Steven T. DeKosky, vice president and dean of the University of Virginia School of Medicine, responds to the Physicians Committee for Responsible Medicine about the use of cats to train graduate physicians in the intubation of premature infants.
January 12, 2012
John Pippin, MD, FACC
Director of Academic Affairs
Physicians Committee for Responsible Medicine
Dear Dr. Pippin:
I am responding to your recent letter to President Sullivan.
As I know you are keenly aware, our physicians believe that the use of cats to train graduate physicians in the technique of inserting breathing tubes into critically ill premature newborns is the most effective teaching method available today.
They do not believe a simulator is currently available to teach this delicate procedure effectively enough to give physicians the level of proficiency they need to perform an intubation in the 30 to 60 seconds it takes to save a premature baby’s life.
Our physicians do not take this training – or their responsibility for saving young lives – lightly. They stay abreast of the new technology and, in fact, use it. All physicians must first become proficient on simulators before they are allowed to perform the procedure on a cat.
You must also be aware that the USDA inspects our facilities and procedures, and the Association for Assessment and Accreditation of Laboratory Animal Care accredits our program. We conduct a thorough annual review on the use of cats for this procedure. This year will be no exception. At that time, our physicians will review all of the latest methods and weigh many factors before deciding how to proceed.
For now, we stand behind the use of cats in this training protocol. At the same time, we continue to look for a simulator that is better able to mimic a live infant in distress.
We hope this happens sooner rather than later. But we do not believe that it’s in the best interest of our physicians – nor in the best interest of the premature infants whom they will be called on to treat – to move from using the cats in response to a public relations campaign mounted by PCRM.
Some important University facts that are repeatedly misrepresented:
- No physician is permitted to intubate one of our three cats before demonstrating proficiency on a mannequin.
- Cats are anesthetized and carefully monitored.
- No cats have died or suffered significant injuries as a result of the training.
- Cats are treated with the greatest of care, and adopted upon retirement.
Until an adequate simulator comes on the market, we believe that our approach – having a physician first intubate a live animal rather than a critically ill infant – is the more humane approach.
With kind regards,
Steven T. DeKosky, MD, FAAN, FACP
Vice President and Dean
James Carroll Flippin Professor of Medical Science