This panel/seminar session was devoted to input on how partners can work together in the Eastern Mediterranean Region to support countries to achieve accreditation of the health professions education colleges. A number of regional and global partners and stakeholders contributed to the session which was chaired by Mohamed Ambarek, Libyan International Medical University, Benghazi.
7.1 Scientific Society of Arab Medical Colleges Dr Azmi Mahafzah
Accreditation so far is dealt with at national level without regional coordination. Such coordination is a necessity as countries are unable to coordinate with others for capacity building in accreditation for example. This meeting represents an excellent opportunity to
plan for coordination between health professions education. One of the themes of the AMEEMR is accreditation. However, the issue of having a regional accreditation body has not been discussed and not raised before. In addition, the issue has not been taken seriously at WHO.
7.2 WFME
Dr Leif Christensen
The regional accreditation of medical education is nonexistent and national systems are the operating mechanism across the world. However, in some of the regions of the world there are sub-regional accreditation bodies, operating for example in the United States and Canada, Australia and New Zealand, Caribbean countries and in Eastern Europe. These mechanisms are created by governments organizing joint accreditation bodies with joint responsibilities. All sub-regional bodies are different in structure and procedures. But have similarities in covering countries of similar socioeconomic background with usually some of the countries are small and contain limited number of colleges. In the WHO South East Asian Region, small countries could not accomplish accreditation alone and hence they mandated the Association of Medical Education in South-east Asia to take care of accreditation in these countries. If governments cannot agree between them, then they can mandate bodies to do so on their behalf.
7.3 AMEEMR
Dr Ibrahim Al Alwan
The regional standards will be benchmarks towards achieving accreditation in the Region. It seems necessary at this stage to document the different experiences on accreditation in the Region. As it is known, WFME is not an accrediting body by itself and accordingly same can be understood on its regional chapters like AMEEMR. However, regional coordination is done by AMEEMR in co-accrediting and selecting of assessors for example. It is necessary that some mechanism needs to be operating to ensure that national systems abide to standards and accordingly are recognized. Bilateral recognition of systems needs to be encouraged.
7.4 WHO
WHO is not an accrediting body. Any regional mechanism needs to start with structure and then function. Is that going to be a bottom-top process or not? There is a need to build regional mechanisms bottom-top and not the other way. Building structures which are not functioning is not needed. National systems need to be encouraged, different incentives to be created to allow smooth work. National bodies can come together gradually once such bodies are legally mandated to accomplish the accreditation goals independently. If AMEEMR is looked at to coordinate between national bodies then this process needs to be from the bottom up, and not through a top–bottom floating body.
7.5 Nursing Council Dr Sawsan Almajali
The council made in 1995 a landmark for the profession in establishing regional standards for accreditation and trying to bring to minimum of nursing profession education to be at least 4 years. Standards were completely adopted in many countries like GCC with high mobility of human resources for health.
7.6 GCC Committee of Deans of Medicine Dr Mohammed Y. Baniyas
There is need for national mandate if any regional or sub-regional body is to accredit on behalf of the national government. The GCC Committee initiated accreditation in the 6 GCC countries, agreed and produced set of standards and guidelines. However, national bodies were also created and took over.
7.7 Discussion
The following points and concerns were raised.
It is worth mentioning that a resolution was endorsed by ministers of health of the Region in 2003 (EM/RC50/Tech.Disc.1) which requested the Regional Director to establish a regional mechanism of accreditation. Such a mechanism would mainly achieve three goals: first, providing support (including capacity-building) to establish and sustain autonomous, impartial national systems that can have an impact on population health; second, ensuring that national systems are on the right tract and use minimum standards and third, coordinating between national systems.
There is a need to focus on regional standards. Involve partners like keen and professional associations through revision of standards. Insist on national aspect to accredit the national system.
It is dangerous creating over-accreditation.
National systems need to work to improve health.
There is a need to support national systems to get legal mandate.
National systems to accredit practice and an outside body still needed to recognize that.
It is noticed that some terms overlap.
The International Pharmaceutical Federation is working on developing standards for pharmacy education.
Reflecting on last four days’ work, need to congratulate countries. The Regional Office needs to work on advocacy through ministries of health to support national bodies and development of accreditation activities jointly by ministries of health and that of higher education.
Meeting need to focus on national accreditation as standards are accepted at that level;
a regional body is not favoured.
Internal recognition: the idea is accountability to people.
It is worth observing the global scene in accreditation; there are no international standards. A regional mechanism is not to be on top of national systems but to support them. One example is the case of small countries where there is conflict of interest where you cannot have a national system. There is a lot to be done at national systems level and the regional body is to help them.