple RO1 grants). In all, the 258 RO1 grants awarded to veterinary principal investigators in 2001 comprise only 4.7% of all the NIH-funded competitive research grants that utilize

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National Need and Priorities for Veterinarians in Biomedical Research FIGURE 2-5 RO1 grant awards categorized by degree of principal investigator. RO1 awards are coded by NIH by degree of principal investigator and include merit awards now designated as R37 awards. Source: National Institutes of Health, Office of the Director. animals (see Chapter 3, “Increase in the Number of NIH-funded Grants Utilizing Animal Research,” for further discussion). These data suggest that the current number of veterinary principal investigators who are conducting long-term research programs in the United States is not adequate, yet the training and experience that comparative medicine veterinarians possess makes them uniquely qualified to carry out animal research successfully. Because of the importance of using animal models in translational research, the veterinary principal investigator can also provide a critical bridge between the bench scientist and the clinical researcher. The necessity of veterinarians directly participating in and carrying out biomedical research was acknowledged during testimony at the NIH reauthorization hearings in 1996, when it was asserted that more efforts should be made to recruit veterinarians to interdisciplinary research teams (Cassell and McCauley, 1996).