Accreditation

The Medical Education Global Standards of Quality for the Improvement of Health Care proposed by the World Federation for Medical Education (WFME) were approved by the World Conference for Medical Education held in Copenhagen in 2003. At the beginning of 2004, WHO and the WFME renewed the existing 1972 partnership, in order to develop a joint strategy to promote medical education through accreditation. A joint task force was established which has already meet twice: in Barcelona on April 1st and in Copenhagen on October 3rd.

The joint task force in Barcelona dealt with the possible roles to be played by the WFME in support of the needs at regional, national or institutional levels; the function of external advisor and how to recruit and train the required international advisors. The Copenhagen meeting dealt with the global accreditation principles, how to develop a global accreditation system, the decision making processes as well as the required accreditation structures. Among the 26 delegates gathered at this meeting, members of the regional associations for medical education, responsible officers for human resources of the WHO regions and headquarters, delegates from accrediting agencies from USA, Great Britain, Australia, South Africa and Switzerland, joined the experts of WHO and the WFME. The relevance of the task started jointly by WFME and WHO deserves that some relevant aspects of what was discussed at the meeting should be known even before the official report is delivered, hopping that any contribution that may generate would help to improve the final strategy. If any inaccuracies between this note and the final report exists, the WFME should not be held responsible for it.

The task force agreed that the regulatory capacity for accreditation resides at the national/state level, nevertheless the possibility to delegate the implementation processes to subnational (provincial) levels or to establish coordination mechanisms at supranational levels remained possible and probably convenient, as in the case of the European Union. The joint role of WHO-WFME would consist in harmonizing the accreditation processes and criteria around the principles established by the WFME Global Standards, to facilitate its implementation wherever no accrediting mechanism are established and to provide support an advice to countries and institutions that so demand. The WHO World Directory of Medical Schools, as a register of recognized educational institutions, was considered adequate as a promoting tool.

The accrediting function at national level should be exercised by an independent statutory body which governance is participated by representatives of all stakeholders, should be capable of promoting regulatory norms and receive the needed resources for the accomplishment of its functions. The accreditation processes should be useful and perceived as such by all stakeholders. They should be build on reciprocal social trust, characterized by its feasibility, credibility, flexibility and efficiency, and capable to be adjusted to the variable environmental conditions of the different regions with different needs. The convenience to act through the Universities, whenever possible, was also considered advisable although recognizing the different perspectives from the Medical Schools that they often express.

The fact that the WHO has declared 2006 as the starting of a decade devoted to the Human Resources for Health, it was deemed convenient to submit to the WHO a proposal on accreditation of medical education institutions and programmes for its approval.

Albert Oriol Bosch