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 Accreditation Council (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 Accreditation Council

Accreditation Process Application to Accreditation Council (NMAC) Pre-evaluation, c.&t.committee  report submitted to medical school  counselling/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 Visit July 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 committee  Report submitted to medical school  If 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)