Ross University School of Veterinary Medicine Saint Kitts and Nevis
High Debt and Falling Demand Trap New Vets
HAYLEY SCHAFER chose her dream job at the age of 5. Three years later, her grandmother told her that if she wrote it down, the dream would come true. So she found a piece of blue construction paper and scrawled on it with a pencil: "Veterianian." "No one told me how to spell it," she remembers. "They just said, 'Sound it out.' "
At the age of 30, she still has the sign, which is framed on her desk at the Caring Hearts Animal Clinic in Gilbert, Ariz., where she works as a vet. She also has $312,000 in student loans, courtesy of Ross University School of Veterinary Medicine, on the Caribbean island of St. Kitts. Or rather, $312,000 was what she owed the last time she could bring herself to log into the Sallie Mae account that tracks the ever-growing balance.
"It makes me sick, watching it increase," she says. "There's also the stress of how am I going to save for retirement when I have this bear to pay off."
They don't teach much at veterinary school about bears, particularly the figurative kind, although debt as large and scary as any grizzly shadows most vet school grads, usually for decades. Nor is there much in the curriculum about the prospects for graduates or the current state of the profession. Neither, say many professors and doctors, looks very promising. The problem is a boom in supply (that is, vets) and a decline in demand (namely, veterinary services). Class sizes have been rising at nearly every school, in some cases by as much as 20 percent in recent years. And the cost of vet school has far outpaced the rate of inflation. It has risen to a median of $63,000 a year for out-of-state tuition, fees and living expenses, according to the Association of American Veterinary Medical Colleges, up 35 percent in the last decade.
This would seem less alarming if vets made more money. But starting salaries have sunk by about 13 percent during the same 10-year period, in inflation-adjusted terms, to $45,575 a year, according to the American Veterinary Medical Association. America may be pet-crazed and filled with people eager to buy expensive fetch toys and heated cat beds. But the total population of pets is going down, along with the sums that owners are willing to spend on the health care of their animals, one of the lesser-known casualties of the recession.
Today, the ratio of debt to income for the average new vet is roughly double that of M.D.'s, according to Malcolm Getz, an economist at Vanderbilt University. To practitioners in the field, such numbers are ominous, and they portend lean times for new graduates.
"We're calling for more bodies coming through the veterinary educational pipeline at higher and higher cost at the very point in time that we need fewer and fewer," says Dr. Eden Myers, a vet in Mount Sterling, Ky., who runs the Web site JustVetData, where she crunches numbers about the profession. "And they are going to get paid less and less."
For years, the veterinary medical association contended that the United States needed more vets, not fewer, especially in rural areas. To support this view, in 2007, the organization helped underwrite a study, hoping to bolster a call for government assistance to help meet a putative shortfall of 15,000 vets by 2024.
The results, released last year, came to a strikingly different conclusion. Titled "Assessing the Current and Future Workforce Needs in Veterinary Medicine" and conducted under the auspices of the National Academy of Sciences, the study found little evidence of vet shortages. It also concluded that "the cost of veterinary education is at a crisis point."
The current president of the veterinary medical association, Dr. Douglas G. Aspros, isn't talking about unmet needs. Instead, he sounds like a man ready to rethink many of the premises his organization has long espoused.
"It's not a sustainable model," he says of vet school economics. "For the long-term success and health of the veterinary practice, we've got to look at every end of it."
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That is a common sentiment among working vets, many of whom say the job market is the worst they have seen. But the deans of many vet schools see growth and opportunities, and one of them is Dr. Elaine Watson of Ross, the only profit-making vet school accredited by the veterinary medical association. Some vets and professors say the school, which is owned by DeVry Inc., a publicly traded educational company based in New Jersey, is a vivid example of all that has gone haywire for aspiring doctors of veterinary medicine, or D.V.M.'s, as they are known.
When you factor in cost of living and commuting costs, Ross is one of the more expensive places in the world to get a degree. And Ross mints D.V.M.'s at a remarkable clip. Last year, it graduated 287 of them — triple the number of many American schools.
Dean Watson, not surprisingly, says focusing on the oversupply of vets is shortsighted. She says educators ought to think about how the field will look in 10 or 20 years. At any rate, she adds, students come to Ross with their eyes open. "They've made the decision that they desperately want to be vets," she says, "and they all realize that when they start taking on debt."
ROSS is on the southern coast of St. Kitts, an island that once did a robust trade in sugar cane but today earns much of its money through tourism. The campus is a five-minute drive from the harbor town of Basseterre, where a cruise ship is often anchored. The hodgepodge of lecture halls and small labs are scattered around a grand, triangular-shaped outdoor amphitheater in front of the student union, with an unobstructed view of the sea.
One afternoon in January, Dr. Kathleen Yvorchuk was teaching a course called Introduction to Physical Exam. That day's lesson was the correct way to check a horse for a sinus infection. The trick is to knock on the bone that runs above a horse's muzzle — knock hard, like that bone is a door — and then listen.
"If they have a mass in their sinuses, it will sound dense and it thuds," Dr. Yvorchuk told a handful of students. A horse named Chocolate stood by, awaiting knocks. "Please recognize, this is a large animal and you're not going to hurt it."
The students took turns knocking on the forehead of Chocolate, who seemed impervious, as well as sinus-infection-free.
Students spend seven semesters at Ross, one after another, without summer breaks. This allows them to get through the program in less time, but to critics, Ross is a bit like a factory that is constantly building up production. This same criticism has also, in a milder form, been leveled at many of the 28 vet schools in the United States.
There are roughly 91,000 working vets in the country, about one-tenth the number of M.D.'s. But this relatively small universe is expanding rapidly. State budget cuts have led many domestic schools to make up lost revenue by adding students, in some cases by 10 percent in one year. Four more vet schools, both public and private, are either in the planning phases or under construction, one in New York, two in Arizona and one in Tennessee. If all are ultimately built, there will be thousands of additional D.V.M.'s on the market in coming years.
At the same time, the veterinary medical association's Council on Education has picked up the pace of its accreditation of foreign schools, like Ross on St. Kitts, giving its imprimatur to 10 of them since 2000. The goal, says Dr. Aspros, the association's president, is to make the United States the global standard setter for veterinary medicine. He defends this practice by noting that you don't need a diploma from a school accredited by the association to practice in the United States; graduates from unaccredited schools simply have to jump through a few additional hoops. But the association's seal of approval means students can qualify for certain federal loans. Because tuition at foreign schools is not subsidized by any states, graduates from places like Ross tend to wind up with larger-than-average debts.
And the level of debt for American graduates, says Dr. Alan M. Kelly, former dean of the veterinary school at the University of Pennsylvania, who led the study on work force needs, is already too high. "The general guideline is that your debt should never be twice your starting salary," Dr. Kelly says. "The debt of graduates today, on average, is three times their starting salary. Well, this is a cataclysm."
For Dr. Schafer, the burden of her student loan has dictated some crucial decisions, including where to live. After she graduated from Ross in 2011, she wanted to head home to San Diego, but she realized the city was too expensive, given her debts. She has a sister who lives in Scottsdale, so she settled on Arizona.
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It took an intensive, monthlong search to find a job. Her technique was to walk unannounced into a clinic — she eventually visited a couple of dozen — and introduce herself to anyone who seemed to work there. She got lots of sympathetic smiles and heard many variations of "We're not hiring." She finally found Caring Hearts through a help-wanted ad, and beat out 30 other applicants.
The job pays well — $60,000, which is higher than the average starting salary for vets in this country. Her days now start at 7 a.m. and are booked until 7:30 p.m. with new-puppy exams, emergency surgeries and anything else that rolls in the door.
"There is no typical day," she says. "I love the job."
Her childhood mission to become a veterinarian was no whim. Soon after she made that sign, she started collecting animals on the 11-acre plot in the town outside San Diego where she grew up. Not just dogs, cats and a horse, but also chickens, fish and iguanas.
"My parents didn't know how to say no," she says, laughing. "When I was 12, we went to buy some equipment for my horse, and I told the guy selling it that I was going to be a veterinarian. So he told my dad, 'You should buy her this pregnant goat.' Which he did."
Today, her debt exceeds her salary by a factor of five — much higher than the recommended twice-starting-salary ratio. She signed up for income-based repayment, a government program available to federal student loan recipients. (A newer program with slightly more generous terms, called Pay As You Earn, or PAYE, is available to more recent graduates.) Both income-based repayment and PAYE allow graduates to lead relatively normal lives by paying back a modest percentage of their income based on a formula. After a fixed amount of time, from 10 to 25 years, the balance of the debt is discharged.
That's the good news. The bad news is that the interest on the debt keeps growing and taxes must be paid on the amount discharged, as if it is income. Dr. Schafer sends $400 a month to Sallie Mae, a sum that will rise. But what kind of tax bill awaits her? Asked to run the numbers, GL Advisor, a financial services company that specializes in student loans, calculated that Dr. Schafer's debt is likely to exceed $650,000 when her tax bill lands 25 years after the start of the loan, which means she will owe the Internal Revenue Service roughly $200,000. That will happen while she is still deep in her career, perhaps around the time she wants to send some children to college.
"What I've done isn't a bright move," she says. "But I can afford to eat. I bought a car. Nothing fancy, but functional."
Dr. Schafer wound up with this huge debt because Ross was the only school to give her a come-hither after American schools refused her. She was twice turned down by the University of California, Davis, where she was an undergraduate, in large part, she says, because she received Bs as a freshman and sophomore. "There were 120 openings and more than 1,000 applicants," she says. "It's competitive."
Getting admitted to Davis would have cut her tuition bills more than 50 percent. But she never balked at Ross's offer. Though Ross is rarely anyone's first choice, even detractors say its educational standards are high and its graduates are impressive. But the commuting costs, the foreign setting and the faint stigma that attends education at profit-making institutions have made it a school of last resort.
If getting in is easy, staying in is surprisingly hard. About 20 percent of Ross's first semester students won't make it to graduation, say administrators, an exceptionally high rate of attrition. (At American schools, it's typically closer to 2 percent.) About half of those students are bounced for poor academic performance. Dean Watson says most students flunk out early on, in the first and second semester. But some fail much later. In 2006, Diana Reyes was ejected in her sixth semester, leaving St. Kitts with $160,000 in debt and no degree.
"It was one of the saddest moments of my life," she says of the day she learned the news. She took a break, then borrowed more money to earn a technical degree from Purdue University. Today she earns $18 an hour as a technician in a veterinary clinic in Lafayette, Ind.
"My father is paying half of my loans," she says. "I can't afford them myself."
THE poor job market for new veterinarians is not the much-publicized fiasco that it is for new lawyers. But it's getting worse. For decades, new D.V.M.'s were snapped up by clinics and hospitals in the months before they graduated. In 2012, a mere 45 percent of graduating vets reported that they had accepted a permanent job offer — as opposed to a time-limited and lower-paying internship, or a residency — down from 84 percent in 1999. Last year, 39 percent of graduates had no job offers, up from 19 percent in 1999.
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But after graduation, little data is collected about employment and salaries. Nobody knows the number of unemployed and underemployed vets. Vet-market optimists have long argued that many parts of the country are underserved. And if you look at a map of where vets set up practices, you will see large areas of the country with little or no coverage.
To address this problem, many states and the Department of Agriculture have offered loan-forgiveness programs, hoping to lure new graduates to places where vets are needed. Success stories are rare. Even with government assistance, it is hard to make it financially as a vet in areas that are both sparsely populated and poor.
Alisha Oehling, a 2009 graduate of Virginia-Maryland Regional College of Veterinary Medicine, gave it a shot when she moved to Clarksville, Va. To qualify for loan forgiveness, she would have to spend 80 percent of her time treating cows and oxen. "I took all the bovine work I could get, but it was just 25 percent of my practice," she says. "There was no way to get to 80 percent."
But even if she qualified for loan forgiveness, she says, it wouldn't have made much difference. During the winter, her phone often didn't ring for days at a time. During the spring, she once worked 42 days in a row. The feast-or-famine pace was trying enough, but even worse was that many of her clients, though devoted to their animals, often couldn't afford needed care.
"The average household income is about $26,000 a year," she says. "If you have a backyard pony, you probably can't afford to spend $1,000 on it."
So recently she moved. She beat out hundreds of vets who applied for a job at a clinic in Northern Virginia, where she will work mostly on high-priced horses, and where a vet can charge more, even for vaccines.
It's slowly dawning on leaders in the field that vet schools can't simply increase the number of graduates and expect them to move to underserved areas, hanging shingles where there currently are none.
The last refuge for rosy forecasters is the most recent Bureau of Labor Statistics report. It states that "overall job opportunities for veterinarians are expected to be good." As Ross's public relations office points out, the report's data suggests that the country will need 22,000 new vets by 2020, far more than will be produced under the current system.
But many people believe that the bureau's report, which was written in 2009, is badly in need of an update. One of them is Henry Kasper, the economist at the Bureau of Labor Statistics who helped draft the report. There are others.
"We've gotten several calls from disgruntled vets who say, 'What is wrong with you guys? Are you completely blind? There is no demand for vet services,' " says Mr. Kasper. "This is pretty high on our list to really home in on the effects of the recession and see if there are long-term trends that have changed." Mr. Kasper said the full impact of the economic downturn had not yet hit when the bureau published its report. Also, the bureau looks at long-term trends, rather than short-term business cycles. Research at the time suggested, as Mr. Kasper put it, that "people will always spend money on pets because they view them as part of the family."
That belief has been tested. Not only are there fewer dogs — from 2006 to 2011, the number of dogs in the country dropped for the first time, albeit slightly, to 70 million from 72 million, according to the American Veterinary Medical Association Sourcebook survey — but the amount owners paid to vets fell, too. Owners reported they spent about $20 less a year in inflation-adjusted terms in that five-year span.
The declines are more significant when it comes to cats. About 36.1 million households owned at least one cat in 2011, down 6 percent from 2006. During that period, the number of cat visits to the vet declined 13.5 percent. In the business, this is known as "the cat problem."
The horse market has suffered the most. Pet horses are expensive, and the market for them since the start of the recession has been crushed. Thoroughbred racing, meanwhile, has been hurt by the expansion of casinos, reducing the number of horses in need of veterinary care.
"The estimates are that the horse population is down about 30 percent since 2008," says Dr. Stuart E. Brown of Hagyard Equine Medical Institute in Lexington, Ky. "Traditionally we have hired five to seven new grads to our internship program. Lately, it's one or two."
There is no simple solution to the problem of sinking salaries and rising debt, nor to the market saturation of vets, Dr. Aspros says. Tuition is expected to keep going up, class sizes are expected to grow and if new vet schools are built to the proper specifications, they will get the veterinary medical association's seal of approval.
An added wrinkle to the debate is gender. The number of women in vet schools has been rising for decades; today they account for 80 percent of graduates, flipping the gender mix on its head as compared to 30 years ago. As with most professions, there is a pay gap between men and women, and in the veterinary field it has widened since the downturn. Last year, starting salaries for women were 16 percent lower than for men, according to figures compiled by Dr. Myers of JustVetData, compared to a 3 percent difference in 2002. Everyone is losing ground, she says, but women are losing ground much faster than men.
"Still, when you go to meetings, almost every person in charge is an old white guy in a suit," she says. "They want to find solutions as badly as anyone else, but we're like ships passing in the night."
DISCUSSIONS about these and other vexing issues are conspicuously absent in most vet schools, say academics. Dr. James Wilson, a veterinarian, lawyer and professor who has taught at more than a dozen vet schools over the years, says he is consistently amazed at how little students know about their financial future.
Many schools do not seem eager to enlighten them. That includes Ross, where Dr. Wilson lectured for seven years, until early 2010. He was asked not to return, he says, soon after he persuaded the school to let him teach a personal finance class as part of the first-semester curriculum. (A Ross representative wrote in an e-mail that the school would not discuss personnel matters, but that "Dr. Wilson's relationship with R.U.S.V.M. did not end for the reasons he's articulated to The New York Times.")
The class, he said, had left many students with an existential case of sticker shock. "By the end of each of these sessions," Dr. Wilson says, "I witnessed much fear and considerable depression. More than once, I saw tears."
"I have said it over and over to myself and friends, 'This is as close to predatory lending as anything I've ever seen,' " Dr. Wilson continues. "The only reason it's not a high-profile crime in 2013 is because income-based repayment and pay as you earn have postponed the reality and pain for 20 to 30 years."
What Dr. Wilson learned long ago is that it is hard to talk anyone out of vet school. Many students, like Dr. Schafer, set their hearts on the job at an early age. If you are doing what you have always wanted, and you find it fulfilling, the numbers don't seem relevant. At least initially.
"It comes down to this," Dr. Schafer says. "Is there anything else I'd be happy doing? No. Is there any way around paying off the loans? No. So, what the heck? A lot of it is just trying to put it out of your mind and maybe it'll disappear."
She realizes that this is crazy. The bear that is her tuition bill has an appointment in about 23 years, and that is the one beast she doesn't know how to treat.
Ross University School of Veterinary Medicine Saint Kitts and Nevis
Source: https://www.nytimes.com/2013/02/24/business/high-debt-and-falling-demand-trap-new-veterinarians.html
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