Unfortunately, the veterinary referral market in the UK is almost completely unregulated. This means that any vet can set up a referral service and imply that they are a specialist, often by claiming to have a special interest in a subject. The Royal College of Veterinary Surgeons (RCVS) do advise that the terms Specialist or Recognised Specialist are only used by those who are on the RCVS list of Recognised Specialists.
I am sure many people have noticed that vets (and many other professionals) often have a line of letters after their names that represent their individual qualifications. These are important indicators of experience and knowledge and may help you decide who is best placed to treat your animal.
Sadly, the use of these postnominals can often form a misleading smokescreen that can be used to imply particular knowledge or skill that may not necessarily have been assessed. Please remember that having more letters after your name does not necessarily mean better qualified!
We firmly believe that where people are offering a service that is considered by the client to be specialised (this includes any referral service), that the vets who are providing the service should have undertaken sufficient specialist training, and should have passed or be working towards the appropriate specialist level examinations. The following is a brief guide through the minefield of veterinary qualifications. The relevant level of qualification according to the Regulated Qualifications Framework (RQF) is indicated.
MRCVS (RQF level 6)
This stands for 'Member of the Royal College of Veterinary Surgeons' and means that the holder has passed an approved veterinary degree. Membership of the RCVS is a legal requirement for anyone to practice as a vet in the UK. Often people will also list their degrees separately which may appear as BVM&S, BVMS, BVSc, MAVetMB or BVetMed depending on which university was attended.
Following graduation, Vets may choose to study for further qualifications areas of interest to them.
Certificates (RQF Level 7)
The first level of qualification is called a Certificate and may be awarded in many subjects including Small Animal Surgery (Cert SAS), Veterinary Ophthalmology (Cert VOpth), Small Animal Medicine (Cert SAM) etc. The Royal College changed the structure of the certificates several years ago in order to make the assessment process easier. The more modern certificates are called a Certificate in Advanced Veterinary Practice (Cert AVP) and by jumping through enough hoops can be obtained in specific areas.
The purpose of the Certificate is to promote further study within first opinion practice. These qualifications indicate that the holder is competent in a subject when assessed at the level of a general practitioner. It is important to realise that obtaining a certificate qualification may be a useful part of the journey towards specialisation, but it does not involve education or assessment to the level of a specialist.
Indeed, a certificate can be taken without any supervision or training from a specialist at all! Unfortunately, for a variety of reasons, largely financial, some Certificate holders portray their Certificate to indicate that they are capable of undertaking referral work and are as capable or as knowledgeable as a specialist. This is not necessarily the case. To further confuse the matter, there are several certificate qualifications proposed that are not all recognised by the RCVS which may be listed as GP certificates (e.g. GP Cert SAS).
Recently the RCVS has tried to simplify the understanding of veterinary specialisation by creating the title of Advanced Practitioner. Vets who are on the list of advanced practitioners must hold a certificate level qualification and participate in more continuing professional development each year than a normal veterinary surgeon. Being an advanced practitioner does not indicate specialist knowledge or allow the use of the term 'Recognised Specialist'
Internships and Residency Training
Often vets may wish to learn more from experienced colleagues and vets may undertake internships or residencies.
An internship is usually a one-year post for relatively inexperienced vets who aim to gain a basic grounding in a subject. Interns may rotate around the departments in a hospital (rotating internship) or be involved with one single discipline (subject specific internship) and are involved with the day to day care of cases in the hospital. Interns generally observe treatments being performed by more experienced colleagues and may perform simple procedures.
More experienced vets may choose to undertake a residency. Competition to be chosen for a residency position is fierce and these posts typically last for three years. During this time the resident will have much greater involvement with the assessment, diagnosis and treatment of clinical cases. This may include performing surgery under the supervision of a specialist.
Clinical research is often undertaken during a residency, again under mentor supervision This novel research is often needed to proceed to the next stage of qualifications. On satisfactory completion of a residency the candidate may be referred to as 'board eligible', meaning that they are able to proceed to sit the Diploma examination.
Diploma (RQF Level 8)
The diploma is the highest level of qualification available and indicates that the holder has attained a high standard of academic and clinical expertise in their chosen subject. It is not possible to sit the diploma examination without having served a suitable period under the direct supervision of a specialist. Many diplomas have additional requirements that may include the publication of ground-breaking clinical research or the production or a very detailed dissertation.
The diploma is recognised as being the appropriate standard to indicate expertise to the level of a specialist. Diplomas are available in many subjects however the RCVS Diploma in Small Animal Surgery (Orthopaedics) remains the only diploma level qualification solely in orthopaedics available in the world. The qualification is unique in that it requires knowledge of comparative orthopaedics (ie all species including man). Diplomas are abbreviated with a prefix starting with 'D' such as DSAS (Orth) which stands for the Diploma in Small Animal Surgery (Orthopaedics).
RCVS recognised Diploma-level qualifications are also awarded by European Specialist Colleges following the completion of a three-year approved residency training program and qualifying examination. The appropriate European Diploma for companion animal surgical specialism is the Diploma from the European College of Veterinary Surgery (abbreviated to DipECVS). For more information see https://www.ecvs.org/home/
RCVS Recognised Specialists
The RCVS maintains a list of recognised specialists in each subject area. Admission to this list is strictly controlled by the RCVS and requires a relevant diploma and strong references from other specialists in addition to enough points being earned for publications, lectures, teaching etc. Revalidation of recognised specialist status is usually needed every five years. Unless a vet is on the list, they cannot claim to be a recognised specialist. Both Simon Roch and Graham Hayes are listed on the recognised specialist list.