New developments from the American College of Veterinary Nephrology and Urology
Following our recent announcement about provisional recognition of the American College of Veterinary Nephrology and Urology (ACVNU), I promised to provide an Executive Summary to provide more detailed information about the College and hopefully to provide some clarity to those who might have interest or questions about the ACVNU. If you have additional questions, please direct them to me or any of the Founders of the College, and we shall attach your question (and answer) to the FAQ page of our website (https://www.ACVNU.org).
American College of Veterinary Nephrology and Urology: Executive Summary
On Tuesday, 08 March 2022, the American Board of Veterinary Specialties (ABVS) granted provisional recognition to the American College of Veterinary Nephrology and Urology (ACVNU) as a Registered Veterinary Specialty Organization (RVSO). With this announcement, the ACVNU became the newest specialty College of the ABVS. The realization of this milestone spans over 30 years of concept with intensive effort, planning, and redirection over the past decade. Provisional recognition authorizes immediate establishment of the College, the ability to train residents, and the authority to certify Diplomates and Associate Members in Nephrology and Urology. This Executive Summary is intended to more formally introduce the ACVNU and provide answers to some of the uncertainties about its missions and programs. Our website (https://www.ACVNU.org) will be available soon with further information and a FAQ page.
The primary objectives of the ACVNU are to promote the field of comparative and veterinary nephrology and urology (as a Specialty) and to increase the competency of those who practice in this field by:
- Advancing scientific knowledge and clinical practice of veterinary nephrology and urology through the promotion of basic and clinical investigation and communication and dissemination of this knowledge.
- Establishing standards of excellence and advancing innovative clinical practices to evaluate and alleviate diseases of the urinary system.
- Establishing training programs and guidelines for specialty education and clinical competency prerequisites for certification of clinical specialists in nephrology and urology.
- Certifying qualified veterinarians as Diplomates and Associate Members of the College in order to elevate the quality, competency, and scope of practice of the Specialty.
- Promoting continued professional development of its membership and promoting the Specialty among the scientific, professional, and lay communities.
In its petition to the ABVS, the Founders of the ACVNU incorporated several non-traditional features into its training and certifying mission to fulfil a variety of unmet needs in the profession and to advance the specialty and specialty training.
- Collectively, nephrology and urology are intersected by a broad array of clinical disciplines and specialties. To extend the depth of knowledge, clinical expertise, interdisciplinary synergism, and to meet the clinical complexity urinary disease, a goal of the College was to facilitate inclusiveness with other specialty colleges with overlapping or complimentary interest in urinary disease. To achieve these goals and meet the requisite requirements for education, training, and clinical experience, the College has established precedent specialty certification by a recognized college or clinical specialty (RVSO or RVS, respectively) or advanced clinical experience in nephrology and urology as a requirement for ACVNU residency training. Diplomates of the ACVNU also will be Diplomates of other veterinary colleges and integrate that heritage, relevance, and perspective in their advancement of urinary disease. In addition, the multi-disciplinary aggregation of these specialists into the ACVNU will serve to better integrate collaborations among these parent organizations.
The ACVNU will confer 2 certifications, but only one would be a Diplomate certification. Diplomate status is be granted to candidates who satisfy all credentialing criteria and enter the residency with a background in an approved patientcare veterinary specialty (or candidates who enter the training program by the alternative patientcare pathway). When certified, these individuals would be designated as “Specialist” in veterinary nephrology and urology. Affiliate Member status is granted to candidates who satisfy all credentialing criteria as an Affiliate Member of the ACVNU and enter the residency with a background in an approved non-patientcare veterinary specialty, e.g., pathology, clinical pathology, nutrition, etc. Affiliate Members have all the rights and privileges of membership in the ACVNU but are not designated or granted “Specialist” status in nephrology and urology.
- The education and training vision of the ACVNU also is non-traditional compared to existing specialty colleges but is creative for the evolving times and the evolving nature of the profession. Education and communication methodologies combined with advanced technologies have afforded unique opportunities and approaches for today’s trainee. Life and career requirements, educational debt, and demographics of the profession also have changed in recent decades. The ACVNU incorporates a training strategy to embrace these changes in the profession yet remain pedagogically robust and consistent with the advanced training standards of an ABVS sanctioned specialty College.
- Diversity in the breadth and depth of content and delivery of residency training by contemporary certifying boards and colleges exposes potential for diversity in the baseline expertise or competencies of specialists within a specialty beyond the objective assessment of a certifying examination. To provide a more advanced and uniform foundation in nephrology and urology for residents regardless of background or professional orientation, the ACVNU incorporates a robust didactic Core Curriculum as a unifying baseline of knowledge (anatomy, physiology, pathophysiology, diagnostics, conventional and advanced therapeutics, advanced procedures, and research) as a component of resident training. The Core Curriculum is provided as a unique “training aid” to promote a consistent foundation for specialty training to enhance mastery of the competencies expected in the Specialty. The Core Curriculum is a comprehensive course of instruction arranged into integrated topical categories (Modules) of nephrology and urology. It will provide over 250 contact hours of directed and advanced didactic instruction and require 2 years to complete. The curriculum contains a proportionate number of sessions and instructional detail for each topical area to ensure appropriate exposure to all designated job task. It is provided as a web-based classroom delivered by expert instructors throughout the world and accessible to trainees anywhere. It is designed to accommodate the constraints of differing clinic and work schedules, geographic locations, and family and life-style commitments.
- The ACVNU sought to create a clinical training strategy with the structure and foundations of traditional, directly supervised residency training programs. In addition, the ACVNU provides flexibility with an indirectly supervised, virtual training alternative to embrace invested resident candidates who cannot relocate to a traditional training center. Both training models maintain appropriate standards of an extended, supervised clinical mentorship provided in a private specialty practice or academic setting extending availability and inclusivity to a broad spectrum of trainees with interest in advanced nephrology and urology. Resident candidates for Diplomate certification will be preexisting boarded specialists in a patientcare veterinary discipline (or individuals with established clinical experience). Consequently, residents enter the training program with advanced clinical acumen, experience, clinical skills, and decision-making capabilities suitable for self-directed training. For residents in an approved residency training program with an available on-site ACVNU Diplomate, the mentoring Diplomate (Residency Advisor) will review all urinary cases managed by the resident and provide in-person instruction, supervision, and consultation. For residents in an approved residency program and no onsite ACVNU Diplomate, an off-site ACVNU Diplomate will be assigned (as the Residency Advisor) to review all urinary cases managed by the resident and to instruct, supervise and mentor the resident by distance learning technologies.
In the virtual model, residents continue to pursue their established careers and family life while simultaneously pursuing their advanced urinary training and specialty aspirations. This training model demands less reliance on pre-established (geographically distinct) training programs with established on-site training mentors. Required training facilities are consistent with contemporary multispecialty private or academic veterinary hospitals. This model does not require the training hospitals or academic centers to recruit and employ nephrology and urology experts to provide on-site training and mentorship if they are not already part of the professional staff. These features greatly extend training opportunities for directed and qualified candidates seeking Diplomate certification. Instruction on unique procedures which are not available within the ACVNU Residency Program will be provided at selected continuing educational venues or as external rotations to facilities where instruction for these clinical proficiencies can be acquired and documented during the residency period.
The ACVNU incorporates an independent training and certifying body, the American Board of Veterinary Nephrology and Urology (ABVNU), constituted to administer, oversee, and regulate residency training and certification of candidate Diplomates and Affiliate Members of the ACVNU. The ABVNU is responsible for all matters related to resident training including the registration of resident candidates, approval of residency programs, review and approval of all residency training requirements, examination of candidate Diplomates and Affiliate Members, and certification of ACVNU Diplomates and Affiliate Members. It is governed by an Executive Training Committee, and all requirements for residency training and candidate certification are detailed in a Certifying Manual.
Resident training must occur in an ABVNU-approved Residency Program that contains the minimum training requirements established by the ABVNU and specifies how those requirements are to be met. A registered Residency Program is intended to prepare Residents for ACVNU board certification by providing training, supervision, research opportunities, didactic education, and clinical experience in nephrology and urology. The Residency Program is supervised by an ACVNU Residency Advisor (and optional Co-Advisor), a Residency Advisory Committee and must provide adequate diagnostic and therapeutic facilities consistent with current standard of specialty care for medical and surgical practice as well current standards for specialty care in nephrology and urology and access to the scientific literature.
There are 3 distinct pathways for acceptance into the ABVNU Residency Training:
- A resident candidate seeking ABVNU residency training leading to Diplomate certification must be accepted into an ABVNU-approved Residency Program, be a graduate of an accredited School or College of Veterinary Medicine, and concurrently certified by a recognized veterinary Specialty College promoting advanced clinical patientcare in a medical or surgical discipline.
- A resident candidate seeking ABVNU residency training leading to Affiliate Member certification must be accepted into an ABVNU-approved Residency Program, be a graduate of an accredited School or College of Veterinary Medicine, and concurrently certified by a recognized veterinary Specialty College of a non-patientcare discipline.
- A resident candidate seeking ABVNU residency training leading to either Diplomate or Affiliate Member certification who is notconcurrently Board-Certified in a patientcare or non-patientcare discipline must be accepted into an ABVNU-approved Residency Program, be a graduate of an accredited School or College of Veterinary Medicine, and have at least four (4) full-time equivalent years of focused patient-care experience (resident working toward Diplomate status) or a non-patient-care experience (resident working toward Affiliate Member status) in nephrology and urology documented within 10 years of application for the residency. Full-time equivalency is the collective percentage of professional time and experience devoted to nephrology and urology. It represents categories of activity related to urinary disease including clinical effort, specialized training, research, teaching/mentoring, continuing education, advocacy, leadership, journal review, and other activities related to the discipline. A documented publication record including authorship of relevant scholarly works in nephrology and urology resulting from clinical investigations or basic research in the discipline, and documented contribution to the promotion, direction, and advancement of the specialty contribute to the full-time equivalency.
Recommendation for certification of a resident candidate is established by the ABVNU upon successful completion of all training and examination requirements and documentation of clinical proficiencies. Certification as a Diplomate or Affiliate Member is conferred by the Executive Board of the ACVNU upon the recommendation of the ABVNU.
Establishment of the ACVNU provides an advanced level of expertise in urinary disease for the primary management, consultation, or referral of patients with needs beyond the capability or interest of other professionals. The establishment of all specialty organizations have advanced the sophistication, scientific foundations, quality, and the recognition of the profession in addition to the delivery of improved veterinary healthcare. The American College of Veterinary Nephrology and Urology now joins the contributions of these existing Specialties to further advance our beloved profession.
Larry D. Cowgill, DVM, PhD, Dipl. ACVIM (SAIM)