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Recognising specialists

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THE Lowe report of 2009 memorably described the way veterinary specialisation is organised as ‘confusing and opaque’, suggesting that ‘the profession's concept of specialisation is inward-looking and orientated towards fellow professionals rather than aimed at informing the customer’. It further suggested that specialisation was ‘underdeveloped’ in the veterinary profession; this, it argued, was out of step with modern thinking about professional expertise and could be limiting the scope for market specialisation and differentiation of veterinary services.

Subsequently, the RCVS set up a working party to look into the current system of specialist qualifications with a view to making recommendations for how it might be simplified and improved. Chaired by Sir Kenneth Calman, a former Chief Medical Officer, the working party has just produced a consultation document on the subject, setting out its thoughts so far. It is seeking views on its ideas, with a view to putting recommendations to the RCVS early in 2012 (see p 399 of this issue). As the Lowe report indicated and the working party's consultation document serves to emphasise, this is more than just an academic exercise: it is one with very practical implications – for vets, clients and animal welfare.

As the working party points out, specialisation is already occurring in veterinary practice but ‘there are currently a variety of systems in place, which can be confusing to the public, insurers, farmers and vets’. It describes these with admirable clarity, which may go some way to reducing the confusion, but also serves to emphasise just how potentially confusing the current arrangements are. Among points made in the document are that the RCVS List of Recognised Specialists is not a mandatory list, so there is no need for vets to join it in order to offer specialist services to the public. Although RCVS Certificate holders must not hold themselves out as specialists, they may be considered as such by other veterinary surgeons who refer cases to them, and may be mistaken as such by clients who may be unaware of the different qualifications available. To add to the confusion, the working party says, there are many vets who are known by reputation as experts in their field, but who have never achieved any further qualifications beyond their initial veterinary degree.

In seeking to simplify the arrangements, the working party sets out some basic principles that it believes should be followed, as well as some of the difficulties that need to be overcome. Not least among these is that there is no statutory list of recognised specialists, nor is there likely to be in the foreseeable future. There is also the issue, discussed in an article by Andrew Gardiner, Philip Lowe and Justin Armstrong in Veterinary Record a couple of weeks ago, that the breadth, structure and nature of veterinary practice mean that models of specialisation familiar in human medicine may not be appropriate in the veterinary field (VR, October 1, 2011, vol 169, pp 354–356).

In proposing a new structure, the working party notes that, in the university sector, all qualifications must be clearly defined and set within a national and European framework, so that there is a notion of equivalence and consistency of titles, and transparency for the public. It suggests that the appropriate level for veterinary specialists should continue to be the RCVS Diploma or equivalent level, and sets out a new level definition for Diplomas and RCVS Fellowships that, it says, would make it easier to judge whether someone was eligible for specialist status, whatever route they may have taken to get there.

It suggests that the term ‘RCVS Recognised Specialist’ should be replaced with ‘veterinary specialist’, with this term being reserved for those accredited as such, and that everyone achieving specialist status should be awarded the title FRCVS. It also suggests that the range of qualification titles and postnominal letters that are shown against veterinary surgeons' names in the RCVS Register should be simplified.

Noting that the Certificate is not a specialist qualification, and in the light of proposals being developed in Europe, it proposes that the RCVS should develop an accredited ‘middle-tier’ qualification that would be subject to periodic revalidation; this, it suggests, might be achieved by someone who had passed the Certificate and could indicate the species or discipline in broad terms.

All in all, the consultation document proposes a fairly radical overhaul of arrangements in an area where talk of change has often proved controversial in the past, and it will be interesting to see the response it elicits. Whatever is decided, it is important that the arrangements are properly communicated. To avoid further confusion, it will also be important to have a period of stability after any changes are made, because obtaining qualifications is a lengthy process and, inevitably, changes take time to work through.

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