World Federation For Medical Education Research Articles

Development of Somaliland national harmonised medical curriculum

Background and objectives The rational for the Somaliland national harmonised curriculum (NHC) was driven by shared concern about the quality of medical education. Process The Ministry of Education and Science and the Ministry of Health Development produced a Medical Education Policy 2018. Policy objectives included the development of the NHC and accreditation for medical schools that met the standards of the World Federation for Medical Education (WFME). Two bodies were asked to oversee these aims: the National Health Professions’ Commission (NHPC) and the National Commission of Higher Education (NCHE). Between 2018 and 2020, a collaborative approach between the Somaliland government, medical school stakeholders, King’s Global Health Partnership’s (KGHP) volunteers and the Tropical Health Education Trust (THET) team was used to design the 6-years NHC. The NHC structure, content and delivery were grounded by WFME standards, health needs of the local population, student focused and active learning methods, and feasibility of implementation in medical schools. Outcomes The NHC comprises details about the educational outcomes, curriculum model and framework, educational principles, instructional and learning methods, core as well as optional content, and assessment strategy. Conclusions The approach used to develop the NHC ensured it is bespoken for Somaliland. Ongoing evaluation of patient and population needs, each medical school’s review of programme implementation and outcomes will inform continuous revision and renewal.

Examining the WFME Recognition Programme at 10 years

Background In 2012, the World Federation for Medical Education (WFME) evaluated and formally recognized the first agency in its Recognition Programme (RP). The RP was developed to review accrediting authorities in response to a 2010 policy by the Educational Commission for Foreign Medical Graduates (ECFMG) to require international medical graduates (IMGs) seeking to practice in the U.S. to graduate from an appropriately accredited medical school. By the end of 2022, WFME had recognized 33 accrediting bodies and received applications from another 16, which accounted for over three-quarters of the world’s medical schools. In 2023, WFME leadership changed hands, and the ECFMG will take its first steps toward implementing its Recognized Accreditation Policy. Approach In this article, we look back at the genesis of the RP and describe its first decade as informed by the limited existing peer-reviewed literature and the emerging activities of accrediting agencies that could have significant implications for the quality of medical education internationally. Conclusions The rapidly growing influence of WFME on medical education worldwide has largely occurred without significant awareness or scrutiny, and there is a need for the WFME to demonstrate greater transparency, proactively engage its stakeholders, and support research and evaluation.

Analysis of the degree of social accountability in accreditation standards for basic medical education

According to the World Health Organization, for medical schools to fulfill their obligation of social accountability, it is necessary for medical education, research, and service areas to ref lect the healthcare system’s relevance, quality, cost-effectiveness, and equity. This study utilized Boelen and Heck’s (1995) social accountability grid model to analyze the degree to which the Accreditation Standards of Korean Institute of Medical Education and Evaluation 2019 (ASK2019) standards apply the World Federation for Medical Education’s (WFME) standards. The social accountability characteristics of the former were compared to those of the WFME, the Liaison Committee on Medical Education, and the Australian Medical Council. Experts with experience and certification in medical education and evaluation classified the ASK2019 standards according to the grid model, evaluated social accountability perspectives, and categorized them according to the process, content, and outcome. Of the 92 standards, 61 (66.30%) were selected as social accountability standards; these encompassed all areas. There was a particular focus on outcome-related areas, such as “mission and outcomes,” “student assessment,” “educational evaluation,” and “continuous improvement.” Education and quality were the most common (33, 54.11%), followed by 18 standards related to education and relevance. However, the standards on cost effectiveness and equity corresponding to education, research, and service were significantly insufficient. As a result of classification using a logic model, many criteria were incorporated into the process, producing results similar to those of international accreditation institutions. Therefore, to fulfill medical schools’ social accountability, it is necessary to develop cost effectiveness and equity standards with reference to grid models and expand them beyond education to include research and service areas. Developing content and outcome standards is also required.

Consistency and quality in written accreditation protocols for pediatrician training programs: a mixed-methods analysis of a global sample, and directions for improvement

BackgroundThe World Federation for Medical Education (WFME) defines accreditation as 'certification of the suitability of medical education programs, and of…competence…in the delivery of medical education.' Accreditation bodies function at national, regional and global levels. In 2015, WFME published quality standards for accreditation of postgraduate medical education (PGME). We compared accreditation of pediatric PGME programs to these standards to understand variability in accreditation and areas for improvement.MethodsWe examined 19 accreditation protocols representing all country income levels and world regions. For each, two raters assessed 36 WFME-defined accreditation sub-areas as present, partially present, or absent. When rating “partially present” or “absent”, raters noted the rationale for the rating. Using an inductive approach, authors qualitatively analyzed notes, generating themes in reasons for divergence from the benchmark.ResultsA median of 56% (IQR 43–77%) of WFME sub-areas were present in individual protocols; 22% (IQR 15–39%) were partially present; and 8.3% (IQR 5.5–21%) were absent. Inter-rater agreement was 74% (SD 11%). Sub-areas least addressed included number of trainees, educational expertise, and performance of qualified doctors. Qualitative themes of divergence included (1) variation in protocols related to heterogeneity in program structure; (2) limited engagement with stakeholders, especially regarding educational outcomes and community/health system needs; (3) a trainee-centered approach, including equity considerations, was not universal; and (4) less emphasis on quality of education, particularly faculty development in teaching.ConclusionsHeterogeneity in accreditation can be appropriate, considering cultural or regulatory context. However, we identified broadly applicable areas for improvement: ensuring equitable access to training, taking a trainee-centered approach, emphasizing quality of teaching, and ensuring diverse stakeholder feedback.

Accreditation of the Iraqi Medical Colleges: Urgent call for action

The National Council for Accreditation of Medical Colleges (NCAMC) has made some progress towards accrediting Iraqi medical schools. However, to date, NCAMC is not internationally recognized by the World Federation for Medical Education (WFME) which fulfils the requirements of the ECFMG’s Recognized Accreditation Policy (due for initial implementation from 2024). The policy requires that a medical school must achieve a recognized accreditation status by a recognized accrediting agency that in itself is recognized and reviewed by an external quality assurance organization. When the policy is fully implemented, only medical schools accredited in line with the Recognized Accreditation Policy will satisfy the requirements of the ECFMG. Medical graduates intending to pursue work, training, registration, research, volunteering or other opportunities are required to apply for verification of their primary medical qualification (PMQ). Certification and verification of PMQ for international medical graduates (IMGs) in the United States, Australia, Canada, Ireland, New Zealand, and the United Kingdom and an increasing number of countries globally is done via the ECFMG’s online system known as Electronic Portfolio of International Credentials (EPIC). Therefore, the future of Iraqi medical schools’ education standards is at stake as they do not meet the international standards risking the future of new graduates. The Ministry of Higher Education, universities, medical colleges and the Iraqi Medical Association (IMA) need to collaborate with the NCAMC to get it recognized by the WFME in order to safeguard Iraqi medical education and the future of new doctors from 2024.

Developing and validating a national set of standards for undergraduate medical education using the WFME framework: the experience of an accreditation system in Iran

BackgroundDefining standards is the first step toward quality assurance and improvement of educational programs. This study aimed at developing and validating a set of national standards for the Undergraduate Medical Education (UME) program through an accreditation system in Iran using the World Federation for Medical Education (WFME) framework.MethodsThe first draft of standards was prepared through consultative workshops with the participation of different UME program stakeholders. Subsequently, standards were sent to medical schools and UME directors were asked to complete a web-based survey. The content validity index at the item level (I-CVI) was computed using criteria including clarity, relevance, optimization and evaluability for each standard. Afterward, a full-day consultative workshop was held and a wide range of UME stakeholders across the country (n = 150) discussed the survey results and made corrections to standards.ResultsAnalysis of survey results showed that relevance criteria had the best CVI as only 15 (13%) standards demonstrated CVI < 0.78. More than two-thirds (71%) and a half (55%) of standards showed CVI < 0.78 for optimization and evaluability criteria. The final set of UME national standards was structured in 9 areas, 24 sub-areas, 82 basic and 40 quality development standards, and 84 annotations.ConclusionsWe developed and validated national standards as a framework to ensure the quality of UME training with input from UME stakeholders. We used WFME standards as a benchmark while addressing local requirements. The standards and participatory approach to developing standards may guide relevant institutions.

When policy meets reality: the new 18-hour on-call shift policy and the Israeli anesthesia workforce crisis

BackgroundThe Israeli physician workforce faces multiple challenges. These include planned policies reducing physician on-call from 26 to 18 h and, from 2026, allowing only graduates of Ministry of Health approved foreign medical schools to take the Israeli licensing examination and an ongoing physician shortage (2019: Israel had 3.19 physicians/1000 persons vs. OECD average of 3.49 physicians/1000 persons). This study examines the potential impact of these planned policies on the Israeli anesthesiology workforce.MethodsSurveys conducted among 34 public and private Israeli hospital anesthesiology department chairs collected data on their department's number of weekday on-call anesthesiologists and current shortage of anesthesiologists. A subsequent survey collected data on each anesthesiologist in the workforce, including the country where they studied medicine.ResultsEach weekday night there were 114 on-call anesthesiologists; 72 residents and 42 attendings. Using productive work coefficients, this translates to 104 resident and 51 attending anesthesiologists. Furthermore, 21 departments had existing anesthesia workforce shortages totaling 110 anesthesiologists. There were 873 anesthesiologists from non-OECD countries whose medical schools are not accredited by the World Federation for Medical Education, of whom 332 were residents (61.9% of residents). Only 20.1% of anesthesiology residents were Israeli medical school graduates.ConclusionsDescriptive survey data assessed the immediate and long-term consequences for the healthcare system and anesthesiology workforce of two new Health Ministry policies. Implementing the 18-h policy will immediately remove from the daytime workforce 155 anesthesiologists and who will be unavailable to staff elective surgery operating rooms. This will compound the current national shortage of 110 anesthesiologists. It is unclear how to replace this shortfall since there are no surplus Israeli physicians and very few Israeli graduates choose anesthesiology as a specialty. This situation will be exacerbated after 2026 when graduates of certain foreign medical schools will be unable to enter the medical workforce, further reducing the pool of potential anesthesiology residents. Both policies were promulgated without adequate operational and budgetary planning or fiscal or workforce resources; implementation of the 18-h on-call policy has already been postponed. Therefore, new or updated policies must be accompanied by specific operational plans, budgetary allocations and funds for additional workforce.

Evaluating and comparing critical thinking skills of residents of Tehran University of Medical Sciences

BackgroundToday’s complexities and diversity in the clinical setting have revealed the need to pay attention to strengthening critical thinking (CT) skills. The present study aimed to evaluate and compare CT skills in the residents of the Tehran University of Medical Sciences.MethodsThis is a cross-sectional study. The study's statistical population included 284 residents in orthopedic, internal medicine, and surgery groups studying in the PGY1 to PGY4 years of residency. The data collection tool was the California Critical Thinking Skills Test (CCTST) form B. The collected data were entered into SPSS-16 software and analyzed using descriptive (mean and standard deviation) and inferential (one-way ANOVA) statistics. The significant level in all tests was considered at P < 0.05.Results189 out of 284 residents completed and returned the questionnaire, and the response rate was 66%. The mean CT skill score of residents (M = 13.81, SD = 3.52) was lower than the optimal level (M = 17.1 SD = 5.0). Comparing the mean CT skill scores of the residents separately for the residency year revealed a significant decrease in CT scores in the 4 years. A significant difference was found between the CT skill scores in the three groups (internal medicine, general surgery, and orthopedic surgery).ConclusionThe CT skills of the residents of Tehran University of Medical Sciences were generally below the optimal level. The CT score of the residents show an increase in PGY2, but a decrease in PGY3 and PGY4. Due to the emphasis of accreditation institutions, the World Federation for Medical Education, and other international educational institutions on the importance of critical thinking, it is recommended to pay more attention to the factors related to the promotion and development of CT skills in residency programs.

The WFME global standards for quality improvement of postgraduate medical education: Which standards are also applicable in Germany? Recommendations for physicians with a license for postgraduate training and training agents.

Background: In Germany, the (model) regulation for postgraduate medical education 2018, the professional codes of conduct of the regional medical councils and the health professions chamber laws of the federal states are the formal basis of postgraduate medical education, but say little about its structure, processes and results. The World Federation for Medical Education (WFME) has developed global standards for improving the quality of postgraduate medical education and published them in a revised edition in 2015. A German version which takes the specifics of medical training in Germany into account has not been published to date.Objective: The Committee for Postgraduate Medical Education (PGME) of the Society for Medical Education (GMA) has set itself the goal of firstly translating the WFME standards into German and secondly making recommendations for physicians with a license for post-graduate training (PLT) and training agents (TA) in clinics and practices which have been adapted to the German context.Methods: The WFME standards were translated into German by a working group of the GMA Committee for PGME, the terminology adapted to PGME in Germany and checked by an interdisciplinary panel of experts made up of 9 members of the committee. In a second step, the WFME basic standards and quality standards for PGME relevant to PLTs and TAs in Germany were iteratively determined by this panel of experts using the Nominal Group Technique (NGT) and compiled in the form of recommendations. Results: The translation of the WFME guidelines was approved by the expert group without any changes to the content, taking into account the terminological system of PGME in Germany. In a second step, 90 standards were identified which were considered helpful for PGME in Germany, especially for PLTs and TAs (such as development of a professional identity, a more patient-centered approach or support of self-directed learning). Care was taken to only give recommendations which can be influenced by PLTs and TAs. These standards have been summarized as recommendations to PLTs and TAs and take into account all chapters of the WFME standards. Conclusion: The WFME standards selected here are recommended to PLTs and TAs in clinics and practices to achieve high-quality PGME. Empirical longitudinal studies will be required to examine both the implementation and the results of applying the modified WFME criteria in Germany.

Exploring possibilities of harmonising social justice with medical education through the use of CanMeds and AfriMeds when engaging in discipline integration

Medical curricula are largely content heavy and grossly overloaded but focus primarily on medical and biomedical sciences. It has been argued by authors such as Gukas and Filies that well-balanced professionals are seldom produced by such content heavy curricula. The incorporation of social justice principles in medical curricula is vital in promoting the production of well-balanced and competent healthcare professionals, as called for in the CanMeds/AfriMeds frameworks. However, the World Federation for Medical Education issued a consensus statement asserting that medical students in the USA and Canada receive little to no formal training and teachings as far as social justice is concerned. In this paper it is asserted that medical students in South Africa are no exception to such consensus. It is further asserted in this paper that if one begins to examine principles of CanMeds/AfriMeds, entry points for the insertion of social justice principles becomes a possibility without having to further overload an overloaded curriculum. In essence, adopting and promoting roles of CanMeds/AfriMeds such as professional, collaborator and scholar enhance a non-hierarchical style and environment of teaching medical students. This new style and environment of learning are shown in this paper to enable an insertion of social justice principles in a medical curriculum in instances where such insertion may otherwise have been impossible.

Accreditation of the Iraqi Medical Colleges: The last warning

By 2024, all international medical graduates (IMGs) intending to apply for certification or gain verification of their primary medical qualification (PMQ) by the Educational Commission for Foreign Medical Graduates (ECFMG) will require that their medical school has been appropriately accredited. The World Federation for Medical Education (WFME) Recognition Program is the only one accepted by the ECFMG for the recognition of medical school accrediting agencies. This applies to anyone intending to work or study in the United States, United Kingdom and an increasing number of countries adopting such approach. The process of accreditation of Iraqi medical colleges started in 2007 but to date there is no internationally recognized body in Iraq to accredit those colleges. This means by the 2024, graduates from Iraqi medical colleges may not be able to work and study in many parts of the world. Urgent action is required as we detailed in this article. ministry of higher education, universities, medical colleges need to collaborate with the National Council to get it recognized by the WFME and save the future of thousands of doctors who will graduate in the forthcoming years starting with 2024 and on.

Altruism or nationalism? Exploring global discourses of medical school regulation.

Although medical school regulation is ubiquitous, the extent to which it should be based on global principles is unclear. In 2010, the Educational Commission for Foreign Medical Graduates (ECFMG) announced that from 2023, overseas doctors would only be eligible for certification to practise in the United States if they had graduated from a medical school that was accredited by a 'recognised' agency. This policy empowered the World Federation for Medical Education (WFME) to create a recognition programme for regulatory agencies around the world, despite a lack of empirical evidence to support medical school regulation. This study employs critical discourse analysis, drawing on the theoretical perspectives of Michel Foucault and Edward Said, to identify discourses that enabled this 'globalising' policy decision to take place. The dataset includes a series of 250 documents gathered around three key events: the Edinburgh declaration by WFME in 1988, the first set of global standards for medical schools by WFME in 2003 and the ECFMG ruling about medical school accreditation in 2010. Two discourses, endorsement and modernisation, were dominant throughout this entire period and framed the move to globalise medical school regulation in terms of altruism and improving medical education worldwide. A discourse of resistance was present in the earlier period of this study but faded away as WFME aligned itself with ECFMG after 2010. Two further discourses, protection and control, emerged in the later period of this study and framed the ECFMG ruling in terms of nationalism and protecting American interests. This study proposes a new conceptualisation of the relationship between ECFMG and WFME in light of the apparently contradictory policy motivations of altruism and nationalism. It goes on to consider the implications of this association for the legitimacy of WFME as an organisation that represents all of the world's medical schools.

Global trends in quality assurance in medical education: implications and challenges to medical education in Sudan

The aim of this paper is to overview the concepts and global trends of quality assurance in medical educationthrough accreditation systems based on internationally embraced standards, the efforts to have an oversightprocess of quality at global level while maintaining a frm commitment to the position that accreditation is anational matter requiring adaptation of the generic global standards to the national context. It also providesan update on international registries of medical schoolsIt mainly targets the medical education community in Sudan and the decision-makers in medical educationto create awareness of the challenges of ensuring and sustaining quality in medical education in Sudan inthe face of expanding number of medical schools. Such efforts are empowered by the recognition of SudanMedical Council (SMC) by the World Federation for Medical Education (WFME) as a national accreditingbody after fulflling the WFME requirements in June 2018 .The overview is to alert the decision-makers and medical schools to the basic concepts on which they willbe held accountable to the community and the stakeholders and highlights the challenges to maintain thisglobal recognition.The paper is based on overviewing key publications addressing the concepts and updates of accreditationstandards and the global vision for a robust global oversight on quality of medical education (1-5 &amp;10) andthe need for international registries in an increasingly expanding number of medical education institutionsand globally mobile medical and health task force.

The World Health Organization and the global standardization of medical training, a history

BackgroundThis article presents a history of efforts by the World Health Organization and its most important ally, the World Federation for Medical Education, to strengthen and standardize international medical education. This aspect of WHO activity has been largely ignored in recent historical and sociological work on that organization and on global health generally.MethodsHistorical textual analysis is applied to the digitalized archives and publications of the World Health Organization and the World Federation for Medical Education, as well as to publications in the periodic literature commenting on the standardization of international medical training and the problems associated with it.ResultsEfforts to reform medical training occurred during three distinct chronological periods: the 1950s and 1960s characterized by efforts to disseminate western scientific norms; the 1970s and 1980s dominated by efforts to align medical training with the WHO’s Primary Healthcare Policy; and from the late 1980s to the present, the campaign to impose global standards and institutional accreditation on medical schools worldwide. A growing number of publications in the periodic literature comment on the standardization of international medical training and the problems associated with it, notably the difficulty of reconciling global standards with local needs and of demonstrating the effects of curricular change.

Beginning of outcome-based medical education: development of medical schools' mission statements based on stakeholders' priority.

BackgroundMany studies report the positive effects of outcome-based education in improving medical education quality. An important aspect of outcome-based education is the statement of learning outcomes, which is closely associated with medical schools’ mission, vision, and educational goals. Medical schools’ mission statement not only sets the standards to determine educational goals and outcomes but also provides an indicator to monitor and evaluate medical education quality.PurposeThis study identified a methodology to provide optimal mission statements at medical schools through the framework of suggested decision-making method.MethodsThis study analyzed the focus of the mission development suggested by World Federation for Medical Education and Liaison Committee on Medical Education medical education standards and searched for appropriate decision-making methods based on these standards. In addition to validate the suggested framework of mission statement, case analysis of medical schools was conducted.ResultsConsequently, a mission development method that applies the mission statement based on stakeholders’ priority (MSSP) was derived. The MSSP involves (1) content analysis, (2) candidate extraction, (3) priority evaluation, and (4) priority validation. The keywords of the mission system derived during this process were categorized and listed in ranks to be suggested as the mission, vision, and core values. The proposed MSSP was applied in two South Korean medical schools and, thereby, the mission, vision, and core values were determined for each medical school.ConclusionThe two schools’ case analysis verified MSSP’s effectiveness as a decision-making methodology to gather and converge diverse opinions from stakeholders for the mission statement at the medical schools.

What Will It Mean for Me? Perceptions of the ECFMG 2023 Accreditation Requirement from an Online Forum.

In 2010, the Educational Commission for Foreign Medical Graduates (ECFMG) announced that as of 2023, physicians applying to train and practice in the United States will be required to graduate from a medical school that has been accredited using criteria such as those developed by the World Federation for Medical Education. This study analyzed posts on the Student Doctor Network (SDN) online forum that refer to this accreditation requirement to investigate how it has been perceived and understood by current and prospective medical students. A keyword search of relevant terms was used to identify posts discussing the accreditation requirement on the SDN online forum, which were subjected to thematic analysis. There were a total of 83 posts from 49 distinct user accounts between May 2012 and January 2020. Seven themes were identified in total; four whose overall purpose was to seek or offer advice and three whose overall purpose was commentary. Themes relating to advice included applications and admissions, future career planning, personal circumstances, and countryspecific issues. Themes relating to commentary included the accreditation requirement policy itself, the potential implications of the requirement, and the educational quality of non-U.S. medical schools. Only half of web links on these posts were to the ECFMG website for official information about the requirement. Although a variety of different perspectives about the ECFMG accreditation requirement were expressed on an online forum for student doctors, the overall number of posts was low, which suggests that the requirement has not been a frequent topic of discussion on this platform. The insights gained from posts suggest personal opinions about the requirement and consequences for individual student application and career choices were the main areas of interest. Signposting to official information channels may help to raise awareness about the requirement and tackle areas of uncertainty and confusion about its implementation.

Public availability of information from WFME-recognized accreditation agencies

The World Federation for Medical Education (WFME) Recognition Programme was created to ensure the comparability of medical school accrediting agencies, so that the schools accredited by those agencies would have similar educational quality. WFME explicitly values transparency and has recognition criteria that relate to agencies making information publicly available. Our study examined 20 WFME-recognized agencies’ transparency by reviewing agency websites for 27 information elements related to accreditation standards, procedures, and processes. We contacted agencies as needed for information that we could not find on their websites. We were only able to retrieve additional information from 3 of the 12 agencies that we attempted to contact. We found that while 12 agencies had over 90% of expected information elements available, 6 agencies had less than 50%. Our findings illustrate barriers for those who wish to better understand medical school accreditation in some regions and raise questions about how comparable WFME-recognized agencies are.

In Reply to van Zanten et al.

We thank van Zanten and colleagues for their interest in our review. Both the Educational Commission for Foreign Medical Graduates (ECFMG) and the World Federation for Medical Education have important influence over medical education on a global scale. We agree that for global accreditation to work, there must be a form of standardized process for approving the local accreditors and ultimately, the medical schools. Our core argument, however, is that this always carries an inherent danger of silencing important nuances in local needs and resources that affect training models. 1 We hope we have raised awareness about assumptions that are inherent in concepts, such as “standardization.” 2 Standardization is a common theme in both medicine and medical education, which may in part be driven by the biomedical paradigm of evidence-based medicine. Proponents of standardization in global standard development emphasize its role in improving quality in both training and patient care and facilitating movement of health professionals. However, as stated by Timmermans, “standardization may seem to be politically neutral on the surface, but in fact, it poses sharp questions for democracy.” 3 Standardization has been criticized for driving a loss of identity and social power and being vulnerable to implementation gaps. 3 Sefton describes the tensions inherent in meeting specific local community health needs while addressing international requirements or standards. 4 Our position is not to eliminate global efforts, such as those in accreditation and curriculum design, but to recognize the complexity and subtleties between local priorities and global differences. We acknowledge the articulated benefits of the new system proposed by the ECFMG. However, we argue that the unanticipated and unintended effects of power relations must be consciously examined, reported, and corrected. As stated in the ECFMG’s 2010 announcement, “the efficacy of such a requirement depends on a universally accepted accreditation process.” 6 Achieving a “universally accepted” accreditation process is likely impossible. For this reason, we argue that we must track which institutions/regions do not end up participating in the new system and, most importantly, why they do not. 5

Integration of the WFME Standards and AUN-QA Criteria for Student Assessment in Undergraduate Medical Education

Quality assurance (QA) is a broad-based activity, which encompasses both quality management and quality control, and requires all the policies, standards, systems and processes in place to maintain and improve medical education quality. QA can be managed through an institutional monitoring that should include the evaluation of teaching and learning approaches, and the assessment. Accreditation standards by international agencies such as the World Federation for Medical Education (WFME) are to be followed for an external quality assurance. In addition, the ASEAN University Network-Quality Assurance (AUN-QA) is the assessment criteria for promoting QA in higher educational programs in ASEAN countries. Both WFME and AUN-QA require that teaching and learning approaches and assessment methods be aligned to the program learning outcomes. The purpose of this review is to compare the WFME standards and the AUN-QA criteria on teaching and learning approaches and methods of assessment to encourage the integration of these two QA systems for undergraduate medical education.&#x0D;

Current trend of accreditation within medical education.

Currently, accreditation in medical education is a priority for many countries worldwide. The World Federation for Medical Education’s (WFME) launch of its 1st trilogy of standards in 2003 was a seminal event promoting accreditation in basic medical education (BME) globally. In parallel, the WFME also actively spearheaded a project to recognize accrediting agencies within individual countries. The introduction of competency-based medical education (CBME), with the 2 key concepts of entrusted professional activity and milestones, has enabled researchers to identify the relationships between patient outcomes and medical education. The recent data-driven approach to CBME has been used for ongoing quality improvement of trainees and training programs. The accreditation goal has shifted from the single purpose of quality assurance to balancing quality assurance and quality improvement. Although there are many types of postgraduate medical education (PGME), it may be possible to accredit resident programs on a global scale by adopting the concept of CBME. It will also be possible to achieve accreditation alignment for BME and PGME, which center on competency. This approach may also make it possible to measure accreditation outcomes against patient outcomes. Therefore, evidence of the advantages of costly and labor-consuming accreditation processes will be available soon, and quality improvement will be the driving force of the accreditation process.