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Describing the Evidence Base for Accreditation in Undergraduate Medical Education Internationally: A Scoping Review

Tackett, Sean MD, MPH; Zhang, Christiana MD; Nassery, Najlla MD, MPH; Caufield-Noll, Christine MLIS, AHIP; van Zanten, Marta PhD, MEd

doi: 10.1097/ACM.0000000000002857

Purpose To summarize the state of evidence related to undergraduate medical education (UME) accreditation internationally, describe from whom and where the evidence has come, and identify opportunities for further investigation.

Method The authors searched Embase, ERIC, PubMed, and Scopus from inception through January 31, 2018, without language restrictions, to identify peer-reviewed articles on UME accreditation. Articles were classified as scholarship if all Glassick’s criteria were met and as nonscholarship if not all were met. Author, accrediting agency, and study characteristics were analyzed.

Results Database searching identified 1,379 nonduplicate citations, resulting in 203 unique, accessible articles for full-text review. Of these and with articles from hand searching added, 36 articles were classified as scholarship (30 as research) and 85 as nonscholarship. Of the 36 scholarship and 85 nonscholarship articles, respectively, 21 (58%) and 44 (52%) had an author from the United States or Canada, 8 (22%) and 11 (13%) had an author from a low- or middle-income country, and 16 (44%) and 43 (51%) had an author affiliated with a regulatory authority. Agencies from high-income countries were featured most often (scholarship: 28/60 [47%]; nonscholarship: 70/101 [69%]). Six (17%) scholarship articles reported receiving funding. All 30 research studies were cross-sectional or retrospective, 12 (40%) reported only analysis of accreditation documents, and 5 (17%) attempted to link accreditation with educational outcomes.

Conclusions Limited evidence exists to support current UME accreditation practices or guide accreditation system creation or enhancement. More research is required to optimize UME accreditation systems’ value for students, programs, and society.

S. Tackett is assistant professor of medicine and international medical education director, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland.

C. Zhang is assistant professor of medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

N. Nassery is assistant professor of medicine, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland.

C. Caufield-Noll is manager of library services, Harrison Medical Library, Johns Hopkins Bayview Medical Center, Baltimore, Maryland.

M. van Zanten is research scientist, Foundation for Advancement of International Medical Education and Research (FAIMER) and Educational Commission for Foreign Medical Graduates, Philadelphia, Pennsylvania.

Supplemental digital content for this article is available at

Funding/Support: None reported.

Other disclosures: M. van Zanten participated in the development of the World Federation for Medical Education Recognition Programme and serves as an ad hoc recognition team member.

Ethical approval: Reported as not applicable.

Previous presentations: Aspects of this work were presented as an abstract at the Accreditation in Health Professions Summit on August 29–30, 2018, in Basel, Switzerland.

Correspondence should be addressed to Sean Tackett, 5200 Eastern Ave., Mason F Lord Building, Suite 2300, Baltimore, MD 21224; email:

Copyright © 2019 by the Association of American Medical Colleges