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The Future of Veterinary Medicine

Educational Session II

Friday, March 14, 2014, 1:30 p.m.–5:30 p.m.

1:30–1:45 p.m. Veterinary Public Health Degree Programs: Assessing and Comparing Organization, Implementation, and Design
Joann Lindenmayer, Tufts University
Miranda Hillyard, Friendship Hospital for Animals

Veterinary public health degree programs, including joint DVM-MPH degree programs, are gaining popularity worldwide and are growing both in number and participation. In order to assess the roles played by the veterinary medical profession in the development, organization and implementation of these programs, we conducted interviews with leaders of 14 veterinary public health degree programs in North America in 2010. We defined veterinary public health degree programs as DVM-MPH joint degree programs, MPH degree programs at universities that also house a college of veterinary medicine, or any degree program with specific veterinary public health content, such as a Master of Veterinary Public Health or Master of Preventive Veterinary Medicine. Topics covered included program vision and design, administrative home, student recruitment, student body, type of program, curriculum content, capstone project, relationship to public health agencies, logistics, funding support, career services, outputs, outcomes and impacts. Preliminary results show that while joint degree programs vary widely in their organization and implementation, all veterinary public health programs seek to include veterinary specific content without compromising education in basic public health concepts. Results provide a useful assessment that can be utilized by new and existent programs alike to develop and refine their veterinary public health programs.

Veterinary Public Health: Beyond Zoonoses
Michael McGuill, Tufts University

When veterinary medical colleges consider the meaning of veterinary public health, they often consider zoonotic diseases as the primary and sometimes, exclusive, component of that discipline. Courses and curricula are developed with this in mind. When this happens, we deprive future clinicians and DVM-MPH practitioners of a full understanding of their actual and potential roles as veterinary public health workers. We wish to broaden the conversation about veterinary public health beyond this limited scope of areas most commonly assumed to be of primary concern. 

In 1994, the Centers for Disease Control (CDC) developed a document to define and guide responsibilities of public health systems. The “Ten Essential Public Health Services” document provides a broad understanding of public health roles, though its focus is human, not veterinary, public health. The ten services are: surveillance, investigation, education, action, policy development, law enforcement, service, especially to underserved communities, training, evaluation, and research.

In developing the Public Health and DVM-MPH curricula at the Cummings Veterinary School, we have re-interpreted the ten services for veterinary public health in an international and interdisciplinary context. We have developed a curriculum and courses with the ten services in mind, and have introduced students to veterinarians serving in all ten services. In our session, we will discuss this broader definition, its relevance to veterinary clinicians and veterinary public health workers, how it may be incorporated into veterinary public health curricula and lessons learned from our experiences that may be used to inform other such educational efforts. 

1:45–2:00 p.m. The Benefits and Challenges of Developing a Practice-based MPH Program within a Veterinary School: The Case of the University of Guelph’s Solid Beginning and Bright Future
Cate Dewey, University of Guelph

The University of Guelph Master of Public Health (MPH) program was created in 2008 to respond to the need for graduate-level trained professionals to work in the public health sector. The Ontario Veterinary College of the University of Guelph embarked on developing a program that would focus on the human-animal interface of public health, a unique position within Canada. The program was developed on existing strengths within the Ontario Veterinary College including epidemiology, infectious disease, environmental public health, and public health policy and administration. A major component of this program is a practicum placement. The main teaching philosophy is to use cased-based and practice-based learning where possible. As the program entered its fifth year of delivery, an outcome assessment grounded in the Core Competencies for Public Health in Canada was conducted to determine whether graduates are receiving adequate public health training and meeting a societal need, as well as to identify areas for program enhancement. A curriculum map of required courses, and an online survey distributed to graduates of the University of Guelph MPH were the main components of the program assessment. Results showed University of Guelph MPH program graduates are very pleased with their experience, and are confident in their knowledge and ability to enter the public health workforce. The core curriculum provides graduates with training in the core competencies to the expected level. Elective courses enhance the student knowledge of the core competencies, provided they maintain a strong relationship to public health. The practicum experience is highly valued by program graduates and considered a strength of the program. Recommendations for amendments to the program include a greater focus on program evaluation and on increased integrated learning within public health practice, where possible. Future plans include having students work with public health agencies to develop and implement public health programs.

2:00–2:15 p.m. Public Health Inclusiveness: Multi-Faceted One Health/Public Health Education for Undergraduate and Veterinary Students at Auburn University
Stephanie Ostrowski, Auburn University

The Auburn University (AU) College of Veterinary Medicine (CVM) engages both undergraduate and veterinary students in the issues, programs, and services that constitute One Health/ Public Health.  The Public Health Association (AUPHA) includes undergraduate students and veterinary professional students interested in public health.    The Undergraduate Minor in Public Health ( ) was established in 2010; to date 40 students have been enrolled and 14 undergraduates have earned the Public Health Minor. Required core courses—Introduction to Public Health, Introduction to Epidemiology, and Global and Comparative Health Systems—are offered during Summer Session    Guest lecturers include faculty from the Colleges of Business, Education, Engineering, and Liberal Arts, and the School of Nursing, as well as the Centers for Disease Control and Prevention (CDC).  All Public Health minor students complete a 40 hour service learning practicum and submit a 10 page report which describes their service learning activities and reflects on the transformative aspects. “Veterinary Public Health Career Day” at Auburn highlights public health career pathways available to veterinarians, with talks by AU-CVM alumni who work for state or federal public health agencies, or the military. Second-year veterinary students receive 50 hours of lectures on zoonotic diseases, food safety (pre- and post- harvest), public health, and environmental health. First, second, and third year veterinary students may elect one-credit courses in Epidemiology and Statistics, Emergency Response/ CCERT, and Wildlife Disease Management.  A 2-week clinical elective in Epidemiology/ Public Health is available to fourth year students.   AU CVM has a formal agreement for an articulated five-year DVM-MPH degree with the Master of Public Health (MPH) program at the University of Alabama – Birmingham (UAB), and is exploring on-line MPH options for AU veterinary students who wish to graduate with both the DVM and MPH degrees.

2:15–2:30 p.m. Flooding the Market or Empowering for Success? Delivery and Outcomes of a Flexible Public Health Training Program for Veterinary Students
Larissa Minicucci, University of Minnesota

Workforce reports document a continued demand for veterinarians with public health training. Veterinarians play a critical role in public health, especially as it relates to food safety and zoonosis prevention/control. A focus on One Health has expanded opportunities for veterinarians in areas such as disaster response and preparedness, ensuring food safety across systems, environmental stewardship, and facilitating the human-animal bond. Students enrolled in DVM programs in the United States receive a median of 60 hours of public health, epidemiology, and preventive medicine in their curricula. Training programs to develop veterinary leaders in emerging diseases, terrorism preparedness, and the human-animal interface with a focus on communication and interdisciplinary teamwork are necessary. This presentation will describe the design of the DVM/MPH program at the University of Minnesota, document program demand, and highlight program features, identified by students in a survey evaluation, that foster feasibility and success. The program is unique in that students can complete the MPH concurrently with their DVM degree utilizing a combination of in-person and distance courses. 

2:30–2:45 p.m. Risk Assessment of Canine Influenza A Viruses to Public Health
Sherry Blackmon, Mississippi State University

In addition to being one of the major causes of respiratory diseases in humans, influenza A viruses (IAVs) naturally infect birds, pigs, horses, sea mammals, and have recently emerged in dogs. Two subtypes, H3N8 and H3N2 IAVs have emerged in canine populations in North America and Asia, respectively. The H3N8 canine influenza virus (CIV) has been shown to be of equine origin, whereas the H3N2 CIV was of avian origin. In addition, canine population was demonstrated with seraconversion to both 1968 H3N2 and 2009 H1N1 IAVs. IAVs evolve rapidly via mechanisms of antigenic drift and antigenic shift, or the reassortment of a segmented genome by co-infection of two or more IAVs in the same host. Recently a novel H3N1 CIV was reported to with H3N2 CIV and NA gene from 2009 H1N1 virus, posing the potential risk of emerging reassortants among CIVs and 2009 H1N1 IAVs, which has been circulating as a human seasonal influenza virus. This study is to assess the risk of H3 CIVs as well as co-circulation of 2009 H1N1 IAVs in human and H3 IAVs in canine to public health. Serological assays using ferret generated anti-sera demonstrated that both H3N8 and H3N2 CIVs are antigenically distinct from contemporary human H3N2 viruses, suggesting currently there is no human herd immunity to the CIV H3 subtypes. Ferrets infected with H3N2 CIV developed rhinitis and bronchiolitis, a result consistent with tissue viral loads. We generated six reassortant viruses using reverse genetics techniques. The replication kinetics of two of the reassortant viruses was compared to their wild-type CIVs, respectively, in MDCK cells and in human alveolar epithelial (A549) cells. These reassortant CIVs replicated to significantly higher titers in vitro than the wild-type CIVs. Our results demonstrated that canine influenza viruses pose a potential threat to public health.

2:45–3:00 p.m. The Auburn University Research Initiative in Cancer (AURIC): A Model of Breaking Down Walls in Cancer Research
Bruce Smith, Auburn University

The interdisciplinary Auburn University Research Initiative in Cancer (AURIC) was established on January 1, 2013. AURIC now numbers over 70 members from across the Auburn University campus (5 colleges) as well as members from other institutions, and AURIC continues to grow. With over $3 million in aggregate funding from the State of Alabama, the program has aggressively supported research through a variety of programs. These include first graduate fellowships in cancer research, seed grants ($20K each), MRI focused grants ($100K each) major grants ($200K each) as well as a number of smaller programs such as supporting summer fellows and travel to research meetings. AURIC members were awarded approximately 3 million dollars in new extramural funding in the program’s first year, including grants to Engineering, Pharmacy and Veterinary Medicine. New clinical trials for bone cancer and two types of skin cancer (melanoma and mast cell tumor) have been started at the College of Veterinary Medicine. Partnerships have been formed internally with the Auburn University MRI Research Center (AUMRIRC) and externally with universities, research centers and the biotechnology and pharmaceutical industry. Planning is underway for a major scientific meeting on cancer and One Health approaches to be held in 2014 that will bring together many of the top research scientists in the field. The creation and growth of AURIC will be discussed as well as strategies to leverage funding for such programs. Approaches to exploit strengths in often disparate fields and channel these into collaborative interdisciplinary projects will also be presented. 

3:00–3:15 p.m. Navigating the One Health Obstacle Course in an Academic Setting
Carolyn Henry, University of Missouri

This session will highlight three programs offered at the University of Missouri that serve as examples of innovative interprofessional training programs. The lessons learned during programmatic development and the challenges that remain as we embrace a One Health-centered approach to education and translational research will be discussed. The first program to be highlighted is Mizzou Advantage, a strategic initiative fostering collaboration in and across four target areas: Food for the Future, Sustainable Energy, Media of the Future, and One Health/One Medicine. Facilitators for each of the four areas are appointed by the Provost and work together to create and support multidisciplinary networks that capitalize upon unique institutional strengths and eliminate a more traditional “silo” approach to academic research and education. The second will be the Biodesign Program, which teams an MBA, an MD, and an engineer for a year-long post-graduate fellowship in biomedical innovation and product development for human and veterinary medical applications. The third is the Michael C. Perry Oncology Fellowship, which provides an MD oncology fellow from the Ellis Fischel Cancer Center with the opportunity to participate in a rotation on the oncology clinical trials service at the Veterinary Medical Teaching Hospital, attend the Veterinary Cancer Society Annual Conference with oncologists from the College of Veterinary Medicine, and present a seminar about their experience at Hematology/Oncology Grand Rounds at the School of Medicine. Through these three examples, we will explore the benefits, obstacles, and needs related to developing educational and research programs that truly advocate a One Health approach to real-world problems.

3:15–3:45 p.m. Break

3:45–4:30 p.m. Building Ecosystem Health Capacity in Veterinary Medicine
Katey Pelican, University of Minnesota
Jonna Mazet, University of California, Davis
Lonnie King, Ohio State University
Dominic Travis, University of Minnesota
Mark Stetter, Colorado State University
Tracey Lynn, U.S. Department of Agriculture
Andrew Tamale, Makerere University

Ecohealth remains one of the most attractive career paths for many veterinary students interested in One Health approaches. Complex environmental challenges like climate change, burgeoning mega-cities, and decreasing biosecurity are compelling and their relationship to human and animal health are headline news. The relevance of veterinary medicine to ecohealth challenges appears self-evident to many current students. Although Ecosystem Health is becoming a relatively well-known concept in veterinary medicine, it suffers from a lack of strategic direction in academia. In addition, there is no obvious career track available, with many ‘practitioners’ forced to carve a path through a creative combination of experience, networking, and further post-doctoral training.  The University of Minnesota College of Veterinary Medicine has been engaged in developing an Ecosystem Health Initiative for the past seven years.  This initiative is focused on developing education, research, and service capacity and partnerships at local, national, and global levels.  All of these efforts are aligned with the larger University mission aimed at exemplifying the idea of becoming a “Global Land Grant” University Model. This panel discussion will focus on the Minnesota experience in (1) understanding the job market; (2) program development; (3) ecosystem health scholarship (research, education and service); and formulating partnerships that create tangible career paths, all through tangible examples of Ecosystem Health Scholarship in action.

4:30–4:45 p.m. Accidental One Health: the Unexpected Opportunities, Rewards, and Challenges of Collaboration
Andrew Specht, University of Florida

The University of Florida College of Veterinary Medicine is fortunate to host a colony of dogs with glycogen storage disease type Ia (GSDIa) as part of a unique interdisciplinary research program. The research team includes veterinarians, physicians, and scientists as well as a large number of students including undergraduates, graduate students, and veterinary students. The primary overall purpose of the research is to utilize a large animal (canine) model of GSDIa to develop a gene therapy protocol for translation to clinical trials in human patients. When I first joined, I did not expect any significant potential contributions to animal health. The goal of this session is to use my experiences as one of many people involved in helping establish and maintain this interdisciplinary team to illustrate some of the opportunities, rewards, and challenges that are intrinsic to, or can develop from, a project when participants are willing to embrace a One Health perspective. In addition to the research mission, the interdisciplinary nature of this project has provided opportunities for education of students and house officers from different departments. 

4:45–5:15 p.m. Systems Biology and Unconventional Animal Models as Tools in Basic and Applied Research within a One Health Theme 
Camilo Bulla, Mississippi State University

Veterinary and agricultural researchers are beginning to embrace systems biology and high throughput data sets (for example, sequencing mRNA and microRNA and proteomic analysis) for identification of biomarkers of disease, generation of hypotheses for new basic research, and identification of potential molecular targets for new drugs. We will describe a few examples in which our researchers have conducted work of this type and obtained results of interest.  Examples include the use of proteomics to characterize protein expression in horses with Summer Pasture Associated Obstructive Pulmonary Disease, which may be an excellent model for asthma in humans; development of a bovine model for mastitis; a mouse model for the association between a zoonotic infection and schizophrenia, proteomic analysis of canine platelets; annotation of ubiquitinases and de-ubiquitinases in the chicken genome; and characterization of the genetic changes and environmental conditions associated with influenza outbreaks. With the goals of reducing, refining, and replacing animals in research, using animals at the lowest possible phylogenetic level is encouraged. Fish species are becoming more popular as animal models of human disease and in routine toxicology assessments. They offer many advantages in addition to low phylogenetic status, and work will be presented demonstrating the utility of fish models in vaccine development, in neuroscience research, and aquaculture fish species, and the potential use of small, rapidly breeding fish species as animal models of diseases in aquaculture species. This overview of recent studies at one College of Veterinary Medicine illustrate the potential value of the One Health approach for improving animal and human health.

5:15–5:30 p.m. Teaching Scientific Information Literacy Skills to Veterinary Students: The Missing Link
Judy Klimek, Kansas State University
Elizabeth Davis, Kansas State University

Veterinary students need skills to filter the cornucopia of available information, both during and after their training. Evidence-based medicine is a concept that is well-rooted in human medical training, and is filtering into veterinary medical education, but specific training in information literacy, key to practicing evidence-based medicine, is seldom provided in veterinary curricula. Our elective course aims to teach students to find and critically evaluate relevant literature for improved clinical and academic decision-making, increased confidence with scientific literature, and hopefully inspiration for some to pursue academic careers. Participants in this session will learn how the course was structured and evaluated; learn how an interdisciplinary approach was utilized involving faculty from the clinics, basic sciences, and library; see examples of course assignments and projects; and take away practical suggestions for designing such a course.

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