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Keeping a watch on EMS

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THE requirement on students to undertake extramural studies (EMS) is unique and has long been regarded as an essential component of veterinary training in the UK; when the RCVS last reviewed the EMS requirements in 2009, the chairman of the working party carrying out the review described it as ‘the jewel in the crown’ of UK veterinary education. Despite EMS being highly valued, the review was undertaken amid concerns that not all students were getting as much out of EMS as they could, and about whether, with increasing numbers of students, higher tuition fees and the changes occurring both in universities and in practice, the system was sustainable. The working party made a number of recommendations aimed at improving the effectiveness, relevance and flexibility of the EMS requirements, which were subsequently adopted by the RCVS Council. So how have things worked out since? In particular, how well is the system working for students? The RCVS carried out an online survey earlier this year in an attempt to find out.

The survey, undertaken in January/February, was aimed at those who graduated from UK veterinary schools in 2012 and 2013. Two hundred and eighty-seven graduates responded, out of a possible total of 1543, giving an overall response rate of 18.6 per cent; the proportion of graduates responding from different veterinary schools varied between 8.4 and 27.2 per cent. Questions asked in the survey covered matters such as how they had identified and booked EMS placements, how long they had spent in them and where the placements took place. Graduates were also asked about whether they had found the placements they wanted, what they had gained from the placements that they would not have obtained from their university studies alone, and what they thought about the current requirements.

On publishing the results last week,1 the RCVS reported that the vast majority (95.6 per cent) of respondents considered EMS to be an essential component of their veterinary degree. In addition, it reported, the majority of the respondents indicated that they had found EMS placements to be beneficial in terms of the variety of clinical skills, professional skills and working practices they encountered, with the possible exception of gaining experience of out-of-hours/weekend work, for which 42.9 per cent of respondents said they did not find EMS placements useful. A majority of respondents (60.6 per cent) felt that the RCVS should continue to specify the number of weeks of EMS that are required.

Despite these and other positive findings, the survey raised a number of concerns. Issues identified included: the variable quality of placements; respondents feeling that they were not able to get as much ‘hands-on’ experience from placements as they would have liked; costs of accommodation and travel limiting placement options; and a shortage of farm/mixed animal practices for placements. Some of these sound familiar from when the EMS arrangements were reviewed in 2009, and they also chime with comments made during a discussion forum organised by the BVA last autumn. Discussing the potential impact of new veterinary schools, this underlined the view that EMS is an essential (albeit unfunded) component of veterinary education in the UK, suggesting that, although in theory at least there should be more than enough placements to accommodate all students, the availability of placements could become a limiting factor if student numbers continued to increase. It also suggested that EMS provision was ‘lumpy’, with variations in the quality and availability of EMS in different subjects, different geographical areas and at different times of the year. As well as farm placements, a shortage of equine placements was identified as a concern (VR, November 2, 2013, vol 173, pp 406, 416-417).

The impact of costs of travel and accommodation on the ability of students to find what might be the most appropriate placement is worrying. The survey found that most placements were obtained locally, with some students reporting that they were limited in their search for practices around their home because they did not feel that they could afford the costs associated with a placement elsewhere. This must be of particular concern given that the survey involved 2012 and 2013 graduates, who would not have been affected by the increase in university tuition fees in 2012. With the increase in tuition fees the pressure to save on costs can only increase. This is not just an educational issue: in a report on a workshop on pastoral care of veterinary students in Veterinary Record last year, Kydd and others (2013) reported that the main issues causing chronic stress among students were perceived to be curriculum overload and the inability to earn money or relax during vacations due to the requirement for extensive EMS.2

Having conducted a thorough review of EMS in 2009, the RCVS has no immediate plans for another review, and concludes from its survey that the current system is working well. However, it says it will keep a ‘watching brief’ over a number of issues and that it plans to repeat the survey every two years. It is clearly important to monitor the situation and it is to be hoped that, in future years, more graduates respond. It might also be worth considering a similar survey of placement providers. Practice and higher education continue to evolve and EMS must remain flexible in the face of changing circumstances.

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