While reason for celebration, accreditation isn’t the finish line for the Schulich School of Medicine & Dentistry, stressed Dean Michael Strong. It is only an important stop along the way.
“We don’t see this accreditation process as once every few years we’re going to be put through this,” Strong said. “Yes, once every few years, there will be this deep, drill-down analysis. But this should be viewed as part of a continuing quality assurance process where we ask, ‘Are we building a better program along the way?’
“This is only one step in a whole process – but it’s a big step.”
Announced this week, the U.S. Liaison Committee on Medical Education and the Committee on Accreditation of Canadian Medical Schools (CACMS) jointly awarded Schulich full accreditation of its Undergraduate Medical Education program. The eight-year accreditation – a “stamp of approval” for the school – says Schulich possesses the essential standards and elements necessary to deliver students a quality medical education program.
Strong said the unprecedented length of the accreditation provides the medical school with room to innovate.
“As part of our building process, we now have a window to look at some changes in our curriculum,” he continued. “If we want to do some things differently, if we want to look at new programs, we can do the introduction, have it all sorted out and have it evaluated before getting into the next accreditation cycle. This is a big opportunity for us.
“Right away, we’ll maintain the standards, but we can also look at some serious changes.”
Accreditation is an ongoing process for Canadian and American medical education that culminates with an in-depth internal and external school and program peer review, at least once every eight years. All undergraduate programs in Canada are accredited in the same manner.
In total, the process reviews 132 standards covering five categories, including Institutional Setting; Educational Program for the MD Degree; Medical Students; Faculty; and Educational Resources.
For Schulich, reviewers identified only four standards as non-compliant – diversity; inter-professional education; preparation of residents; and service learning – and one as in compliance with need for monitoring – direct observation of student assessment in clinical learning.
“The team has spent the better part of several years preparing for this – constantly looking at our curriculum, looking at our teaching, looking at how we evaluate,” Strong said. “This tells me we have done it right. We are on track. Everything we have brought along in terms of change – from how we teach to how we get feedback – is exactly where it needs to be.
“Basically, this is a stamp of approval. This says we have an excellent medical school that meets all the standards.”
Western has had a successful history with the accreditation process. The eight-year full accreditation, however, is the longest in recent memory for the school. It means Strong, whose term runs through June 30, 2021, will hand over a fully accredited school to his successor. When named to the post in 2010, Strong also received a fully accredited school from Carol Herbert, who served as Schulich dean for 11 years.
“From the faculty engagement right down to the student engagement, what it says to me is, as a community, we are really well engaged. At every level, people take ownership of the medical school and its curriculum,” Strong said.
The accreditation process touched all corners of the school, and involved the collection and research of more than 20 binders full of 2,000 pages of documentation, as well as a four-day site visit in April 2015.
“When you look at the number of people engaged in making this go well, the number is huge. The buy-in was massive. From my end, that means the school is firing on all cylinders,” Strong continued. “This is a collective celebration today – this was a huge chunk of work.”
Accreditation is far from a rubber stamp for medical schools, as two Canadian institutions recently discovered.
Last summer, McGill University’s medical school was placed on probation for the first time in its 186-year history. Its dean of medicine said last week the school is not “out of the woods” yet, according to the Montreal Gazette. In a report made public in June, CACMS found McGill’s undergraduate program had fallen short of two dozen standards. The committee gave the university until Dec. 1 to develop a plan to correct the problems.
Earlier this month, the University of Saskatchewan’s medical school was taken off probation after making changes to its undergraduate curriculum and its leadership ranks.
Starting next year, the accreditation landscape will change as Canada will gain more power to over its own medical schools.
In the past, medical school accreditation was based on 100 per cent American standards, formed from a literal act of the U.S. Congress. These standards were developed without Canadian input. In the past decade, however, a wave of new Canadian medical school deans started to question the heavy U.S. influence on the process.
Starting in 2016, Canadians will lead the assessment with only yes/no input from the Americans on Canadian schools. The University of British Columbia and the University of Calgary will be the first schools evaluated under the new criteria.
The criteria won’t be more lax, but better reflect Canadian values and practices, Strong said.
“It has never been with any Canadian input as to what those standards look like to reflect our society and our societal needs,” Strong said. “This is an important step.”
Schulich is among the last to be reviewed by the previous standards.