It seems like the norm in human medicine is to see your family physician for a health issue but if the problem is the least bit complicated then a referral to a specialist follows. In the veterinary world the general practitioner manages most of your pet’s medical problems. There are, however, complicated cases that require specialists and veterinarians will recommend a consult with a specialist. For example if your dachshund needs back surgery for a slipped disc, there is most likely a neurologist who is not too far away who can image the area and perform back surgery. This is good for the owners and great for the animals.
Exactly what is a specialist and how are they trained? These are veterinarians who have done extensive advanced training beyond the four years of veterinary school. They start with a one-year internship that is usually directly after veterinary school and is associated with a university or a large private specialty hospital. The interns are basically emergency room doctors who work day and night managing all varieties of cases and thereby get a crash course in medicine and surgery. This year prepares the budding specialist for what is to come and helps the new doctor decide which discipline to pursue. The internship year is necessary to guide the development of the new specialist.
If all goes well the next step is to apply for a residency in a university teaching hospital. This rigorous training phase can last for 3 to 5 years and has very difficult examination requirements. These residents will eventually “take the boards” and hopefully pass. If so, then these board-certified specialists will be ready to serve the public, its animals, and the veterinary profession. There are 22 fields of board certification. These specialties are as varied as internal medicine, surgery, preventive medicine, dermatology, ophthalmology, and pathology. According to the 2017 marketing statistics of the American Veterinary Medicine Association (AVMA), there are 13,035 active board-certified diplomates in the United States. The highest numbers are as expected: internal medicine 2,922, surgery 1,753, and pathology 1,798. There are other specialty organizations that have much fewer members: behaviorists 72, nutrition 83, toxicology 99, and dental 162.
We think of specialists helping our pets with complicated medical problems: that is, surgeons performing difficult procedures, oncologists treating cancers, and emergency room doctors saving pets with their critical care expertise. There are also many in the profession that work in industry. For example there are board-certified poultry veterinarians, nutritionists developing veterinary diets, and pathologists doing research at pharmaceutical companies. Animal care and concern is now at the forefront with a specialty in animal welfare 49, shelter medicine 8, and of course laboratory animal medicine 1,009.
AVMA statistics from the 2017 report tells us there are 110,531 practicing veterinarians in the US. With 13,035 board-certified veterinarians this means that only about 12 percent are specialists. As we can see, 78 percent of veterinarians are general practitioners, which is good for your pet and pocket book. Of the 1 million human physicians in the U.S., there are more specialists than primary care doctors (it’s at least 60 percent specialists). Veterinary medicine will never reach human levels of specialization because veterinarians are still able to practice most areas of medicine and surgery, which makes for a very efficient system for pets and their owners. It is also a fun challenge to go from dermatology, to critical care, to radiology, to surgery in the span of one hour. Never boring to be a general practitioner.