The Future of Veterinary Education: Part 1. The Multiple-Choice Veterinarian (#650)
- Rick LeCouteur
- 2 days ago
- 5 min read
When Assessment Becomes the Curriculum
My friend Greg Bishop, DVM, is a small animal veterinarian based in Portland, Oregon, working in both emergency and general practice. Greg is also a writer, speaker, and cartoonist. He is the creator of Sasquatch Paw, an online platform that blends illustration and storytelling to explore clinical communication, professional identity, and the emotional landscape of veterinary practice. He lectures on the use of humor as a tool for connection in veterinary medicine.
In May 2010 Greg orchestrated and starred in a parody video titled The Campus 2 – Dr. LeCouteur, in which "Dr. LeCouteur" leads Greg’s class through a brain-modeling exercise.
I recently came across a cartoon by Greg Bishop that made me laugh.
And then made me think.
A professor stands before a lecture hall and announces:
We want to teach you medicine as realistically as possible, so we're going to use a series of non-overlapping multiple-choice questions with only four discrete options each.
The humor lies in the obvious contradiction.
Nothing about medicine is discrete.
Patients do not present with four clearly defined options. Diseases do not read textbooks. Clients do not ask multiple-choice questions. Clinical decisions are rarely black and white.
Most of the time veterinarians navigate uncertainty, incomplete information, competing priorities, and imperfect outcomes.
Yet increasingly, we assess future veterinarians using tools that imply there is always a single correct answer waiting to be selected.
Greg’s cartoon raises an important question:
Are we teaching veterinary medicine, or are we teaching students how to pass examinations?
A Different Era
When I began teaching, most of my examinations were not multiple-choice.
Students answered short-answer questions.
They filled in blanks.
They interpreted images.
They explained concepts in their own words.
They solved clinical problems.
Sometimes they had to defend their reasoning.
The examinations took much longer to grade, but they offered something invaluable:
Insight.
I could see how students were thinking.
I could identify misconceptions.
I could tell which concepts had landed and which had not.
I could recognize patterns across an entire class.
I could see where my own teaching had failed.
If twenty students misunderstood a concept, perhaps the problem was not the students.
Perhaps the problem was me.
The examination became a form of feedback - not just for the student, but for the instructor.
I even deducted points for misspelled medical terminology.
That may sound harsh today, but medicine is a language.
Precision matters.
A veterinarian who cannot distinguish between paresis and paralysis is not merely making spelling errors. They are demonstrating uncertainty in concepts.
Examinations revealed far more than whether a student knew the answer.
They revealed how the student arrived there.
Then Everything Changed
As veterinary classes grew larger, educational priorities changed.
Faculty numbers did not necessarily keep pace with student numbers.
Administrative demands increased.
Students expected faster feedback.
Accreditation requirements expanded.
Technology made instantaneous grading possible.
And perhaps most importantly, institutions became increasingly focused on efficiency.
The result was predictable.
Multiple-choice examinations became increasingly attractive.
They could be administered to hundreds of students simultaneously.
They could be graded instantly.
Results could be posted within hours.
Statistical analyses could be generated automatically.
From an administrative perspective, they were nearly perfect.
From an educational perspective, the picture became more complicated.
The Legal Reality
There was another factor driving the transition toward multiple-choice examinations that deserves acknowledgment.
Legal defensibility.
When I began teaching, veterinary schools operated in a different environment.
Students occasionally challenged grades, but formal appeals were relatively uncommon.
Faculty were generally trusted to exercise professional judgment in evaluating student performance.
Over time, however, universities became increasingly concerned about consistency, fairness, transparency, and legal risk.
From an administrative perspective, multiple-choice examinations offer significant advantages.
Every student receives the same question.
Every student is graded according to the same answer key.
There is no variation between graders.
There is no interpretation of handwriting.
There is no debate about whether an answer was partially correct.
The scoring process is objective, reproducible, and easily documented.
If challenged in a grievance process - or even in a courtroom - the institution can demonstrate exactly how a student's score was determined.
Short-answer and essay examinations are different.
They often reveal deeper understanding.
They allow students to demonstrate reasoning.
They can expose misconceptions that multiple-choice questions never uncover.
But they also introduce an element of judgment.
Two faculty members may award slightly different marks to the same answer.
A student may argue that their reasoning deserved partial credit.
An appeals committee may question whether grading standards were applied consistently.
What educationally rich assessments gain in nuance, they sometimes lose in legal simplicity.
In many ways, the rise of multiple-choice testing reflects a broader trend in higher education.
Universities increasingly seek assessment systems that are standardized, measurable, auditable, and defensible.
Those goals are understandable.
Students deserve fairness.
Institutions require consistency.
Faculty need clear standards.
Yet there is an inherent tension.
The assessments that are easiest to defend legally are not always the assessments that reveal the most about how students think.
The assessments that most accurately reflect clinical reasoning are often the very assessments that require professional judgment in grading.
And that raises a difficult question:
Should the primary purpose of assessment be to withstand legal scrutiny, or to understand how future veterinarians think?
Ideally, educational systems would accomplish both.
In practice, achieving that balance remains one of the central challenges facing veterinary education.
The Problem with Multiple Choice
Multiple-choice examinations are not inherently bad.
They can effectively assess factual knowledge.
They can sample broadly across a curriculum.
They can be reliable and objective.
They can reduce grading bias.
But they also have limitations.
Students recognize answers rather than generate them.
Reasoning processes often remain invisible.
Partial understanding can masquerade as mastery.
Guessing becomes a factor.
Most importantly, some of the most important aspects of veterinary medicine become difficult to assess.
Can a multiple-choice examination measure judgment?
Can it measure empathy?
Can it measure communication?
Can it measure professionalism?
Can it measure wisdom?
Can it assess how a veterinarian handles uncertainty when none of the available options appears entirely correct?
The further we moved toward multiple-choice assessment, the more I found myself asking a different question:
Were we testing understanding, or were we testing test-taking?
The Rise of Nitpicking
Over time, another phenomenon emerged.
Once the obvious facts had been tested, examination writers began searching for increasingly subtle distinctions.
Questions became more intricate.
More nuanced.
More obscure.
The challenge was no longer identifying important concepts.
The challenge became distinguishing between answer B and answer C.
Students learned strategies.
They looked for clues.
They analyzed wording.
They learned how examination writers thought.
The examination itself became the curriculum.
Instead of asking:
What do I need to know to become a better veterinarian?
students are increasingly asked,
What do I need to know to answer this question?
Those are not the same thing.
What Are We Really Trying to Produce?
The purpose of veterinary education is not to create graduates who can identify the correct answer from a list of four possibilities.
The purpose of veterinary education is to create veterinarians.
Veterinarians who can think.
Veterinarians who can communicate.
Veterinarians who can make decisions when there is no perfect answer.
Veterinarians who can recognize uncertainty and still move forward.
Veterinarians who can earn the trust of clients and colleagues.
Knowledge matters.
Examinations matter.
Standards matter.
But if assessment drives learning - and it unquestionably does - we must be careful what we choose to assess.
Because students become what we reward.
Looking Ahead
The future of veterinary education will undoubtedly include technology, artificial intelligence, competency-based assessment, and educational innovations we can scarcely imagine today.
But before we embrace every new assessment tool, we should pause and ask a simple question:
What does a great veterinarian actually look like?
Once we answer that question, we can begin designing assessments that measure the qualities that truly matter.
And I suspect many of those qualities will not fit neatly into four discrete options.
Coming Next
Part 2. The Lost Apprenticeship: What Happened to Mentorship?
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