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What is the Difference Between a DACVIM and a DVM?

Updated: Jun 7, 2023

Whenever you're discussing the practice of medicine of any kind – whether it's human or animal – you're going to encounter a wide variety of acronyms and letters that follow up the names of the people you talk to. In veterinary medicine, two of the most common are the DVM and DACVIM. What do they mean, and what's the difference between them?


Simple Definitions


First, let's start with the basics: what do these two sets of letters mean in the first place?


DVM: Doctor of Veterinary Medicine


The DVM is a doctorate-level degree in veterinary medicine and is a certification that the vet in question graduated with a full doctorate from a veterinary school and is at least educated to practice veterinary medicine. Note that we said educated; a DVM still needs to be licensed in order to practice, and they must pass whatever licensing requirements are issued in any given state where they want to practice.


A DVM doctorate degree is generally a four-year degree program involving a lot of training at a veterinary school. Half the time is usually spent in labs and classrooms, where the aspiring vet studies things like pharmacology, pathology, toxicology, and immunology, along with topics that include surgery and surgical tech, infectious diseases, and parasites.



The second half is more often spent in clinical rotations and hands-on experience, like an apprenticeship under a seasoned vet.


All of this requires that the aspiring vet have at least an undergraduate degree in some relevant field. Vets can come from a variety of different angles, so you have some with undergrad degrees in biology, chemistry, anatomy, psychology, and microbiology, while others focus directly on subjects like animal nutrition and zoology.


As an aside, you may also see a VMD rather than a DVM. The VMD is essentially the same thing, but it's issued solely from one institution: the University of Pennsylvania's School of Veterinary Medicine, aka PennVet.


PennVet is one of the oldest vet schools in the United States, and its curriculum is venerable and well-established.


DVM and VMD are nearly identical qualifications, often leading to similar career paths. The critical difference lies in their specializations: while a DVM graduate might focus on various animal healthcare practices, a VMD graduate often specializes in areas such as ophthalmology, dermatology, or orthopedics.


DACVIM: Diplomate, American College of Veterinary Internal Medicine


The DACVIM is a specialist certificate – a diploma, to be specific – that follows from a program offered by the American College of Veterinary Internal Medicine.


ACVIM, as it's known, is a specialist association that turns general vets into specialists with licensing and further specialized education. It's a board-certified degree.


Vets need to graduate from a school that is certified by the American Veterinary Medical Association and have a license to practice veterinary medicine in the United States in order to be able to apply for the DACVIM certification program.


The DACVIM is not itself a training program but rather a certification exam and inspection. Vets must have a sufficient amount of training from internships, residencies, and documented experience in clinical settings.



Becoming a DACVIM entails more than just passing an exam. It involves a comprehensive journey of acquiring extensive education and experience. After earning an undergraduate degree and a doctorate, candidates must undergo full-residency programs, amassing thousands of hands-on hours dealing with complex patient cases. They gain expertise in diagnosing and treating these cases, often including rotations through various specialties to enhance their skill set. Further, they must pass rigorous examinations and contribute to their field by publishing an original research study. Only then can they apply for the DACVIM certification and earn the title upon completion.


The American College of Veterinary Medicine also provides some sub-categories within the DACVIM.


For example, a vet with a DACVIM that is Limited to the Practice of Surgery means the doctor has completed a residency and can practice surgery on animals, but they don't have full board certification for comprehensive internal medicine. Likewise, the Board Certified title indicates that the vet passed the exam but isn't still a member of the ACVS, so they fall into a slightly different category.


Other Potential Titles


There is another group of specific titles and letter strings you might see after a vet's name.


While they aren't the focus of this post, it's still worth knowing how to decode them.


DACVS: The Diplomate, American College of Veterinary Surgeons, is a surgical specialty. A DVM must complete a minimum of a three-year residency, get a scientific manuscript published in an approved journal, and pass a variety of exams to be eligible for the title, making it a fairly advanced title to hold.



C-, L-, or RVT represents Certified, Licensed, or Registered Veterinary Technician, akin to "Veterinary Nurses." These professionals hold state certifications to perform various veterinary practices under the supervision of a veterinarian.


They play crucial roles, from assisting with surgeries, conducting lab procedures, and monitoring anesthesia to providing nursing care. They're not just assistants; they're at the heart of patient care, indispensable in maintaining the health and well-being of our animal patients. As a practicing vet, I can confidently say that I couldn't live without them.



Vet Techs are required to pass an exam to be licensed and need to take continued education courses throughout their career.


Whether the tech is listed as a CVT, LVT, or RVT depends on the state where they're certified; there's no further nuance to it.


VTS: The Veterinary Technician Specialist is the DACVIM to the DVMs of the vet tech. VTS is usually accompanied by a specialty so that an individual may be a VTS of critical care, or of oncology, or of equine care, dentistry, and so on.



VTS titles require at least 4+ years of experience in the field and enough education, credentials, and skills to pass additional exams. It's standardized by the National Association of Veterinary Technicians in America and certifies that the vet tech is experienced in a given specialty.


A Matter of Specialty


If you ask a DACVIM what the difference is between them and a DVM, you likely get a deflective answer. It's not because of uncertainty or a lack of confidence; rather, the DACVIM is a specialist certification and includes advanced study and knowledge, such that simply explaining it tends to feel a lot like bragging, and many DACVIM-certified vets don't like to brag.

  • Most of the time, if someone brings a patient – a dog, a cat, a bird, a horse, what have you – to a vet, they're going to be seeing either a CVT/LVT/RVT or a DVM. If that patient has advanced care needs, they're more likely to see a DVM.

  • If their case is especially complicated or advanced, they'll be more likely to be referred to a DACVIM. It's not an exaggeration to say that the DACVIM is a certification of being at the top of the field.

In addition to a full undergraduate degree and a full doctorate, these individuals also have to go through full-residency programs, obtain thousands of hours in direct, hands-on experience helping patients with all manner of complex cases, handle diagnosis and treatment of complex cases, and more. On top of all of that, they often go through rotations through other specialties to further broaden their knowledge. They also have to pass multiple high-level exams and publish an original, unique research study.

It's a lot!



To draw a few comparisons, consider other fields.


In a retail store, you have front-line workers as cashiers, stockers, and so on; these are equivalent to, say, the front-desk workers at a vet who do secretarial work but need to be certified to work with the animals directly. You also have your store managers.

These are the ones trained and approved to have more authority in their store and are more like the Vet Tech role. You then have district and regional managers; they have more responsibilities, greater decisions to make, and more power to wield and are closer to the DVM. Then you have the company corporate managers and executives, the people with the greatest overview, the most authority, and the best perspectives, the DACVIM equivalent.



The realm of veterinary medicine aligns closely with human healthcare in terms of roles and responsibilities. If you equate a DVM (Doctor of Veterinary Medicine) to a family doctor handling general health concerns, a VTS (Veterinary Technician Specialist) parallels the role of a Nurse Practitioner, with advanced training to handle complex situations. Picture an urgent care scenario: for minor cases, you'd consult a registered nurse, similar to a basic veterinary technician. However, for intricate or ongoing health matters, you'd seek a Nurse Practitioner, just like you'd consult a DVM for your pet. For specialized needs, a human medical specialist would be called upon, akin to a DACVIM in veterinary medicine.


In veterinary medicine, we're a collaborative, unified team, each member playing a unique role, none more prestigious than the other. General practitioners, specialists, and veterinary technicians – we all bring diverse expertise and experiences to benefit the animals we care for. We're akin to a puzzle, and every piece is essential to completing the picture of holistic animal care.


Communication and collaboration between us are both crucial. So, don't hesitate to reach out at 253-341-5835, whether you're a pet owner or a fellow professional. We frequently engage with doctors and are here to help, free from intimidation. We're all part of the same team.



Is It Better to See a DVM or DACVIM?


If you're a pet owner and you're wondering who you should be seeing for the care your animal needs, should you see a DVM, or should you push to see a DACVIM?


Truthfully, it depends on the case. Most common issues – parasites and infections, basic injuries, and common cancers – can be handled by a DVM just fine. It's usually only for advanced, unusual, or special cases where a DACVIM is the better choice. Consider the difference between going to an oncologist versus going to "one of the three foremost experts in Lymphoma in the world."


Or, to put it another way, the care provided by a DACVIM is more than likely overkill for simple cases.


You don't need a DACVIM to set a broken leg, prescribe antibiotics, or treat a common and responsive cancer.



However, a DACVIM may have resources, connections, or knowledge that can provide better treatment or alternatives in specific cases. A complex cancer case is a good example. A DVM will have a handful of options, like the usual roster of chemotherapy in the CHOP protocol or connections with modern service providers like FidoCure.


Meanwhile, a DACVIM is more likely to be able to enroll a pet in a clinical trial of a promising new treatment or analyze the quirks of a case to offer a different treatment than the standard, with a greater chance of success.


The downside, of course, is that there are relatively few DACVIM-holders out there. Since it's so specialized and requires so much work, education, research, and time, there are a lot more DVMs than there are DACVIMs.


It can be challenging to find them, contact them, and work with them.


That's where we come in.


At Hope Vet, we're a connection between vets and primary care providers and the specialty connections, information, and consultations a DACVIM can provide. In fact, our team consists of a number of DACVIM, ACVIM, and similar vet specialists, with a broad and comprehensive knowledge base across the board.


The Bottom Line


As a pet owner, your goal is to get the best possible care for your animal. That doesn't necessarily mean going to the best DACVIM you can find, though; it means going to the most appropriate provider for your case.


If your dog sprains a joint, a DACVIM isn't going to help any more than a vet tech, and all you'll do is spent an excessive amount of money on a consultation you don't need.


Your best option is to go to your local vet and talk to a vet tech. They'll be able to tell you if your issue is easily solvable or if it's complex enough they need to get the DVM involved. If the latter, you progress to the DVM. They will then examine your patient and, just like the tech, will either be able to provide care or will want to refer you up the chain.


As a vet, if you're a DVM, wonderful! You're in a great position to provide excellent care for your patients. You can also reach out to us, and we'll be more than happy to provide consulting for you and your complex cases. Whether it's internal medicine, oncology, neurology, emergency care, critical care, or dermatology, we have specialists on hand to offer advice and options for anything you can't handle on your own.


And, if you choose to pursue your own DACVIM, we'd welcome your insight as well.

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