1. REACTION Jose Y. Cueto Jr., MD, MHPEd Professional Regulatory Board of Medicine

2. Situation: Medicine 38 medical schools 38 medical schools Based on institutional passing percentage in PLE 21 schools: satisfactory performance 21 schools: satisfactory performance 17 schools: poorly performing 17 schools: poorly performing

3. 2000-2012 Medical School Accreditation UP-Mla UP-Mla UERMMMC UERMMMC CIM CIM UST UST SLU SLU FEU FEU XU XU DLSU DLSU

4. Article Education for Health, Vol. 19, Number 2, July 2006 Education for Health, Vol. 19, Number 2, July 2006 Title: “Accreditation of Undergraduate Medical Training Programs: Practices in Nine Developing Countries as Compared with the United States” Title: “Accreditation of Undergraduate Medical Training Programs: Practices in Nine Developing Countries as Compared with the United States”

5. Authors Jose Cueto Jr Vanessa C. Burch Nor Azila Mohd Adnan Bosede B. Afolabi, Zalina Ismail Wasim Jafri E. Oluwabunmi Olapade-Olaopa Boaz Otieno-Nyunya

6. Authors Avinash Supe Altantsetseg Togoo Ana Lia Vargas Elizabeth Wasserman Page S. Morahan William Burdick Nancy Gary

7. Countries Argentina Argentina India India Kenya Kenya Malaysia Malaysia Mongolia Mongolia Nigeria Nigeria Pakistan Pakistan Philippines Philippines South Africa South Africa USA USA

8. Accreditation Data Argentina (28) Argentina (28) Mandatory Mandatory India (233) India (233) Mandatory Mandatory Kenya (2) Kenya (2) Mandatory Mandatory Malaysia (13) Malaysia (13) Voluntary Voluntary Mongolia (5) Mongolia (5) Voluntary Voluntary Nigeria (16) Nigeria (16) Mandatory Mandatory Pakistan (35) Pakistan (35) Mandatory Mandatory Philippines (35) Philippines (35) Voluntary Voluntary South Africa (8) South Africa (8) Mandatory Mandatory USA (126) USA (126) Voluntary Voluntary

9. US System Accrediting body: LCME Accrediting body: LCME Voluntary Voluntary Functions as a mandatory system Functions as a mandatory system Only graduates of LCME-accredited schools can take the USMLE Only graduates of LCME-accredited schools can take the USMLE All medical schools accredited All medical schools accredited

10. India Accrediting Body Accrediting Body NAAC NAAC MCI MCI

11. NAAC for Quality in Higher Education Dr. Madhukar 11 Type of Institutions No. of Institutions (as of Feb 2012) Central Universities 43 State Universities 297 Deemed Universities 130 Institutions of National Importance 65 Private Universities 100 Total635 Colleges33023 Higher Education in India – A Glimpse Source : UGC Annual report 2011 -2012

12. Observation All 233 medical schools in India are externally accredited All 233 medical schools in India are externally accredited All 126 medical schools in the US are externally accredited All 126 medical schools in the US are externally accredited Only 8 out of the 38 PH medical schools have participated in the external accreditation system Only 8 out of the 38 PH medical schools have participated in the external accreditation system

13. QA Mechanism CHED MEDICAL SCHOOLS EXTERNAL ACCREDITING BODY GRADUATES PRC

14. Accrediting Bodies Year Established/Years of Existence PAASCU PAASCU 1957 (56 years) 1957 (56 years) PACUCOA PACUCOA 1973 (40 years) 1973 (40 years) ACSC-AA ACSC-AA 1976 (37 years) 1976 (37 years) AACCUP AACCUP 1989 (24 years) 1989 (24 years)

15. Conditions 1. External accreditation must be voluntary. 2. It must be independent. 3. It must not have government participation.

16. Conditions 1. It must be voluntary 2. It must be independent. 3. It must not have government participation 1. It must be mandatory. 2. It must allow supervision or some oversight function. 3. It must allow government participation.

17. The Real Role of Accrediting Bodies Is the accreditation system responsible for the high quality of medical education in our country? Is the accreditation system responsible for the high quality of medical education in our country? UST: 400 years UST: 400 years UP: 100 years UP: 100 years PAASCU: started by Catholic schools in 1957 PAASCU: started by Catholic schools in 1957 57 years 57 years

18. With so many years difference between the establishment of the schools, and establishment of accrediting body, the role was focused on validating the excellent practices of the two schools. With so many years difference between the establishment of the schools, and establishment of accrediting body, the role was focused on validating the excellent practices of the two schools. But with relatively younger schools, the accrediting bodies should have a developmental role But with relatively younger schools, the accrediting bodies should have a developmental role Not possible if only 11-15% of HEI’s have voluntarily participated in the system Not possible if only 11-15% of HEI’s have voluntarily participated in the system

19. Side story to our article Initially submitted to Academic Medicine Initially submitted to Academic Medicine Then to Medical Teacher Then to Medical Teacher Eventually to Education for Health Eventually to Education for Health Reason: the first two wanted revisions to include the IMPACT of accreditation on the quality of institutions and graduates Reason: the first two wanted revisions to include the IMPACT of accreditation on the quality of institutions and graduates

20. Realities in the Philippine Setting Where is the evidence about the IMPACT of external accreditation? Where is the evidence about the IMPACT of external accreditation? If only 11-15% have volunteered to participate in the accreditation process, how can the system help the 85% of HEI’s improve their quality of education and the quality of their graduates? If only 11-15% have volunteered to participate in the accreditation process, how can the system help the 85% of HEI’s improve their quality of education and the quality of their graduates?

21. A Study to Determine Impact “Medical Education Accreditation in Mexico and the Philippines: Impact on Student Outcomes” Marta van Zanten, Danette McKinley, Irene Durante Montiel & Concepcion V Pijano Medical Education, 2012, 46, 586-592

22. Study: correlation Outcomes (first attempt pass rate on USMLE components and rate of ECFMG certification) Medical school accreditation

23. USMLE Components Part I: Basic Sciences Part I: Basic Sciences Part II: Clinical Sciences Part II: Clinical Sciences Part II: Performance-based Part II: Performance-based

24. Results of the study Correlation only in Part I Correlation only in Part I CONCLUSIONS. These findings support the value and usefulness of accreditation in Mexico and the Philippines by linking accreditation to improved student outcomes

25. Weaknesses Research Design Research Design Analysis Analysis Conclusions Conclusions

26. Questions From the perspective of the accrediting bodies, what kind of interventions in the present accreditation system should be adopted? From the perspective of the accrediting bodies, what kind of interventions in the present accreditation system should be adopted? How can accreditation help in the reform of the educational system? How can accreditation help in the reform of the educational system? How can it help the implementation of the PQF, and its referencing to the AQRF in 2018? How can it help the implementation of the PQF, and its referencing to the AQRF in 2018?

27. Philippine Situation Submitted the article around 2003-2004 Submitted the article around 2003-2004 No medical school accredited by PAASCU No medical school accredited by PAASCU