America trains far fewer veterinarians than it needs — and the reason isn't a lack of people who want the job. Entry into the profession runs through a small number of private organizations that control accreditation, testing, and licensure, with little outside oversight. Here is how that system works, what it's producing, and how other professions solved the same problem.
This isn't only a problem for veterinarians. It's a crisis for pets, families, farms, the food supply, and the animals with no one left to help them.
America held at roughly 34 veterinary schools for 45 years, even as the animal population climbed. Those decades bred a culture where today's shortage seemed unimaginable, and the institutional focus was mostly on the danger of oversupply. Meanwhile, the gates of the profession were handed to insular private organizations with monopoly power and no outside oversight — a gap no one questioned in a profession where little had changed in generations. Decades of dogma plus unaccountable power hardened into a single conviction: that the job was to limit supply. That's why the system still can't see the shortage it created.
Human medicine faced similar pressures and took a different path: competing accreditors, a steady pace of new schools, recognition of internationally trained doctors, and the removal of outdated bottlenecks. Veterinary medicine kept the cautious structure — and the shortage families and animals feel today is the result.
Medicine spreads the power to accredit across many bodies, at home and abroad. Veterinary medicine concentrates it in one.
A university opening a medical school chooses between two competing accreditors — and licensure doesn't even require a U.S.-accredited school. Internationally trained doctors qualify through schools accredited by a wide range of recognized accreditors worldwide.
America opens roughly two new medical schools a year, decade after decade.
One accreditor — a council of the AVMA — with no competitor and no appeal. And it recognizes no one else's accreditation, even abroad: a foreign school counts only if the AVMA itself accredited it.
Opening a new veterinary school can take a decade or more, advancing through stages a twice-yearly council can defer or deny at any point. The school challenging the AVMA in federal court alleges the standards were reinterpreted mid-process.
It is now easier for an internationally trained doctor to be licensed to treat people than for an internationally trained veterinarian to treat pets.
Medicine eliminated its hands-on clinical licensing exam in 2021. At 23 states — plus Guam and the Northern Mariana Islands — now allow qualifying internationally trained physicians to reach full licensure without repeating accredited North American residency training, with another 18 considering it.
In 2026, 9,682 internationally trained doctors entered the U.S. physician pipeline.
Internationally trained veterinarians face a four-step process ending in a 3-day hands-on surgery exam no U.S. graduate ever takes — offered at just 2 sites, about 248 seats a year, for a $12,804 fee.
The result: roughly 168 internationally trained veterinarians make it through per year.
The body that accredits every U.S. veterinary school is appointed by the existing institutions — and the schools already operating hold half the votes. Even with the best intentions, that's a structure in which expansion is easy to slow and hard to speed up.
Before anyone can practice veterinary medicine in the United States or Canada, they must pass a single exam — the NAVLE. It is owned and run by one private organization, the International Council for Veterinary Assessment (ICVA). No government body oversees it. No regulator audits it. There is no appeal.
The concerns are documented, and they come from more than one direction. A public petition signed by more than 1,200 candidates, veterinarians, and educators reports confusing and poorly written questions, content that doesn't match the published blueprint, and questions with no defensible correct answer. A national plaintiffs' law firm has alleged the exam is "potentially anticompetitive, fraudulent, and discriminatory" — including third-party allegations that outcomes differ across groups of similarly prepared candidates. The national veterinary press has reported on the same pattern.
No state board or independent body has ever conducted a forensic audit of the exam's scoring, or even seen ICVA's raw item-level data, score-production logs, or invalidation records. After the legal notice, ICVA reset its retake policy — five new attempts for every candidate, prior attempts erased — saying the change rested on "a comprehensive review of candidate feedback and NAVLE data." It has not released that data.
ICVA has since announced an independent audit, but with no clear public scope — and it is being managed through ICVA's own law firm, which raises questions about how much will ever be disclosed.
We don't assume the worst. But because ICVA discloses so little, these allegations are impossible to refute — and none of this requires assuming bad intent. It is what predictably happens when a single organization controls a high-stakes exam with no outside oversight, no appeals, and no obligation to show its work. Questions go unanswered. Errors go uncorrected. Trust erodes. The simplest way to settle a fairness question is to release the data. ICVA hasn't.
We are not asking states to lower the bar. We are asking them to reclaim it from private interests and restore it to the public domain where it belongs.
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