Getting and maintaining RCVS Advanced Practitioner status requires hard work and dedication, and many wonder if it's worth it. To find out, I hunted down some Advanced Practitioners, and asked them what it means to them.
The RCVS describes Advanced Practitioner status as a 'middle tier' between a vet working in general practice and an RCVS Specialist. Advanced Practitioners have demonstrated advanced knowledge and skills in a particular area of veterinary practice, backed up by postgraduate qualifications and ongoing Continuing Professional Development (CPD). They are not RCVS Specialists, but have developed expertise beyond that expected in general practice.
Find out more about the requirements for RCVS Advanced Practitioner status.
For many of the Advanced Practitioners I spoke to, the biggest benefit was simple: being able to offer better care to their patients.
"Being an Advanced Practitioner in internal medicine is incredibly meaningful to me because it allows me to offer the very best, evidence-based treatment options for my patients" said Alison Irwin, RCVS Advanced Practitioner in Small Animal Medicine. "It represents a commitment to continually improving my knowledge and skills, ensuring that I can provide the highest standard of care."
For Colin Dickson, RCVS Advanced Practitioner in Small Animal Surgery, that same commitment to developing his skills has a direct impact on patients: "It helps ensure patients receive the highest standard of evidence-based care".
In some disciplines, Advanced Practitioners can also help make higher-level care more accessible. Sarah Brown, RCVS Advanced Practitioner in Zoological Medicine points to the particular challenges faced by owners of exotic pets. "Pet insurance is often limited for exotic species, and financial constraints often limit Specialist referral. As a result, Advanced Practitioners form a backbone of good care provision, improving welfare for species that sadly may not always receive appropriate care", she says.
Advanced Practitioners can also fill an important space between general practice and Specialist referral.
Russell Chandler MRCVS, RCVS Advanced Practitioner in Orthopaedic Surgery sees this as an important part of his role. "Many cases require referral, though not necessarily at Specialist level," he explained. "This is one place where the skills and experience of an Advanced Practitioner can be brought to bear".
Sarah Keir MRCVS, Advanced Practitioner in Small Animal Medicine agrees. "Some cases require further skills and experience beyond an omnicompetent general practitioner but not full referral." She gives the example of a dog with myxomatous mitral valve disease: a case that may be managed by an Advanced Practitioner, while referral to a Specialist may be appropriate if the owner wants to explore options such as valve repair.
Advanced Practitioner status isn't something vets achieve once and keep indefinitely. RCVS Advanced Practitioners have to reapply for accreditation every five years, demonstrating their ongoing development in their chosen field.
That might sound like another hoop to jump through, but the Advanced Practitioners I spoke to saw it as part of the value of the status.
"Revalidation indicates that I am keeping up to date within the field" said Sarah Brown, while Alison added "Staying up to date with the latest advances in internal medicine is a key part of the responsibility".
Developing advanced knowledge also creates opportunities to share it.
"Equally important is the ability to collaborate with like-minded colleagues" says Alison, who loves "sharing knowledge, discussing complex cases, and striving together to achieve the best possible outcomes for [...] patients".
Russell also highlighted the relationship between Advanced Practitioners and referring vets, saying he was "grateful" he could collaborate with referring clinicians and "assist in the care our mutual animal patients and their owners".
Rather than removing cases completely from the primary-care team, that collaboration can allow the Advanced Practitioner and referring vet to contribute different skills to the same patient's care.
Advanced Practitioner status can also provide formal recognition for vets developing advanced clinical skills without following the RCVS Specialist pathway.
For some disciplines, that route is particularly important. "Attaining Specialist status in the field of Zoological Medicine in the UK is currently challenging given the paucity of residencies and training options." says Sarah Brown. For her, Advanced Practitioner status provides another way to have that additional expertise formally recognised and to "provide a vital source of information and referral availability for GP vets".
For vets who want to keep progressing clinically, Advanced Practitioner status can also offer something important: a route forward that doesn't necessarily mean moving into management.
"It allows some progression within the profession as a clinical vet, and increased responsibility without having to go into management or leadership positions," said Sarah Keir.
That makes Advanced Practitioner status particularly relevant to experienced vets who want to develop their clinical role further, but don't want or aren't able to pursue the Specialist training route.
The Advanced Practitioners I spoke to were positive about what the status meant to them, but there was one clear frustration: the wider profession doesn't always understand what it represents.
Sarah Keir feels that "people assume that having a CertAVP is the same as having AP status" and that "the additional requirements to become an Advanced Practitioner aren't well known by vets".
That's an important distinction. A relevant postgraduate qualification can provide a route towards Advanced Practitioner status, but vets still need to meet the RCVS's additional requirements before they can use the title.
One Advanced Practitioner, who wished to remain anonymous, went further: "I believe Advanced Practitioners are undervalued [...] and that greater recognition and a more structured job market are needed to fully utilise their expertise".
For the vets I spoke to, Advanced Practitioner status meant more than another qualification or another line of postnominals. It represented better care for patients, recognition of years spent developing their skills, opportunities to support colleagues with more complex cases, and a way to continue progressing clinically.
As Colin Dickson said - "Achieving RCVS Advanced Practitioner status was a significant professional milestone and recognition of the years invested in developing my knowledge and clinical expertise". But their comments also highlight why greater understanding of the status matters. Becoming an Advanced Practitioner involves more than completing a certificate, and that additional commitment isn't always recognised by vets, employers or clients.
The RCVS's newer accreditation process for postgraduate qualifications should help make the qualification stage of that route clearer, with eligible programmes now subject to direct review and ongoing quality assurance. But gaining the qualification is still only one part of becoming an Advanced Practitioner: vets must also meet the RCVS's wider requirements for Advanced Practitioner status.