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Seeking consensus on EMS

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EXTRAMURAL studies (EMS) have, in one form or another, been an integral part of veterinary undergraduate education in the UK for more than 70 years. However, in recent years, a number of factors have conspired to raise questions about whether the current arrangements are sustainable. These include increasing numbers of students which, together with consolidation in practice, can make it difficult to find placements, changing approaches in higher education, and the impact of EMS requirements on student debt. The RCVS is currently reviewing the requirements for EMS and, in June, after an initial review, produced a consultation document recommending ways in which the system might be improved. Responses to the consultation will be considered by the College's Education Policy and Specialisation Committee at a meeting in October, and by the RCVS Council in November. In the meantime, a debate at the BVA Congress in Cardiff later this month will provide another opportunity to comment on the future of a system in which all branches of the veterinary profession have an interest.

The initial review undertaken by the RCVS found no support in the profession for the idea of dropping EMS. Indeed, on publication of its consultation document, Dr Barry Johnson, chairman of the working party that carried out the review, commented on the 'widespread view that EMS is the “jewel in the crown” of UK veterinary education and must be nurtured' (VR, June 27, 2009, vol 164, p 794).

The working party was impressed by 'the wide consensus on the enduring value of EMS'. Nevertheless, it identified weaknesses, as well as strengths, in the current arrangements, and made a number of recommendations for improvement. In particular, it recommended changes in the way the 26 weeks of clinical EMS currently required of students is phased and structured, so that students would spend six weeks on 'observational' EMS in at least three different types of placement, followed by 20 weeks of 'practical' EMS, during which they would spend a significant amount of time in a 'base practice' or pursuing an area of particular interest. The time to be spent in the base practice would not be specified, nor would the number of weeks to be spent on different types of placement or with different species; the aim would be to allow more flexibility while enabling students to focus on areas of particular interest and to build a relationship with the placement provider.

The other main change recommended by the working party concerned the practical component of training in veterinary public health. This, it argued, is too important to be left to 'the vagaries of ad hoc EMS placements', and it recommended that 'visits to fully commercial abattoirs and other meat processing plants, which form an essential part of teaching in veterinary public health for all students' should instead be seen as part of the core curriculum.

In addition, the working party made a number of recommendations aimed at improving communication between everyone involved in EMS, including recommendations on record-keeping by students, and a suggestion that practices should identify named individuals who would act as EMS contacts. It called on universities to allocate sufficient staff time and resources to ensure that EMS is administered, coordinated and monitored effectively and recommended that, in visitations to universities, the RCVS should take an audit-based approach to ensuring compliance with EMS requirements.

In its response to the RCVS consultation, which closed last week, the BVA has indicated that it agrees with most of the working party's recommendations, which take account of many of the points raised by the Association during the initial review (see VR,, May 30, 2009, vol 164, p 699). However, it makes the additional suggestion that the RCVS should develop a mechanism for ensuring that newly qualified vets from outside the UK, who may not have had equivalent practical experience, meet the same standards as UK graduates. It also suggests that the RCVS should make recommendations regarding the format and content of student records.

In seeking to maintain flexibility while trying to ensure a more consistent approach and gain maximum value from EMS, the College's proposals seem sound in principle, although there will doubtless be many practical issues to be resolved. Not least among these will be dealing with the implications of introducing more quality control at a time when most businesses are under pressure, students are having to contribute more towards the cost of their education and the resources available to universities look increasingly likely to be squeezed.

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