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Letters to the Editor

In Reply to Pinsky

Tackett, Sean MD, MPH

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doi: 10.1097/ACM.0000000000003032
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I would like to thank Dr. Pinsky for providing additional insight into the Educational Commission for Foreign Medical Graduates’ (ECFMG’s) approach to its 2023 accreditation requirement and express appreciation for ECFMG’s transparency in communicating its plans to the public, particularly through its website,1 which is a valuable resource for those seeking the latest developments of its policy implementation plan. Now that it is clear that ECFMG intends to implement the accreditation requirement worldwide starting in 2023, I would also like to emphasize the need to study its implications.

Accreditation has been considerably underresearched,2,3 especially in proportion to its influence on medical education. As more resources are invested in developing accreditation systems and adhering to their requirements, evaluating accreditation’s value as a quality improvement mechanism will be critical to understand if it is worth the potential diversion of resources from clinical care or teaching activities.

Indeed, the ECFMG and World Federation for Medical Education have created a historic opportunity to not only ensure accreditation system adequacy but also encourage innovation in quality assurance and improvement processes. Thoughtful design, implementation, and study of accreditation systems will allow us to make comparisons and learn so that accreditation can become more effective and efficient globally.

Sean Tackett, MD, MPH
Assistant professor of medicine and international medical education director, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland;; ORCID:


1. Education Commission for Foreign Medical Graduates. 2023 Medical School Accreditation Requirement. Accessed September 30, 2019.
2. Kulasegaram KM, Tonin P, Houston P, Whitehead C. Accreditation drives medical education. Does evidence drive accreditation? Med Educ. 2018;52:772–773.
3. Tackett S, Zhang C, Nassery N, Caufield-Noll C, van Zanten M. Describing the evidence base for accreditation in undergraduate medical education internationally: A scoping review [published online ahead of print July 2, 2019]. Acad Med. doi:10.1097/ACM.0000000000002857.
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