S. Tackett is assistant professor of medicine and director, International Medical Education, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; ORCID: https://orcid.org/0000-0001-5369-7225.
Acad Med. 2019 Jul;94(7):943-949. doi: 10.1097/ACM.0000000000002675.
In 2010, the Educational Commission for Foreign Medical Graduates (ECFMG, Philadelphia, Pennsylvania) announced that, beginning in 2023, graduation from a formally accredited medical school would be necessary for an international medical graduate (IMG) to be eligible for ECFMG certification. The announcement is notable because ECFMG certification is required for graduate medical training and practice in the United States. Graduating from a school accredited by an agency formally recognized by the World Federation for Medical Education (WFME), which has been formally evaluating and recognizing accrediting agencies since 2012, would fulfill the new ECFMG requirement. In 2015, ECFMG applicants came from 1,141 medical schools located in 139 countries or territories. As of December 2018, the WFME had formally recognized 14 accrediting agencies, which would cover only approximately a third of these recent ECFMG-certified IMGs. In this Perspective, the author compares the context of the ECFMG announcement to the beginning of accreditation in the United States so as to provide insight into the challenges the WFME faces as it seeks to evaluate and recognize what could ultimately be over 100 more accrediting authorities. The author then explores the possible effects of the requirement-specifically, its potential to restrict the ECFMG applicant pool-on the quantity and quality of the U.S. physician workforce. The author ends the Perspective by considering the implications of three broad policy options that the ECFMG could consider starting in 2023: implementation as announced, maintenance of the status quo, or a policy modified from the original announcement.
2010 年，外科学教育委员会（ECFMG，宾夕法尼亚州费城）宣布，从 2023 年开始，国际医学毕业生（IMG）要想获得 ECFMG 认证，必须毕业于一所经过正式认证的医学院。这一宣布意义重大，因为 ECFMG 认证是在美国进行研究生医学培训和执业的必要条件。毕业于世界医学教育联合会（WFME）正式认可的、自 2012 年以来一直对认证机构进行正式评估和认可的机构认证的学校，将符合新的 ECFMG 要求。2015 年，ECFMG 的申请人来自 139 个国家或地区的 1141 所医学院。截至 2018 年 12 月，WFME 已正式认可了 14 个认证机构，而这些机构仅涵盖了最近获得 ECFMG 认证的 IMG 的约三分之一。在本观点文章中，作者将 ECFMG 公告的背景与美国认证的开始进行了比较，以便深入了解 WFME 在评估和认可可能最终超过 100 个以上的认证机构时所面临的挑战。作者随后探讨了这一要求的可能影响——特别是其对 ECFMG 申请人数量和质量的潜在影响。作者最后通过考虑 ECFMG 可以考虑在 2023 年开始实施的三种广泛的政策选择，来探讨这一观点的影响：按公告执行、维持现状，或修改原始公告的政策。
