Unlocking Potential: The Untapped Power of Immigrant Veterinarians

When I left Chile after earning my veterinary degree, I never imagined how winding the road would be to becoming a board-certified criticalist in the United States. My dream, like that of many foreign-trained, immigrant veterinarians, was simple: to practice veterinary medicine at the highest level in a country with vast opportunities. But even with drive, dedication, and advanced training, I discovered just how steep the climb could be.

This article is brought to you in partnership with Pawsibilities Vet Med.

I arrived in the United States as a licensed veterinarian, only to start over, working as an unlicensed veterinary technician in Florida while I faced the rejections of the Veterinary Internship and Residency Matching Program (VIRMP), and saved and started the American Veterinary Medical Association’s (AVMA) Educational Commission for Foreign Veterinary Graduates (ECFVG) certification program. Four years later, I was fortunate enough to obtain an emergency/critical care (ECC) internship at the University of Georgia outside of the match program, followed by another ECC internship at the University of Florida, finally landing an ECC residency at Cornell University. It wasn’t until 12 years after I had started the ECFVG process, after I had already been working as a boarded criticalist, that I was finally able to complete the ECFVG. I even failed the anesthesia section of the Clinical Proficiency Exam (CPE), twice—a humbling reminder that credentialing can be as much about navigating a system as it is about clinical competency.

I wasn’t alone. Over the years, I’ve met hundreds of veterinarians from Latin America, India, Africa, and Asia who have walked similar paths. Many remain behind the scenes, overqualified, underpaid, and unseen. It’s time we tell their stories, understand the system, and build a better one.

The Pathways to U.S. Licensure

The AVMA ECFVG certification program and the American Association of Veterinary State Boards (AAVSB) Program for the Assessment of Veterinary Education Equivalence (PAVE) are the 2 primary pathways for non–AVMA-accredited graduates to practice in the United States. They are rigorous, multistep programs designed to ensure clinical and academic equivalency. They are also expensive, time-consuming, and frequently misunderstood. Detailed steps for each program can be found in TABLES 1 AND 2.

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While both the ECFVG and PAVE include a standardized multiple-choice exam to assess foundational veterinary knowledge, their approaches to clinical assessment differ significantly.

The ECFVG pathway culminates in the CPE, a high-stakes, 3-day clinical skills test that evaluates a candidate’s practical competency in areas like surgery, anesthesia, diagnostic imaging, and large animal handling. The CPE is challenging, expensive and must be completed at 1 of only 2 testing centers in the U.S. Because it is a 1-time exam, candidates must often prepare intensively with little margin for error, and there is no embedded mentorship component. However, the ECFVG process can be completed on a tourist visa, as it does not require enrollment in a formal U.S. educational program. ECFVG certification is accepted in all 50 states.

In contrast, PAVE replaces the CPE with a mandatory 12-month supervised clinical experience at an AVMA-accredited veterinary school. This step integrates candidates into a U.S. academic hospital setting, providing direct mentorship and real-time feedback. But it also demands a full-time, unpaid commitment, often preventing participants from holding paid employment during that year. Moreover, PAVE participants must obtain a student visa to complete the clinical year, adding another layer of immigration complexity and requiring financial resources for tuition, living expenses, and travel. PAVE is currently accepted in 47 states.

Once either pathway is successfully completed, candidates must still pass the North American Veterinary Licensing Examination (NAVLE) and any applicable state jurisprudence exams. Furthermore, to work in the United States, foreign graduates must obtain a valid employment visa (e.g., H-1B), which is different from the student visa used for PAVE participants.

Ultimately, ECFVG may offer more flexibility for those already residing in the U.S. or working while studying, whereas PAVE provides an immersive training experience but demands higher upfront logistical and financial planning. The decision often hinges on a candidate’s visa status, access to funding, and preferred learning environment.

Many foreign graduates begin their U.S. journey as veterinary assistants or technicians, not because they lack skills, but because they lack licensure. In states like Florida, where no formal credential is required to be a technician, it’s common to find foreign-trained veterinarians performing technical duties while preparing for exams. Others are abroad, navigating the process remotely and trying to secure visas, with the added struggles of not fully understanding the way veterinary medicine is practiced in the United States.

Some foreign-trained veterinarians, including myself, have been able to work in academic settings before completing U.S. credentialing. University hospitals may allow foreign veterinarians to serve as interns, residents, clinical professors, or researchers without full U.S. licensure. While this exception does not apply to private practice, it can offer a valuable entry point for those pursuing specialty training or academic careers.

However, this pathway is limited and highly competitive. Most clinical training positions are available only once per year through the VIRMP, and demand for these roles far exceeds supply. Securing one is difficult, and these roles come with their own set of pressures, particularly related to immigration status and long-term career planning. Licensure is still required to work outside of academia, and academic positions do not facilitate that process.

Additionally, full-time faculty and research roles are rare and typically require advanced credentials, training, and experience, which may not be feasible for every candidate. This pathway also confines individuals to academic environments, since neither professorships nor research positions lead directly to licensure or expanded career options beyond the university setting.

Making Credentialing More Visible at the Clinic Level

Veterinary professionals, especially managers and credentialed technicians, often don’t realize the unique limbo foreign-trained veterinarians occupy. Creating open, respectful conversations can shift that. Veterinary support staff are uniquely positioned to support foreign-trained team members through the credentialing process by recognizing the dual burden of working and studying. Leadership can start by offering tangible support: allocating paid study time, providing financial assistance for exam prep courses, CPE fees, travel and accommodation, and even helping cover NAVLE registration.

Beyond financial aid, inclusivity matters; if a foreign-trained veterinarian is working in a technician or assistant role, they should still be invited into doctor rounds, medical discussions, and CE opportunities. This affirms their professional identity without minimizing the value of their current role. Hospitals can also develop “ECFVG/PAVE Allyship Toolkits,” offering practical guidance for managers and teams to create a culture that supports credentialing candidates, ensuring they feel seen for the full scope of their training, as a doctor-in-transition, regardless of their current work responsibilities (RESOURCE 1).

Download this toolkit for clinic use!

Advocating for Systemic Change

The United States is facing a well-documented veterinary workforce shortage, with AVMA and AAVMC projections estimating a deficit of over 15,000 veterinarians by 2030 if current trends continue. This shortfall is being compounded by new federal loan limitations under the Big, Beautiful Bill Act, which caps lifetime federal student loans far below the $300,000-plus cost of attending veterinary school.^1,2 As financial accessibility narrows for U.S. students, foreign-trained veterinarians present a critical opportunity to fill the gap. These professionals often bring years of clinical experience and are willing to work in rural or underserved communities. However, recent policy shifts may severely restrict this pipeline. The cost of credentialing through the ECFVG program is set to double from approximately $10,000–12,000 to $20,000–22,000 starting in 2026,³ creating a significant barrier for international candidates. At the same time, proposed changes to the H-1B visa process will increase employer costs from $2,000–5,000 to over $100,000 per employee,^4,5 making sponsorship financially untenable for most private clinics. These dual increases threaten to choke off one of the most viable solutions to the veterinary shortage just as the system is most in need of support. Without meaningful reform or relief, the United States risks deepening its workforce crisis by making it financially and logistically impossible for qualified foreign veterinarians to contribute.

This moment calls for clear-eyed advocacy from within the profession. Despite the profound impact of the ECFVG fee increase, the AVMA has not publicly released a financial breakdown to justify the cost doubling, nor has it provided transparent data on how these new fees were calculated. The justification has been attributed to rising expenses from test site partners (Viticus Group and Mississippi State University, the only 2 current CPE sites), yet at least one of these sites operates as a for-profit entity, raising ethical concerns about accessibility and equity in licensing. The AVMA must prioritize transparency and actively explore alternative, more affordable testing centers, especially if credentialing is to remain a viable pathway for global veterinary talent. An email template can be found in RESOURCE 2.

Beyond fee structures, federal advocacy is urgently needed: placing veterinary medicine on the U.S. Department of Labor’s official shortage occupation list (Schedule A) would open immigration priority pathways and reduce barriers for foreign professionals.

Finally, education and awareness within the profession, through hospital training, mentorship, and administrative support, are essential. Change starts with understanding: When more clinics, managers, and colleagues comprehend the process, they are better equipped to support those going through it. The veterinary shortage is not just a numbers problem, it’s a policy, equity, and leadership challenge. And we all have a role to play in solving it.

BOX 1 displays strategies to attract and retain foreign-trained veterinarians.

In Summary: One Profession, Many Journeys

Foreign-trained veterinarians bring diversity, determination, and global skill sets to the U.S. veterinary profession. They also face barriers that are often invisible, yet solvable if we work together. Whether you’re a clinic manager, technician, intern, or client, awareness of this journey fosters inclusion.