Making the grade: licensing examination performance by medical school accreditation status

Marta Van Zanten,John R Boulet,Christine D Shiffer

doi:10.1186/s12909-022-03101-7

Abstract

BackgroundAccreditation systems strive to ensure the quality of undergraduate (basic) medical education and encourage ongoing improvements. Despite increasing global emphasis on quality assurance activities, there is limited research linking accreditation of medical education to improved student and graduate outcomes. The purpose of this study is to compare the United States Medical Licensing Examination® (USMLE®) performance of students and graduates who attended international medical schools accredited by an agency recognized by the World Federation of Medical Education (WFME) to individuals who attended schools that did not meet this criterion.MethodsDuring the 2018-2020 study period, 39,650 individuals seeking Educational Commission for Foreign Medical Graduates® (ECFMG®) certification took one or more USMLE examinations. We cross-tabulated USMLE performance (first-attempt pass/fail result) and medical school accreditation status.ResultsIndividuals seeking ECFMG certification who attended international medical schools accredited by an agency recognized by WFME had higher or comparable USMLE first-attempt pass rates compared to individuals who attended medical schools that did not meet this criterion.ConclusionsImplementing and maintaining meaningful accreditation systems requires substantial resources. These results provide important positive evidence that external evaluation of educational programs is associated, on average, with better educational outcomes, including in the domains of basic science, clinical knowledge, and clinical skills performance.

Highlights

Accreditation systems strive to ensure the quality of undergraduate medical education and encourage ongoing improvements
As of April 2021, 23 accrediting agencies functioning in 57 countries have been recognized by World Federation for Medical Education (WFME) and 16 agencies are in the process of recognition [8]
Across the three-year study period (2018 – 2020), 39,650 individuals took one or more examinations required for Educational Commission for Foreign Medical Graduates (ECFMG) certification: 36,828 applicants took United States Medical Licensing Examination (USMLE) Step 1, 17,860 applicants took Step 2 Clinical Knowledge (CK) and 10,345 took Step 2 Clinical Skills (CS)

Summary

Introduction

Accreditation systems strive to ensure the quality of undergraduate (basic) medical education and encourage ongoing improvements. World Federation for Medical Education (WFME) Recognition Program In response to this variability in accreditation systems worldwide and to support improved outcomes, the World Federation for Medical Education (WFME) implemented in 2010 a recognition program for medical school accrediting agencies with the goal of providing an independent, transparent, and rigorous method of ensuring that accreditation is conducted at an internationally accepted high standard [8]. As part of its recognition program, a WFME ad-hoc team evaluates the compliance of an accrediting agency against pre-defined criteria, including suitable governance structure and use of appropriate standards, processes, and procedures. The recognition process includes a site visit, where the WFME team observes the agency performing an accrediting review of a medical school and attends an agency meeting where accreditation determinations are made regarding one or more other schools. As of April 2021, 23 accrediting agencies functioning in 57 countries have been recognized by WFME and 16 agencies are in the process of recognition [8]

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