Re: Accreditation of Graduate Medical Education Programmes : One size fits all - or does it ? = رد : إعتماد برامج الدراسات العليا للتعليم الطبي : مقياس واحد يناسب الجميع أم لا ؟

Abstract

Sir, I read with interest the article by Burney and Al-Lamki on the accreditation of graduate medical education (GME) programmes which appeared in the May 2013 issue.1 However, I would like to raise an issue regarding their belief that the way forward for GME in Oman is to seek accreditation through the Accreditation Council for Graduate Medical Education International (ACGME-I).1 Accreditation of medical education at any level is regarded as a national responsibility by international organisations such as the United Nations Educational, Scientific, and Cultural Organization (UNESCO), the World Health Organization (WHO) and the World Federation for Medical Education (WFME). This implies that a national accreditation agency must have a clear mandate, and be authorised by a government entity, to conduct the accreditation. Anchoring the accreditation firmly within the country reflects a fundamental regard for the specific political, socio-economic and cultural conditions, the disease patterns, the characteristics of the healthcare delivery system etc., of the nation and would thus enable the medical programmes to be relevant to the country’s needs. National conditions must be taken into account when designing the standards or criteria used in the accreditation process as the basis for evaluation, and for the decisions on accreditation. I concur with the authors regarding the notions that: (1) Accreditation is a powerful tool in quality improvement and quality control, and (2) In addition to the GME “curriculum” (what is done and why; how it is done and where; how it is assessed and evaluated, using which standards), other issues central to the discussion on accreditation include the institutional culture, its state of readiness for change and other contextual parameters.1 It is in this light that I would like to draw attention to the global standards framework for quality improvement in medical education published in 2003 by the WFME as a pathway to accreditation of GME in Oman.2 This framework ‘trilogy’ covers all three phases of medical education: basic medical education; postgraduate medical education, and continuing professional development [Figure 1]. The global standards framework was developed by an international working party of experts from all regions of the world.2 Recently, Sultan Qaboos University has gone through the accreditation process for basic medical education using the WFME standards framework, and is the first institution to go through this process in the region. For the sake of continuity, is it not more natural that the accreditation of postgraduate medical education should follow the same route? Figure 1: The World Federation for Medical Education framework ‘trilogy’ covering all three phases of medical education. Second, in response to the inherent question regarding GME programmes: does (or rather, should) one size fit all? I will obviously repond: ‘Yes’ and ‘No’! I say Yes in the sense that parameters that are globally agreed through an international organisation sanctioned by the WHO should guide the recognition process; and No in the sense that nation-states or closely-related regional blocks should have the final mandate to accredit (recognise) training programmes. In conclusion, I would like to posit that the road to accreditation (I prefer to use the word ‘recognition’) of GME programmes in Oman should lead to the WFME and not to any other accrediting body. The Oman Medical Specialty Board (OMSB)—the nationally mandated body to accredit GME programmes—could seek accreditation through the WFME’s programme for the recognition of accrediting agencies.3