Considerations When Planning an Accreditation System

Sabri KEMAHLI, M.D.Ankara University, Faculty of Medicine

Turkey

Why accreditation (in Turkey)?

• Increase in the number of medical schools (50+)• Different curricula employed (Traditional-

integrated)• PBL introduced in increasing number of medical

schools- in differing weights• Clinical skills labs introduced in many schools• Differences in the faculty members- number and

seniority• National core curriculum defined in 2001

Entrance to Medical Education• Centrally administered university entrance

examination• Considerable differences in medical

school entrants- according to their scores-• Major question: Are all medical school

graduates equally trained?/ Do all medical schools meet some minimum requirements?

• How can we be sure?

Two initiatives

• Examinations planned for all medical students after 3rd and 5th years (as a prerequisite for graduation)

• Accreditation scheme planned

by Council of Medical Schools Deans

Principles Discussed While Planning

• Initiative should be started by Deans (Council)• Accrediting body should be an independent

organisation• Deans’ influence on the process should be

minimum; Deans cannot work as members of accreditation council and other committees

• All stakeholders should be represented (faculty members, students, MoH, practising doctors)

• Example:

• First organised as a body of the Engineering Deans’ Council

• Later a society was established

• Members of Accreditation Council first named by the Deans’ Council- following nominations by accreditation council autonomously

Accreditation Organisation

• Deans’ Council

• National Medical Accreditation Council

• Standards Committee

• Pre-evaluation, Counselling and Training Committee

• Visitation and Follow-up Committees

Accreditation Organisation

National Medical

AccreditationCouncil(NMAC)

Standard Setting and

Development Committee

Pre-evaluation, Counselling and

Training Committee

Visitation and Follow-up

Committee-1

Visitation and Follow-up

Committee-2

National Medical Accreditation Council

• 7 faculty members from 7 different medical schools

• 4 members nominated by Turkish Medical Association (1 university faculty member, 1 specialist from state hospitals, 1 general practitioner, 1 free practicing doctor)

• 1 doctor nominated by the Ministry of Health• 2 student representatives from 2 different

medical schols• 1 Secretary nominated by Secretary General of

Deans Council

Standard Setting and Development Committee

• 4 faculty members from Departments

(Units) of Medical Education of 4 different medical schools

• 3 faculty members, one from each of basic, surgical and internal medical sciences

• 1 general practitioner

• 1 student representative

Accreditation Types

• Full accreditation (6 years)

• Accreditation candidacy (re-visit in 1 year)

• Re-accreditation (after 6 years; provided the medical school successful in the interim period of 3 years)

Main elements in the process of accreditation

The WHO/WFME Guidelines• Institutional self-

evaluation of the medical school

• External evaluation based on the report of self-evaluation and a site visit

• Final report by the review team containing recommendations regarding the decision on accreditation

• Decision on accreditation.

• Pre-evaluation, Counselling and Training Committee

• Visitation and Follow-up Committee

• Visitation and Follow-up Committee

• Accreditation Council

Accreditation Process

Application to Accreditation Council (NMAC)

Pre-evaluation, c.&t.committeereport submitted to medical schoolcounselling/training given to medical school, if required/demanded

July

Self-evaluation report submitted to NMAC

October

December

NMAC decision for visitation programme

March May

Site VisitJuly

Final decision by NMAC

January

Possible Problems

• Voluntary basis- difficulty in finding volunteers-pioneers (medical schools)

• Acceptance by the faculty members might be difficult

• Only a few people to work

• Setting standards- which standards?

WFME global/European standards and national specifications

Work Ahead

• Setting the standards- national specifications

• Planning the application and evaluation process details

• Format of the self-evaluation report

• Training the evaluation teams and the applicant medical schools

Accreditation Process

• January: Application to Accreditation Council (NMAC)• Pre-evaluation, counselling and training

committeeReport submitted to medical schoolIf required/demanded counselling/training given to medical school (July)

• Until October: Self-evaluation report submitted to NMAC• NMAC decision for visitation programme (until

December)• Visit by the Visitation Committee (March-May) and report

submitted to NMAC• Decision by NMAC (until July)