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Stakeholder consultation on tracking in UK veterinary degrees: part 1
  1. E. Crowther, BVSc, MRCVS1,
  2. K. Hughes, BVMS, BSc, MSc, MRCVS2,
  3. I. Handel, BVSc, MSc, PhD, MRCVS3,
  4. R. Whittington, BVSc, MRCVS4,
  5. M. Pryce, BVetMed, MRCVS5,
  6. S. Warman, BSc, BVMS, DipECVIM-ca, DSAM, FHEA, MRCVS6,
  7. S. Rhind, BVMS, PhD, FRCPath, FHEA, MRCVS7 and
  8. S. Baillie, BVSc, CertCHP, PhD, MRCVS8
  1. 1School of Veterinary Sciences, Langford House, Langford, Bristol BS40 5DU, UK
  2. 2The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Midlothian, Edinburgh EH25 9RG, UK
  3. 3The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Midlothian, Edinburgh EH25 9RG, UK
  4. 4The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Midlothian, Edinburgh EH25 9RG, UK
  5. 5Avonlodge Veterinary Group, 283 Wells Road, Bristol BS3 1PW, UK
  6. 6School of Veterinary Sciences, Langford House, Langford, Bristol BS40 5DU, UK
  7. 7The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Midlothian, Edinburgh EH25 9RG, UK
  8. 8School of Veterinary Sciences, Langford House, Langford, Bristol BS40 5DU, UK
  1. E-mail for correspondence: Emma.Crowther{at}bristol.ac.uk

Abstract

There is on-going debate regarding whether veterinary students should focus on one (or a small number of) species during their undergraduate training (ie, track). The aims of this study were to: evaluate UK stakeholders’ opinion on partial tracking (whereby students continue to qualify able to practise in all species) and full tracking (students qualify in a limited number of species necessitating restricted registration); and evaluate students’ career aspirations in relation to the UK veterinary profession's employment profile. This paper presents the quantitative results of surveys completed by practitioners, students and university staff. The majority of respondents (69.4 per cent) disagreed or strongly disagreed with full tracking, however, there was widespread support for partial tracking (79.0 per cent agreed or strongly agreed). Students favoured partial tracking more so than practitioners (P<0.001). Univariate analysis of demographic factors did not identify differences in opinion regarding tracking within stakeholder groups. Students’ knowledge of the UK veterinary employment profile appeared accurate. However, their career aspiration changed with year of the course, and only final year students’ intentions were aligned with the profession's current profile. Qualitative data from these surveys are presented in a second paper and include the advantages, disadvantages and implications of partial and full tracking.

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Introduction

A report conducted by the Association of American Veterinary Medical Colleges (Willis and others 2007) used foresight technology to envisage various future societies and the role of the veterinary profession within them. The report concluded that the best way for the profession to be flexible enough to cater for society's future needs was to have a national veterinary education plan, in which universities had defined areas of focus, admitted students to conform to national demand, and graduated species-specific or area-specific veterinary surgeons. Although a number of American veterinary schools run tracked degrees, all students currently still have to pass the ‘all species’ board examinations in order to practise.

In response to the medical information overload of the preceding decades, in 1993, the General Medical Council (GMC) proposed a new curriculum structure composed of a ‘core’ curriculum of subjects and skills essential for all medical graduates, and ‘special study modules’ or ‘options’ to allow students to study subjects of their choice in more depth (General Medical Council 1993, Harden and Davis 1995). The successor of special study modules, student selected components, must now comprise a minimum of 10 per cent of UK medical courses (General Medical Council 2009). Eyre (2002) argues that the veterinary profession should follow the engineering model, whereby undergraduates are taught the fundamentals of engineering in the first year of their course, but continue to study a chosen discipline such as mechanical or electrical engineering, and graduate equipped to meet specific societal needs.

In 2001, the Royal College of Veterinary Surgeons (RCVS) stated that the requirement for graduates to be omnicompetent was ‘unrealistic and fundamentally misguided’, and suggested the further development of electives in veterinary curricula (Royal College of Veterinary Surgeons 2001). This was not supporting a ‘tracked’ curriculum (defined as ‘pre-graduation specialisation’), but a broad degree, equipping graduates with specified Day 1 Competences while allowing an element of student choice. Currently, students at all UK veterinary schools can undertake elective rotations in the final year, and several universities have additional track rotations, although these occupy a relatively small amount of course time. The RCVS additionally proposed a supervised ‘Professional Training Phase’ after graduation, which when completed would lead to a full license to practise in that species area (Royal College of Veterinary Surgeons 2001); a related system, the Professional Development Phase, was introduced in 2007, but full registration still occurs at graduation (Johnson and Andrews 2007). In 2001, the Faculty of Veterinary Medicine of Utrecht University, The Netherlands, introduced tracking to their six-year course (van Beukelen 2004, Jaarsma and others 2009) with tracked units in each year except the fifth, and a final year entirely spent on the track.

Other universities run tracked veterinary programmes. The University of Veterinary and Pharmaceutical Sciences in Brno, Czech Republic, has run parallel courses in Veterinary Medicine, and Food Hygiene and Ecology since 1975 (Vecerek 2006). Students apply to their specific course, but all graduates competent to work in any veterinary area, having studied core subjects such as clinical science and food hygiene weighted appropriately to each course. The University of California, Davis, also started tracking in the mid-1970s and currently offers nine clinical tracks, including equine, food animal, small animal and combinations of two or three of these (Klosterman and others 2009). A study of 744 graduates from University of California, Davis (UCD), and 970 graduates from a traditional curriculum at Ohio State University (OSU), found that graduates had comparable career outcomes and instilled values; for example, both groups valued the comparative aspects of veterinary medicine, although the non-tracked (OSU) graduates valued this slightly more than did the tracked graduates from UCD (Klosterman and others 2009, Walsh and others 2009). A higher percentage of OSU graduates entered mixed practice on graduation, but this area of practice had a high attrition rate regardless of degree type (79 per cent attrition of Ohio graduates, 75 per cent of UCD); ignoring those who started in mixed practice, a similar percentage of graduates from both universities changed career area (Klosterman and others 2009). A move away from mixed practice after graduation has also been reported in Australia (Heath 1998) and in a UK study that found that a higher proportion of graduates in mixed practice wished to change species area compared to those in species-specific practice (small, farm or equine) (Kinnison and May 2013). Geographical location of upbringing appears to influence career choice, with those from urban environments tending towards small-animal practice, and those from rural areas more likely to enter or aspire to farm or mixed practice (Sans and others 2011, Kinnison and May 2013). Similarly, Serpell (2005) found that prior ownership of either small animals, food-producing animals or horses was positively correlated with first year students’ desire to work with that species category at the University of Pennsylvania.

The employment profile of veterinary surgeons in the UK has changed over recent years. Comparing the RCVS Survey of the Profession from 2006 and 2010 (Robinson and Hooker 2006, Robertson-Smith and others 2010a), there has been an increase in the percentage of Members of the Royal College of Veterinary Surgeons (MsRCVS) working in small animal (45–48.9 per cent) and equine (6–7.6 per cent) practice, with a decrease in the percentage of MsRCVS who work in farm practices (4–3.8 per cent), and mixed practices from 25 per cent (2006) to 22.1 per cent (2010). Of the practices recorded, RCVS Facts 2008, 2009 and 2010 show an increase in small animal, equine and farm practices, with a decline in mixed practices (Royal College of Veterinary Surgeons 2008, 2009, 2010). Since 2010, data collection has changed and it is not possible to determine whether the trend has continued. However, it is important to consider whether veterinary education in the UK needs to reflect changes within the employment profile of the profession.

A UK survey of 1833 veterinary students, conducted by the Association of Veterinary Students, found that 78.8 per cent of respondents were in favour of all subjects being taught in veterinary curricula, despite only 45.3 per cent agreeing that the course gives adequate time to understand all areas (British Veterinary Association/Association of Veterinary Students 2008). The same survey reported that 43.4 per cent of students would consider ‘doing a more specialised degree to be qualified to work in a narrower field’, with the fourth year being the most popular time to start ‘specialisation’. The aim of the current project was to evaluate opinion on undergraduate tracking from three stakeholder groups - students, university staff and practising veterinary surgeons - using a mixed-methods approach to gather quantitative and qualitative data. Additionally, the study aimed to evaluate students’ knowledge of the profession and relate their career aspirations to the employment profile of the veterinary profession. To avoid confusion with RCVS ‘Specialist’ status (Royal College of Veterinary Surgeons 2013), the terms ‘partial tracking’ and ‘full tracking’ were used throughout this study as shown in Table 1.

TABLE 1:

Definitions relating to tracking

The project received ethical approval from the University of Bristol Faculty of Medicine Veterinary Science Committee for Ethics (reference FMV-111210).

Materials and methods

Participants

A single point of contact was approached at each veterinary school to distribute the survey to university staff and students. Students in the first, fourth (penultimate) and final years of the veterinary degree were selected for inclusion in the study; this represented naive students at the start of the course, students who were about to start rotations, and students approaching the end of the course. It was not possible to specifically target academic staff at all institutions, so any staff involved in veterinary curricula were able to respond. To recruit veterinary surgeons in practice, home-practising MsRCVS (n=500) were selected randomly from the RCVS register; those with a university address were excluded from selection as they were expected to receive a survey via their institution. Several £25 voucher prises were offered as incentives to participate.

Data collection

Questionnaires containing demographic questions, closed answer questions, Likert-style questions and free text responses, were designed and piloted with all the stakeholder groups. The university staff and practitioner surveys included questions related to current employment and experience of tracking as an undergraduate. Students were asked to indicate what percentage of veterinary surgeons they thought worked in each area of the profession, and also in which area they were interested in working.

All three stakeholder groups were asked about their opinion on partial and full tracking. This was obtained using five-point Likert-style responses to the statements ‘I think students should “partially track” (focus but qualify in all species) in veterinary degrees’, and ‘The RCVS should allow “fully tracked” degrees (vets qualify in one or a limited number of species)’. Options ranged from ‘strongly disagree’ through to ‘strongly agree’. Free text questions asked participants to identify perceived advantages and disadvantages of each option. Electronic questionnaires (hosted by SurveyMonkey, www.surveymonkey.com) were distributed using university emailing lists to staff and students. It was expected that a higher response rate would be obtained if practitioners received a paper version of the survey, so this was sent with a covering letter and stamped return envelope, with an option to complete the survey online. The practitioner survey is provided in online supplementary Appendix 1 as an example.

Data analysis

Responses were excluded from the analysis if either the demographics or Likert-style questions were incomplete. Demographic information for practising veterinary surgeons was compared with RCVS data (Robertson-Smith and others 2010a, Royal College of Veterinary Surgeons 2012). Descriptive statistics were produced for the student and university staff sample although there was limited demographic data available for comparison.

Quantitative data analysis

Exploratory analysis established the opinion of each stakeholder group on partial and full tracking. Each group was then analysed independently of the others.

Table 2 identifies the independent variables that were investigated to describe the opinion of students, university staff and practitioners on partial and full tracking using the Kruskal-Wallis Test (KWT). Analysis was restricted to univariate analysis due to the small sample size of some groups.

TABLE 2:

Variables considered in univariate analysis of opinion on full and partial tracking

Additionally, descriptive statistics were produced to compare the career aspirations of students to the employment profile of the profession. The χ2 test was used to compare different career aspirations between year groups, within species discipline. For all analyses, ‘exotics’ was included in the small-animal discipline, due to the small number working, or aspiring to work, with exotic species. Statistical analysis was performed in Microsoft Excel 2010, IBM SPSS V.19 and R V.3.0.1.

Qualitative data analysis

Qualitative analysis has recently been used in veterinary research in several contexts including animal welfare (Collins and others 2012), behaviour (Roshier and McBride 2013), and veterinary education (Magnier and others 2011). Free text responses were analysed using thematic framework analysis, which allows the researcher to identify major themes in the data while preserving links to original comments made by participants. Due to the size of the datasets, quantitative data are reported in this paper, and the qualitative data in the next paper in the series.

Results

Response rate

Six universities participated in the study, from which 231 university staff and 855 students returned surveys. When incomplete responses were excluded, there were 203 responses from university staff and 700 from students. A number of student responses (n=155) were excluded as at two universities the survey was mistakenly sent to second and third year cohorts, who were not intended to be included in the sample. Using estimated numbers from mailing lists, this represented a response rate of 8.72 per cent for university staff, and 26.4 per cent for students. The university staff mailing lists contained the details of people for whom the survey was not relevant which reduced the percentage response rate for this group. Practitioners returned 175 surveys of which 158 were suitable for inclusion, representing a response rate of 31.6 per cent.

Demographics

The modal age group of university staff was 31–40 years (range ‘26–30’ to ‘over 60’ years), and 58.1 per cent were female. Of the university staff, 171 (84.2 per cent) did a veterinary science degree as an undergraduate. Unfortunately, no comparative data were available, and this was further confounded by the use of mailing lists which include a range of staff groups.

The modal age group of students was 22–25 years, and 35 per cent were in their first year of study, 37 per cent in the penultimate year and 27 per cent in the final year; 1 per cent of students were intercalating. Only 18.7 per cent of student respondents were male, meaning they were slightly under-represented in our sample (Royal College of Veterinary Surgeons (2012) reported 23.0 per cent of students were male).

The age distribution of practitioner respondents was similar to that of the profession, with a modal group of 31–40 years (Royal College of Veterinary Surgeons 2012). Of these respondents, 49.3 per cent were male, compared to 45.0 per cent in RCVS Facts 2012. The location of practitioners in the UK, and the distribution across small, farm, equine and mixed practices was similar to published data (Robertson-Smith and others 2010a, Royal College of Veterinary Surgeons 2012). Approximately a quarter (26.0 per cent) of practitioner respondents indicated that they had made a significant career change, such as a change of species.

Full tracking

The majority of respondents (69.4 per cent across all stakeholders) strongly disagreed or disagreed with full tracking; 11.6 per cent of respondents indicated ‘neither agree or disagree’ and 19.0 per cent ‘agree’ or ‘strongly agree’ in relation to full tracking. Fig 1 illustrates responses categorised by stakeholder. No significant difference was found in the distribution of responses between the stakeholder groups; 70.9 per cent of university staff, 70.0 per cent of students, and 64.5 per cent of practitioners disagreed or strongly disagreed with full tracking.

FIG 1:

Stakeholder opinion on full tracking

Previous career change in practitioners was the only variable listed in Table 2 that correlated with a significant difference in opinion within any of the stakeholder groups. Practitioners who had made a significant career change were less likely to agree with full tracking (KWT P<0.05) compared to practitioners who had not made a significant career change.

Partial tracking

Across all stakeholder groups, the majority (79.0 per cent) of respondents supported partial tracking; 6.8 per cent indicated ‘neither agree or disagree’ and 14.2 per cent ‘disagree’ or ‘strongly disagree’.

Categorised by stakeholder group, 72.9 per cent of university staff, 82.3 per cent of students and 72.2 per cent of practitioners agreed or strongly agreed with partial tracking (Fig 2). A significant difference was found between the distribution of responses for students and practitioners; students favoured partial tracking more so than practitioners using KWT P<0.001. The differences between university staff and students, and university staff and practitioners were not significant.

FIG 2:

Stakeholder opinion on partial tracking. A significant difference was found in the distribution of practitioner and student responses (P<0.001)

Age, gender, undergraduate degree, prior experience in non-university practice, level of postgraduate study, country of origin, and experience of tracking in their degree were investigated in relation to university staff opinion. None of these variables correlated to differing opinion among university staff in relation to partial tracking.

In the student population, there was no correlation between respondents’ opinion on partial tracking and the variables: age, gender, current academic year, country of origin, educational background, intention to do further study, and intention to stay in the same career long term.

Among practitioners, there was no correlation between respondents’ opinion on partial tracking and the variables: age, gender, year qualified, current species working with, level of postgraduate study, being an employer, history of employing new graduates, geographical location of the practice, species the practice treats, first opinion versus referral practice, or rural versus urban client base. Practitioners who had made a previous career change were more likely to agree with partial tracking (KWT P<0.05).

Interestingly, a very small minority of respondents (n=31, 2.92 per cent) indicated ‘disagree’ or ‘strongly disagree’ with partial tracking, but ‘agree’ or ‘strongly agree’ with full tracking, which ran counter to the norm, however, no demographic variables described this group, and they appeared evenly spread throughout the three stakeholder groups.

Student understanding of the profession, and career aspirations

Figs 36 illustrate students’ understanding of where veterinary surgeons work in relation to their own career aspirations. For small-animal practice, students’ responses to ‘what percentage of veterinary surgeons work in this field?’ varied from 0 per cent to 85 per cent. The modal group was 40–50 per cent which contains the reported percentage of veterinary surgeons working in small-animal practice, 48.9 per cent (Robertson-Smith and others 2010a). However, only 29.4 per cent of students indicated that they wanted to work in small-animal practice. For farm-animal practice, students’ responses to the question on the percentage of veterinary surgeons that work in that area ranged from 1 per cent to 100 per cent with a modal group of 10–20 per cent, which was higher than the reported value of 3.8 per cent working in farm-animal practice (Robertson-Smith and ­others 2010a). Overall, 6.8 per cent of students wanted to work in exclusively farm-animal practice. For equine practice, students’ estimates ranged from 0 per cent to 32 per cent, with a modal group of 10–20 per cent, which was higher than the reported percentage of veterinary surgeons working in equine practice, 7.6 per cent (Robertson-Smith and others 2010a). Furthermore, 5.86 per cent of students ­indicated they wanted to work in equine practice. For mixed practice, students’ estimates varied from 0 per cent to 60 per cent, with a modal group of 10–20 per cent. This underestimates the reported number of vets working in mixed practice (22.1 per cent) (Robertson-Smith and others 2010a), and both are much lower than the overall number of students who indicated that they wanted to work in mixed practice, 56.14 per cent.

FIG 3:

Students’ understanding of the profession, and career aspirations: Small Animal. Blue histogram=students response to the question ‘what percentage of veterinary surgeons work in each field?’, solid line=percentage of MRCVS working in that area (Robertson-Smith and others 2010a), dashed line=percentage of veterinary students that want to work in that area. RCVS, Royal College of Veterinary Surgeons

FIG 4:

Students’ understanding of the profession, and career aspirations: Farm Animal. Blue histogram=students response to the question ‘what percentage of veterinary surgeons work in each field?’, solid line=percentage of MRCVS working in that area (Robertson-Smith and others 2010a), dashed line=percentage of veterinary students that want to work in that area. RCVS, Royal College of Veterinary Surgeons

FIG 5:

Students’ understanding of the profession, and career aspirations: equine practice. Blue histogram=students response to the question ‘what percentage of veterinary surgeons work in each field?’, solid line=percentage of MRCVS working in that area (Robertson-Smith and others 2010a), dashed line=percentage of veterinary students that want to work in that area. RCVS, Royal College of Veterinary Surgeons

FIG 6:

Students’ understanding of the profession, and career aspirations: Mixed Practice. Blue histogram=students response to the question ‘what percentage of veterinary surgeons work in each field?’, solid line=percentage of MRCVS working in that area (Robertson-Smith and others 2010a), dashed line=percentage of veterinary students that want to work in that area. RCVS, Royal College of Veterinary Surgeons

Career aspirations by year group

Analysis of student career aspirations by year group revealed different aspirations in different year groups. The proportion of students wanting to work in small-animal practice was significantly higher in final year students than in first year students (P<0.001). The proportion of final year students wanting to work in mixed practice was significantly lower than the proportion of first years (P<0.001). For farm-animal practice, there was a non-significant decrease in the proportion of students wishing to work in that area from first to final year, and the proportion of students wishing to work in equine practice appeared constant throughout the course. Moreover, in all species areas, the CI of career aspirations of final year students overlapped recent graduate employment figures (first 2 years postgraduate) (Robertson-Smith and others 2010b), and excepting mixed practice, overlapped the employment figures for the whole profession (Robertson-Smith and others 2010a). This is illustrated in Fig 7.

FIG 7:

Student career aspirations in the 1st, 4th and final year with 95% CIs (black line) and Royal College of Veterinary Surgeons (RCVS) employment figures for the profession (dashed line)(Robertson-Smith and others 2010a) and for graduates up to 2 years qualified (dotted line)(Robertson-Smith and others 2010b)

Discussion

The aim of this study was to determine whether three key stakeholder groups agreed or disagreed with the concept of tracking in UK veterinary curricula and what factors might influence this opinion. University staff, students, and practising veterinary surgeons were invited to complete a survey relating to full tracking, where graduates would be qualified to treat only a small number of species, and partial tracking, where students would get the opportunity to focus on a small number of species, but continue to graduate with omnipotential. The findings suggest that a move towards full tracking would not be supported; any such move would represent a significant change to the profession, and require new legislation, accreditation and guidelines. However, according to the data, partial tracking would be widely accepted.

The response rate for university staff was low (8.72 per cent); one explanation for this is that some university mailing lists do not distinguish between staff groups; for example administrative and support staff may have been emailed, but the instructions were for only staff involved on the veterinary curriculum to complete the survey. However, this limitation should be taken into account when discussing the results. The group sizes were uneven and were not proportional to the population size: practitioners were by far the largest population, although had the smallest number of responses. Therefore, comparisons between groups were made only when the group sizes permitted. When compared with RCVS data (Robertson-Smith and others 2010a, Royal College of Veterinary Surgeons 2012), the practitioner and student samples were similar to the population in terms of age, gender, location and species worked with.

Seventy-nine per cent of respondents supported partial tracking in the UK. The findings indicated that the practitioners were less supportive of this move than students, but in light of the relatively small sample size of the practitioner group, further consultation should be undertaken to determine if this is representative.

A range of variables was investigated to try to identify subgroups that may hold differing opinions to that of the stakeholder group as a whole; for example, would mixed practitioners be more opposed to tracking than exclusively small-animal practitioners? Over a quarter of practitioners (26 per cent) reported a significant career change, and this was the only subgroup identified as having a different opinion on tracking, compared to the remainder of their stakeholder group. Interestingly, this subgroup was more in favour of partial tracking than other practitioners, but as could be predicted, were less in favour of full tracking.

The data presented in this study indicate that students had a fairly accurate understanding of the employment profile of the profession. Initial analysis of all student responses revealed a concerning finding; that student career aspirations did not match the employment profile and likely opportunities. However, when a secondary analysis was conducted, evaluating career aspiration by academic year, the CI of final year students’ aspirations overlapped the employment data for recent graduates in all species areas. As this was a cross-sectional study looking at different cohorts, it is not possible to say whether career aspirations change throughout the course; however, these data would support that hypothesis.

Chigerwe and others (2010) found that the only significant factors affecting students’ choice of track were prior experiences and other personal reasons; predicted employment opportunities, income and quality of life did not affect students’ decisions. Recent work in the UK identified that a higher percentage of veterinary surgeons raised in urban locations were currently employed in small-animal positions, compared to those from rural environments (Kinnison and May 2013). Additional longitudinal research could investigate this further, and identify reasons for students to change their career plans. The importance of supporting students during track selection cannot be overemphasised, particularly if career aspirations are liable to change.

A move towards tracked curricula would not be without challenges, some of which are discussed in the second paper in the series, however, such tracked curricula are permissible within the European Association of Establishments for Veterinary Education (EAEVE) regulations; providing that the core competencies are attained, up to 20 per cent of the course may be directed to a track (European Association of Establishments for Veterinary Education and Federation of Veterinarians of Europe 2012). All UK veterinary schools currently run electives, which could be considered a form of partial tracking, and a number have introduced tracked rotations, but to the authors’ knowledge, none of the schools track to the amount permissible within EAEVE regulations.

This study is the first to evaluate opinion from three key stakeholder groups in the UK on tracking in veterinary curricula, and has indicated that there is widespread support for partial tracking, which would allow students to focus on a small number of species while still graduating competent in all species, but that a move towards full tracking and limited licensure would not be popular. The second paper in this study presents data from free text responses in the same survey, and on-going work by the project group aims to further explore the issues identified in this study via focus groups and telephone interviews. Future work in this area could evaluate the opinion of other stakeholder groups, such as clients, the RCVS and other professional bodies.

 Additional references are published online only. To view please visit the journal online (http://dx.doi.org/10.1136/vr-2013-102342)

Acknowledgments

The authors gratefully acknowledge the participants who completed the survey. In particular, we would like to thank the contacts at UK veterinary schools for facilitating the dissemination of the survey within their universities.

References

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Footnotes

  • Provenance: Not commissioned; externally peer reviewed.

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