Dear Editor,
In accordance with the rules and regulations of the World Federation for Medical Education (WFME), an undergraduate medical education program is considered acceptable if the medical school is listed in the World Directory, which is possible if the medical school has been accredited by one of the recognized bodies worldwide. The Undergraduate Medical Education Council (UMEC) in Iran was recognized by WFME in 2019, and this recognition is valid until 2029 (1). Some commitments must be fulfilled as part of the UMEC recognition certificate, including the accreditation of every medical school in Iran and post-accreditation monitoring (2, 3). In this regard, several M.S. theses, Ph.D. dissertations, and scientific projects related to accreditation have been designed and implemented; the present study is one of such projects (4, 5). All undergraduate medical education programs (UMEP) in Iranian medical schools were accredited during two rounds from 2019 to 2024. In this letter, we report on some opinions gathered from stakeholders in the northern region of Iran (region 1), including the provinces of Mazandaran, Guilan, Semnan, Shahroud, Babol, and Golestan.
1. Accreditation has made academic staff more aware of quality matters in medical education. This increased awareness has enhanced critical judgment regarding the educational processes in medical schools.
2. The impact of accreditation on students' learning is evident, as it contributes to improve curricular development and the educational policies in place.
3. Accreditation is a dynamic process, requiring regular revision of standards. Feedback from research studies, extensive stakeholder consultations, and networking with national and international medical education agencies such as the WFME are essential. Regular reviews with national and international experts would be a good practice for accreditation agencies.
4. Accreditation bodies and medical schools should collaborate as educational partners to enhance community health through high-quality education.
5. After revising the standards, continuing professional development for external assessors should be considered. External assessors must meet expertise requirements before being included in the accreditation team. Given the specialization of accreditation areas (areas 1 to 8) and fundamental challenges in standards, a common understanding of the standards among external assessors is crucial to ensure interrater reliability.
6. A common language in the understanding of standards is necessary to prevent subjective judgment, which can significantly reduce interrater reliability.
7. Challenges may arise due to differences in understanding among internal assessors, differing perspectives of external assessors, disagreements between internal and external assessors, and conflicts between external assessors and the board committee, as all cycles in program evaluation are interdependent.
8. Considering the aforementioned challenges, training for internal assessors, clear communication with external assessors, mediation for disagreements between internal and external assessors, board committee involvement throughout the accreditation process, improving feedback loops, and fostering continuing improvement are essential.
9. In quality management, quality assurance ensures that "no bad apples" are put on the market, while quality improvement aims to produce "the best apple" based on context. Using these metaphors, the accreditation of undergraduate medical education (UME) in Iran meets basic standards when compared to other accreditation systems and demonstrates self-critical and self-corrective thinking. This approach reflects a commitment to ongoing improvement.
10. Iran's UME accreditation has been approved by the WFME. The UMEC, recognized as an official agent of the WFME, received the highest level of approval for a period of 10 years. This achievement, recently attained by neighboring countries such as Pakistan, Iraq, and India was succeeded by UMEC in 2019. Additionally, Iran has recently achieved cross-border accreditation, a milestone previously accomplished by only a limited number of countries.
