One Group Hopes to End the Use of Live Animals in U.S. Surgical Residencies

When John J. Pippin, MD, was in medical school years ago, live animals were a normal part of learning human physiology.

In Pippin’s case, it was dogs, he told MedPage Today. “And that was at a time when if you refused, then you would fail the course.”

However, Pippin, now the director of academic affairs for the Physicians Committee for Responsible Medicine (PCRM), helped convince the University of Massachusetts medical program, where he was studying, to end the use of animals for physiology training.

Today, pediatric residencies in the U.S. and Canada no longer use animals in their training, and only 3% of emergency medicine residencies do. However, some surgical residencies are still using live animals — most often, pigs — as practice patients.

PCRM, known for its advocacy around animal testing, fast food, and dietary guidelines, is pushing for the practice to end altogether. Their latest efforts have focused, in part, on Oregon Health & Science University’s (OHSU) surgical residency program, one of 60 the group has confirmed still use live animals.

“OHSU likes to say, we use animals, and we’re not the only ones. And there are some things that have to be taught to aspiring surgeons you can’t not use animals for. Well, that’s nonsense,” said Pippin. “They should tell that to Harvard and Yale and Mayo Clinic and Cleveland Clinic and so on — they don’t use animals and OHSU can hardly claim that they’re superior to all these programs in the way they train their surgeons. So that’s false.”

Of 281 surgical residencies that the organization has surveyed, 79% do not use animals — though others that do may not have been surveyed.

According to PCRM materials, as many as 132 live pigs every 3 years are used to teach 35 different procedures at OHSU, including chest and breathing tube placement, gallbladder removal, and the use of surgical cameras. If the animals survive the repeat operations, they are killed with barbiturates or other drugs, Pippin said.

OHSU told MedPage Today in a statement that it “only uses animal models in its surgical training program when non-animal methods are inadequate or too dangerous for human participants; all animals are anesthetized and under the care of veterinarians during surgical training.”

Of non-animal surgical training methods, the university noted that “technology currently does not exist to recreate some of the most complex procedures surgeons must regularly perform in humans.” (MedPage Today asked for examples of these procedures, but did not hear back by the time of publication.)

PCRM argues otherwise. A letter sent by the group to OHSU President Danny Jacobs, MD, MPH, pointed out that “over the last three decades, advances in technology have led to the development of simulators based on human anatomy that are remarkably lifelike. Today, these devices replicate human organs, skin, and blood, and they allow for realistic tissue handling and repetitive practice of procedures.”

“A substantial body of scientific evidence shows that simulators and cadavers are equivalent or superior to animals when teaching surgical skills,” the letter noted.

Are alternatives to animals too expensive for hold-out surgical residency programs? OHSU did not mention cost in its statement.

“It’s not a cost issue or all these other programs wouldn’t have done it,” Pippin said. “We have found over the years that when you have a situation like this, where one program is way out of line with other programs, it’s because someone in the program … wants to keep it that way. That may be how they learned how to do it, so they want to continue to do it.”

PCRM offered to pay for a demonstration at OHSU of a perfused cadaver model known as EnvivoPC to convince the school to stop using animals. It’s made by Maximum Fidelity Surgical Simulations and has a $13,000 value, according to the letter.

Pippin also pointed out that the school already has two simulation centers in which to practice surgeries.

OHSU has amassed 31 violations of the Animal Welfare Act from 2014 to 2022, Pippin said, though these, according to other reports, appear to have come largely from its primate research center. The school agreed to pay fines to the Department of Agriculture in a related settlement agreement in 2022.

Icahn School of Medicine at Mount Sinai in New York City, Johns Hopkins University in Baltimore, and Kaiser Permanente Southern California are among the programs that still use live animals, according to PCRM.

Of more than 120 programs that PCRM helped convince to move away from animal models, nearly all have stuck with the choice, Pippin noted.

“There’s no law that says they have to change. They don’t really care what I think, or what we think. They care what the best training is,” he said. “And for that many programs to have changed and not gone back to using animals, well, I think that tells you what the value of it is.”

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