A Mayo Clinic medical training program that includes surgery on live pigs has come under fire from a national physicians organization that says it violates federal animal protection laws.

The Physicians Committee for Responsible Medicine filed a complaint with the U.S. Department of Agriculture last week contending that Mayo is violating the federal Animal Welfare Act of 1966, which says that institutions must "assure that discomfort and pain to animals will be limited to that which is unavoidable."

"The time has largely passed when animals were … considered the equivalent of laboratory equipment, and there is more attention paid to ethical issues," said Dr. John Pippin, director of academic affairs for the Washington, D.C.-based group, which advocates for scientific ethics and nutrition.

Mayo declined to make someone available for an interview but said in a statement: "Mayo Clinic meets or exceeds all standards set by the federal agencies and accrediting agency required for the use of animals."

Switching to simulators

The Rochester-based clinic is one of only 15 programs in the country that continue to use live animals to train medical residents in emergency medicine, according to the Physicians Committee. The group said most training programs have switched to simulators to educate new doctors in surgical techniques such as inserting breathing tubes or opening chest cavities.

Hennepin Healthcare, which operates HCMC in Minneapolis and trains residents from the University of Minnesota, recently ended its use of live sheep and rabbits in emergency medicine residency training after it was targeted by the same group. That campaign lasted four years and included billboards and protests.

The doctors' group said use of live animals is avoidable because of advances in sophisticated medical simulators, which are models of the human body that allow students and residents to learn surgical techniques.

Over the past 15 years, the use of animals in medical education has largely ended, according to the Physicians Committee. Medical schools no longer use them, and many residency programs, including pediatrics and anesthesiology, have followed suit.

For emergency medicine residency training, 86 percent of programs used live animals in 2004. Today just 6 percent of programs continue to use live animals, according to a Physicians Committee survey.

Inferior training?

"The alternatives are as good if not better," said Dr. Kerry Foley, a retired emergency physician, who met with Hennepin Healthcare's leaders last summer. "Pigs are not anatomically identical to human beings."

Foley noted that Mayo has a simulation training center in Rochester.

Mayo said in its statement that it uses pigs to teach techniques used to provide "lifesaving care to pediatric patients" that "cannot be effectively taught in a simulation center."

Pippin said the Physicians Committee approached Mayo in January 2018 about dropping its live animal training but that it decided to file a complaint after meeting resistance from Mayo leadership.

"It has been made clear in the 13 months that I have been communicating with them that they are not interested in what we have to say," Pippin said.

Dr. Sophie Dojacques, one of the nearly 1,000 Minnesota doctors who are members of the Physicians Committee, said studies show that simulators provide better training than animals.

"Mayo's decision is not only unethical but a disservice to their training residents by providing inferior training experiences," she said. "I sincerely hope that Mayo Clinic … follows Hennepin Heathcare's lead and switches from live animal use to modern, human-relevant training methods."

Rabbits and sheep

Hennepin Healthcare used sheep and rabbits to train residents in emergency techniques that get air to the lungs, as well as drilling holes in the animal's skulls, a procedure that is used to relieve brain swelling.

"This change was made at the end of 2018 due to advances in airway technology that have reduced the need for surgical airway procedures, as well as new applications available in our cutting edge simulation center for training our future generation of physicians," the health care system said in its statement.

Regions Hospital in St. Paul also has an emergency medicine residency program that uses simulators only.

Both Regions and Hennepin Healthcare are training sites for residents at the University of Minnesota Medical School.

The use of animals in research, which is partly regulated by the Animal Welfare Act, is still common in academic institutions as well as by private companies, including medical technology firms.

Mayo and the University of Minnesota each used about 2,000 animals subject to regulatory requirements for research and training purposes in 2017, according to reports they filed with the Agriculture Department. Those numbers do not include mice and rats, which are exempt from the law.

The U's philosophy is to "reduce the use, refine the use and replace the use wherever possible," said Dan Gilchrist, director of communications for the Office of the Vice President for Research.

"But where there is not a comparable substitute then it goes through a rigorous committee process," he said.

Pippin said his group is also interested in taking animals out of research.

"Using animals is not the way to go forward," he said.