EDITORIAL

Accreditation of faculties of medicine in Spain

Acreditación de las facultades de medicina en España

Jordi Palés-Argullós

Fundación Educación Médica. Universitat de Barcelona. E-mail: jpales@ub.edu

Some seven years ago, most of the Spanish faculties of medicine began undertaking the Bologna process with the implementation of the new curricula. To do so, they had to previously submit their proposals to the National Agency for Quality Assessment and Accreditation (ANECA) and to the corresponding autonomic agencies for their mandatory verification. The need to have their proposals verified has meant that the universities - and, within them, their faculties of medicine - have had to take great pains to draw up exhaustive plans for their bachelor's degrees, while at the same time, and with a view to transparency, coherence and organisation, they have implemented (at least theoretically) internal quality assurance systems.

Yet, the proposals are precisely that, proposals, catalogues of good intentions in which they stated that they met all the requirements needed to offer a training programme, but which did not guarantee that everything set out in them was actually going to be fulfilled. And as the old saying goes 'paper doesn't blush'.

Seven years later and now our faculties are going to find themselves involved in what is known as the process of renewing the accreditation of their training programmes. This means that they are going to have to offer proof of the extent to which they have fulfilled their commitments and that the results obtained justify the renewal of those training programmes.

This involves making new efforts to collect a series of data and evidence to show they have met the different accreditation criteria. The process is complex and painstaking, but undoubtedly necessary as a system of self-evaluation for detecting strong and weak points, as well as possibilities for improvement that will determine possible changes. I am sure that if this process is carried out properly, it will reveal aspects in need of change along the lines of those discussed in the editorial of the previous issue of the Journal. But to achieve this, all the members of the educational community have to be involved.

Together with this process of compulsory accreditation, the ANECA has begun another process called 'ANECA-Plus', which, for the time being, is limited to certain disciplines and which allows international seals of recognition to be awarded in accordance with the evaluation of aspects set out in international quality standards. These disciplines do not currently include medical studies, although it should be remembered that since 2004 such studies have a series of international standards defined, in this case, by the World Federation for Medical Education (WFME) [1]. These standards have been revised several times in recent years and European specifications have even been drawn up for these standards [2]. Nevertheless, the criteria or standards used in the accreditation of the bachelor's degrees in medicine in Spain are criteria common to all the disciplines and are not specific to medicine.

Going further into this issue, it should be pointed out here that the US Educational Commission for Foreign Medical Graduates (ECFMG) has announced that, as of the year 2023, doctors who wish to apply for the ECFMG certificate in order to be able to practise professionally in that country will have to have graduated from a faculty of medicine (including those in Europe) which has been duly accredited by means of a formal process based on standard criteria comparable to those established for US faculties of medicine by the Liaison Committee on Medical Education (LCME) or other globally accepted equivalents, such as those of the WFME. The WFME, in conjunction with the Foundation for Advancement of International Medical Education and Research (FAIMER), has developed and implemented a programme for the recognition of accreditation agencies.

In the near future it will thus become necessary to make yet another effort so that our faculties can be evaluated in accordance with these international standards. A comparative study presented by the author at the last congress of the Spanish Medical Education Society (SEDEM) concluded that the aspects evaluated by the criteria followed by the national agencies and those followed by the WFME agreed in approximately 70% of cases. But it is necessary to implement mechanisms that allow that level of agreement to reach 100%.

Although the initiative must be started by the evaluation agencies, the involvement of the National Conference of Deans of Faculties of Medicine (CNDFM) must also be sought. I am aware that some steps have already been undertaken in this sense, but they must be completed so that, by the time we reach the year 2023, we have already done our homework and none of our students (future physicians) can be affected by non-compliance with the ECFMG requirements.

References

1. World Federation for Medical Education. Estándares globales en educación médica, 2004. URL: http://wfme.org/standards/bme/2-wfme-trilogy-bme-pgme-and-cpd-spanish/file.         [ Links ]

2. World Federation for Medical Education. Global standards for quality improvement in medical education. European specifications. URL: http://wfme.org/standards/european-specifications/21-european-specifications-english/file.         [ Links ]