Rural areas need more veterinarians, but low pay and student debt make choice difficult
Veterinarian clinics in rural towns have been dramatically declining in numbers for decades. Rural veterinarians often get paid less than urban practitioners, take on more workload and carry thousands of dollars in debt from medical school.
For as long as she can remember, Dr. Cyrena Hull wanted to be a veterinarian — she recalls how as a child she would pretend to hook up her stuffed animals to makeshift IVs.
Hull began working at the Perry Veterinary Hospital in Perry, Oklahoma, straight out of veterinary school six years ago. She’s one of the two doctors that work at the small town clinic, and her experiences growing up in rural Colorado make working in the town feel like home.
“I love the profession. I love what I do,” Hull said. “It's just really pretty crazy to look at the debt load that it takes to get there.”
Hull currently has more than $100,000 of student loan debt from medical school.
Rural veterinary clinics, especially those practicing on large animals like cattle, have been declining since World War II, according to the U.S. Department of Agriculture. As of 2020, less than 2% of private practices nationwide were exclusively large-animal clinics and less than 6% were mixed-animal clinics, like Perry Veterinary Hospital, according to the American Veterinary Medical Association.
Low wages are one of the biggest discouraging factors for graduates deciding where to practice, said Dr. Daniel Grooms, the dean of Iowa State University’s College of Veterinary Medicine.
“There are financial barriers to going into rural practice,” Grooms said. “Typically, rural practices have lower salaries than practices that are located in more populated areas.”
In 2019, Grooms and two students surveyed veterinary students and clinics across Iowa to understand why there’s a shortage of veterinarians in rural parts of the state. In addition to low salaries, they found that long hours and the potential lack of mentorship also contributed to the shortage.
“The ability to have balance in your life in a rural practice can be challenging,” Grooms said, “especially if it's a one- or two-person practice versus a larger practice with multiple doctors and lots of help.”
The Debt Problem
Since 2010, the USDA has offered the Veterinary Medical Loan Repayment Program, a loan repayment program aimed at helping rural veterinarians. It identifies rural vet shortage areas and pays off some student loans for vets who get accepted into the program and set up shop there. Those veterinarians can get up to $75,000 over three years.
But the awarded amount is less than half of today’s average loan debt for graduating veterinarians. U.S. veterinarians graduate from medical school with nearly $200,000 in debt, according to the American Veterinary Medical Association. Dr. Robert Smith, who oversees the loan repayment program, said there’s talk of increasing the amount they give out.
"We see [debt] numbers for individuals up to a half million dollars,” Smith said. "I mean, it really makes you cringe and wonder how they're ever going to pay that back.”
Yet, even if more money does become available, earning the repayment award isn’t easy. That’s partly because the program only awards one veterinarian per designated area of need, and the application process can be daunting.
Just over half of the 144 veterinarians that applied for the program last year received the award. Eligible veterinarians are required to fill out and submit seven different forms on top of a resume, a copy of unofficial transcripts and loan documents. For busy veterinarians like Hull, the application can be discouraging.
“There’s a lot of hoops to jump through,” she said. “I’m not sure it’s worth the time it takes away from my family or clients, which is already difficult to find a balance there.”
Although USDA's National Institute of Food and Agriculture hosts informational webinars about the program's application process, Smith said it’s something he hopes the program can improve on.
“Practitioners are not used to writing grants,” Smith said. “This is a nut we’re going to try to crack and provide some kind of coaching or mentoring — to work with them on putting together a better application.”
Currently, those veterinarians who receive the awards for debt repayment are also taxed on that money, although the USDA covers the cost. That’s something veterinary advocates are trying to change.
“Getting taxed 39% means less goes to the people that want to go to these [shortage] areas and practice food animal medicine,” said Dr. Jose Arce, the president of the American Veterinary Medical Association.
The organization has been trying to get rid of the program’s tax clause by lobbying Congress to pass the Veterinary Loan Repayment Program Enhancement Act.
Vital to rural communities
Access to good veterinary care is critical to farmers and ranchers who have livestock. Losing an animal is not only a major financial loss, but it’s also a loss of time and work invested into raising the animal.
“The job of the veterinarian is to work as a partner with the livestock producer to make sure the animals are healthy,” said Dr. Brad White, director of Kansas State University’s Beef Cattle Institute. “That’s because we need to be sure that we protect that food supply and make sure that it's healthy and as productive as it can be.”
Kansas State University has worked to place its veterinary graduates in less-populated parts of the state since 2006 with its Veterinary Training Program for Rural Kansas. The state-funded program gives up to five students a year a $20,000 loan toward their tuition. After graduation, veterinarians who work in a Kansas town with fewer than 35,000 residents for four years can get up to $80,000 in loans forgiven.
“Over the past 15 years of that program, we know that about 90% of those students are still in rural practice,” White said. “About 80% of them are still in the practice that they started in.”
White said implementing a similar program in other veterinary medical schools could be a potential solution to mending the shortage of rural veterinarians across the country.
But Grooms of Iowa State’s veterinary school said that attracting new veterinarians to rural clinics goes beyond posting a job opening — it starts by establishing mentorship with students early in their career.
“You’re going to have to be creative in the way you recruit,” Grooms said. “You’re going to have to invite people into your practice. You’re going to have to come and meet them at their college of veterinary medicine and go to some of the networking events.”
Hull said the mentorship her boss and owner of the practice, Dr. Martin Roth, has given her is invaluable.
"I think that having a mentor from the community is helpful in gaining that trust a little bit faster, versus if I were trying to just do it on my own," she said, "and this community has been great."
And ultimately, Hull said, it’s “just flat out the community” that keeps her in this small town veterinary practice.
This story was produced in partnership with Harvest Public Media, a collaboration of public media newsrooms in the Midwest. It reports on food systems, agriculture and rural issues. Follow Harvest on Twitter: @HarvestPM