Barbados, Government of 09/19/2016 08/26/2016 Final Review Determination

U.S. Department of Education

Initial Comparability Determination for Barbados

Prepared September 2016


Barbados is seeking an initial determination from the NCFMEA that the accreditation standards it uses to evaluate its medical school are comparable to those used to evaluate programs leading to the M.D. degree in the United States. The University of the West Indies (UWI) was formally chartered in 1962 by royal decree as an entity independent from the University of London where it had its roots. Shortly after Barbados became independent in 1966, a UWI campus was established in Barbados called Cave Hill. (UWI is a regional university with campuses throughout the Caribbean.) The School of Clinical Medicine and Research (SCMR) was then established on the Cave Hill Campus and provided clinical training on Barbados for students who had completed their basic medical education at UWI campuses on other islands. During 2008-2010 (through Ordinance 53) UWI had upgraded SCMR to become the Faculty of Medical Sciences at Cave Hill (Cave Hill). The purpose was to provide students with their entire medical training on Barbados and not just the clinical training portion. The General Medical Council of Great Britain decided that it would no longer be responsible for the accreditation of medical schools outside of Britain and the European Union after 2003. As a result, several countries in the Caribbean banded together to establish a regional authority to provide independent accreditation evaluations of their medical schools. That regional accreditation authority is called the Caribbean Accreditation Authority for Education in Medicine and Other Health Professions (CAAM-HP). In 2005 the government of Barbados signed the agreement that had established CAAM-HP. Furthermore, in May 2016 the parliament of Barbados enacted legislation to specifically confirm its commitment to the 2005 agreement to use the accreditation services of CAAM-HP in Barbados. Based on the information provided, it appears that Barbados has an evaluation system that is substantially comparable to that used to accredit medical schools in the United States. While Barbados has provided much information regarding the quality assurance system and standards used for medical education in that country, there are some areas where further information may be helpful. Those issues are noted in the Summary of Findings and the Staff Analysis sections.

Summary of Findings

Additional information is requested for the following questions. These issues are summarized below and discussed in detail under the Staff Analysis section. -- It is unclear what process and standards were used by the Barbados Accreditation Council to grant institutional accreditation to Cave Hill for a period of six years. It is also unclear how that process and standards related to those used by CAAM-HP. [Approval of Medical Schools, Question 1] -- The NCFMEA may want to question the country further regarding the distinctive regional control structure and the Cave Hill campus. [Approval of Medical Schools, Question 3] -- How and when the new standard on a medical school’s external authority will be implemented, and if it will be applied to the Cave Hill campus, are still unclear. [Governance, Question 2] -- It is unclear if student performance outcomes measures or benchmarks are considered of genuine value and would serve a significant role in the country’s accreditation process. [Student Achievement, Question 4] -- It is unclear if the required complaint mechanism will be revised to incorporate the name and contact information of CAAM-HP. In addition, it is unclear if the required complaint mechanism will be revised to clearly inform students that they may submit complaints to CAAM-HP that are not resolved at the institutional level. [Student Complaints, Question 2] -- It is unclear if Barbados would consider requesting a site visit report from CAAM-HP that would provide a comprehensive and concentrated focus on all of the aspects of the medical education taking place at the Cave Hill campus. [Onsite Review, Question 1] -- It remains unclear whether CAAM-HP will conduct an on-site review at new clinical sites inside or outside of Barbados within 12 months of the placement of Cave Hill students at those sites. [Onsite Review, Question 3] -- It is still unclear if CAAM-HP will be adopting a written policy specifying that if a clinical program is located in the United States, or in an approved (NCFMEA-listed) third country, that CAAM-HP must have conducted an on-site visit and approved that clinical training program. [Onsite Review, Question 5] -- It is unclear what substantive changes must be reported to CAAM-HP one year in advance, and what deadlines are applied to other types of substantive changes. [Substantive Change] -- The NCMEA may still wish to ask for current documentation demonstrating the application of CAAM-HP’s conflict of interest policy. [Conflicts of Interest, Inconsistent Application of Standards, Question 1] -- It is still unclear what future discussions CAAM-HP plans to hold on incorporating at least rudimentary graduate performance data into its accreditation decision-making process. [Accrediting/Approval Decisions, Question 2] -- It is still unclear if CAAM-HP has any plans to establish a structured mechanism for collecting data regarding each medical school’s graduates, including the range of performance data suggested by the NCFMEA guidelines, and to begin using that data in its decision-making process. [Accrediting/Approval Decisions, Question 3] -- It is still unclear when CAAM-HP will realistically incorporate outcomes data analysis into its accreditation decision-making process. [Accrediting/Approval Decisions, Question 4]

Staff Analysis