EDUCATIONAL QUALIFICATIONS OF

EDUCATIONAL QUALIFICATIONS OF PUBLIC HEALTH VETERINARIANS 1. General Scope of the Field Veterinary medicine has made many important contributions to the health of man. Our civilization has profited greatly from the recognized work of such scientists as Koch, Pasteur, Curtice, Kilbourne, Smith, Loeffler, Frosch, Bang, Hall, and Mohler. Their research in the field of veterinary science which was begun with imagination, conducted with industry and persistence, and followed to logical conclusions, has paved the way for many new means of protecting and impi;oving the health of human beings. Analysis of their work in the early identification of bacteria and viruses, in the initial development of protective vaccines, in the recognition of arthropods as vectors of disease, in the development and application of practical diagnostic tests using antigens, in the development of methods to treat and control parasites common to man and animals, and in the development of improved methods and higher standards for meat and milk hygiene, reveals the scope and magnitude of the work and the resulting effects on our health and well-being today. Today, as in the period of these accomplishments, multiple problems are associated with preventive medicine. The fact that most disease agents may affect or reside in several host species, and that this may be accomplished by the organism selectively adapting itself to new hosts, indicates that these problems can- Approved by the Governing Council of the American Public Health Association October 30, 1958, on recommendation of the Committee on Professional Education. This report is a revision of a Report on Educational Qualifications of Public Health Veterinarians approved by the Governing Council on October 31, 1951, and is intended to supersede the earlier reporl not be solved on a single host basis, nor can they be arbitrarily segregated into areas of human or veterinary medicine. To state that a disease affects only one species of animal or that a disease of animals does not affect man is to ignore the modern concept of disease ecology and prevention. The host-parasite relationship and the selective adaptations of disease agents to new hosts is dynamic rather than static. There is always the probability that future discoveries will alter present concepts of disease and health. The list of diseases capable of affecting both man and animals continues to grow. The epidemiological findings, the diagnostic tests and protective biologics for zoonoses, and the proved and established control measures for certain livestock diseases have resulted not only in the provision of an abundant supply of foods and animal products, including pharmaceuticals for man, but also in controlling and reducing the incidence of many of the zoonoses, e.g., anthrax, brucellosis, tapeworms, tuberculosis. Through the reduction of disease in the animal population, efforts of veterinary medicine are helping to reduce the opportunities for animal diseases to be transmitted to the human population. Examples of this work include the reduction of bovine tuberculosis in the United States from 5 per cent in 1918* to 0.15 per cent in 1957 and the current nationwide program in the eradication of brucellosis which has reduced the occurrence of this disease in cattle from 11 per cent in 1935 to an estimated 0.66 per cent in 1957. * Many counties in northern United States had infection rates that ranged from 25 to 50 per cent. In the South and the West the rate was 1 to 2 per cent. JANUARY, 1959 113

Research in the field of veterinary medicine is furnishing and w-ill continue to furnish information that wvill provide newv approaches and new procedures, for future programs of preventive medicine and the protection of human health. I. Future Outlook The field of veterinary public health and comparative medicine offers many opportunities in public service and research. Health officers have recognized the contributions to be made by public health veterinarians and are integrating their services with public health programs. While challenges in the field of communicable disease control are being met with ever greater vigor and success, many problems still exist, especially among the zoonoses. Questions are still unanswered regarding rabies, toxoplasmosis, Q fever. psittacosis, leptospirosis, to mentioni a fewv specific diseases. In addition there is opportunity for research in the field and in the laboratory with the newlv recognized influenza-like enteroviruses anid myxoviruses which are found in both man and animals. There are other important areas besides the zoonoses to which the veterinarian is prepared to make valuable contributions. Among these are studies on the effects of air pollution on both animals and man in the same rural and urban environments. It is possible that air contaminianits produce the same pathologic changes in animals as in mnan and that animals may, in effect, serve as sentinels for the presence of nloxious substances. Similarly this would be applicable to radiological fallout problems. Certain biologic effects of fall-out detection have already been demonstrated in animals and animal products. such as milk. Continued -igilance for increased levels of radioactivity in animals is of immediate concern to public health. Because of his broad professional training including radiology the veterinarian qualifies for further training in radiation health. The civilian use of radiobiology in the control of animal diseases and in the preservation of food is a new development which will be of especial concern to the public health veterinarian. Radiobiologic projects already include trichina sterilization, and the processing of certain foods. Civil defense agencies also find a need for veterinary services in many areas. Veterinarians and members of other professions who specialize in food hygiene have raised many questions about the indiscriminate use of additives in food without prior evaluation of their effects on human health. This is a public health problem that challenges the specialist in food hygiene. Meat and poultry hygiene must also be reviewed with particular reference to the prevention of communicable disease as well as to the problem of additives or growth stimulants and the development of standards for the safety and wholesomeness of meat and poultry. Rural health programs will have an increasing need for public health veterinarians in the immediate future. Precedents have already been established by agricultural-medical groups studying health problems of our rural population. To expedite the application of new knowledge of disease control in rural areas the services of veterinary practitioners are being utilized in local health activities other than inspection programs. Though, to date, the contributions bv the veterinarian to chronic disease and geriatric programs have been limited. veterinary practitioners, veterinary research clinicians, and workers in basic veterinary sciences all have data that may be of value to these programs. This material should be compiled and made available to vorkers in the field. Research programs should be integrated and coordinated so as to serve both the 114 VOL. 49, NO. 1. A.J.P.H.

PUBLIC HEALTH VETERINARIANS human and veterinary aspects of chronic diseases and geriatrics. This area will no doubt develop rapidly and will require special attention from veterinary public health workers. As veterinarians in the field of public health become more experienced they are eligible for higher level administrative positions in health departments. This has been recognized and the future should present more such opportunities. Ill. Functions of Public Health Veterinarians The public health veterinarian is responsible for that field of activity which protects and advances the health of man by utilizing the knowledge and resources concerned with the interrelationships of animals and human health. His sphere of activity includes the planning, conducting, supervising, and coordinating of community efforts for the improvement of health and well-being of man. The public health veterinarian's efforts are directed toward improvement of public health by application of his professional knownledge in coordination with other public health competencies. The public health veterinarian is responsible for a broad variety of functions which depend on the problems of the area and the scope of the agency with wvhich he is associated. The functions listed below are illustrative of some of his activities and responsibilities at the local, state, or federal level. Any one position may not include all these functions nor will all functions necessarily be listed. The functions include: 1. Promotion of veterinary public health activities in urban and rural env-irons to prevent and control those animal diseases that are transmissible to man by direct contact, indirectly through food products, or by insect vectors. 2. Consultative and field assistance in health administration to obtain the maximum professional coiitribution of veterinarians in the areas of public health relating to veterinary medicine. For example: As a staff function the veterinarian advises the health officer and other divisions of the health department in the areas where his broad professional training in biology, medicine, and public health can be applied to the planning and development of programs. 3. The epidemiological estimation of public health dangers and problems arising from the diseases of animals. 4. Development and maintenance of animal disease reporting and statistical services for the evaluation of the danger presented by the zoonoses and of the procedures employed for their control and prevention. 5. Participation in the planning, promotion, coordination. and supervision of programs related to the inspection and hygiene of milk. meat, and other food and the application of biological principles to the production, processing, and distribution of food products. 6. Planning and participation in laboratory and research activities in the field of comparative medicine, including diagnosis, epidemiology. epizootiology, microbiology, production of biological products, and all aspects of comparative pathology. 7. Active participatioin in the definition of radiation hazards and in the planning and promotion of programs for the prevention or alleviation of radiation hazards as thev mav affect the interrelationships of humani and animal health. 8. Enlisting the cooperative participation of private veterinary medical practitioners in urban and rural community public health problems. Liaison with the veterinary medical practitioner. Prornotion of various programs such as JANUARY, 1959 115

accident prevention, selected animal disease prevention and control programs, milk and meat hygiene, and general health in the community. 9. Active participation in cooperation wvith health education personnel in the planning, promotion, and development of health education programs relating to veterinary public health activities and the public health needs in the community and participation in the development and enforcemenit of health laws and regulations. 10. Conisultation and liaison with voluntary and official organizations at local, state, and federal level, as well as enlisting the cooperation of the departments of agriculture and conservation in the prevention and control of animal diseases affecting the public health. For example: (a) Provision of consultative services to the Public Health Service, state and local health officers. and other departments of government. medical and veterinary medical practitioners. animal and food industries, universities, and the general public; (b) Cooperation wvith farm and rural orcranizations for the control of health hazards peculiar to agriculture in the improvement of rural health: (c) Consultation and liaison with agriculture and conservation departments in the prevention and control of animal diseases affecting the public health. In any program to influence and benefit the public health, both from an investigational viewvpoint and by development of feasible solutions, the ten areas of activity listed require the biological approach, the concept of group or community health. and the use of the principles of comparative medicine, pathology. bacteriology, and physiology. The veterinarian has been taught to aplproach problems in terms of the herd or the flock. and thus has been trained in the public health and preventive medical concept of considering the group or the community as a unit. IV. Educational Background and Experience of Public Health Veterinarians Professional training in veterinary medicine leading to the D.V.M. degree is a basic requisite. Preveterinary college training (two-four years) providing a background in the sciences and humanities is required for entrance to schools of veterinary medicine in the United States that are approved by the American Veterinary Medical Association. Completion of a four-year curriculum leading to the degree of doctor of veterinary medicine in a school of veterinary medicine approved by the Council on Education of the American Veterinary Medical Association is acceptable evidence of such training. Graduates of veterinary medical schools of recognized standing outside the United States may be considered acceptable. These would be considered on an individual basis. Acceptability of the training should be referred for an opinion to the Council on Education of the American Veterinary Medical Association. A license to practice veterinary medicine is required in all states and anyone entering the field of veterinary public health should have become licensed following the conferral of the D.V.M. degree. Completion of one academic year of postgraduate study in a school of public health accredited by the American Public Health Association or its equivalent is essential. Practical field experience, preferably before commencing the public health course, is desirable. This is required by several of the accredited schools of public health before a degree is awarded. Field work should provide supervised experience in disease control and eradication. or in meat, milk, and poultry hygiene in a department or service that is recognized for interstate purposes or by state health departments. Of par- 16 VOL. 49. NO. 1. A.J.P.H.

PUBLIC HEALTH VETERINARIANS ticular value is a period of supervised training in a health department to permit the candidate to determine whether he is suited for work in this field of veterinary medicine. Prior to admission to a school of public health, the candidate for a postgraduate public health degree will have had fundamental training in veterinary medicine leading to the D.V.M. degree. Therefore, his efforts should be directed toward obtaining a professional public health education. The broadening influence available in a school of public health, of contact with members of other professions, and the opportunity for exchanging ideas, are of inestimable value. This exchange of ideas and understanding of the varied professions contributing to public health work is essential if the individual public health veterinarian is to bring to bear upon an over-all public health program the technics and professional training of veterinary medicine. The training for public health veterinarians in a school of public health should include: (a) Basic and specialized fields in which instruction is of particular importance to -eterinary public health. These fields include epidemiology, bacteriology, parasitology, immunology, virology, tropical medicine, medical entomology, environmental sanitation, food hvgiene. biostatistics, and radiology; (b) Instruction in the general principles and practice of public health, e.g., public health administration and practice, public health lawvs and economics, and health education, in order that the v-eterinarian will understand and be able to contribute to the development of a comprehensive health program and to the solution of problems of the other professional groups in public health. It wvill also enable him to define his own activities more clearly. In the schools of public health in the United States, the master's or doctor's degree is conferred on veterinarians upon successful completion of the program of study. Graduate education in schools other than schools of public health, leading to a master of science, doctor of science, or doctor of philosophy degree, may be accepted in certain cases. It should be shown, however, that the major subjects of study have direct application in public health. In regard to the training of veterinarians who will be concerned primarily with research laboratory work, similar degrees in science and philosophy are the most appropriate. Such training may be obtained in some of the schools of public health. medicine, veterinary medicine, or in the graduate schools of the larger universities. An adequate period of full-time practical experience in increasingly responsible positions constitutes an essential part of the education and training of the veterinarian if he is to assume the direction of a veterinary public health program. In this connection. public health veterinarians, otherwise qualified, wvho have achieved notable success and who have had many years of full-time experience in an organized agencv. may be considered as qualified even though lacking formal postgraduate academic training. However, it is to be emphasized that an exception to the requirements of a postgraduate course and supervised field training should be made only if the candidate has actually demonstrated his ability as a public health veterinarian by at least four years of constructive service. V. Personal Qualities It is desirable that professionally trained personnel in veterinary public health, responsible for administrative practices and policies as well as relations with the public, have personal qualities that will enable them to carry out their tasks. These should include adaptability, common sense, creative ability, sound health, good judgment. leadership, alertness, and enthusiasm for the field. MIuch of the success of the director of a JANUARY, 1959 117

program of v-eterinary public health will depend on his capacity to establish favorable relationships, stimulate cooperative efforts, and earn the respect and confidence of those with whom he COMIMITTEE ON PROFESSIONAL EDUCATION PHILIP E. BLACKERBY, JR., D.D.S., Chairman BERWYN F. MATTISON, M.D., Secretary ROBERT H. FELIX, M.D. ALBERT V. HARDY, M.D. GEORGE JAMES, M.D. OTTO T. MALLERY, JR., M.D. KARL M. MASON. M.P.H. JANICE E. MICKEY, R.N. DAVID S. RUHE, M.D. CHESTER B. STEWART, M.D. WALDO L. TREUTING, M.D. RAY E. TRUSSELL, M.D. ROBERT G. WEBSTER, M.P.H. Consultant: WILSON G. SMILLIE, M.D. The Committee on Professional Education expresses grateful appreciation to the subcommittee which assisted wvith the preparation of this report. This subcommittee consists of: JAMES H. STEELE, D.V.M., NI.P.H., Chairman KARL M. NIASON, M.P.H., Referee ROBERT K. ANDERSON, D.V.N., M.P.H. W. MAx DECKER, D.V.M. MARTIN M. KAPLAN, V.M.D., M.P.H. W. T. S. THORP, D.V.M. FRANK A. TODD, D.V.M., M.P.H. ERNEST J. WITTE, D.V.M., M.P.H. This is the first of the educational qualifications reports that, according to the new procedures of the Committee on Professional Education, has been circulated for comment before publication in the American Journal of Public Health. Of more than 100 persons with special interest in the training and practice of public health veterinarians-faculty members of schools of public health and schools of veterinary medicine, members of the American Board of Veterinary Public Health, officials of the American Veterinary Medical Association, and veterinarians in state health departments-to whom the proposed report was sent, replies were received from 41. The present report was revised in the light of their comments. The Committee on Professional Education expresses its thanks to these many persons who have helped in the preparation of this report. It joins with the subcommittee in special appreciation to Robert D. Courter, D.V.M., of the Public Health Service Communicable Disease Center, and secretary, Conference of Public Health X'eterinarians. wvho was co-opted by the group as secretary to the subcommittee. National Health Survey Concepts The framework in which the National Health Survey is being conducted is described in "Concepts and Definitions in the Health Household-Interview Survev. This is a necessarv tool for those who are using the data from the health survey and drawing conclusions from them. Public Health Service Publication No. 584-A3. Gov. Ptg. Office. Washington 25, D. C., 30 cents. 18 VOL. 49. NO. 1. A.J.P.H.