Inside the LCME: A College of Medicine Student’s Experience on the National Accrediting Agency

Q: Who accredits medical school and establishes standards?

A: The Liaison Committee on Medical Education (LCME), is recognized by the U.S. Department of Education as the official accrediting agency for M.D. programs. The group was formed in 1942 by the Association of American Medical Colleges (AAMC) and the American Medical Association (AMA). Every eight years, all M.D.-granting programs in the U.S. and Canada must go through a highly structured process that includes at least one site visit by the LCME.

Katherine Joyce, M.D. (’19), learned as an active participant that LCME accreditation is a lengthy and costly process – but also a fascinating one. Dr. Joyce was one of just two students selected for the privilege of serving on a national 19-member committee during the 2018-19 academic year.

As her final meeting in June approached, Dr. Joyce talked about her experience.

Q: How were you selected for the committee?

A: Each medical school in the country nominates two students – one for consideration by the AAMC and one by the AMA. After seeing a school-wide email from Dr. Mowad [vice dean of the College of Medicine] during my third year, I submitted a short essay and my CV. I was lucky enough to be nominated by NEOMED to the AMA and subsequently nominated to the LCME by the AMA Board of Trustees.

Q: What’s the makeup and what are the duties of the committee?

A: The other student and I have been full voting members of the committee. Most of the other members are physicians who are current or former deans. Students serve one year; the other members serve three.

The committee meets as a group three times a year, typically with two meetings in Chicago and one in another major city (this year, in Scottsdale, Arizona). Subcommittees meet throughout the year via conference call, while members are assigned various schools for review prior to each of the three meetings.

Q: What have you learned about the process?

A: Prior to my nomination, I wrongly assumed that the curriculum was the group’s primary focus. While curriculum is one piece the LCME considers when a school is up for accreditation, the LCME is intentionally vague on curricular requirements as they do not wish to stifle innovation. The “Standards and Elements” established by the LCME set the expectations all schools must meet and include curriculum, staff satisfaction, financial elements and numerous other pieces. They vary in scope from the specific (6.8 – “A medical education program includes at least 130 weeks of instruction”) to those that are more readily up for interpretation (4.3 – “The faculty of a medical school demonstrate a commitment to continuing scholarly productivity that is characteristic of an institution of higher learning.”).

I’ve learned that the LCME is made up of an incredibly dedicated group of educators who put patients and students first. While there are at times disagreements, these discussions are rooted in a dedication to medical education. The chance to see how different schools across the country operate has been invaluable. Seeing the efforts put forward by NEOMED faculty and students also showed me how difficult the process is. Having seen the process from multiple angles, I think that despite the challenges of accreditation it is a process that protects students, staff and the patients we will one day treat.

Q: During 2018-19, NEOMED was one of the schools scheduled for this periodic accreditation process. What does the process entail?

A: Schools compile numerous reports, improve upon issues uncovered in a self-study process and are visited by an LCME site visit team.

NEOMED students may remember the lengthy survey and impressive report compiled by our classmates on the Student Impact Committee. Known as the “Independent Student Analysis” (ISA), the crucial report is reviewed by NEOMED, the site visit team and the LCME. The site visit teams sometimes include current or past LCME voting members who have been trained specifically in the accreditation process. During the site visits the teams speak with school stakeholders and review documents including financial reports, the ISA and Graduate Questionnaire data. They also review a massive report called the Data Collection Instrument, which requires schools to show proof of compliance with each standard and element.

After a site visit, the teams assemble a report and determine if a school’s compliance with a given element or overall standard is “satisfactory,” “satisfactory with a need for monitoring” or “unsatisfactory.” This does NOT constitute a final decision. Any determination by the site visit team may be changed. Upon completion of the site team’s report, a voting member of the LCME reviews the reports and determines whether or not they agree with the site visit team’s recommendations. These reports are then reviewed at one of three annual LCME meetings, where voting members discuss each school at length and make the final decision on each standard/element as well as the school’s compliance overall. At this time the LCME may request more information, follow-up reports, etc. Members are excused from the room if a school from their state is being reviewed. NEOMED has not yet been evaluated by the committee and will not be discussed until the October meeting. I will have finished my appointment at that time and would not have been permitted to participate, regardless.

Q: What’s your final takeaway?

A: While some may view the LCME process as a burdensome and costly administrative hurdle, I view it as a necessary safeguard for students, faculty and patients. The LCME includes some of the most dedicated educators I have ever met. While there are often disagreements, LCME members are all incredibly dedicated to medical education, students and patients. Serving on this committee has been a phenomenal learning experience and a chance to advocate for my fellow students at schools across the country.

I will be forever grateful to NEOMED for providing me this opportunity, and I hope other students serve in future years!