INQAAHE 2009 ConferenceINQAAHE 2009 Conference

THEME:THEME: New Approaches to Quality Assurance in the New Approaches to Quality Assurance in the Changing World of Higher EducationChanging World of Higher Education

TITLE:TITLE: Quality Assurance of Medical Education Quality Assurance of Medical Education Programmes in the Anglophone Caribbean:Programmes in the Anglophone Caribbean:

Accreditation by the Caribbean Accreditation Accreditation by the Caribbean Accreditation Authority for Education in Medicine and Authority for Education in Medicine and

Other Other Health Professions as one method of Health Professions as one method of Assuring QualityAssuring Quality

AUTHOR:AUTHOR: Lorna Maria Parkins, B.A., M.A., Postgraduate Lorna Maria Parkins, B.A., M.A., Postgraduate Diploma Diploma in Technical and Specialised Translations in Technical and Specialised Translations (Spanish, (Spanish, French and Portuguese), Executive French and Portuguese), Executive Director, CAAM-HPDirector, CAAM-HP

CAAM-HP Secretariat Office:CAAM-HP Secretariat Office:

Suite #4, Seymour Park, 2 Seymour Avenue, Kingston 10, JAMAICASuite #4, Seymour Park, 2 Seymour Avenue, Kingston 10, JAMAICATel: 876-927-4765; Fax: 876-9276781; e-mail: Tel: 876-927-4765; Fax: 876-9276781; e-mail:

lorna.parkins@caam-hp.orglorna.parkins@caam-hp.org

THE CARIBBEANTHE CARIBBEAN

Cuba

Jamaica

Haiti Dominican Republic

Puerto Rico Anguilla

Antigua and BarbudaGuadeloupeDominica

MartiniqueSt. Lucia

St. Vincent and the Grenadines

Grenada

Trinidad and Tobago

Belize

Mexico

Honduras

Nicaragua

Costa Rica

Panama

Colombia

Venezuela

GuyanaSuriname

Barbados

Turks and Caicos Islands

Bahamas, The

Cayman Islands

Virgin Islands

British Virgin Islands

St. Kitts and Nevis

El Salvador

ATLANTIC OCEAN

CARIBBEAN SEA

GULF OF MEXICO

Aruba

Netherlands Antilles

BackgroundBackground

Medical education in the Medical education in the Anglophone Anglophone CaribbeanCaribbean began in 1948 at the began in 1948 at the University University College of the West Indies (UCWI)College of the West Indies (UCWI), then a , then a part of the University of London.part of the University of London.

From then onwards and after full From then onwards and after full university status university status (The University of the (The University of the West Indies (UWI))West Indies (UWI)), in 1962 the medical , in 1962 the medical education programme was accredited by education programme was accredited by the the General Medical Council (GMC) General Medical Council (GMC) of the of the United Kingdom (UK).United Kingdom (UK).

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Background (cont’d)Background (cont’d)

GMC accreditation enabled UWI graduates GMC accreditation enabled UWI graduates to register freely in the UK and other to register freely in the UK and other Commonwealth countries.Commonwealth countries.

However in 2001, the GMC discontinued However in 2001, the GMC discontinued this practice of accrediting overseas this practice of accrediting overseas institutions.institutions.

Over the last 30 years, the region has Over the last 30 years, the region has witnessed significant change and growth in witnessed significant change and growth in medical education.medical education.

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Background (cont’d)Background (cont’d)

Medical schools have been established at the Medical schools have been established at the University of GuyanaUniversity of Guyana and the and the University of University of SurinameSuriname..

In addition, there has been an increase in the In addition, there has been an increase in the number of ‘number of ‘offshoreoffshore’ medical schools in the ’ medical schools in the region, the first being St. George’s University region, the first being St. George’s University School of Medicine followed by Ross School of Medicine followed by Ross University School Medicine.University School Medicine.

According to the IMED there are over 30 such According to the IMED there are over 30 such schools in the Caribbean today.schools in the Caribbean today.

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Background (cont’d)Background (cont’d)

Therefore there are 3 types of medical Therefore there are 3 types of medical schools in the region: regional, national schools in the region: regional, national and offshore.and offshore.

In1989, the UWI established schools in In1989, the UWI established schools in Dentistry and Veterinary Science.Dentistry and Veterinary Science.

Other schools in dentistry and veterinary Other schools in dentistry and veterinary medicine have since been established.medicine have since been established.

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Background (cont’d)Background (cont’d)

Quality–control oversight measures have Quality–control oversight measures have varied.varied.

Achieving reliable accreditation is difficult.Achieving reliable accreditation is difficult.

This is cause for concern in the light of the This is cause for concern in the light of the rapid increase in the number of medical rapid increase in the number of medical schools.schools.

Such a situation adds to the disquiet and Such a situation adds to the disquiet and requires international cooperation.requires international cooperation.

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Background (cont’d)Background (cont’d)

In response to these developments as well In response to these developments as well as the regional thrust to ensure quality as the regional thrust to ensure quality education and training in the context of education and training in the context of the the CARICOM Single Market and CARICOM Single Market and Economy (CSME)Economy (CSME), The Caribbean , The Caribbean Accreditation Authority for in Medicine Accreditation Authority for in Medicine and Other Health Professions and Other Health Professions (CAAM-HP)(CAAM-HP) was established under the aegis of the was established under the aegis of the Caribbean Community (CARICOM)Caribbean Community (CARICOM)..

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Background (cont’d)Background (cont’d)

In today’s world, the continuous In today’s world, the continuous movement of professionals and movement of professionals and technology and rising quality standards technology and rising quality standards make accreditation an imperative.make accreditation an imperative.

The purpose of CAAM-HP is the The purpose of CAAM-HP is the accreditation of undergraduate accreditation of undergraduate programmes leading to qualifications in programmes leading to qualifications in medicine, dentistry, veterinary medicine medicine, dentistry, veterinary medicine and other health professions in CARCIOM and other health professions in CARCIOM member states.member states.

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Background (cont’d)Background (cont’d)

CAAM-HP objectives:CAAM-HP objectives:

(a)(a) To achieve and maintain standards of To achieve and maintain standards of excellence in programmes of education in excellence in programmes of education in medicine and other health professions;medicine and other health professions;

(b)(b) To establish an efficient system of To establish an efficient system of regulation in relation to the standards and regulation in relation to the standards and quality of such programmes of education;quality of such programmes of education;

(c)(c) To secure international recognition of the To secure international recognition of the programmes of education in medicine and programmes of education in medicine and other health professions;other health professions;

(d)(d) To maintain the confidence of the peoples of To maintain the confidence of the peoples of the region in the quality of medical and the region in the quality of medical and other health professions training offered in other health professions training offered in the region.the region.

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Background (cont’d)Background (cont’d)

What is Accreditation?What is Accreditation? Accreditation is a peer review process of Accreditation is a peer review process of

quality assurance based on standards for quality assurance based on standards for process and outcomes.process and outcomes.

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Accreditation ProcessAccreditation Process

The CAAM-HP process uses established The CAAM-HP process uses established criteria, standards and processes. It aims:criteria, standards and processes. It aims:

To certify that a medical education To certify that a medical education programme meets the prescribed standardsprogramme meets the prescribed standards

To promote institutional self-evaluation and To promote institutional self-evaluation and improvementimprovement

To assure society and the medical profession To assure society and the medical profession that graduates of accredited schools meet that graduates of accredited schools meet educational requirementseducational requirements

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Accreditation Process (cont’d)Accreditation Process (cont’d)

Accreditation asks the following questions:Accreditation asks the following questions:

What are the objectives of the medical What are the objectives of the medical education programme?education programme?

Has the institution organised its Has the institution organised its programme and resources to accomplish programme and resources to accomplish these objectives?these objectives?

What is the evidence that the school is What is the evidence that the school is accomplishing its objectives?accomplishing its objectives?

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Accreditation Process (cont’d)Accreditation Process (cont’d)

The process is characterised by:The process is characterised by:

an institutional Self-Study by the school,an institutional Self-Study by the school,

an on-site review by a team of surveyors an on-site review by a team of surveyors andand

a review of the survey team’s written a review of the survey team’s written report by the CAAM-HP which forms the report by the CAAM-HP which forms the basis of the determination of a basis of the determination of a programme’s accreditation status.programme’s accreditation status.

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Accreditation Process (cont’d)Accreditation Process (cont’d)

Institutional Self-Study (ISS)Institutional Self-Study (ISS)

The ISS is central to the process.The ISS is central to the process.

It is built around pre-set standards under the It is built around pre-set standards under the headings:headings:

The Institutional SettingThe Institutional Setting The StudentsThe Students Educational ProgrammesEducational Programmes The FacultyThe Faculty Educational ResourcesEducational Resources InternshipsInternships

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Accreditation Process (cont’d)Accreditation Process (cont’d)

ISS (cont’d)ISS (cont’d)

In the self-study, a school brings together In the self-study, a school brings together representatives to:representatives to:

collect and review data about the school and its collect and review data about the school and its educational programmeeducational programme

identify institutional strengths and issues identify institutional strengths and issues requiring action, andrequiring action, and

define strategies to ensure that the strengths define strategies to ensure that the strengths are maintained and any problems addressed.are maintained and any problems addressed.

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Accreditation Process (cont’d)Accreditation Process (cont’d)

The ISS report evaluates the quality of the The ISS report evaluates the quality of the programme and the adequacy of programme and the adequacy of resources.resources.

It also identifies strengths and It also identifies strengths and weaknesses.weaknesses.

The report also includes an independent The report also includes an independent evaluation by students.evaluation by students.

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Accreditation Process (cont’d)Accreditation Process (cont’d)

The usefulness of the ISS is enhanced when The usefulness of the ISS is enhanced when participation is broad and representative. participation is broad and representative.

The process also serves as a vehicle to The process also serves as a vehicle to affirm the school’s mission and goals or set affirm the school’s mission and goals or set new strategic directions.new strategic directions.

Of note, in at least one instance, the survey Of note, in at least one instance, the survey team found participation to be limited.team found participation to be limited.

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Accreditation Process (cont’d)Accreditation Process (cont’d)

Site VisitSite Visit

The CAAM-HP Secretariat recruits and The CAAM-HP Secretariat recruits and trains a team of persons to assess how well trains a team of persons to assess how well a programme complies with the standards.a programme complies with the standards.

During the visit the team meets with the During the visit the team meets with the necessary persons from the institution.necessary persons from the institution.

At the end of the visit the team presents an At the end of the visit the team presents an oral report of its findings to the dean and oral report of its findings to the dean and vice chancellor/president.vice chancellor/president.

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Accreditation Process (cont’d)Accreditation Process (cont’d)

Report Development and ReviewReport Development and Review

The team makes a written report of its The team makes a written report of its findings.findings.

The draft report is perused by the school for The draft report is perused by the school for correction of any errors of fact and then sent correction of any errors of fact and then sent to the secretariat.to the secretariat.

The final report is sent to the CAAM-HP The final report is sent to the CAAM-HP members for review prior to the next meeting.members for review prior to the next meeting.

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CAAM-HP ActionCAAM-HP Action

The CAAM-HP meets to consider the The CAAM-HP meets to consider the report and determines accreditation report and determines accreditation status.status.

This is communicated to the school and This is communicated to the school and CARICOM.CARICOM.

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CAAM-HP Action (cont’d)CAAM-HP Action (cont’d)

Programmes are judged as:Programmes are judged as:

Accredited for a term of up to six yearsAccredited for a term of up to six years Accredited on ProbationAccredited on Probation Not AccreditedNot Accredited Provisionally AccreditedProvisionally Accredited

Full accreditation is awarded when a Full accreditation is awarded when a programme is deemed to have met the programme is deemed to have met the standards.standards.

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CAAM-HP Action (cont’d)CAAM-HP Action (cont’d)

Of the three schools that completed the Of the three schools that completed the process, none received full accreditation for process, none received full accreditation for six years.six years.

The regional university was granted full The regional university was granted full accreditation for four years.accreditation for four years.

The national university was asked to The national university was asked to resubmit its documentation.resubmit its documentation.

The offshore school was accorded provisional The offshore school was accorded provisional accreditation for two years.accreditation for two years.

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Impact and Outcomes (cont’d)Impact and Outcomes (cont’d)

Weaknesses/deficiencies identified in the ISS and Weaknesses/deficiencies identified in the ISS and verified by the team is communicated to the verified by the team is communicated to the school by CAAM-HP.school by CAAM-HP.

Areas in which schools were deemed non-Areas in which schools were deemed non-compliant or partially compliant included:compliant or partially compliant included:

GovernanceGovernance CurriculumCurriculum StudentsStudents

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ConclusionConclusion

Schools have acknowledged the Schools have acknowledged the usefulness of the process.usefulness of the process.

Schools also recognise the importance of Schools also recognise the importance of regular accreditation for quality regular accreditation for quality assurance.assurance.

The cyclical process of accreditation is a The cyclical process of accreditation is a mechanism for on-going quality mechanism for on-going quality improvement.improvement.

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END OF PRESENTATIONEND OF PRESENTATION

THANK YOUTHANK YOU

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