There's no question that the veterinary profession has changed through the years in its demographic makeup, from a profession that was mainly made up of men to one that becomes more and more female each year. But is veterinary medicine lacking diversity in other areas? Are there groups of people who would make great veterinarians but are pushed out before they can even complete an application? And what does that mean for the profession?
Lisa Greenhill, MPA, EdD, senior director for institutional research and diversity at the Association of American Veterinary Medical Colleges (AAVMC), is looking for answers to these questions.
"My work with the AAVMC has always advocated for increased diversity and inclusion in the veterinary profession. To that end, we're interested in making sure we can recruit and create the most diverse and developed pool of talent that we can," Dr. Greenhill says. "We want to recruit a lot of different people with a lot of different kinds of talent and experiences, because that raises the overall competitiveness of the pool."
This competitiveness includes factors besides just academic experience, Dr. Greenhill explains—it means broader life experience as well. Applicants who are lower socioeconomic status (SES) or first-generation college attendees are what Dr. Greenhill calls the "grittiest" applicants, and there's a lot of overlap with racially and ethnically underrepresented populations within those groups, she says.
Dr. Greenhill's research shows that these applicants are far more likely to be working part- or full-time during their undergraduate education, and they may take longer to complete that undergraduate degree because they have to balance education with earning. They also don't have the family resources that their more well-off counterparts do.
"The lower SES or first-generation applicants have about one-third more undergraduate debt than more affluent applicants," Dr. Greenhill says. "So they come in with more debt, and they're working and they don't have time to volunteer, so they have to find experiences [to list on their application] that are paid."
The implications are significant, Dr. Greenhill explains. Because of the challenges low-income and first-generation students face, they often take longer to complete their undergraduate education, taking fewer credit hours during a semester. A veterinary school admissions committee may see that and wonder if the applicant can bear the full weight of a DVM curriculum.
"What's not shown in that application is that they're taking less hours because they're also working 40 to 50 hours a week," Dr. Greenhill continues. "They're hustling and they're gritty and putting in the work, but there are a lot of barriers to getting to the application and being able to afford the application itself."
Cost isn't a driving factor
These applicants also put a lot of thought and strategy into where they apply to veterinary school, because they may only be able to afford one shot. That means they get one letter of acceptance, unlike their more affluent peers, who might have multiple offers. When you have multiple letters of admission, Dr. Greenhill explains, you have more choices when it comes to cost.
"The research shows that that's when people start to think about cost a lot more,” she says. “The people who have more financial resources actually have greater freedom to think about cost than the lower income students who’ve risked everything on that one letter [of acceptance], and that's where they'll go."
Dr. Greenhill notes that all veterinary school applicants work hard to get into the pool, but this year, about 30 percent had overcome major barriers, including navigating the higher education system for the first time. These applicants don't have multiple generations of family members who have been to college and understand the higher education system, including financial aid options and the types of advising available to students.
In her research Dr. Greenhill also found that lower income applicants typically have more experience hours listed on their applications, but those hours are more likely to be from paid positions. This can hurt their chances of acceptance.
“The low-income and first-generation applicants have a higher likelihood that they're in paid positions, because they have to be,” Dr. Greenhill says. “The more affluent applicants who can afford to volunteer may have more diversity in the type of hours or clubs they're able to participate in. Lower-income or first-generation applicants don't have as much diversity in their experience, because if you have a job you can't jump around as easily."
This means lower income students often don't present as nice a mix of experience as what the colleges are looking for, even though their experiences are still valuable, Dr. Greenhill says.
Is there a path forward?
As part of its annual conference this year, the AAVMC rolled out guidance on a holistic review program that encourages veterinary schools to look for attributes that will make someone a good veterinarian, not just a good student, Dr. Greenhill says.
"We're looking for applicants who are diverse in all areas—men, rural backgrounds, applicants from areas where there may be a veterinary care desert, or who are interested in working with certain types of communities,” she says.
Dr. Greenhill wants to see member colleges use this diversity data to guide outreach and recruiting efforts. "We value folks who have come up on the rough side of the mountain because we recognize that there are qualities in these applicants like resilience, grit, courage and independence that we value and will make amazing professionals later in life," she says.
How one school aims to see change
Virginia-Maryland College of Veterinary Medicine has taken just the kind of holistic look at its application and admission process that Dr. Greenhill applauds. Jacque Pelzer, DVM, director of admissions and student services, told dvm360 that she thought diversity in their program existed at one time but that the veterinary admissions process over time has introduced the wrong kind of barriers. Now that's changing.
"We’ve looked at the actual application process and tried to identify potential barriers to underrepresented applicants, and I think that in itself has increased diversity within our applicant pool and given our program access to people other schools aren't looking at," Dr. Pelzer says.
One step the college has taken is to reduce the number of veterinary experience hours it requires of its applicants. Dr. Pelzer says there's no literature in any medical profession that addresses how many experience hours an individual needs to be successful in the profession.
"Where is an African-American male from Washington, D.C., going to get large animal experience? And should that in itself keep him out of veterinary school?" Dr. Pelzer asks. "So for our program we're no longer looking at a variety of species, and we've actually decreased the number of experience hours to no more than 100."
Testing requirements have also changed at the college. Many veterinary programs require applicants to submit scores on a standardized test, such as the Graduate Record Exam (GRE), as part of the admission process, but this isn't the case at Virginia-Maryland anymore.
"We no longer require the GRE because that's a barrier," Dr. Pelzer says. "It's a test of affluence because some people can afford to take it over and over to get a competitive score. Or they can take a Kaplan course that costs $1,800. Not everyone can afford to do that, and it's excluding individuals."
Dr. Pelzer also notes that Virginia-Maryland looked at its own data and found that students who scored better on the GRE didn't necessarily perform better in school.
The college also changed how it weighted different elements of the application. As an application is processed in the system it’s assigned points—a certain value for GPA, another for veterinary experience and so on—and then the applications are ranked based on those points, Dr. Pelzer says. It has recalibrated the weighting system, moving from an 80 percent academic/20 percent non-academic value to a 60 percent academic/40 percent non-academic value.
The GPA cutoff has also been removed. Now the college reads every application it receives rather than discarding those that didn't cross the GPA threshold.
"We found that we were missing out on applicants who had very compelling stories,” Dr. Pelzer says. “Sometimes those stories would explain why they weren't what we'd consider 'competitive' academically. Maybe someone is a first-generation applicant who grew up in Appalachia and had to work on the farm in the morning and evening and that impacted their ability to study all the time. Or someone was supporting themself through an undergraduate program and had to wait tables to get through, and that impacted their ability to study. We didn't feel like individuals should be penalized because of what they had to do to make it through."
The other important piece of the the application review process is looking at attributes that are critical to success in the profession—things like communication skills and ethical and moral judgment, Dr. Pelzer says. Those attributes are looked for during the interview process, which consists of multiple mini interviews after students have been selected via the initial ranking and application-reading process.
"We invite the students who we think would be academically successful and who have told compelling stories to an interview," Dr. Pelzer says. "The rankings are reset to zero at that point, and the interview itself determines if the applicant is admitted or wait-listed. That's how important we feel the interviews are, and we have the data to support that."
Addressing the skeptics
Dr. Pelzer says she’s faced skepticism from her colleagues when she speaks about the changes Virginia-Maryland has made to the application process.
"People make assumptions about me because of my appearance sometimes, and they think I'm crazy because we're doing something different here. But we have the data to back up why we've made these changes," she says. "Some schools are so entrenched in tradition and 'we've always done it this way, and we graduate veterinarians,' but we're not graduating veterinarians that look like society. If you have an all-white female population practicing, you're not really addressing societal needs."
Though the application requirements have changed, the standards haven't been lowered, Dr. Pelzer says. Students still have to pass the same rigorous curriculum as before; the school just has a different way of looking at the applications.
"We care about the outcome because we're graduating them and we want them to be good veterinarians,” Dr. Pelzer says. “We're still considering if they have the aptitude and if they'll make it through the program, but unless we push the boundaries we'll never have answers."
The attrition rate at the Virginia-Maryland College of Veterinary Medicine hasn't increased since changes were made to the application review process, Dr. Pelzer says. Very few students fail out of the program, and if they do it's typically because they have other things in their life that impact their ability to focus. It's not because they don't have the ability, she says.
"We recognized that we were excluding people, and that was a big thing for us," she says. "Our process might not work for other schools, but it's worked for us. It's broadened the net and has given us access to more underrepresented applicants."