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Accreditation systems for Postgraduate Medical Education: a comparison of five countries

  • Dana FishbainEmail author
  • Yehuda L. Danon
  • Rachel Nissanholz-Gannot
Article

Abstract

There is a widespread consensus about the need for accreditation systems for evaluating post-graduate medical education programs, but accreditation systems differ substantially across countries. A cross-country comparison of accreditation systems could provide valuable input into policy development processes. We reviewed the accreditation systems of five countries: The United States, Canada, The United Kingdom, Germany and Israel. We used three information sources: a literature review, an online search for published information and applications to some accreditation authorities. We used template analysis for coding and identification of major themes. All five systems accredit according to standards, and basically apply the same accreditation tools: site-visits, annual data collection and self-evaluations. Differences were found in format of standards and specifications, the application of tools and accreditation consequences. Over a 20-year period, the review identified a three-phased process of evolution—from a process-based accreditation system, through an adaptation phase, until the employment of an outcome-based accreditation system. Based on the five-system comparison, we recommend that accrediting authorities: broaden the consequences scale; reconsider the site-visit policy; use multiple data sources; learn from other countries’ experiences with the move to an outcome-based system and take the division of roles into account.

Keywords

Accreditation Outcome-based medical education Postgraduate Medical Education Residency 

Abbreviations

PGME

Postgraduate Medical Education

RCPSC

Royal College of Physicians and Surgeons of Canada

CFPC

College of Family Physicians of Canada

CMQ

Collège des médecins du Québec

ACGME

Accreditation Council for Graduate Medical Education (USA)

IMA

Israeli Medical Association

GMC

General Medical Council (UK)

GMA

German Medical Association

LEP’s

Local Education Providers in UK (hospitals, trusts and other facilities employing residents)

LETB’s

Local Education and Training Boards in UK

Notes

Acknowledgements

The authors would like to thank colleagues from several countries for their kind and very helpful replies to our requests for information: Sarah Taber of the Royal College of Physicians and Surgeons of Canada for conversation and correspondence; Dr. Ramin Parsa-Parsi, Siobhan O’Leary and Elisabeth Jibikilayi of the German Medical Association for their detailed and comprehensive correspondence; Yoram Shapira, Professor Emeritus of Anesthesiology, Chairman of Israeli Supreme Accreditation Board of the Scientific Council of the Israeli Medical Association (at that time), for a comprehensive interview.

Compliance with ethical standards

Conflict of interest

D. Fishbain declares being an employee of the Israeli Medical Association, one of the authorities mentioned in the manuscript, as the director of its Scientific Council. Y. Danon and R. Nissanholz-Gannot report no declarations of interest.

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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of Health Management, School of Health SciencesAriel UniversityArielIsrael
  2. 2.The Scientific CouncilIsraeli Medical AssociationRamat GanIsrael
  3. 3.Myers-JDC-Brookdale InstituteJerusalemIsrael

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