Global trends in medical education accreditation

(2021) 19:70 Bedoll et al. Hum Resour Health https://doi.org/10.1186/s12960-021-00588-x Open Access RESEARCH Global trends in medical education accreditation Deborah Bedoll* , Marta van Zanten and Danette McKinley Abstract Background: Accreditation systems in medical education aim to assure various stakeholders that graduates are ready to further their training or begin practice. The purpose of this paper is to explore the current state of medical education accreditation around the world and describe the incidence and variability of these accreditation agencies worldwide. This paper explores trends in agency age, organization, and scope according to both World Bank region and income group. Methods: To find information on accreditation agencies, we searched multiple online accreditation and quality assurance databases as well as the University of Michigan Online Library and the Google search engine. All included agencies were recorded on a spreadsheet along with date of formation or first accreditation activity, name changes, scope, level of government independence, accessibility and type of accreditation standards, and status of WFME recognition. Comparisons by country region and income classification were made based on the World Bank’s lists for fiscal year 2021. Results: As of August 2020, there were 3,323 operating medical schools located in 186 countries or territories listed in the World Directory of Medical Schools. Ninety-two (49%) of these countries currently have access to undergraduate accreditation that uses medical-specific standards. Sixty-four percent (n = 38) of high-income countries have medicalspecific accreditation available to their medical schools, compared to only 20% (n = 6) of low-income countries. The majority of World Bank regions experienced the greatest increase in medical education accreditation agency establishment since the year 2000. Conclusions: Most smaller countries in Europe, South America, and the Pacific only have access to general undergraduate accreditation, and many countries in Africa have no accreditation available. In countries where medical education accreditation exists, the scope and organization of the agencies varies considerably. Regional cooperation and international agencies seem to be a growing trend. The data described in our study can serve as an important resource for further investigations on the effectiveness of accreditation activities worldwide. Our research also highlights regions and countries that may need focused accreditation development support. Keywords: Accreditation standards, Medical education, Health professions education, Regulation Background There are currently over 3000 medical schools providing education and training to aspiring physicians around the world. The medical education curriculums, experiences *Correspondence: Foundation for Advancement of International Medical Education and Research (FAIMER), Philadelphia, USA offered, available resources, length of study, etc., vary widely depending on regional, political and other contextual factors. This variability in educational models, combined with the rapid increases in the number of medical schools worldwide [1] and increasing international mobility for education and employment [2] necessitate oversight of quality assurance, such as formal accreditation systems, to ensure medical educational institutions © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Bedoll et al. Hum Resour Health (2021) 19:70 function appropriately [3]. For the purpose of this paper, we use the definition of accreditation as described by van Zanten et al. [4], “a process by which a designated authority reviews and evaluates an educational institution using a set of clearly defined criteria and procedures”. Accreditation systems in medical education aim to assure various stakeholders, including students, educators in postgraduate educational programs, employers, and patients, that graduates are ready to further their training or begin practice. Oversight of the educational content and pedagogical methods is necessary to ensure that the learning needs of the students are met and endeavor to ultimately impact the quality of medical care provided to patients. While there should also be significant consequences for educational institutions that do not meet the standards, an important aim of the accreditation process should be encouraging ongoing institutional improvement and fostering the dissemination of best practices, both regionally and globally. The development and sustainability of educational quality assurance systems is supported by various international organizations worldwide. The World Health Assembly in its Global Strategy on Human Resources for Health: Workforce 2030, encouraged all countries to have accreditation for medical and other health training programs by 2020 [5]. The World Medical Association also supports quality assurance mechanisms to promote trust in the health workforce [6]. The World Federation for Medical Education (WFME) Recognition Programme aims to provide an independent, transparent and rigorous method of ensuring that accreditation of medical schools worldwide is at an internationally accepted and high standard [7]. As part of the Recognition Programme, WFME evaluates compliance of accrediting agencies with pre-defined criteria [8]. Since 2005, the Foundation for Advancement of International Medical Education and Research (FAIMER®) has been gathering and publishing data on accreditation activities worldwide. Their Directory of Organizations that Recognize/Accredit medical schools (DORA) lists organizations that recognize, authorize, or certify medical schools and/or medical education programs and related data [9]. Summary data from DORA of accreditation activities around the world showed that while over half of all countries with medical schools indicate that there is a national process of accrediting medical educ (...truncated)