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Re-evaluating EMS

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VETERINARY students in the UK have been required to ‘see practice’ since the early 1930s. ‘Seeing practice’ is now known as ‘extramural studies’ (EMS) to better reflect its purpose, but is still regarded as an essential component of a veterinary undergraduate’s education. Despite the continuing importance of EMS, a number of factors have conspired to raise questions about whether the current arrangements are sustainable. They include the problem of student debt, which, as highlighted in a recent BVA/Association of Veterinary Students survey, is exacerbated by the requirement for EMS, which makes it difficult for veterinary students to take jobs in their vacations (see VR, May 23, 2009, vol 164, pp 638-639). Increased numbers of students, together with consolidation in practice and other areas in which the profession is active, can make it difficult to find appropriate placements – and questions also arise about value for money and for whom. Having last thoroughly examined the situation in 1998, the RCVS, in consultation with the profession, is currently reviewing the requirements for EMS. The review is expected to be completed by the autumn and the outcome will be of interest to students, practitioners and teachers alike.

Some of the issues surrounding EMS were discussed at this year’s conference of the Association for Veterinary Teaching and Research Work in Scarborough (see p 673 of this issue) and the results of that debate will be fed into the RCVS review. Meanwhile, the BVA has submitted comments to the review, and will continue to contribute, right through to its annual congress in September. This will include a debate on the sustainability of EMS in which one of the speakers will be the RCVS review group’s chairman.*

In its comments so far, the BVA has drawn attention to both strengths and weaknesses of EMS which, at its best, can help produce vets who are clinically competent in the fundamentals of the subject before they specialise, inform career choice and help build confidence. It gives students an opportunity to practice and develop their skills, and can help them identify first-job practices while also helping employers to identify future employees. As has often been remarked, it provides practitioners with an opportunity ‘to give something back to the profession’, as well as to update their knowledge through contact with students. Placements need not be confined to mainstream practice, and can allow students to experience other important areas of veterinary activity, such as veterinary research

Among the weaknesses of the current arrangements is that EMS is relatively unstructured, and the experience, for both students and practitioners, can be mixed. Arrangements differ from school to school, and the quality of teaching and supervision can vary. The process is time-consuming for everyone involved, and potentially frustrating if a student’s enthusiasm for a required subject is lacking. Short placements may not allow time for practical involvement; there is always the danger that students really do just ‘see’ practice, rather than getting involved.

Possible solutions might include introducing more flexibility into the arrangements so that, while still covering essential topics, students have more scope to ‘specialise’ and focus on subjects they are particularly interested in. For the purposes of quality assurance, the system might benefit by becoming more formalised, with wider use of case logs and some form of appraisal. There is scope for closer coordination between the veterinary schools, with better communication of what is required during EMS and a more structured approach to encourage feedback between veterinary schools, students and practitioners. The BVA has produced guidance on EMS for students and providers, and more information is available from the RCVS and the universities, but there can be little doubt that, for all the effort that has been made over the years, the system could be improved.

Despite the difficulties, there seems to be little appetite in the profession to remove the requirement for EMS, the benefits of which far outweigh the weaknesses. This is not to say that the requirements cannot be modified. The challenge, given the changing circumstances of students, practices and the veterinary schools, is to ensure that the system is workable and can continue to operate to everyone’s advantage.

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