The Accreditation Paradox: Does Protecting Quality Also Protect the Status Quo? (#684)
- Rick LeCouteur
- 6 days ago
- 14 min read
Accreditation matters.
It matters enormously.
When a student graduates with a veterinary degree, the public has every right to assume that the graduate has received an education that meets rigorous professional standards.
Employers need that assurance. Licensing authorities need it. Students investing years of their lives and hundreds of thousands of dollars need it.
And, most importantly, our patients need it.
Few would seriously argue that veterinary schools should simply be allowed to educate veterinarians however they choose, without external scrutiny or accountability.
But accreditation presents an interesting paradox.
The stronger a system becomes at protecting established standards, the greater the possibility that it may also protect established ways of doing things.
Quality and tradition are not necessarily the same thing.
And neither are standards and structure.
That distinction may become increasingly important as veterinary education confronts perhaps the greatest period of change in its modern history.
What Is Accreditation Actually Supposed to Protect?
At its heart, accreditation should answer a relatively straightforward question:
Can the graduates of this veterinary school become competent veterinarians?
That deceptively simple question requires scrutiny of curriculum, faculty, clinical training, facilities, research, student support, outcomes, governance and resources.
In the United States, that responsibility rests with the American Veterinary Medical Association Council on Education.
Accreditation provides something immensely valuable:
Confidence.
It tells society that a veterinary degree means something.
But there is a subtle danger whenever a profession creates standards.
Over time, the methods historically used to achieve an outcome can become intertwined with the outcome itself.
We begin by asking:
What must a veterinarian be able to do?
Eventually we may find ourselves asking:
Does this veterinary school look sufficiently like the veterinary schools we already know?
Those are not the same question.
Arizona Just Conducted an Interesting Experiment
The University of Arizona College of Veterinary Medicine provides a fascinating contemporary example.
In July 2026, the college received full accreditation from the AVMA Council on Education.
It had begun enrolling students in 2019 and graduated its first class in 2023.
What makes this particularly interesting is not simply that another veterinary school has been accredited.
It is how Arizona chose to educate veterinarians.
Arizona did not simply reproduce the traditional veterinary school model.
Its DVM is an accelerated, year-round three-year program.
Its preclinical curriculum emphasizes active and team-based learning rather than relying primarily upon traditional lectures.
And perhaps most significantly, its clinical education uses a hybrid-distributive model. Students receive early clinical education through university resources, but their later clinical rotations occur through a network of affiliated clinical sites rather than being centered exclusively around a traditional university veterinary teaching hospital.
When the program was being developed, the university described a network of more than 250 veterinary practices participating in clinical education - from specialty hospitals to rural mixed-animal practices and zoological facilities.
Think about what that represents.
Three years rather than four.
Active learning rather than predominantly lecture-based education.
A distributed clinical network rather than dependence upon a traditional centralized teaching hospital.
And now:
Full accreditation.
That should cause everyone interested in the future of veterinary education to pay attention.
Accreditation Did Not Prevent Innovation
There is an important point here that deserves acknowledgement.
Arizona's success demonstrates that accreditation need not prevent educational innovation.
The Council on Education ultimately accredited a veterinary school that looks substantially different from the traditional model.
That is significant.
Indeed, it would be unfair to portray accreditation simply as an obstacle to change when Arizona provides evidence to the contrary.
But Arizona also raises a more interesting question.
How much further could innovation go?
And perhaps more importantly:
How difficult is it for institutions to attempt it?
There is a difference between a regulatory system that permits innovation and one that encourages it.
Universities contemplating radical educational change must inevitably ask not only:
Will this produce better veterinarians?
but also:
Will the accreditation agency accept it?
That second question can exert an enormous gravitational force.
The Safest Veterinary School Is the Familiar Veterinary School
Imagine being the dean charged with creating a new veterinary college.
You have two choices.
The first is to build something resembling successful accredited veterinary schools that already exist.
The second is to create an entirely different educational model.
Which carries greater institutional risk?
The answer is obvious.
If you reproduce familiar structures - departments, laboratories, curricula, faculty roles, clinical rotations and a teaching hospital - you can point to decades of precedent.
But if you propose something radically different, you must demonstrate that it satisfies standards developed within a profession whose existing institutions necessarily helped shape those standards.
That does not mean the standards are wrong.
It means that innovation carries an additional burden of proof.
And therein lies the paradox.
The established model has already proved that it can be accredited.
The innovative model must prove that it deserves to be.
When Inputs Become Proxies for Outcomes
This distinction becomes particularly important when thinking about what accreditation measures.
There are broadly two ways to judge an educational program.
One is to examine its inputs.
How many faculty members?
What facilities?
What clinical resources?
What curriculum?
What equipment?
What case exposure?
What support services?
The other is to examine its outcomes.
What can graduates actually do?
Can they reason clinically?
Can they communicate?
Can they perform essential procedures?
Can they recognize when they need help?
Can they use evidence?
Can they navigate uncertainty?
Can they work effectively within a veterinary team?
Can they adapt as knowledge changes?
Are they prepared for the profession they are entering?
Inputs are relatively easy to inspect.
Outcomes are much harder to measure.
But if we genuinely believe in competency-based veterinary education, outcomes should increasingly matter more than architecture.
A veterinarian is not competent because the school possessed a particular building.
The veterinarian is competent because he or she acquired the knowledge, skills, judgment and professional behaviors required to practice veterinary medicine.
That distinction sounds obvious.
Its implications are profound.
The Teaching Hospital Question
Consider the traditional veterinary teaching hospital.
For much of the twentieth century, it was almost synonymous with serious veterinary education.
And for good reason.
Teaching hospitals concentrated specialists, sophisticated equipment, researchers, residents, students and complex cases in one place.
They transformed veterinary medicine.
But the clinical world outside universities has changed dramatically.
Specialty hospitals now exist throughout the private sector.
Advanced imaging is widely available.
Large referral centers employ multiple specialists.
Emergency and critical-care facilities operate around the clock.
Primary-care practices collectively provide an extraordinary diversity of clinical cases.
Shelters, farms, government agencies, wildlife organizations and community clinics offer educational experiences that no university hospital can completely reproduce.
If these environments can provide high-quality supervised clinical education, why must the university own the building in which that education occurs?
Arizona's accreditation makes that question considerably harder to dismiss.
Its model suggests that what matters is not necessarily ownership of the clinical environment, but quality control of the educational experience within it.
That is an important conceptual shift.
Accreditation and the Innovator's Dilemma
Accrediting organizations face an unenviable responsibility.
Move too slowly, and they risk preserving educational models that no longer reflect professional reality.
Move too quickly, and they risk allowing experimentation that produces inadequately prepared graduates.
That tension cannot be eliminated.
Nor should it be.
Veterinary students are not educational guinea pigs.
But neither should we have always done it this way become an invisible accreditation standard.
The challenge is therefore to distinguish between standards that protect competence, and conventions that protect familiarity.
Every profession should periodically examine its requirements and ask:
Is this requirement here because graduates demonstrably need it?
Or because veterinary schools have historically provided it?
Is this essential to educational quality?
Or is it simply the way quality has traditionally been delivered?
Would we invent this requirement today?
Or have we inherited it?
Those questions should not threaten accreditation.
They should strengthen it.
What If Accreditation Became a Driver of Innovation?
Perhaps we have been thinking about accreditation backwards.
Instead of asking innovators to prove that their new educational models can fit within an accreditation system, perhaps accreditation could deliberately encourage institutions to demonstrate better ways of achieving clearly defined professional outcomes.
Imagine standards that said, in effect:
Show us that your graduates are competent.
Show us the evidence.
Show us that students are protected.
Show us that clinical experiences are appropriate.
Show us that faculty and clinical educators are qualified.
Show us that your outcomes are continuously measured.
And then:
Show us how you can do it better.
One school might use a traditional teaching hospital.
Another might use a distributive network.
Another might combine university referral medicine with community primary care.
Another might rely heavily upon simulation before students encounter live patients.
Another might develop regional teaching hubs.
Another might integrate artificial intelligence and virtual case environments in ways we have barely begun to imagine.
The standard would remain rigorous.
The pathway would not have to remain uniform.
That may be the distinction veterinary education increasingly needs.
Standardize the destination.
Experiment with the route.
The New Veterinary Schools Will Test the System
This question is becoming more urgent because veterinary education is expanding.
New veterinary schools are appearing, and not all of them are following the historical template.
That creates both opportunity and risk.
Some innovations will succeed.
Others may not.
That is precisely why rigorous accreditation remains essential.
But the proliferation of educational models also provides something veterinary education rarely receives:
Natural experiments.
We should study them.
Not defensively.
Not ideologically.
Empirically.
How competent are the graduates?
How prepared do employers believe they are?
How do students perform after graduation?
What clinical experiences matter most?
Which educational methods produce durable clinical reasoning?
Does distributive education produce different strengths or weaknesses from teaching-hospital education?
Does a three-year curriculum produce outcomes comparable to a four-year curriculum?
Which model costs students less?
Which is more scalable?
Which produces veterinarians prepared not merely for their first job, but for a forty-year professional career?
Those data should shape future accreditation standards.
Not tradition alone.
Arizona Changes the Conversation
The significance of Arizona's full accreditation therefore extends beyond Arizona.
The college has demonstrated that a veterinary school can depart substantially from the historical model and still satisfy the profession's accrediting body.
That is good news for veterinary education.
But it should not end the conversation.
It should begin one.
Because once we accept that there can be more than one legitimate model for educating veterinarians, an obvious question follows:
How many other assumptions are actually negotiable?
Four years?
The lecture?
The academic department?
The clinical year?
The teaching hospital?
The geographical campus?
The distinction between university faculty and community clinical educators?
Perhaps some of these will prove indispensable.
Perhaps others will not.
But we will never know if accreditation unintentionally makes asking the question too risky.
Protect the Standard, Not the Structure
The purpose of accreditation should never be to make veterinary schools identical.
It should be to make their graduates trustworthy.
Those are profoundly different objectives.
Veterinary medicine absolutely needs accreditation.
The public deserves protection.
Students deserve protection.
Animals deserve protection.
The veterinary profession deserves protection.
But professions also need the freedom to evolve.
The challenge for accreditation in the twenty-first century is therefore not to choose between quality and innovation.
It is to make innovation prove its quality.
Arizona has now demonstrated that an unconventional model can cross that threshold.
Perhaps the lesson is larger than one veterinary school.
Perhaps the next evolution in veterinary accreditation should begin with a deceptively simple principle:
Be uncompromising about what a veterinarian must become.
Be much more imaginative about how they get there.
Glossary of Terms
Accreditation
A formal process through which an independent accrediting body evaluates an educational institution or program to determine whether it meets established standards of quality. In veterinary medicine, accreditation is intended to assure students, the profession and the public that graduates have received an education appropriate for entry into professional practice.
American Veterinary Medical Association (AVMA)
The major professional organization representing veterinarians in the United States. The AVMA is closely associated with the establishment and maintenance of professional standards across veterinary medicine.
AVMA Council on Education (COE)
The accrediting body responsible for evaluating veterinary medical education programs seeking accreditation in the United States and certain international programs. It assesses veterinary schools against established accreditation standards.
Clinical Competence
The ability to integrate knowledge, technical skills, clinical reasoning, communication, professional judgment and appropriate behavior in the care of patients and interaction with clients and veterinary teams.
Clinical Education
The portion of veterinary education in which students apply their knowledge and skills to clinical problems involving animals and clients. It may occur in university teaching hospitals, community practices, specialty hospitals, farms, shelters, government agencies and other approved settings.
Competency-Based Veterinary Education (CBVE)
An educational approach that emphasizes what graduates can actually demonstrate they are capable of doing rather than relying primarily on the amount of time spent completing courses or clinical rotations.
Distributive Clinical Education
A model in which substantial portions of students' clinical training take place at approved sites outside the university, such as private veterinary practices, specialty hospitals, shelters, farms, government facilities and community clinics.
Educational Innovation
The introduction of substantially different approaches to curriculum, teaching, assessment or clinical training intended to improve educational outcomes. Examples include distributive clinical training, simulation, competency-based assessment, accelerated curricula and technology-assisted learning.
Educational Inputs
The resources and structures used to provide an educational program. Examples include faculty numbers, buildings, laboratories, equipment, curriculum hours, clinical facilities and patient caseload.
Educational Outcomes
Measurable results of an educational program, particularly what students and graduates know and are able to do. Outcomes can include clinical competence, communication skills, professional behavior, licensing examination performance and preparedness for practice.
Full Accreditation
Accreditation status indicating that a veterinary educational program has demonstrated compliance with the accrediting body's applicable standards. The University of Arizona College of Veterinary Medicine received full accreditation from the AVMA Council on Education in 2026.
Hybrid-Distributive Model
An educational model combining university-based instruction and clinical experiences with substantial clinical training at external partner sites. The University of Arizona uses this approach rather than relying exclusively upon a traditional university teaching hospital for clinical education.
Natural Experiment
A situation in which different approaches arise in real-world settings and their outcomes can subsequently be compared. Different models of veterinary education provide opportunities to examine which approaches best prepare graduates for professional practice.
Outcome-Based Accreditation
An approach to accreditation that places substantial emphasis on evidence of what graduates can actually do, rather than judging educational quality predominantly through prescribed institutional structures or resources.
Practice-Ready
A commonly used term describing a graduate who possesses sufficient knowledge, clinical skills and professional capabilities to enter veterinary practice with an appropriate level of supervision. The term remains debated because no new graduate can be expected to function immediately as an experienced veterinarian.
Profession-Ready
A broader concept than practice-ready. It describes preparation not merely for the graduate's first job, but for a professional career requiring adaptability, ethical judgment, lifelong learning, communication, collaboration and the ability to respond to changes in veterinary medicine.
Simulation
The use of models, mannequins, computer-based environments, simulated clients or other techniques that allow students to practice clinical skills and decision-making without initially depending upon live patients.
Standards
The criteria against which veterinary educational programs are evaluated during accreditation. Standards are intended to establish minimum expectations necessary to ensure educational quality and protect students, the profession, patients and the public.
Status Quo
The existing or traditionally accepted way of doing something. In this blog, the term refers particularly to established structures of veterinary education that may be regarded as necessary partly because they have historically been used successfully.
Teaching Hospital
A university-affiliated veterinary hospital in which patient care, clinical teaching, specialist training and often clinical research occur together. Traditionally, the teaching hospital has served as the principal center of clinical education at many veterinary schools.
Three-Year DVM Program
An accelerated veterinary curriculum completed over three continuous calendar years rather than the more traditional four academic years. The University of Arizona College of Veterinary Medicine uses a year-round three-year DVM curriculum.
University of Arizona College of Veterinary Medicine
A relatively new U.S. veterinary college that provides an important case study in alternative veterinary education. Its accelerated three-year curriculum and hybrid-distributive clinical model differ from the traditional four-year, teaching-hospital-centered approach. It received full AVMA Council on Education accreditation in 2026.
Veterinary Teaching Model
The overall structure through which a veterinary school delivers professional education. Models may range from traditional university teaching-hospital systems to distributive or hybrid approaches involving extensive partnerships with external clinical sites.
Commentary: The Central Distinction
Standards versus Structure
Standards describe the quality and competence veterinary education must produce.
Structure describes the particular institutional arrangements used to produce them.
The central question of the accreditation paradox is therefore:
Should accreditation prescribe how veterinary education must be organized.
Or should it rigorously define what graduates must be capable of doing while allowing schools greater freedom in determining how they achieve those outcomes?
The goals of accreditation should always be:
Be uncompromising about what a veterinarian must become.
Be much more imaginative about how they get there.
References and Additional Reading
American Veterinary Medical Association (AVMA). Council on Education.Accreditation Policies and Procedures and Standards of Accreditation.
The AVMA Council on Education (COE) is the accrediting body for veterinary medical education programs in the United States and evaluates programs according to standards covering areas including organization, finances, facilities, clinical resources, faculty, curriculum, students, research programs and outcomes assessment. https://www.avma.org/education/center-for-veterinary-accreditation/accreditation-policies-and-procedures-avma-council-education-coe/coe-accreditation-policies-and-procedures-principles
University of Arizona: An Alternative Model.
U of A College of Veterinary Medicine Fetches Full Accreditation. The University of Arizona College of Veterinary Medicine received full accreditation from the AVMA Council on Education in 2026. The milestone is particularly relevant because Arizona has developed a veterinary education model that differs substantially from the traditional four-year, university-teaching-hospital-centered model. The college uses a year-round three-year DVM curriculum and a hybrid-distributive approach to clinical education. https://azvma.org/u-of-a-college-of-veterinary-medicine-fetches-full-accreditation/
Association of American Veterinary Medical Colleges (AAVMC).Competency-Based Veterinary Education (CBVE) 2.0.
The CBVE framework represents an important shift toward defining veterinary education according to what graduates should be capable of doing rather than simply what courses they have completed or how much time they have spent in training. CBVE 2.0 includes three principal components: a competency framework, developmental milestones, and entrustable professional activities (EPAs). The framework identifies nine domains of competence and 32 core competencies expected of veterinary graduates. This document is particularly relevant to the argument made in this blog because it emphasizes longitudinal assessment of graduate capabilities. It provides a useful example of how veterinary education can move from an emphasis on educational inputs toward demonstrable educational outcomes. https://www.aavmc.org/resource/competency-based-veterinary-education-cbve-2-0/
Development of the CBVE Framework.
Development of a Shared Framework for Competency-Based Veterinary Education.
This paper describes the international collaborative effort that produced the original CBVE framework. It argues that competency-based education can help ensure that veterinary graduates meet the needs of patients and society by emphasizing student-centered education and measurable professional outcomes. It provides important intellectual background to the question posed in this blog: Should veterinary education be defined primarily by the structures through which education is delivered, or by what graduates can ultimately demonstrate they are capable of doing? https://pubmed.ncbi.nlm.nih.gov/32530802/
Distributive Veterinary Clinical Education.
Distributive Veterinary Clinical Education: A Model of Clinical-Site Selection.
This paper examines the distributive clinical education model used by Western University of Health Sciences College of Veterinary Medicine. Unlike the traditional model centered upon a university-owned veterinary teaching hospital, Western University's program uses external clinical sites for substantial portions of clinical education. The paper is particularly valuable because it addresses one of the major challenges of distributive education: ensuring that external clinical sites and preceptors provide sufficiently rigorous and consistent educational experiences. https://utppublishing.com/doi/pdf/10.3138/jvme.0217-029R
Distributed Education and Spectrum of Care
Distributed Veterinary Education: How Can Veterinary Practices and Veterinary Schools Work Together to Improve Spectrum of Care Training?
This article examines the increasing use of distributed models of veterinary clinical education and their potential role in exposing students to a broader spectrum of veterinary care. It is particularly relevant to the argument that community veterinary practices may provide educational experiences - especially involving everyday clinical medicine, financial constraints and different standards of care - that can be difficult to reproduce within tertiary referral hospitals. https://avmajournals.avma.org/view/journals/javma/263/S3/javma.25.07.0451.xml?tab_body=pdf-prime
The assessment toolkit provides information about multiple approaches to evaluating veterinary student competence. It is important because competency-based education ultimately depends upon something more difficult than changing a curriculum: reliably determining whether a student can actually perform as a veterinarian. If accreditation moves increasingly toward outcomes rather than institutional inputs, robust assessment methods will become even more important. https://www.aavmc.org/resource/cbve-assessment-toolkit-2025/
Commentary
Together, these sources illuminate the central tension discussed in this essay:
Veterinary medicine needs rigorous accreditation.
But rigorous accreditation does not necessarily require rigid educational structures.
The challenge is to protect the standards that matter - competence, patient safety, professional judgment and public trust - without inadvertently protecting educational traditions simply because they are familiar.
Or, put more simply:
Protect the standard.
Question the structure.
A particularly important source is the AAVMC CBVE 2.0 framework. It explicitly describes competency-based veterinary education as learner-centered and outcomes-based and says the model de-emphasizes time-based training to meet targeted learner outcomes.
The Arizona example is also now especially strong because its full accreditation is not hypothetical: the university announced on July 9, 2026, that the AVMA Council on Education had granted the college full accreditation.
The distributive-education literature is useful as a counterbalance, because it recognizes that distributed training creates real quality-control challenges involving clinical sites, preceptors, caseload and students' active participation in cases.
The argument isn't that innovation is inherently better.
The argument is that innovation should be judged by whether it produces competent veterinarians, rather than by how closely it resembles the traditional veterinary school model.
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