Understanding experiences: A key element in the retention of cattle veterinarians

A key element in understanding the concerning trend of attrition in rural veterinary practice is to appreciate the potential factors driving this behavior. Recent graduates in rural veterinary practice face numerous challenges derived from a variety of experiences. In this session, thought will be given to the challenges and opportunities encountered in rural practice, which were identified through in-depth interviews of recent graduates


Introduction
Recruitment and retention of veterinarians in food animal practice is a complex topic with far-reaching implications.The veterinary profession, along with the livestock agriculture industry, has maintained deep interest in this topic given the public recognition of a perceived shortage of food animal practitioners.This is an alarming issue due to the critical role of food animal veterinarians in ensuring a safe, secure food supply for consumers globally.Recruitment and retention of veterinarians in food animal practice has many characteristics of a complex adaptive system including numerous stakeholders, difficulty in identifying viable solutions, chronicity, and many more.Adding to the level of complexity is the delay in feedback following the adoption of a proposed solution.A decade or more may pass before fully appreciating the unintended consequences resulting from a change in the system.Additionally, poor understanding of interconnected relationships drives one's inability to identify high leverage interventions and generate meaningful change.An important exercise to begin studying a topic of this nature is termed "admiring the iceberg".A portion of this exercise is geared toward gaining a deeper understanding of the current reality of food animal practice.
According to the American Veterinary Medical Association (AVMA) 2023 Report on the Economic State of Veterinary Profession and AVMA membership statistics, the number of veterinarians in private practice has consistently increased over the past 8-10 years.However, the number of veterinarians active in food animal practice has decreased steadily during this same timeframe (Figure 1).In addition, membership data obtained from the American Association of Bovine Practitioners (AABP) revealed attrition of recent graduates who failed to maintain membership 5 or more years following graduation.The trends mentioned above lead to central, focusing question: "Despite an increase in total veterinarians engaged in clinical practice over the past 10 years, why does there appear to be a decrease in food animal veterinarians?".
To begin examining this question, it is vital to further evaluate the underlying structure driving the abovementioned behaviors (trends).Previous research explored the various factors causing veterinarians to leave rural veterinary practice.Villarroel and others collected responses from 805 veterinarians currently or previously employed in rural veterinary practice.Top reasons cited for leaving rural veterinary practice were emergency duty, time off, salary, practice atmosphere and family concerns.Grotelueschen and colleagues provided perspective on the attrition of beef cattle veterinarians by incorporating systems thinking, a discipline commonly applied when facing complex issues.According to the authors, attending to the needs of students and new graduate beef cattle veterinarians is a key leverage point.Partnering with colleagues in organized veterinary medicine provided an opportunity to ascertain the experiences of recent graduates in bovine practice.

Materials and methods
A qualitative assessment was conducted to investigate the challenges experienced by recent graduates in bovine practice in the United States.Focus groups were organized to stimulate indepth responses through a series of questions.The aim of this effort was to better understand reasons why recent graduates remain in bovine practice and reasons why one might consider leaving bovine practice.In total, 23 recent graduates (< 8 years in practice) participated in 1 of 3 separate focus groups.Stem questions were developed from an initial pilot focus group to guide the in-depth interviews.All focus group sessions were recorded, anonymized and transcribed for full coding and thematic analysis.Practice types represented included exclusive dairy (n = 1), bovine consultant (n = 1), industry (n = 2), bovine predominant (n = 6), and mixed animal (n = 13).Regarding gender, 14 females and 9 males participated.

Results and discussion
A central theme emerged from questions related to reasons for remaining in bovine practice.Recent graduates expressed a deep, emotional connection to their work and profound respect for their clients.A strong sense of professional fulfillment and overall enjoyment for their work was clearly articulated.One participant stated, "I find the clients to be incredibly rewarding.And the people who care for these animals are very near and dear…They are appreciative, they are humble, and they care for me…".
Major themes identified from the analysis regarding reasons to leave bovine practice were health preservation, work-life balance, a sense of isolation, need for mentorship, and gender inequities.Many participants had already sustained physical injuries related to their careers.One recent graduate noted, "Obviously, the injuries would cause you to potentially leave or at least look under other areas, industry or something like that."Poor work-life balance was a concern for many, intensified by a high percentage of time spent covering emergency services.Factors contributing to burnout are of major concern provided the cost of burnout is highest among food animal practitioners.A sense of isolation in rural communities was a shared challenge for several recent graduates.Paired with an inability to find appropriate housing and job opportunities for significant others, feelings of isolation left participants seeking community in rural settings.One recent graduate commented, "I'll add one.And that's that, it can be really isolating.Nobody tells you that part."The need for mentorship was expressed as a potential reason for leaving bovine practice.Recent graduates discussed the importance of mentorship for early career success and recognized the need for clear communication to set appropriate expectations.Gender inequities revolved around lack of ownership opportunities for female associates and poorly defined or absent policies for maternity leave.Unsurprisingly, the challenges experienced by recent graduates correlated to reasons stated for potentially leaving bovine practice.
The findings from the current qualitative assessment were not quantified, therefore, comparisons to previous research for ranking purposes is not possible.Additionally, a more robust sample size is needed for adequate data to quantify and rank factors.Regardless, the factors discovered in this assessment parallel previous research.Specifically, poor work-life balance resulting in burnout, lack of mentorship, gender inequities, and isolation (location) are recurring themes.

Conclusion
Recent graduates participating in a qualitative assessment articulated a deep passion for agriculture, the cattle industry and their clients.Major concerns encountered in their early practice careers included health preservation, work-life balance, isolation in rural communities, lack of mentorship, and gender inequities.It is incumbent upon the food animal veterinary profession to foster the passion portrayed by recent graduates.Opportunity exists to identify high leverage interventions to better position recent graduates for success in bovine practice.Additional effort should be geared toward promoting the health and safety of food animal veterinarians.The role of mentorship may be addressed through traditional and non-traditional relationships such as peer-to-peer mentoring.Additionally, peer networks foster a sense of togetherness, which may reduce the feeling of isolation in rural communities.Intentional feedback and open communication of expectations will stimulate the dialogue necessary to positively integrate professional work with the demands of personal life.Veterinary organizations must maintain a leadership position to influence the change necessary to sustain our profession beginning with recruitment and retention of veterinarians in bovine practice.

Figure 1 :
Figure 1: AVMA membership statistics demonstrate a decline in food animal veterinarians.