In November, I sat for the most important exam of my career, thus far – the North American Veterinary Licensing Exam, or NAVLE. While you could argue that I’ve been studying for this test for the last 4 years, the formal studying for NAVLE started (for me) in May – almost 7 months prior to when I would take the exam. I made it to 100% completion of my VetPrep program, continued to answer both the daily VetPrep and Zuku Review questions emailed to me, and continued to make Quizlet flashcards of material I struggled with, the VetPrep study materials, and the review sessions our clinicians had for us.
My future career would depend on one, 7 and a half hour, multiple-choice exam consisting of a total of 6 sections and 360 questions. In reality, only 300 of these questions would determine my score, as 60 of the questions sprinkled throughout the exam are newly developed questions that are being tested for future years.
300 questions to cover 4 years of a veterinary education. 300 questions to cover anatomy and physiology, pharmacology, disease processes, etiologies and pathophysiologies, treatments, pharmacology, animal behavior, statistics, public health, epidemiology, radiology, anesthesia, histology and pathology, animal husbandry, bacteriology and virology, hematology, toxicology, nutrition, surgical techniques, ethics, and communication.
300 questions to cover ALL those topics above, for every major species of veterinary medicine, as well as some of the not-so-common creatures veterinarians tend to.
Sitting in my NAVLE, I couldn’t help but feel that a multiple-choice exam of just 300 questions was not an accurate portrayal of my veterinary education. Even though many of the questions required multifaceted information, there was just no way that this single exam could encompass what I’d learned. Moreover, I found the communications questions almost comical; for such a nuanced and complicated skill to master and turn it into a black-and-white multiple-choice question had me battling internally on many of the questions where I could justify more than one answer.
As an equine-oriented individual, I left the exam feeling like I saw a disproportionate amount of small animal questions. My small animal peers reported feeling like there was an overabundance of large animal questions. For my small animal classmates who have no intention of ever touching a cow or horse, they are studying for the exam. For me, I was studying small animal strictly for the exam, as my career aspirations and passion lie within the equine industry.
So, I left my NAVLE – the exam that had to cover dozens of species, dozens of subjects, hundreds of diseases, hundreds of drugs – feeling that 300 questions in one sitting was no way to determine my knowledge base.
The exam didn’t accurately test the knowledge I’d learned, it didn’t assess in any way my level of practical and technical skill, it didn’t really assess my communication skills or any of my other soft skills, my animal handling, my ability to work on a team with other veterinarians, veterinary nurses and staff, the ability to work under pressure or in emergency situations, or any other ‘real-life’ situation.
And *this* is the exam that determines if I get to be a veterinarian or not.
Contrast this with human medicine – licensing in the United States is a 3-step process. The first step and day of examination consists of maximum 280 multiple choice questions to test over basic science and medical foundations. The second step is sub-divided into a clinical knowledge and a clinical skills portion. In the clinical knowledge portion, an additional testing day that covers medical skills and knowledge, disease prevention and clinical science is a multiple-choice exam with a maximum of 318 questions.
The clinical skills portion is a separate day with 12 patient encounters and/or telephone conversations that require the taker to interact with the patient, ask questions, gather information, write orders and diagnostics, perform a physical exam, and develop a medical record following the encounter.
The final third step is a two-day test that focuses on ambulatory medicine, diagnosing and managing diseases, ethics, communication, disease progression, medical decision making, prognosticating, integrating physical exam, history and diagnostics, public health, and epidemiology. This portion of the test has both multiple choice and simulation questions. The first day is a 232-question multiple-choice exam, and the second day is 180 multiple choice questions and 13 simulations.
So, for United States Medical Licensing, there are 3 sections, 5 days, 1,010 multiple choice questions, 12 patient encounters and 13 simulations.
But for the hopeful veterinary professional, who will have to treat many more species with anatomical, physiological and pharmalogical differences and be unable to vocalize their problem to their doctor – there is 1 day and 300 multiple choice questions to determine if they are worthy to add D.V.M. to the end of their name.
Veterinarians must learn a wildly vast amount of information in the same time as human doctors but are somehow scarcely tested over it. Vets earn the same title of ‘Doctor’, so it would make sense to me that we would be tested similarly but I was genuinely surprised when I started looking up the medical licensing exam format.
Especially with as diverse and specialized as the veterinary field is becoming, the veterinary profession has outgrown the NAVLE. We need an exam that is more comprehensive, more representative of our education and does justice to the hefty price tag, time and effort we spend to get to sit for our licensing exams. We need an exam that evaluates our communication and interpersonal skills that are so important in our field, that evaluates our observation skills, our clinical and technical skills, and covers more of the expansive knowledge base we amass over our veterinary education than just 300 questions.