COMMENTARY

New Global Accreditation Evaluation for Med Schools

Sean Tackett, MD, MPH

Disclosures

May 15, 2019

This past April, 810 participants from 57 countries gathered in Seoul, South Korea, for the World Federation for Medical Education (WFME) World Conference. This was the third time the WFME organized a world conference since it was founded in 1972. The first conference, held in 1988, saw an endorsement of the Declaration of Edinburgh, a list of 12 principles that helped establish an international consensus regarding medical education. The second conference, held in 2003, led to an international endorsement of the WFME's complete set of standards for medical education.

At this third conference, the WFME's Recognition Programme took center stage. In this program, the WFME evaluates agencies that accredit medical schools to ensure that they meet its criteria for formal recognition. Because accreditation influences how medical schools educate physicians, it can have profound effects on medical practice. The WFME Recognition Programme could also significantly influence changes in physician migration.

The Programme fits into the general movement toward globalization, as leaders in medical education have long expressed an interest in standardizing the training that physicians receive. Ultimately, this should "raise all boats" so that every physician is better prepared to care for patients. It should also give physicians more flexibility to learn and work where they'd like.

Challenges to International Education Standardization

Standardization on an international level is especially difficult because medical education looks very different around the world. For example, the United States, Canada, and the Philippines require all medical students to have a bachelor's degree before enrollment, whereas most countries enroll medical students directly from secondary school. Some places, such as Australia, have both models. Massive differences in the density of medical schools are also observed worldwide. Wealthy countries often have one medical school for every million people, whereas some countries have a ratio worse than one school for every 10 million people; cohort sizes can be over 1000 students per year at some schools.

Further complicating things is a movement to tap into growing demand for medical education. Medical education is becoming big business. More medical schools are available in the Caribbean than are needed locally because many enroll US citizens hoping to enter residencies in the United States. Elsewhere, an increasing number of medical schools are seeking to attract students from other countries, such as China and India; these schools teach in the languages of the students they hope to attract rather than the languages spoken by local patients.

Having more medical schools in the world is not inherently bad. Most people agree that we still do not have enough physicians to serve the world's health needs; however, the rate at which the number of schools is increasing and the documentation of "diploma mills" should cause concern for any provider or patient.

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