There are philosophical propositions stating the belief that every event is caused by an unbroken chain of events.

Here is an example. The soaring cost of higher education forces veterinary students to assume a high amount of debt. That financial burden pressures many young veterinarians to pursue and accept the highest starting salaries they can find. Those opportunities are often in small animal practices in urban areas.
Yet, according to the American Veterinary Medical Association (AVMA) and the U.S. Department of Agriculture (USDA), there is a great need for veterinarians to establish careers in food animal medicine in rural areas.
“The USDA Veterinary Medical Loan Repayment Program is aimed at providing monies toward tuition that were spent by an applicant to encourage them to work in a rural area,” says John Middleton, DVM, PhD, a professor of food animal medicine and surgery at MU’s College of Veterinary Medicine (CVM).
Those rural areas are identified each year in Missouri by the state veterinarian.

“Each state’s appointed animal health official identifies underserved areas that need a veterinarian and sets priorities for their state,” Middleton says. “Those areas are identified on a map, and folks who apply to this program can look at the map and say, ‘Well, I’m already in that area and might remain there, or I might move to that area. This program will be an enticement for me to move to that area by offsetting my educational debt.’”
“There are multiple tiers to this process,” Middleton says. “The state veterinarian or animal health official identifies areas of need and those go to the USDA for review. The USDA says, ‘Yes, this is an area of legitimate need in the state of Missouri; we’ll list that on the website.’ So, not only did our state veterinarian nominate areas of need, but the USDA had to approve them.”
For 2018, a need for a food animal veterinarian in an unconventional, underserved area of public practice was identified.
“Working with our state veterinarian, we found that we had a need for a tenure track faculty member in the food animal area, because most of our faculty are not tenure track,” Middleton says. “Some might say, ‘This is not an area of need,’ but it is if you are not fulfilling all of the missions of the college and needs of the state.”
“Dr. Pamela Adkins’ position is unique in this college in that, other than me, she’s the only tenure track food animal faculty who does research, teaching and service. Her research is also an essential part of teaching,” Middleton says. “If you look at the Standard 10 of the Council on Education, we have to train our students in research. Pamela is involved in the Veterinary Research Scholars Program, she’s training graduate students, and imparting the importance of research to our veterinary professional students. So having and retaining a tenure track faculty member in food animal was a public practice need that we saw here.”
Adkins, DVM, PhD, is an assistant professor in food animal medicine and surgery. Adkins, who earned DVM and master’s degrees from the Ohio State University, was named the Doctoral Student Marshal when she received her PhD during MU’s May 2017 commencement.
“This money goes directly toward paying off my debt; it’s very helpful,” Adkins says. “I understand and can empathize with the students of today and their debt load. Veterinary school has become very expensive, and then spending extra time in a residency and doing a PhD, I didn’t have a lot of money to put into paying off my debt, and it continued to accrue interest. That makes your debt load bigger, so I am super grateful for the opportunity to have some help to pay it back.”
“Pamela’s case underscores that you don’t have to be a new graduate to qualify for this program,” Middleton says. “Some of the underserved areas identified each year are in rural practice and may be oriented to enticing recent graduates to go into those practice areas. While in other cases a practitioner may have been in an area for some time, but is struggling to pay off their educational debt. This program provides them with the means to stay and serve a community in need of a veterinarian.
“I think it’s important to highlight that these programs are not only essential to fulfill private practice needs in underserved locales, but they’re important for academic and public practice as well,” Middleton says. “One of the things we’re struggling with nationally is training and recruiting our replacements in academia and public practice. You have to look to the future in the colleges of veterinary medicine, because if you don’t have the appropriate spectrum of people to impart to students the requisite pieces of their education — be that in research or general veterinary practice — we’re going to struggle going forward. The vast majority of our clinical faculty in food animal don’t have specific research appointments, so when we look at replacing ourselves as researchers, and generating new knowledge from research, it’s essential that we have a diverse faculty who not only teach, but conduct important basic and applied research that will benefit our students, livestock producers, and the public within and beyond the state of Missouri. Faculty have other opportunities, not only in academia but also in the private sector, that can be more financially rewarding, so assistance from the loan repayment program can be very helpful in recruiting and retaining the next generation of veterinary scientists and educators.
Help with student debt was a need for Adkins, and she has benefitted from the program. It’s another outcome linked to a chain of events.
“Because Pamela delayed the start of her real-world income generation through advanced training and degrees, that put her loans in deferment and she was accruing interest,” Middleton says. ” If she had been making $100,000 a year as a dairy practitioner during those six or seven years that she was doing an internship, a residency and a PhD, she could have been paying off a lot more of those loans. The delay in starting payment on those loans by six or seven years affected her educational debt as well as her total career income potential.”
“Student loan debt can be a major factor for students when deciding which areas of veterinary medicine to pursue. The loan repayment program helps people pay off some of their debt and be able to establish their life and maybe start a family in that location without being under so much stress from student loan debt. I hope that this program will continue and potentially expand. Additionally, I hope more Missouri veterinarians and MU faculty can benefit from the program in the future, as it promotes veterinarians to stay in the state and help our local producers in underserved areas” Adkins says.
More information on the Veterinary Medical Loan Repayment Program can be found here: https://nifa.usda.gov/program/veterinary-medicine-loan-repayment-program