Accreditation
1. Does the WFME accredit medical schools?
No, WFME does not provide an accreditation process for medical schools. The WFME Recognition Programme grants Recognition Status to individual accrediting agencies normally operating within a specific country that have been evaluated as meeting WFME recognition criteria. Recognised agencies then accredit individual medical schools and programmes of instruction.
2. What is the purpose of the WFME Recognition Programme?
The purpose of the WFME Recognition Programme is to provide a transparent and rigorous method of ensuring that accreditation of medical schools, world-wide, is at an internationally accepted and high standard.
WFME assures the standard of accreditation of medical schools, by evaluating accreditation agencies. It provides a system to review and recognise existing accreditation systems on the basis of a transparent process and with public announcement of the results of the assessments.
3. Why and how does WFME have authority?
WFME offers the Recognition Programme to support quality improvement and the maintenance of quality of medical education, world-wide. In 2004 and 2005, WFME worked jointly with the World Health Organization to develop guidelines for accreditation of medical education, and a programme to promote accreditation of medical education.
When the Educational Commission for Foreign Medical Graduates (ECFMG), a member of Intealth, introduced in 2010 medical school accreditation by a recognised accrediting agency, it explained that accreditation should use criteria comparable to those used in the USA, or other globally accepted criteria such as the WFME Global Standards for Quality Improvement in Basic Medical Education (BME). For current information on the ECFMG policy, refer to the ECFMG website at www.ecfmg.org/accreditation.
4. What is the World Directory of Medical Schools, and is it related to the Recognition Programme?
The World Directory of Medical Schools (WDMS) is a list of medical schools. To be included in the directory, schools must be recognised by the government of the country in which each is situated.
It is the objective of WDMS to list all the medical schools in the world, with accurate, up-to-date, and comprehensive information on each school. The World Directory defines “medical school” as an educational institution that provides a complete or full programme of instruction leading to a basic medical qualification. Listing does not mean or imply that the school is accredited. WDMS is working jointly with interested accrediting agencies on a project to include information in the directory on which medical schools are accredited by WFME recognised agencies.
WDMS is managed jointly by WFME and FAIMER.
Recognition Process
The following types of agencies are eligible to apply for WFME recognition:
a) a government or inter-governmental entity, or
b) an independent professional body that is authorised or recognised by the relevant national or state/provincial government (Ministry of Health or Ministry of Education or both), or the legislator (parliament), or
c) an independent professional body that is authorised or recognised by a professional or scientific association with appropriate authority.
6. What is the difference between the WFME Global Standards for Quality Improvement in Basic Medical Education (BME) and the WFME Recognition Programme?
In the WFME Recognition Programme, the criteria for recognition status require that an accrediting agency must work to predetermined, agreed to and publicly available standards, which must be appropriate to the local context. The standards used may be the WFME standards, or a variant of them, or other standards suitable for the local setting.
WFME developed the Global Standards for Quality Improvement in Basic Medical Education (BME) to guide medical education programme development and evaluation. They are intended for use by institutions, organisations and national authorities responsible for medical education, and to stimulate quality improvement.
7. Must an accrediting agency use the WFME BME standards to receive WFME recognition?
No. The accrediting agency should use the standards for basic medical education that are agreed for medical education in the country or region where it operates. The country or region must adopt or develop its own set of standards for basic medical education, which must consider the local needs, context and culture of medical education and medical care. They may be the WFME BME standards themselves, or be based on those WFME standards, or be a different set of comparable standards.
8. What is the time-scale of the WFME recognition process?
An application to the Recognition Programme usually takes 12-18 months, from submission of eligibility application through to Recognition Status decision. A detailed timeline is available here.
9. What percentage of the Criteria for Recognition must an accrediting agency meet to be recognised by WFME?
There is no exact percentage of the Criteria for Recognition that must be fulfilled provided that the overall assessment shows the accrediting agency to be working at an acceptable level. The assessment procedure is rigorous, and it is likely that to be successful, an accrediting agency will meet a very high proportion of the criteria.
10. How much does WFME recognition cost and who pays for it?
There is a fee of $1,000 for assessment of the application form. In the event that examination of the application form shows that the agency is not eligible for recognition by WFME, this fee is non-refundable.
The fee for the full process of recognition is $60,000 (inclusive of the $1,000 assessment fee).
These fees are payable by the accrediting agency seeking recognition. In addition, the accrediting agency seeking recognition pays for the travel and accommodation of WFME recognition team members.
11. What elements are covered by the WFME recognition cost?
The costs of the Recognition Programme include the academic, administrative and clerical support of the programme and specific costs relating to the evaluation of each application. These costs include: the initial assessment of the full application, administrative and logistic support of the WFME recognition team and recognition process, the recognition team’s observation of the accrediting agency during a site-visit to a medical school, and a meeting of the agency’s decision making committee. The fee also covers the costs of preparing the final report, including feedback to the agency, and the meeting of the WFME Recognition Committee.
The fee also supports the further development of the recognition programme.
12. The accrediting agency in my country has low resources and cannot afford to participate in the WFME Recognition Programme. What should I do?
Contact the WFME office ( accreditation@wfme.org ) to discuss the position. WFME policy is that all eligible accrediting agencies should be able to approach WFME for recognition even if based in a country with low resources.
13. Who can the accrediting agency in my country contact if they need assistance in preparing for WFME recognition?
The WFME office, accreditation@wfme.org and admin@wfme.org
14. Does WFME offer advice to an accrediting agency to help it prepare for the recognition process?
WFME no longer offers advisory visits to an accrediting agency that is planning to apply to WFME for recognition. WFME can provide a list of independent experts who can be approached by an accrediting agency that seeks advice. For further details, consult the WFME office, mailto:accreditation@wfme.org.
WFME does not maintain a publicly available list of medical schools accredited by WFME recognised agencies. However, the World Directory of Medical Schools (WDMS) is currently working jointly with interested accrediting agencies on a project to include accreditation information on medical schools accredited by WFME recognised agencies.
Accreditation Standards
16. My medical school did a self-evaluation using the WFME BME standards. Is this sufficient for WFME recognition?
No. The WFME Recognition Programme does not accredit individual medical schools, but grants Recognition Status to individual accrediting agencies normally operating within a specific country that have been evaluated as meeting WFME recognition criteria. The WFME recognised agencies then accredit individual medical schools. Self-evaluation against WFME standards is not sufficient for WFME recognition.
17. My medical school was evaluated by an external evaluator using the WFME BME standards. Is this external evaluator eligible for WFME recognition?
Only if the external evaluator is an acceptable accrediting agency as set out in the answer to FAQ 5 above.
18. My medical school is accredited by an accrediting agency that uses the WFME BME standards. Is this accrediting agency eligible for WFME recognition?
Only if the accrediting agency is an acceptable accrediting agency as set out in the answer to FAQ 5 above.
19. My school is accredited by an accrediting agency which does not use the WFME BME standards. Could the accrediting agency receive WFME recognition?
The accrediting agency must use standards that are at the right level, predetermined, agreed and publicly available and appropriate to the local context, it does not have to use the WFME standards.
20. The accrediting agency in my country uses standards that are applicable across all higher education programmes and are not specific to medical schools. Could the accrediting agency receive WFME recognition?
According to the WFME Recognition Criteria, the accreditation system must be medicine-specific or possess similar characteristics. A general system for all higher education in the country is not necessarily sufficient to assess and ensure the quality of medical education and its outcomes. In a medicine-specific system, the standards or criteria address the mission and social accountability of the medical school, medical programme outcomes, ensure coverage of subjects in the curriculum such as professionalism, medical ethics and patient safety, and define appropriate content in the biomedical disciplines, behavioural and social disciplines, and the clinical disciplines. The standards and the accreditation process must also include clinical training: through clerkships or rotations in medical disciplines and in a variety of clinical settings. These aspects of medical education must be embraced in an accreditation process for medical education
The accreditation process needs to draw on appropriate expertise by including contributors with academic background or professional interests in medicine, health professions education, and health care in assessing the educational programmes and medical schools and making decisions on accreditation.
By including standards or criteria on medicine relevant topics and by making use of medical expertise in accreditation, a general accreditation system can fulfil the needs of medical education and be recognised by WFME.
Accrediting Agencies
21. My country does not have an accrediting agency. What should I do?
Accreditation of medical programmes is an important process to enhance the quality of medical education, by verifying that medical schools are competent in the delivery of medical education, and that medical education programmes are suitable. Medical schools, medical students, the profession and the public can advocate with government and other authorities for an accreditation system for medicine.
22. My country has only a few medical schools. Is it possible for there to be an accrediting agency solely for a small country?
For accreditation to be trustworthy, it is essential that the experts undertaking assessment of medical schools are able to give an unbiased and dispassionate assessment. If there are so few schools in a country the staff of every medical school know almost all of the staff of every other medical school, this may be impossible. Countries with few medical schools have addressed this problem by (a) using an accrediting agency based in another country or (b) developing an accrediting agency for two or more countries that may be geographically, culturally and linguistically close. Other options may also be possible.
23. How do I support the development of an accrediting agency, and what are the requirements for such an agency?
The requirements for an accrediting agency for medical education are set out in “WHO-WFME Guidelines for Accreditation of Basic Medical Education 2005” which can be downloaded from http://wfme.org/publications/. The current WFME Recognition Criteria can be found at http://wfme.org/accreditation/recognition-criteria/.
The creation of such an agency should be a joint endeavour of all the interested parties. It is useful to learn from long-established and well regarded accrediting agencies, and also from the experience of regional associations for medical education.
24. Can WFME help us set up an accrediting agency?
WFME can offer general advice on accreditation, but does not provide detailed support in the setting up of accrediting agencies. If it were to do so, then there would the risk of a conflict of interest – WFME assessing an agency that it had helped to create.
25. My country has an accrediting agency but the agency leadership is not interested in participating in the WFME Recognition Programme. What should I do?
All accrediting agencies should understand the value of a regular quality assurance and quality improvement process conducted against clear criteria. Participation in the WFME recognition process allows accrediting agencies:
- to assess their own performance against the WFME criteria and implement improvements as necessary,
- to demonstrate to the organisations that fund or support the agency’s commitment to good practice and external review,
- to learn from the collegial interactions with members of the WFME recognition team’s quality improvement recommendations and the recognition report.
The right course of action is to persuade the leadership of the accrediting agency of the advantages of having international recognition of the agency, and therefore also of the standards of medical education in your country.
26. There are several accrediting agencies in my country. Which one(s) should apply for WFME recognition?
WFME does not limit the number of agencies from a country permitted to apply for recognition.
Any of the agencies in your country that meet the eligibility requirements (see response to question 5) may apply for recognition (or several may apply), but an agency that is specifically focused on accrediting medical education Programmes may be the most appropriate.
ECFMG Policy
26. What is the ECFMG 2024 (previously 2023) policy?
ECFMG has announced that, starting in 2024 (previously 2023), individuals applying for ECFMG Certification must be a student or graduate of a medical school that is accredited by an accrediting agency recognised by the World Federation for Medical Education (WFME).
The WFME Recognition Programme is the only programme accepted by ECFMG at the current time for the recognition of medical school accrediting agencies.
Thus, beginning in 2024, medical schools will need to be accredited by a WFME-recognised accrediting agency if they wish to ensure their students and graduates are eligible for ECFMG Certification. For more information regarding the ECFMG 2024 Medical School Accreditation Requirement, please see: www.ecfmg.org/accreditation/.
27. Where can I find more information on the ECFMG 2024 policy?
The ECFMG website is the best source of information on the ECFMG 2024 policy.
To find out whether your medical school is accredited by a recognised agency, first enquire of your school whether or not it is accredited and if so, by which agency. You can probably also verify this school’s accreditation status on the agency’s website. You can then check whether that agency is recognised by WFME by consulting our website: http://wfme.org/accreditation/accrediting-agencies-status
If you are concerned about whether you will be eligible for ECFMG Certification starting in 2024, please see the ECFMG website for details on applicant eligibility.
29. What is the relationship between WFME, ECFMG and FAIMER?
The US Educational Commission for Foreign Medical Graduates (ECFMG) is represented on the Executive Council of WFME as an elected Executive Member.
The Foundation for Advancement of International Medical Education Research (FAIMER) is a non-profit foundation founded and supported by ECFMG. WFME and FAIMER are the partners who manage the World Directory of Medical Schools.
Yes, it has. ECFMG previously announced that, starting in 2023, applicants for ECFMG Certification will be required to be a student or graduate of a medical school that is accredited by an agency recognized by the World Federation for Medical Education (WFME).
ECFMG has acknowledged that many countries have been forced to suspend or limit their accreditation efforts due to COVID-19 (Coronavirus). Because of this, ECFMG moved the implementation of the requirement to 2024. An effective date will be announced as the year 2024 is approached.
