According to stats.oecd.org, about 46,000 Indian-trained doctors and 12,500 Pakistan-trained doctors currently work in the US, increasing by 850 and 550 respectively each year.
That intake – a significant part of the 25% foreign medical graduates the United States requires every year – is threatened by the Recognized Accreditation Policy of the Educational Commission for Foreign Medical Graduates (ECFMG).
The Policy, first announced in 2010, declared that effective 2023, (revised to 2024) “physicians applying for ECFMG Certification will be required to graduate from a medical school that has been appropriately accredited.”
This means that a graduate emerging from a school that is not “appropriately accredited” will be ineligible to obtain an ECFMG Certificate – so excluding him/her from the US medical system.
What is “Appropriately Accredited?”
I’ve written before about the meaning of “appropriate accreditation.” Briefly put, it means that a medical school’s accrediting agency has been recognized by the World Federation for Medical Education (WFME), or, (since October 2022), the US Education Department’s National Committee on Foreign Medical Education and Accreditation (NCFMEA).
The Cases of India and Pakistan
For years, the accrediting authorities of both India and Pakistan had serious credibility issues. The Pakistan Medical and Dental Council and the Medical Council of India were both viewed with suspicion and medical schools of questionable quality pervaded their territories. Allegations of corruption were rampant in both organizations, and in their degraded state, neither PMDC or MCI was likely to subject itself to the scrutiny of WFME.
Clearly, if India and Pakistan wished future medical graduates to have access to the United States, something had to be done to make their accrediting authorities effective and transparent.
Protracted Legal Battles
In both countries, after protracted legal battles that took close to a decade, their respective Supreme Courts dissolved their accreditation authorities, and established new ones in their place. India’s National Medical Commission (NMC) was established in September 2020. Two years later, in September 2022, the Pakistan Medical Commission came into existence.
Both new agencies quickly commenced the WFME recognition procedure to ensure that they would meet the ECFMG’s requirements by 2024.
Improving International Medical Education
When ECFMG announced its Recognized Accreditation Policy in 2010, it did so with a view to improving international medical education. The agency wanted to ensure that doctors entering the US medical profession didn’t just pass the United States Medical Licensing Exam (USMLE) but had a thorough medical education as well.
The cases of India and Pakistan illustrate the effectiveness of this policy. By reeling in their errant accrediting authorities and subjecting them to WFME examination, both countries were forced to establish a meaningful, systematic, and transparent framework for the accreditation of their medical schools.
A Noble Price
At the time of writing in January 2023, neither India or Pakistan has yet obtained WFME recognition – and the US risks losing a significant source of foreign doctors. However, it can be argued that this temporary exclusion is a noble price to pay to ensure that future graduates are properly qualified to treat their patients.
