Diplomates Express Concerns About Oversight and Supervision of Residents

Dear Colleagues,

Diplomates bring many concerns to the Board of Regents. Depending upon the urgency and nature of the issue, the Board may address the issue or seek input from the appropriate committee or the membership at large before responding. An issue that has been raised by several Diplomates is oversight and supervision of residents during training programs. The Board of Regents asks that each of us involved with resident training takes time to review ACVS residency requirements relative to our programs and the practices employed to train residents from day one through residency completion.

Currently, any ACVS Diplomate can supervise residents. Program Directors (PDs) and Resident Advisors (RAs) are the on-site liaisons for the ACVS to ensure appropriate residency program conduct and completion. Logs and activities are reviewed for accuracy by the PDs and RAs at the home program before the Resident Credentialing Committee reviews individual resident’s materials. The web-based system has certainly streamlined the process, but detailed log review continues to be an important component of each residency program. Verification of the accuracy of the log by the PD and RA should certify that the word and the spirit of the ACVS principles of resident training are upheld.

The concerns that have recently been voiced are varied. Some concerns have had similarities since logs were put in place in 1987. Residents are fairly famous for waiting until the last minute to submit logs for PD and RA review and verification to meet the ACVS deadline. Simply signing off without review has always been easy, however, ACVS gives much credence to supervisors’ approval of these resident materials. We need your help and renewed commitment to ensure that our programs are producing highly skilled, knowledgeable residents who, when certified, truly perform at a specialist level. A solid, thorough review of materials submitted by the resident must be performed by the supervisors and that remains ACVS’s expectation of members who function in these roles.

Another concern has been supervision of residents in the operating room. Through the years, the ACVS has tried to define what “Diplomate supervision” means. Defining supervision seems like an odd thing to have to do, but some residents leaving programs indicate that they were not directly supervised, and therefore not instructed, on surgical procedures that were signed off and certified as supervised procedures within case logs. A residency, by definition, is a time of training and learning. The expectation of the ACVS is that Diplomates who train residents will be actively involved with the individuals in their programs.

The skills and quality of our residents and new Diplomates are largely dictated by the quality of training programs. The ACVS program requirements aim to train residents and produce Diplomates of the highest standards of skill and ethical behavior. The esteem of our specialty college is only as great as the honesty and integrity of its members. We are currently under siege from outside forces moving aggressively into veterinary surgery and attempting to offer a credential indicating surgical expertise from weekend and short course participation. If the ACVS does not maintain the highest and most rigorous standards of veterinary surgical practice and residency training, we may end up weakly positioned to claim sole proprietorship of the designation “veterinary surgeon.”

Our request is for you to review your residency practices in regard to how residents are trained, supervised and encouraged to work through the three years of an ACVS residency program. ACVS relies on the stringent oversight and supervision by Diplomates to produce the very best in veterinary surgery.

I welcome your comments (egaughan@vt.edu), and thank you for your continued hard work. 

Best wishes,

Earl M. Gaughan, DVM
Diplomate and President, American College of Veterinary Surgeons

2012-2013 Residency Program Guidelines