Accreditation in the United States is a complex process and it’s also
rather siloed, such that medical, nursing, and residency programs
are all accredited in different ways. We’ve been breaking down the silos in
education; for example, students from the nursing school are side by side
with students from the medical school. In the future, we’ll have to explore
possibilities for collaboration between various accreditation agencies.
This has already begun with the ACGME and the AOA.
In the United States, accreditation is largely a voluntary process. Of
course programs need to be accredited, but it’s a self-study and volunteer
process. This is a tremendous gift to the professions themselves as working
professionals dedicate a significant portion of their time to accredit other
programs. This ensures that high standards are being applied to all our
programs. We have the finest programs in the world, and they remain
excellent because of our peer-review process.
Leaders in academic health centers need to work with accrediting bodies
to ensure they maintain pace with the rate of change. Residency training
programs are undergoing major accreditation changes, and the LCME is
watching this process closely with development of milestones that students
must achieve upon graduation. As a result, educational processes are
evolving. We must challenge ourselves in our programs, and throughout
our institutions, to adapt innovative teaching methods; but, as we do so,
it’s vital that we emphasize accreditation expectations. For example, we
are about to engage in accreditation for our nursing school. I have to
make the case that the landscape has changed, requiring our nursing and
medical students to work more closely with one another.
The entire institution mobilizes during an accreditation, and for good
reason. Accreditation affords enormous institutional opportunity. The
process begins with self-study. We take a step back, examine all the
standards, and we ask ourselves: are we meeting those standards? The
process takes about 18 months, and we dedicate the time of very senior
people to the enterprise. Self-reflection provides the opportunity for selfaction.
Standards are increasingly challenging, so the institution needs to
stay at the cutting edge and find ways to maintain quality.
Academic health centers are a tremendous asset to our country. Future
directions in healthcare could be influenced by a more enlightened
view of accreditation in which accreditation takes the lead in fostering
innovation in health sciences education—including interprofessional
education and competency-based frameworks for evaluating learning
needs across the continuum from pre-medical to undergraduate medical
to graduate medical education and beyond.
Michael F. Collins,
University of Massachusetts Medical School