College of Medicine, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
Med Teach. 2013;35 Suppl 1:S8-14. doi: 10.3109/0142159X.2013.765544.
Saudi Arabia (SA), the largest country in the Gulf Region, has witnessed unprecedented expansion in undergraduate medical education (UME) with more than 200% increase in medical schools over the last five years. Such rapid expansion creates major challenges in relation to quality of outcomes to the extent that some authors argue that SA needs reform similar to Abraham Flexner. This may explain the strong movement towards accreditation of UME in SA but it is important to reflect on purpose of accreditation and learn from the experience of developed countries. In USA, more than 100 years ago Flexner used a predetermined gold standard to judge all medical schools and resulted in closing more than 50% of the medical schools at that time. For accreditation to fulfill its promises in ensuring quality of UME, it has to reassure stakeholders of its contribution to their culture of quality rather than an external judge of their quality. Recently, the World Federation for Medical Education recognizes that the presence of accreditation systems "does not provide a guarantee that the system is working and resulting in trustworthy decisions on the quality of programs in medical education". However, there must be a way of introducing quality management that maintain recent needed quantity development of UME in SA while ensuring the quality of products of medical schools. This paper describes accreditation development in SA and suggests a strategy for creating a culture of quality in medical schools in preparation for meaningful accreditation systems that ensure proper participation of all stakeholders in quality management on basis of evidence.
沙特阿拉伯（Saudi Arabia）是海湾地区最大的国家，在过去五年中，其本科医学教育（Undergraduate Medical Education，UME）经历了前所未有的扩张，医学院数量增加了两倍多。这种快速扩张给教育质量带来了重大挑战，以至于一些作者认为，沙特阿拉伯需要进行类似于 Abraham Flexner 的改革。这或许可以解释沙特阿拉伯 UME 认证的强烈趋势，但重要的是要反思认证的目的，并从发达国家的经验中吸取教训。在美国，100 多年前，Flexner 曾使用预定的金标准来评判所有医学院，导致当时超过 50%的医学院关闭。为了使认证能够履行其确保 UME 质量的承诺，它必须让利益相关者相信其对他们的质量文化有贡献，而不是他们质量的外部评判者。最近，世界医学教育联合会（World Federation for Medical Education）认识到，认证系统的存在“并不能保证该系统在运行，并能对医学教育项目的质量做出可信的决策”。然而，必须有一种质量管理方法，在确保医学院产品质量的同时，保持沙特阿拉伯 UME 近期所需的数量发展。本文描述了沙特阿拉伯的认证发展，并提出了在医学院中建立质量文化的策略，为确保所有利益相关者在基于证据的质量管理中适当参与的有意义的认证系统做好准备。
