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Time for a reality check?
  1. Kathryn Clark

Statistics from Altmetric.com

‘If you make a mistake, you’ll get struck off.’

That, apparently, is the gist of comments that students on extramural studies (EMS) placements report they receive from some of the vets with whom they are seeing practice.

While it is to be hoped that, in these cases, the remarks were intended to be light-hearted, there was some consternation (and possibly some examination of consciences) among BVA council members, when they learned of this at their meeting last December.

Taken together with another comment made at the council meeting – that ‘fear of getting into trouble’ affects new graduates’ confidence and makes them reluctant to attempt treatments that they are not completely certain of – it would seem that these casual asides could be having more of an impact than imagined.

Last month’s SPVS conference also discussed how many student vets on EMS placements are simply terrified about the thought of losing their registration.

But, in reality, how likely is it that young graduates will end up in front of the RCVS Disciplinary Committee? Their fears do not appear to be borne out by the evidence available.

Figures from the RCVS show that there were 24,422 practising vets on the register at the end of March 2018 (this encompasses all fields and disciplines in which vets are active). In the 12 months between 1 April 2017 and 31 March 2018, the Disciplinary Committee heard 19 cases against veterinary surgeons and in only four of those cases did the committee direct that the vet involved should be removed from the register – that’s four vets out of 24,422 or 0.016 per cent of the profession receiving a striking off sanction in 12 months.

And, although Vet Record recently reported that 2018 was a ‘record year’ for disciplinary hearings, there were still only 23 cases against veterinary surgeons heard by the Disciplinary Committee – with fewer than half of the respondents in those cases receiving a striking off sanction.

In reality, the majority of formal concerns raised with the RCVS do not end in disciplinary hearings. Most are closed at the initial investigation stage, either with no further action being taken, or the vet concerned being given appropriate advice. Of those that do make it to the Preliminary Investigation Committee stage, again many are closed with no further action or with advice.

Despite the limitations imposed by the Veterinary Surgeons Act, the RCVS’s disciplinary processes have evolved in recent years. The Disciplinary Committee is now fully independent of the college’s council and a more nuanced approach to certain cases is evident, with the option of dealing with concerns relating to substance misuse, health issues or clinical performance under appropriate alternative protocols.

There is also an alternative dispute resolution system to which cases that do not fall under the remit of the formal disciplinary process can be referred – for example, fee disputes or cases of alleged negligence or inadequate care (which, incidentally, tend to be among the most common types of enquiry and concern registered by the RCVS).

The profession must have a mechanism by which it can hold to account those members who do not meet the high standards expected. It is also important to recognise that, for those who do end up subject to disciplinary proceedings, it can be a stressful, drawn out process that could ultimately result in loss of their right to practise.

The overwhelming majority of practising vets will never face a disciplinary hearing

However, young vets in particular need to realise that, while some unhappy clients are an inevitable part of practice life, the evidence suggests that their fears of disciplinary action are unfounded and the overwhelming majority of practising vets will never face a disciplinary hearing.

So, perhaps it is time for a reality check – and time too for those who host students on EMS to consider the unintended consequences of a light-hearted remark.

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