COMMENTARY

New Global Accreditation Evaluation for Med Schools

Sean Tackett, MD, MPH

Disclosures

May 15, 2019

US Interest in Global Medical Education Quality

The United States has a special interest in assuring that international medical education is of high quality because it receives the largest number of physicians migrating from other countries. Since the 1950s, the Educational Commission for Foreign Medical Graduates (ECFMG) has been authorized by the government to vet international medical graduates (IMGs) to assure that they are ready to enter residency in the United States. In 2010, the ECFMG announced that all IMGs would need to come from properly accredited medical schools by 2023.

That's where the WFME Recognition Programme fits in. The WFME was designated as the authority to evaluate accrediting agencies to make sure that their standards and processes are sufficient to evaluate medical school quality. Therefore, any medical school accredited by this agency should be considered trustworthy by the ECFMG and US residency programs. This has raised the profile of the WFME considerably, which had previously maintained data resources and provided consultative services with limited authority.

What Comes Next

WFME has made progress in formally recognizing agencies for ECFMG purposes. Shortly after the April conference, the WFME added more agencies to its list. More are signing up to be evaluated by the WFME, although no one knows how many more will be added before 2023. Given that there are more than 100 agencies that cover those who apply to the ECFMG, this may prove problematic.

For example, anyone in the United States would have a hard time picturing a workforce without Indian doctors; however, India's inclusion is in jeopardy because it currently has no functioning accrediting agency, and the creation of a new one is waiting on legislation in Parliament. If Indian ECFMG applicants are excluded, the pool of applicants for residency positions in 2023 could decrease by 10% or more. Pakistan, another country that sees many of its physician trainees come to the United States, is also not currently on the WFME's pending-recognition list. In 2023, US IMGs will almost certainly come from fewer countries than before, with the potential for a shortage of applicants to fill first-year residency positions.

Unlike previous WFME conferences, the third conference was not seeking to achieve an international endorsement. Rather, it was a time of reflection and preparation at another inflection point in international medical education. Many attendees came to learn more about the Recognition Programme and to hear directly from WFME and ECFMG leaders. These leaders confirmed that the Recognition Programme would continue and expand, and that the 2023 deadline set by the ECFMG for those seeking to practice in the United States would remain. Additional discussion included revising WFME standards and consideration of the WFME's role in accreditation of postgraduate training programs, which has been driven primarily by the Accreditation Council for Graduate Medical Education International.

Although there is a good chance that you had not previously heard of the WFME, it may soon have real influence over medical school education worldwide and will certainly have an impact on physician migration into the United States. The next world conference is tentatively slated for 2022, which will be on the cusp of the ECFMG deadline.

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