MISSION OF THE VETERINARY PROFESSION
The veterinary profession is founded on service to society and advancement of medical knowledge; therefore, the profession as a whole must periodically reassess its role in society and the emphasis of veterinary medical education and its specializations. Historically, the profession has adapted successfully to the changing needs of society. Equine medicine was the dominant focus of the veterinary profession during the 19th century; as epizootics in other agricultural animals erupted and the understanding of germ theory was acquired and put into practice, agricultural medicine dominated the profession during the early 20th century. Then, as dogs and cats became more common in American households during the second half of the 20th century, the profession once again responded to society’s particular needs for veterinary services (Eyre, 2002). Currently, some 61% of veterinarians are involved in a predominantly or exclusively small-animal clinical practice, and 84% of the veterinary workforce is involved in private clinical practice (AVMA, 2001).
While companion and agricultural animal care has most recently dominated the veterinary profession, veterinarians make significant contributions in other fields, including biomedical research (defined as research contributing to understanding of human physiology and pathology, including behavioral and clinical research). Veterinarians participate in biomedical research through the utilization of their specialized training in animal biology and medicine to model human physiology and disease.
VETERINARIANS AS PRINCIPAL INVESTIGATORS
Some veterinarians, referred to as principal investigators, participate in biomedical research by directly initiating and leading research programs at academic and corporate research institutions. Veterinarians also contribute to research programs as co-investigators, research scientists, and technical advisors. In fact, many of the first discoveries in modern biomedical research originated from veterinarians investigating diseases common to both humans and animals, such as blood-borne parasitic diseases and leukemia. These discoveries have led to major advancements in the understanding and treatment of human and animal diseases, and have occurred in every major field of biomedical research.
Virology and Microbiology
In 1898, the veterinarians Loeffler and Frosch were the first to discover an animal virus when they demonstrated that a particle smaller than a bacterium could cause foot-and-mouth disease (Brown, 2003). Ten years later Danish veterinarians Ellerman and Bang (1908) provided the first evidence that some leukemias are caused by viruses. William Hadlow, a Public Health Service veterinarian, discovered histologic similarities between scrapie and kuru, leading to the breakthrough research on prion disease (Eklund and Hadlow, 1973). Smith and Kilborne (a veterinarian) (1893) were the first to demonstrate that an insect could transmit disease. Their research into identifying the arthropod vector for Texas fever contributed to the discovery that mosquitoes transmitted malaria and yellow fever. Veterinary medical scientists continued to make significant contributions in microbiology, especially in the field of retrovirology where the feline retroviruses were investigated by William and Oswald Jarrett, Neils Pedersen, Charles Rickard, Max Essex, William Hardy, and Edward Hoover; chicken retroviruses by Peter Biggs; and cattle leukemia viruses by Carl Olson, Martin van Der Maartin, and Arsene Burny, all veterinarians (Gallo, 1991). Theilen, Essex, and many other veterinarians were among the first to study simian immunodeficiency. This important animal model continues to advance our knowledge of human acquired immunodeficiency syndrome through studies led by the veterinary scientist A. A. Lackner and associates, among others (Veazey and Lackner, 1998).
Veterinarians have been instrumental in elucidating the etiopathogenesis of many infectious (NRC, 1991) and non-infectious (Fox et al., 2001) diseases of laboratory animals, and they continue to make important contributions, such as the recent discovery of murine Helicobacter spp. and their role in disease (Fox et al., 2000). Others have contributed by defining the pathologic and clinical chemical changes seen in infectious and non-infectious diseases of laboratory animals (Percy and Barthold, 2001).
Veterinarians have also advanced our understanding of cellular physiology. In 1922, a veterinarian named Schofield discovered that moldy hay caused hemorrhagic disease (Schofield, 1922). He went on to isolate the causative agent, dicoumerol, analogues of which are used to treat throm-boses in humans. At the other end of this disease spectrum, veterinarian Jean Dodds characterized the clinical and hematologic abnormalities in several spontaneous hemorrhagic diseases of dogs (Dodds, 1988). These investigations have continued under the auspicious work of James Catalfamo and Margory Brooks, a veterinarian, and include the molecular and genetic characterization of many inherited hemorrhagic diseases in dogs, which serve to model illnesses of humans and in which gene therapy trials are under way (Gu et al., 1999).
The physician-veterinarian team of Miller and Mitchell, using laboratory mice, was the first to demonstrate the importance of thymic-derived lymphocytes in providing “help” to bone marrow-derived cells in the production of antibody (Miller and Mitchell, 1969). Veterinarian Morten Simonsen was the first to discover graft vs. host disease in chicken embryos (Simonsen, 1957). British veterinarian Robin Coombs developed the antiglobulin test, which bears his name, now used in the diagnosis of auto-immune hemolytic anemia in humans and animals (Coombs et al., 1945). And in 1996, veterinarian Peter Doherty, won the Nobel Prize in physiology or medicine for discovering that the immune system is capable of dual recognition; that is, it can recognize foreign and endogenous antigens (Zinkernagel and Doherty, 1974a,b).
Public health and safety have also benefited from the involvement of veterinarians. D. E. Salmon, founding director of the Bureau of Animal Industry, instituted significant public health policies, including a nationwide system for meat inspection and quarantine requirement for imported livestock, and for the inspection of exported cattle and the ships on which they are transported. Veterinarians are also on the front lines of the war on biological terrorism, as the majority of biological terror agents are zoonotic diseases. Of special note in this regard, Frederick Murphy, a veterinarian, was the first to demonstrate the morphology of Ebola virus (Murphy, 1971), and Nancy and Gerald Jaax, both veterinarians, were the first to describe an outbreak of Ebola virus in monkeys in the United States
(Geisbert et al., 1992). Veterinarian Tracy McNamara was the first to identify West Nile virus in North America (Hansen et al., 2001).
Cutting Edge Research and Innovations
Veterinarians continue to make significant contributions in virtually every area of biomedical research. Ralph Brinster is credited with the pioneering discoveries that allowed for the production of transgenic animals. In addition, he is among the first to successfully transplant germ cells and appreciate the role of stem cells and the microenvironment of this new area of research (Brinster and Avarbock, 1994). Gus Aguirre and Greg Acland, both veterinarians, have published the clinical, molecular, and genetic abnormalities in dogs with inherited retinal diseases and were the first to restore vision to a blind dog by gene therapy (Acland et al., 2001). Veterinarian John Sundberg has contributed greatly to our understanding of the molecular and pathological basis of inherited skin diseases (Sundberg and King, 2000).
VETERINARIANS IN ROLES THAT SUPPORT BIOMEDICAL RESEARCH
Veterinarians also participate in biomedical research in a supportive role as the key individual who oversees the veterinary medicine program at research institutions and who, by law, has direct or delegated authority for activities involving animals (9 CFR Sec 1.1). In this capacity, these individuals are known as attending veterinarians. Attending veterinarians not only directly provide medical care for research animals (also referred to as laboratory animals), but they also are a federally-mandated member of animal care and use committees. Using their specialized knowledge base, they work collaboratively with the committee to establish standards and provide ongoing evaluations of the care, treatment, housing, and use of all animals utilized at the research institution. In addition, they provide technical instruction to researchers, collaborate and provide technical advice on experiments utilizing animals, and ensure animal well-being. Large research institutions may also employ additional veterinarians to assist with the veterinary medicine program. These individuals are usually referred to as staff veterinarians. Both attending and staff veterinarians have specialized training or experience in laboratory animal medicine, and the preferred standard of training experience is board certification in laboratory animal medicine through the American College of Laboratory Animal Medicine (ACLAM).
Paramount to successful research is information on selection of animal models, animal sources, animal anatomy, physiology, and care and management. This information is comprehensively provided by attending and
staff veterinarians as well as veterinarians with training in other specialties such as pathology. Their expertise allows them to train and otherwise support investigators in the performance of animal-based experimental techniques, which include providing surgical expertise, perioperative care, anesthesia and analgesia, and approved euthanasia methods. The needed training extends past the level of the investigator to animal care providers, to animal care and use committee members, and to the institutional administration charged with providing the resources to support animal research. These veterinary professionals both protect and promote research through their knowledgeable understanding and implementation of federally required animal care and use policies, and through educational outreach in the role of veterinary caregiver and research facilitator with the lay community, media, and regulatory agencies.
In summary, the contributions made by trained comparative medicine veterinarians are critical to the successful execution of biomedical research. These veterinarians have the knowledge base to construct policies and procedures that optimize animal husbandry and environments, which in turn affects the health status and breeding capabilities of research animals. Management that promotes optimal animal health congruent with maximizing an institution’s resources requires the specialized expertise that veterinarians, particularly those specializing in laboratory animal medicine, possess. As pointed out during the National Institutes of Health (NIH) reauthorization hearings (Cassell and McCauley, 1996), “individuals well trained in laboratory animal medicine (clinician-scientists) are essential to ensure the highest quality of laboratory animal care as well as to achieve the maximum benefit from research using animals.”
SCOPE OF THIS STUDY
Throughout the last century, the biomedical research workforce has steadily increased. After World War II, the US government became a major sponsor of scientific research leading to the dramatic expansion of publicly funded biomedical research (NRC, 1985). During the same time period, the discovery of antibiotics led to a large expansion in pharmaceutical and privately funded research (Rowan and Loew, 2001) that has continued into the 21st century. The research-scientist workforce is composed primarily of individuals holding PhDs (NRC, 2000); however, other doctorates, such as MDs and DVMs, also play important and unique roles in the biomedical research enterprise, and special attention to these subpopulations is necessary. In 2000, a NRC report highlighted the decline in MDs identifying research as their primary professional activity and recommended that efforts to train and retrain physicians be intensified until the clinical biomedical research workforce includes substantially more MDs (NRC, 2000). Simi-
larly, anecdotal evidence now suggests that the increased demand for laboratory animals, increased regulatory requirements, and increased focus on translational research have led to an increased need for veterinarians in biomedical research workforce (Gaertner, 2001; Jacoby, 2000a,b; Schub, 2001). In fact, the importance of translational research is being recognized at the highest levels of NIH. Dr. Elias Zerhouni, Director of NIH, identified new priorities for healthcare research in the United States while speaking at the Steps to a Healthier US Summit in April of 2003, including the “...need to more quickly translate our discoveries into practice.” Dr. Zerhouni indicated a new emphasis at NIH on translational research, the process where information gleaned from molecular, cellular, and animal research requires interpretation and further study by researchers (in particular veterinarians) so the information can be translated into human therapies. This process relies heavily on animal research and on comparative medicine veterinarians, and suggests that societal needs for veterinarians are changing and the veterinary profession must adapt to continue to fulfill its mission.
In response to these changes, the Institute for Laboratory Animal Research (ILAR) Committee for Increasing Veterinary Involvement in Biomedical Research was commissioned to examine the question: How can more veterinarians be prepared for careers in laboratory animal medicine, comparative medicine, and comparative pathology? This statement of task presupposes that the current workforce is inadequate, based on the experiences of the sponsors, NIH (Office for Laboratory Animal Welfare and National Center for Research Resources), ACLAM, the American Society for Pharmacology and Experimental Therapeutics, the American Veterinary Medical Association (AVMA), GlaxoSmithKline, Merck and Co., and Pfizer, Inc. After hearing testimony from sponsors, veterinary leaders in biomedical research, and the public, the authoring committee concluded that the development of a comprehensive strategy for recruiting more comparative medicine veterinarians into postgraduate training programs required thorough examination of the assertion that more veterinarians are needed in biomedical research. This examination entailed three steps: (1) defining the population of veterinarians that are involved in biomedical research; (2) assessing the adequacy of the current workforce; and (3) projecting the future of this workforce. The remainder of this chapter is devoted to the committee’s efforts to define the population, while the analysis of the adequacy of the current workforce appears in Chapter 2, and the projections of the future workforce are described in Chapter 3. These analyses then enabled the committee to develop recommendations, covered at length in Chapter 4.
DEFINING THE POPULATION OF VETERINARIANS INVOLVED IN BIOMEDICAL RESEARCH
When defining the population of veterinarians in biomedical research, the committee relied on public testimony, invited speakers, and their own professional experience and expertise in academic, corporate, and government research settings. It became apparent that veterinarians not only act as attending veterinarians and clinical practitioners of laboratory animal medicine, but they also participate in research in every manner that a PhD or MD would be involved: as a principal investigator, co-investigator, research scientist, or technical advisor.
While some veterinarians participate in the biomedical research endeavor successfully without benefit of specialized training, postgraduate training provides a necessary and preferred foundation of knowledge and experience for these veterinarians. The necessity of this training becomes apparent when the educational curriculum at veterinary schools is examined. For example, in a 2002 American Association of Veterinary Medical Colleges (AAVMC) survey of the top 27 NIH-funded veterinary medical programs, only six of 22 respondents required one or two courses in laboratory animal medicine (none required more), 13 offered electives (from one to six electives), and three offered no courses in laboratory animal medicine.
In an effort to unify the concept of the veterinarian participating in biomedical research, the authoring committee chose to identify this group of individuals as “comparative medicine veterinarians” and describes them as veterinarians who receive postgraduate research and/or clinical training that is applied to the endeavor of biomedical research. This training can be in one of many specialties areas including, but not limited to, laboratory animal medicine, comparative medicine, comparative pathology, genetics, physiology, microbiology, pharmacology, and toxicology. This definition emphasizes the importance of postgraduate training to the success of the comparative medicine veterinarian, but also acknowledges the diversity of experience, education, and responsibilities within this workforce.
In identifying the population of veterinarians included in this report, the authoring committee included individuals who participate in research directly relating to human disease and health. Because of the lack of a comprehensive database, this population has been restricted to individuals that participate in NIH-funded biomedical research or research at pharamceutical/biotechnical companies. For example, veterinarians involved in agricultural research were not included, nor were veterinarians participating in federal programs to ensure public health or safety, such as the US Department of Agriculture (USDA), Food and Drug Administration (FDA), or Centers for Disease Control and Prevention (CDC). It is important to
point out that individuals with similar training can assume varied responsibilities. For example, the ACLAM/ASLAP salary survey (ACLAM/ASLAP, 2003) identifies laboratory animal veterinarians as clinical veterinarians (e.g., attending veterinarian), administrative staff (e.g., research animal resource program directors), faculty (e.g., principal investigators or co-investigators), and private consultants.
The authoring committee categorized comparative medicine veterinarians by their primary professional duty either as veterinarians participating directly in biomedical research or as veterinarians providing professional support for biomedical research. Many veterinarians whose primary duty is participating directly in biomedical research as principal investigators, co-investigators, research scientists, and technical consultants also have clinical duties as an attending or staff veterinarian, although the majority of their time is spent working on a research project. The other category of comparative medicine veterinarian is composed of those individuals whose primary professional duty is as an attending or staff veterinarian providing clinical services to the veterinary medicine program at a biomedical research institution. These individuals often contribute to specific research projects as technical advisors and even collaborators; however, the majority of their efforts are directed toward clinical and management aspects of the veterinary medicine program. Although these general categorizations are used throughout this report, it is important to understand that most comparative medicine veterinarians have professional duties in both categories, and that in many cases, this pull between various duties can be a source of professional frustration. During public testimony on the subject, it was apparent that many times faculty positions for veterinarians are contingent on a certain percentage of their time being given to clinical duties that support the institution’s veterinary medicine program—a contingency to which few other PhD faculty are subject, although MD faculty are. Attending and staff veterinarians may be pulled between their desire to interact more directly in the research programs at their institution and the large amount of time required to manage the extensive regulatory aspects of an animal research facility.