AAMC Reporter: April 2008

New Medical Schools Advance Through Accreditation Pipeline

The AAMC recently added three new medical schools to its membership roster. These additions follow the decision by the Liaison Committee on Medical Education (LCME) to grant preliminary accreditation to Texas Tech University's Paul L. Foster School of Medicine in El Paso, Texas; the Florida International University College of Medicine in Miami; and the University of Central Florida College of Medicine in Orlando, Fla. The total number of accredited U.S. medical schools now stands at 129.

In addition, six other schools are in some phase of the accreditation process, and several more are under informal discussion around the country. As the sole source for accreditation of educational programs leading to the M.D. degree in the United States, the LCME is at the center of the nation's medical school expansion. With this in mind, the committee is taking steps to reach out to officials at new medical schools as well as the public to ensure that they have an understanding of the accreditation process.

"I think the predominant sense of the LCME has been that we're a nagging sheriff," said LCME Secretary Dan Hunt, M.D., M.B.A. "But we've added a consultative role, as well. We are making an effort to be as clear as possible about the steps and the requirements. It's all about clarity and transparency."

A joint venture of the AAMC and the American Medical Association's Council of Medical Education, the LCME accredits the programs of each school leading to the M.D. degree, as opposed to the school itself. Accreditation decisions are made by 17 volunteer committee members with varying roles such as deans, faculty, medical students, practicing physicians, and members of the general public.

In order for an institution to begin the process, it must pay the $25,000 application fee, create a medical education database cataloguing all aspects of its program, and prepare a self-study document identifying strengths and areas for improvement.

At each stage of the accreditation process, a school must explicitly demonstrate that it meets the relevant standards set forth in the LCME's Guidelines for New and Developing Medical Schools. Ultimately, each school must adhere to the committee's 131 specific standards for accreditation. That may seem like a daunting number at first, but a recent change from a less specific narrative description of standards to an annotated listing of explicit standards has made the process easier for all involved, particularly considering that many school officials are encountering the process for the first time.

"Because we haven't had many new medical schools in the past 30 years, we've had to revamp the system for these new schools," said Assistant LCME Secretary Robert F. Sabalis, Ph.D. "When you open a new school, you may have people who haven't had experience with the LCME or the process."

The first level of the accreditation process is applicant school status. To attain applicant status, a school must produce basic prerequisites, including a charter and plans to provide the program in the United States or Canada. Schools currently in the applicant phase include Scripps School of Medicine in California, Oakland University Beaumont Medical School in Michigan, Hofstra University School of Medicine in New York, the Commonwealth Medical College in Pennsylvania, and the Virginia Tech Carilion School of Medicine in Virginia.

To advance to candidate school status, a revised medical education database and self-study document must be approved by the LCME, and an initial LCME site visit must be scheduled. Upon reaching candidate status, schools have the option to pay a fee to the AAMC to participate as guests in AAMC professional development meetings, access AAMC data resources, and subscribe to AAMC flagship publications. Currently, Touro University College of Medicine in New Jersey is in the candidate phase.

A review of the medical education database and self-study summary and a site visit lead to an LCME vote on whether to grant preliminary accreditation status. Once preliminary accreditation is granted, the program may begin accepting student applications. Schools that receive preliminary accreditation become eligible for AAMC membership, which is required for participation in the American Medical College Application Service®, among other AAMC services. The medical schools at Texas Tech, Florida International University, and the University of Central Florida are all at the preliminary accreditation stage. Established in 2004, this is the newest stage of the accreditation process.

After receipt of preliminary accreditation and the enrollment of its charter class, a school submits updated database and self-study documents, and undergoes another site visit, after which the LCME votes on whether to grant provisional accreditation. Canada's Northern Ontario School of Medicine is currently in this stage. Full accreditation may be granted to a school after review of its comprehensive database and self-study documents and another site visit.

LCME staff said they are committed to working closely with applicant and potential applicant schools, with the aim of not only guiding schools through accreditation, but disseminating information designed to better educate tomorrow's doctors. A revamped LCME Web site at www.lcme.org, along with plans to consult with the leadership at new schools, is helping to establish the LCME as a more prominent partner in quality improvement—and in the accreditation process itself.

"We want to be accessible for early, confidential consultations without any risk to the schools," Hunt said. "Any medical school can call us any time. They can ask us to come down and meet with their faculty to share best practices. We want to provide more information to people up front."

—By Scott Harris

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