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Call the Vet! Rural Veterinary Medicine Is Struggling

Here’s what happened and how we can fix it.

Two years ago when Jacey McDaniel (right) graduated from vet school and moved to western Kansas to practice, she couldn’t have imagined the challenges she would face. Last fall, McDaniel’s boss, Kristina Booker, passed away unexpectedly of a pulmonary embolism at age 42. Booker owned the two-vet mixed animal clinic in Oakley, did most of the cattle work, and had been working long days at the local sale barn before she died. Now McDaniel, who was mainly doing companion animal work before Booker’s death, had to keep the clinic running and handle the cattle work. On top of that, McDaniel and her husband, Sam, had their first child in October.

“It’s been a whirlwind,” says McDaniel. “Mixed practice is tough. Out here in western Kansas, there isn’t much around, and vets are hard to come by. Finding someone who wants to live in the middle of nowhere and have such a demanding schedule is hard.”

With the help of relief vets who come in once a week or so, she is surviving. “The community has been helping to keep it going,” says McDaniel. She is grateful to her technicians, office staff, and kennel help. She recently purchased the clinic from Booker’s family.

Underserved

There are about 500 counties in the U.S. underserved by a veterinarian in 2019, according to the USDA. The vast majority are in rural areas. There are shortages this year in 44 states, the highest number reporting shortages since tracking began.

veterinarian Chase Reed
In north-central Kansas, Chase Reed, 30, (right) is in a two-man mixed animal veterinary practice that is heavy on cow-calf work. “I had a lot of job offers,” says Reed. “There is a ton of opportunity for a person with the drive to work on livestock. The reality is that veterinarians who do that kind of work don’t get the same salaries as vets in metropolitan areas, and the call structure is not appealing. I’m on call 180 days a year, any hour of the day or night. It takes a special person to come out here and persist in this style of practice.”

In Olney, Texas, Keelan Lewis is managing three mixed practice veterinary clinics in five counties. Lewis’ father, Arn Anderson, also a veterinarian, co-owns one clinic with Lewis and two others himself. 

veterinarian Keelan Lewis
“When I got out of school in 2011, I was told rural medicine and bovine practices were dying,” says Lewis (second from right with veterinarians Brittany Berry, Amy Eiland, and Carrie Foltyn). “The rural practice of my dad’s generation is dead. A solo practitioner in a small town who does everything for everybody at all hours of the day at the expense of his family is dead. That is a thing of the past. It is not sustainable. But the need of a veterinarian for agriculture is more alive now than it has been in 10 years. The managers running cattle operations are motivated and seeking information. They need that relationship with a veterinarian.”

Rural veterinary medicine is going through a sea change. To understand the impacts to farmers, 21 veterinarians in 13 states were interviewed. Several trends and concerns came to the surface quickly.

1. Clinics are going corporate.

Did you know that the largest employer of veterinarians in the world is a candy company? Mars, known for M&Ms as well as pet food, owns more than 2,000 veterinary hospitals in the U.S. and Europe and employs over 50,000 veterinary professionals. Of the approximately 30,000 veterinary practices in the U.S. today, about 3,500 are corporate-owned, says the American Veterinary Medical Association (AVMA), and that number is increasing rapidly.

2. Women are taking over.

Today, more than 60% of the 110,000 veterinarians in the U.S. are women, according to the AVMA. That percentage gets larger by the year because vet schools are now 80% to 90% women. Why has that trend developed? There are many reasons, but the general consensus runs along these lines: “Women seem more willing than men to tackle the extra four years of school and the associated debt. They are more driven by passion for the profession,” says Trevor Ames, dean of the University of Minnesota College of Veterinary Medicine.

“The increasing number of women in the profession are impacting the overall supply of veterinarians because of their different work-life balance expectations,” says Dan Grooms, dean, College of Veterinary Medicine, Iowa State University. “Women tend to have shorter or interrupted careers. Many work part time instead of full time.”

Practices are adjusting. “This generation works a lot smarter,” says Anderson. “There isn’t a dang thing our female veterinarians can’t do faster than me. They are palpating 120 cows an hour using hands-free ultrasound. I can knock off 110 with my arm, but they are going faster.”

veterinarian Jacey McDaniel with bull

The competent skills of women can overcome the physical skills, says Brian Aldridge, professor, University of Illinois College of Veterinary Medicine. “The strength needed in a C-section is lifting the calf from deep in the abdomen while the cow is standing. Many women vets use sedatives and lay the cow down to do a ventral belly. Now the calf is right there under your incision.”

Labor-saving tools have another benefit – less wear and tear on bodies. “My shoulder is shot; it hurts all the time,” says veterinarian Scott Pendleton, 59, Cadiz, Ohio. He’s having surgery on his “palpation arm” soon. “My doctor asked me when I injured it. I said I injured it 50,000 times. Every time you go up the rear end of a cow, you injure your shoulder.”

Young veterinarians place great value on having time off, says Anderson. “They want to know their families. When I came here, one of the vets told me he didn’t know his sons until they went to college. The employee handbook said if you get pregnant, you are fired. Thankfully, that has all changed.”

Female veterinarians who practice in food animal medicine are outstanding, says Russ Daly, Extension veterinarian and professor at South Dakota State University (SDSU). That said, when every single one of the 12 students going to vet school from SDSU this year is a woman, it becomes a phenomenon that merits investigating. “We have done surveys of our students for years about attitudes toward the profession,” says Daly. “The males are less likely than the females to want to go to school longer. They are more willing to take their four-year degree and get out and start paying back student loans instead of delaying everything four more years.”

3. High debt hurts rural practices.

According to the AVMA, 2018 graduates from U.S. veterinary colleges (including grads without debt) averaged $143,000 of debt, an increase of $10,000 from 2017. “We have fewer graduates interested in going into rural practice, and a big reason is the debt,” says Grooms. “They have to take jobs that can service that debt, and often, those are not in rural America. If we want to attract students to rural areas, we have to figure out a way to offset some of the cost of education.”

The younger generation, male or female, is less likely to want to own practices, says Daly. “There are headaches. I’ve been there. But ownership creates better opportunities to pay back your student loans more quickly. Our students nowadays are more apt to forgo the management headaches and the extra investment rather than what might create the best return in the long run. As a result, I’m concerned about who will carry the torch of independent veterinary medicine into the future.”

Chase Reed wants to be an owner one day, and it’s one reason he came to the practice in Washington, Kansas. “One of the pathways to real financial freedom as a veterinary practitioner is practice ownership,” he says. “I had six figures worth of debt when I graduated. I could toil away as an associate forever and get my debt paid off, but the pathway to creating wealth is through practice ownership.”

4. Farm booms and busts affect veterinarians.

Pendleton’s bread and butter in his southeastern Ohio hill country practice used to be dairy. “I had 30 dairies when I started in the early 1990s; we are now down to one,” he says. Beef is often “fire engine veterinary medicine,” instead of steady income, says Pendleton. “Beef herds are also consolidating. Instead of five herds with 500 cows, there are two herds with 1,500 cows. Fewer herds are split between the same number of veterinarians.”

The problem is not a shortage of large animal veterinarians; it’s the distribution of available vets, says Nigel Cook, professor in food animal production medicine, University of Wisconsin-Madison School of Veterinary Medicine. “You can’t expect a veterinarian to set up shop in an area where there isn’t enough work to sustain a livelihood. In low-density livestock areas, farmers complain that there aren’t enough veterinarians around. But if we doubled the number of graduates going into food animal practice, the farmers would still be complaining because nobody is going to go work in those areas.”

5. Larger farms mean larger expectations.

Livestock producers have more invested in their operations today, and the expectations for the level of service provided by the veterinarian has increased, says Bob Larson, professor of production medicine, Kansas State University. “The demand from the clients to provide sophisticated service and highly specialized advice has gone up.” There’s a higher level of entry-level competency needed, particularly in reproduction and cow health issues, says Larson.

Reed feels the pressure. “There are weighty financial implications behind every pregnancy diagnosis I make. It is always on my mind that this could be a death sentence for the cow and a money loser for the client if I am wrong. You don’t feel the gravity of those decisions in vet school. It’s not until you are standing with your arm in a cow that it sinks in.”

At North Carolina State University College of Veterinary Medicine, lecturer Juliana Bonin Ferreira created a new elective course that looks at the modern pig business, including economics. “We help students understand and interpret farm records,” says Ferreira. “They learn how to analyze the cost of vaccinating or not vaccinating.” Nutrition, food safety, transportation, and even meat exports are covered. Students visit feed mills and large integrated swine farms.

6. Fewer vet students are coming from rural backgrounds.

Only about 10% of final-year students at veterinary schools have an interest in food animal medicine at graduation.

Veterinary schools need to rethink admissions, says Daly at SDSU. “It should be OK to accept more people into the profession with rural farm backgrounds yet not at the top of the class, grade-wise. A lot of our farm kids work part time, and many go home on the weekends to help their folks with calving. As a result, these students often end up with a 3.3 GPA instead of a 4.0. I think it’s just fine to have a student who doesn’t have a stellar academic record but has the personality, the drive, and the desire to come back to rural South Dakota and be a part of this profession.”

Pendleton says the universities could recruit better. “Instead of basing everything on who scores the best and interviews the best, base part of it on ZIP code. You might get a kid from southeastern Ohio who wants to come back and work at a mixed animal practice but doesn’t have quite the scores.”

Many food animal veterinarians come from urban or suburban backgrounds, says Gary Althouse, associate dean of sustainable agriculture and veterinary practices, University of Pennsylvania School of Veterinary Medicine (Penn Vet). “We get those students to go out and work on livestock facilities during summers. By the time they graduate, they may have not been raised on a farm, but they have that comfort level to serve that practice successfully.”

Many new students know nothing about the livestock industry, says Aldridge. “We think about education as inspiration as much as information. We want to open their minds, their curiosity, their compassion for livestock farming and a secure food chain. The older curriculum was designed around diseases and drugs. To be a successful livestock veterinarian, it’s much broader. You must be data literate.”

7. Schools are recruiting more out-of-state students.

This is purely economics, says Grooms. The class size at Iowa State has grown to 150, but only 60 of those are reserved for Iowa students. “Only 20% of the funding to run our college comes from the state of Iowa. The remaining 80% comes from tuition and from research and service fees.” Those out-of-state students are less likely to stay in Iowa and work on food animals. “You tend to go back to the kind of background that you came from,” explains Grooms.

Once schools start depending on out-of-state tuition, there seems to be no turning back, says Daly. “The real question I never hear anyone address is why veterinary education is as expensive as it is. Adding out-of-state students enables schools to raise their budgets, but it shrinks the proportion of students who would more likely go into rural areas to practice.”

8. Consumers are demanding change.

Pain management and animal welfare are two areas Anderson is spending more time on at his vet clinic in Texas. “New graduates expect to provide a higher standard of care. We love that. The new generation points out your witchcraft, the stuff you are doing that doesn’t make any sense.”

Many farms today have to pass animal welfare audits. Veterinarians are helping to solve facility issues, designing barns, and helping to prevent pneumonia with better ventilation systems. “We train our students to improve animal welfare,” says Cook. “Veterinarians are not just there to treat an individual animal with an injection of medicine.”

9. Veterinary work is high stress.

Veterinarians in the U.S. are at an increased risk of suicide, according to a 2018 study by the Center for Disease Control. Female veterinarians are more than three times as likely to die from suicide as the general population. Male veterinarians are twice as likely. “You have to be mentally tough,” says McDaniel. “You have to do your job well and leave it behind when you go home. It’s hard. Compassion fatigue is a thing. Putting animals to sleep is not fun. The increase in suicides probably stems from the type of people who want to be veterinarians. All of us are detail-oriented and want perfection. When things happen in the real world and nothing is going your way, that takes a toll on you mentally. The time, the stress, the finances – it’s a lot to handle.”

10. Heightened livestock disease risks add pressure.

On March 19, Carlos Risco, dean, Oklahoma State University Center for Veterinary Health Sciences, was attending the Oklahoma Youth Fair when disease became a top priority. “A number of pigs being shown there broke down with coughing and respiratory problems,” he says. Samples were brought to the veterinary school’s laboratory. In less than 10 hours, the diagnosis was made: PED, porcine epidemic diarrhea, a deadly virus. Foreign animal diseases, such as African swine fever, could be even more devastating to agriculture. “Rural veterinarians are in the front row to guard against the entry of those diseases,” says Risco.

Penn Vet sits near livestock-dense Lancaster County and in the population-dense Mid-Atlantic. “There is an interesting interface between the public and agriculture,” says Althouse. “We are in a high-risk area for foreign animal diseases, with international airports and ports of call. We are having lots of discussions about the increased risk of emerging infectious diseases. It’s ramped up the veterinarian’s acumen at developing a solid biosecurity program to help the farmers.”

How do you prepare for a massive foreign animal disease break? “Our private practitioners and regulatory veterinarians are on the front lines of protecting billions of dollars’ worth of agricultural assets,” says Jonathan Townsend, director of Extension programs, Purdue University College of Veterinary Medicine. “It is imperative that we keep training food animal veterinarians to recognize those diseases and prevent them from causing a massive problem.”

11. Scholarships, grants, and loans are trying to help.

The federal Veterinary Medicine Loan Repayment Program (VMLP) pays up to $25,000 each year toward student loans of eligible veterinarians who agree to serve in a designated shortage area for three years. Vet schools can also get grants from the USDA to improve the hands-on experience for food animal students, to provide continuing education for rural vets, and more.

Penn Vet has several full-ride (tuition and fees) scholarships for students who show an interest in rural, food animal practices, says Althouse. The first recipients will graduate this spring. “With the scholarships, students are walking out with minimal or no veterinary education debt and can go into rural Pennsylvania and work in those practices. It’s exciting.”

Kansas has a rural veterinarian loan repayment program, says Larson, where five students in every class get a loan for $20,000 a year. The state will repay that loan for every year that they practice in a county with fewer than 35,000 people. “That’s been successful at providing an incentive to go to rural communities and stay for a while,” he says.

Several states have early commitment programs for rural students in animal science programs. There are 10 seats available at the Ohio State University College of Veterinary Medicine. “If they maintain their academic record and continued demonstration of interest, those people would have a guaranteed seat in the class of veterinary medicine,” says Rustin Moore, dean. “The problem is, we can’t fill those. Last year, we only had five qualified applicants.”

veterinarian Scott Pendleton
In rural Ohio, Scott Pendleton (far right) has his own solution. “I raise my own veterinarians,” he explains. “Two of my vets have been working here since they were 16. It has been successful, but it takes a long time. I’ve had 12 students work here and two have come back.”

When young veterinarian Matt Friend (right) wanted to take over large animal work in Pendleton’s area, the older vet gave Friend his client list and equipment. Friend purchased a truck and does only farm calls. Pendleton’s clinic will cover emergencies for him when he needs time off. “I want him to be successful,” says Pendleton.

12. Mixed practice vets are most at risk.

“The real shortage is with rural mixed animal practices,” says Townsend. “They are having a harder time finding new graduates. The folks doing 100% dairy or beef can find students. Mixed animal practitioners who do a high-quality job on both small and large animals – that is an excellent veterinarian. It’s a really tough job.”

Who will step into the gap? “I can’t remember a time when there have been more veterinary practices looking for associates in our state than there is now,” says Daly at SDSU. “I counted 20 advertisements in our association’s newsletter. Most of those are in rural, mixed animal settings. As practices become less able to meet the needs of livestock producers, those needs will be filled by nonveterinarians, often with a product to sell. If that unbiased local rural veterinarian is not as available to the livestock owners, they are going to seek their knowledge and services from other people. That is unfortunate for animal health and the livestock industry as a whole.”

The nonprofits coming to town offering veterinary services for below reasonable costs, often funded by grants and operating tax-free, are hurting local vets, says Anderson. “They roll into town once a month, do spays and neuters for next to nothing, vaccinate everybody’s dog, and hand out heartworm pills. That is taking away part of what keeps a rural practice alive. Communities have to take care of their vets.”

You have to use your veterinarians if you want them to stay around, says Pendleton. “There is a shortage of veterinarians, but there is also a shortage of farmers who use veterinarians. If you want them to stay in rural areas, you have to make it worth their time. Too many farmers look at veterinarians as an expense, not as partners. We can save farmers money, but not when we are just putting in uteruses and pulling calves.”

13. Rural veterinarians are undervalued.

The heart of the problem, says Gordon Spronk, veterinarian in Pipestone, Minnesota, is that food and mixed animal practitioners are undervalued. Companion animal vets can raise rates easier than food animal veterinarians, who are working in commodity industries. Traditionally, rural vets also sold products. Today, pharmaceutical companies and distributors make every effort to sell direct to farmers. “Farmers like the perceived value of buying the product cheap, but the local veterinarian can’t make up the cost on two hours in the middle of the night doing a C-section,” says Spronk. “You can’t charge enough to make it worth it. Farmers who complain about the cost may wake up some day to no veterinarian at all. Who is going to sign up for a career of cutting a cow open at 2 a.m. with compensation lower than what a plumber makes? We need to find new ways for rural veterinarians to be compensated. That is the real challenge for the profession, rural communities, and our educators.”

Betsy Freese has been writing for Successful Farming magazine for 35 years. Freese’s husband, Bob, is a mixed-practice veterinarian in Indianola, Iowa. His hard work, long hours, and dedication to the practice of large animal medicine over more than three decades is the inspiration for this article.

Email Betsy.Freese@meredith.com

Response from Dale Schueler: I am a mixed practice rural solo practice veterinarian and have practiced in the Texas panhandle and eastern New Mexico for almost 43 years. I wanted to tell you that the article "Call the Vet" is in my opinion the most correct description of what is causing the shortage of large animal vets. Thank you for putting this together. I hope the supporters of the newly proposed vet school for Texas Tech, as well as my own alma mater, Texas A&M, get a copy of the article. 

Response from Lloyd Leifeste, DVM, Kerrville, Texas: This is my 50th year in mixed practice and I have, as of last year, given up the large animal part of my practice. Sad to have to do, but can’t do it anymore at 100% so it is time to quit. If I can’t do it at 100% is not fair to the animal or the owner. I hope someone else will fill the gap. The major problem is getting paid enough for what we do and people appreciating what we do. We have the fly-by-night vaccination clinics come here on Sunday and then leave with the money. We have the feed stores that sell vaccines and medications—and the only education they have is how to run a cash register. Then we have the so-called animal welfare clinics that will not work on anything if you cannot pay—some welfare. They send people to private practices if they have no money to take care of their animal. As I am writing this, an unknown person who I have never seen came in a handed me $100.00 bill. We asked what that was for and he said it was in appreciation for what we do. That has never happened before, so maybe there is a glimmer of hope for us wore-out and broken-down veterinarians. Thank’s again for your article. It was spot on.

Response from a female veterinarian: When I graduated in 1994, I was told of the need for veterinarians in agriculture. I grew up on a livestock farm, and upon graduation, I went to a practice in rural Nebraska. As long as I was employed by a male veterinarian, life was good, I was accepted. But when I bought the clinic, the complaints started. "I'd rather my cow die than be treated by a woman!" Our area was, and still is, male chauvenistic. Rural areas are far behind cities for acceptance of change. I found that farmers would spend 3x the money to have a male work their cattle than a woman. In short, my clinic, that once served the whole county, closed. Farmers were content to drive an extra 25 miles so a man could work on their cattle. I just wanted you to realize there was another reason for the lack of vets in rural areas. I know of at least four other women veterinarians in neighboring areas that were pushed out because of male chauvenism.

Response from a livestock producer in Nebraska: I read your article on rural DVMs and found it very informative. We have a local vet clinic that employs 12 vets. They now have a monopoly, as we lost our hometown vet a couple of years ago. As a small 150-head cow/calf operation, I now find myself being over charged and under served. Large operations get all the price breaks on medicine and services. I gained a lot of understanding from your piece until we got to #13, your final part, when you stated that farmers who complain about the cost may wake up to no vet at all. I know vets have a large investment in schooling, but I have a large investment in my livestock and equipment. The producer possibly spent 3 hrs with that cow before calling the vet and a week with her afterward if the cow and calf did not die. If they did die, I still paid the bill and took a large loss. I chose to go into debt by buying the cows, feed, and equipment. So did the vet. This should be a working partnership. I hope the vet does not wake up some time at midnight and say, "I wish someone would call."

Response from Harlan R. Anderson, DVM, Cokato, Minnesota: I just finished reading your story “Call The Vet." Many of the concerns you indicated in your article I have shared over the years with [vet school officials]. It has been met with “you are just trying to cause trouble." I think you did an excellent job of describing the present state of large/mixed animal veterinary medicine. I started as a mixed animal veterinarian. Because I am also a fourth-generation family farmer, I evolved into a large-only veterinarian. When my practice became too much small animal, I sold it and worked on public policy as it related to farm animals. The last 20 years I have been focused on developing and researching equine nutrition. It has been the most rewarding part of my veterinary career. Veterinary medicine is the best career second to farming.

Response from Alice Allen, Al-lens Farm, E. Ryegate, Vermont: What an excellent and timely article! Now retired from nearly 50 years in the dairy business, I have to say we depended on our vets. Your article explained in great detail what our vets are experiencing! I just want to thank you for writing such a thoughtful explanation of the current situation for our rural vets -- especially our large animal practitioners. I am sending this article along to my friends in the dairy business as well as several of our local vets.

Response from Jake Streck: Thankfully, my older brother receives one of the loan grants you mention in your article. He graduated from Oklahoma State, moved to Pond Creek, Oklahoma, to work as an associate, and has recently finished building his own clinic. He does a lot of farm calls with mobile equipment, including an alley that he built himself. He travels to different parts of the state to work for some larger clients. You did a great job of describing and analyzing some of the issues our vets and farmers are facing in rural America. Growing up on the farm, my family knew the value of a good vet long before my brother received his degree. I work at the bank in Pond Creek and see the economic challenges facing our producers. There might be some scary times ahead for all of us and our way of life, but I hope I'm wrong. I wanted to let you know that I really appreciated your article. Thank you for recognizing people like my brother who work harder than most people realize to make sure animals are taken care of so that people can continue to make their living in rural areas. I hope the article gets read by a lot of people, whether they are directly involved with agriculture or not!

Response from John Huffard, Huffard Dairy Farms, Crockett, Virginia: "Call the Vet" is such a timely and informative piece. My wife is the vice president of instruction at Wytheville Community College (Wytheville,VA) and received the green light this week to offer a vet prep program which will begin this fall. The program is an associate in science with all prerequisite courses required for application to the Virginia-Maryland school of veterinary medicine located on the Virginia Tech campus. The students can apply for acceptance during their sophomore year. The local Wythe-Bland foundation will fund all tuition costs incurred for the associate degree by students of the two counties. As a dairy farm / education family it is uncanny how we  "feel" nearly every aspect of your article. We are excited this can serve the industry and our local pre-vet students.

Response from Kim Flottum, editor, Bee Culture magazine: I read with great interest your piece on vet shortages. Believe it or not, the beekeeping industry has encountered this issue without much resolution. Because of the change in status of administering antibiotics, beekeepers now need a vet inspection to OK a prescription for Terra or other medicines. Finding a vet who wants to do this has been an issue, and your article points to a lot of good reasons. 

Response from Matthew Kelly in Norfolk, Virginia, via Facebook: Great article, but I would have liked a bit more in the way of what is being done to address the problems. For instance, are states considering better funding their land grant schools, so they don't have to beg for corporate research grants and cater to their corporate needs as much? Are there innovators in the mixed veterinary field that are working out how to deal with a increasingly rarefied client base in a rural setting? And what are veterinary organizations doing to change the the ranching culture to view them as a partner and not just an operating cost?

Response from Barry Delks, coordinator of career services, animal sciences, Purdue University: Thank you for writing "Call the Vet!" Excellent article that address all the major issues students and DVMs are facing. Great information. Comprehensive and a must read for all pre-vet students. I have worked with prevet students for decades – started in 1982. I will share this with my 650 undergraduates students (88% come in as pre-vet as a freshmen). I will also send a copy to department heads, deans, and academic advisors. Important issues to talk about! Thank you for writing this article.

Response from Jessie Webster, Amarillo Economic Development Corporation: Texas Governor Greg Abbott’s state budget allocates $17.35 million in operational funding for the Texas Tech University School of Veterinary Medicine in Amarillo. This program will address the state’s growing need for veterinary medicine, especially large-animal veterinary services for rural Texas. A significant portion of the High Plains economy is built upon the agricultural economy, but 75% of the state’s veterinary workforce is supplied by programs outside of Texas. This shortage will only get worse, as 40% of Texas’ rural veterinarians are over 60 and are likely to retire soon. The new veterinary school will address the critical veterinarian shortage that disproportionately effects rural Texas counties. Most importantly, this investment further supports area ranchers and producers.

Response from Chet Peterson Jr., Lindsborg, Kansas: I thought your "Call the Vet" article was most excellent. I have endowed a scholarship at the K-State College of Veterinary Medicine. In 2019, graduates came from 16 states and three countries. That meant a certain number of slots were denied to Kansans serious about wanting a career in large animal health. A veterinarian told me he had tried to hire a large animal vet school graduate for five years. He said the farm and ranch boys don't study as much in high school or the first two years in college, so their grade point is lower. When they learn how to study, they do well. My hope is that the country's vet colleges read and think about your detailed and thought-provoking article.

Response from Brian Whitlock, associate professor, University of Tennessee - Knoxville: I read your article on rural vets and very much agree with what you discussed. One thing I didn’t see mentioned that might help is a move to large animal relief vets (especially taking calls at nights and weekends). Unfortunately, unlike small animal vets, large animal vets have not taken the opportunity to utilize emergency services. We have a faculty member at our vet school (Meggan Graves) that does this in the Knoxville area and had it as a business in Asheville previously. By not doing emergencies in addition to working all day, I’m a happier large animal vet!

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