Dartmouth College Uses Animals in Medical Training

Valley News Staff Writer
Published: 5/30/2017 12:07:05 AM

Hanover — Though emergency medicine residents can learn some skills using simulators, there is still a role for live animals in this training, a Dartmouth College spokeswoman said last week.

“As part of its emergency medicine training, Dartmouth regularly uses simulators as alternatives; however, for certain life-saving procedures, other alternatives cannot offer the same degree of training,” Dartmouth spokeswoman Amy Olson said via email on Thursday.

The explanation of this element of Dartmouth’s curriculum for emergency medicine came after the Physicians Committee for Responsible Medicine, a Washington, D.C.-based nonprofit, alleged in a complaint with federal regulators that the school — in training conducted at Dartmouth-Hitchcock Medical Center in Lebanon — was continuing to use live sheep when other methods of teaching these skills are available.

“This animal use is at odds with the current standards of practice in emergency medicine training in the United States,” according to the complaint, which was filed with the U.S. Department of Agriculture Animal and Plant Health Inspection Service in March.

The USDA is responsible for ensuring animal research programs are in compliance with the Animal Welfare Act. As part of that work, a USDA team of inspectors visited Dartmouth’s facility in April.

During the inspection, regulators found several deficiencies, including flaws in the way an internal body tasked with monitoring the college’s use of animals in research — the Institutional Animal Care and Use Committee — determines that using animals is necessary.

Another deficiency detailed in the USDA report, provided by the Physicians Committee for Responsible Medicine, pointed to an incident in March 2016 when investigators found seven dead voles in their cages at Dartmouth’s research facility. An eighth vole had to be euthanized. Investigators determined that the animals died because they were without water for two days.

According to the report, Dartmouth staff have addressed the problem in caring for the animals and there have not been any futher incidents.

There were also some issues with the way Dartmouth researchers were caring for primates.

Two such animals were held alone in their cages and the reason they were not in more social quarters was not consistently recorded by the attending veterinarian, according to the report.

Despite these findings, Olson said that the school “is committed to the humane treatment of all animals under its care for research and teaching purposes, and works to comply with all federal and state laws, regulations and policies.”

Olson noted that none of the findings detailed in the USDA report addressed the use of sheep by the emergency medicine residency program.

“The USDA found no violations of the Animal Welfare Act with that particular protocol,” she said.

She added that the school has submitted a corrective action plan to address the deficiencies identified in the report.

Dr. John Pippin, director of academic affairs for the Physicians Committee for Responsible Medicine, said many other emergency medicine residency programs around the country have given up using animals for training.

A partial survey of such programs conducted by Pippin’s group shows that 90 percent of these programs have given up using animals, Pippin said.

“Simulation has moved very quickly to the point where it can replicate human anatomy better than non-human animals,” Pippin said. “Training using non-animal methods is producing emergency medicine physicians as qualified (as) those using animals.”

But, Dr. William Fales, an associate professor of emergency medicine at Western Michigan University in Kalamazoo, said that there are certain procedures in which live animal models are necessary for teaching skills that students would not learn elsewhere.

Fales noted that Kalamazoo is a relatively safe part of the country, so the emergency department does not see as many gunshot or stabbing victims as more urban areas do.

“The nature of our patient population is we’re not seeing these things,” Fales said.

For example, doctors in Kalamazoo might perform a resuscitative thoracotomy, a life-saving procedure that involves opening the chest wall and repairing wounds to the heart, only every couple of months, Fales said.

“We don’t have a good model for that outside of the animal world,” he said. Western Michigan uses pigs for its training, and they are fully anesthetized for procedures, he said.

Simulators are valuable for teaching other skills, such as inserting chest tubes for a collapsed lung or finding vascular access for intravenous infusions, Fales said. And it’s an evolving tool.

“We’re constantly looking at ways to try and improve our simulation,” he said.

Fales acknowledged that there are ethical and cost considerations for animal use, but for now, live animals are important tools because residents will need to be able to perform procedures on humans once they leave, he said.

“Do you want this person doing this life-saving thing on your family member when they’ve kind of read about it in (a) book?” he said.

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.




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