Response to “Letters or not,here we come! A communal perspective on credentials needed for a productive career in veterinary pathology”

I certainly agree with Drs Pardo et al. that “a lifelong commitment to education, integrity, and productivity (personal and communal) are the surest predictors of an enjoyable, flexible, and fruitful pathology career.” ² I would add to their comment on productivity, as I did in a recent editorial in the Journal of Veterinary Diagnostic Investigation, ¹ that part of our work life as pathologists requires not just credentials but documentation of ongoing competence. It is all well and good to hold all relevant credentials, in my case DVM (1969, Saskatchewan), PhD (Guelph, 1973), and diplomate American College of Veterinary Pathologists (ACVP) (anatomic, 1984, 29% pass rate, not that it left permanent scars), but who’s to say many years later that I was still competent as a diagnostic pathologist?

The addition by ACVP of Maintenance of Certification (https://www.acvp.org/page/MOC) is commendable and was of course required by the American Board of Veterinary Specialists. Included as one of the four categories of the Maintenance of Certification requirements is “Maintenance of professional proficiency (work you do as a pathologist).” The requirement in this category in the Maintenance of Certification Program Policy Manual is for “Number of credits determined by % of full time equivalent,” without further definition. Post ACVP boards, we all diverge into a range of professional activities. In the case of diagnostic pathologists, as noted in my editorial, the AAVLD (American Association of Veterinary Laboratory Diagnosticians) Requirements for an Accredited Veterinary Medical Diagnostic Laboratory (https://www.aavld.org/accreditation-requirements-page), which are based on the ISO/IEC 17025:2017 international standard, state in Article 5.2. “Personnel 5.2.1. The laboratory shall ensure the initial and ongoing competence of laboratory personnel to do their assigned work using objective criteria.” ¹

The egregious example of failure to document the competence of a pathologist is the case of Charles Smith, MD, who was regarded as an expert forensic pediatric pathologist, but who practiced without oversight, and “performed flawed child autopsies that resulted in wrongful convictions” (https://en.wikipedia.org/wiki/Charles_Smith_(pathologist)).

As outlined in my editorial, ¹ we have used a process of documentation at the Animal Health Laboratory at the University of Guelph for more than 20 years, and I believe that, based on our common practice and on successful AAVLD accreditation audits, our process is effective in documenting ongoing competence and suggest that such objective measures be added to this component of the Maintenance of Certification Program Policy Manual. Our competency assurance process involves documented participation in histopathology rounds, peer review of random cases, and external proficiency testing, all of which can be done simply in order for the process to be sustainable.