McGill University Medical School Accreditation Probation 2015-2017
McGill University’s medical program is the oldest in Canada, founded in 1829, and was the school’s first faculty. In the fall of 2014, McGill’s website noted that McLean’s magazine had named it as Canada’s top university, for the tenth year in a row, among institutions with medical programs. The website also noted that McGill’s medical program had placed 11th in the world by the Times Higher Education rankings in 2011-2012. Considering the prestigious history and reputation of this institution, it would have been quite shocking when the school was put on probation by the Committee on Accreditation of Canadian Medical Schools (CACMS) and the Liaison Committee on Medical Education (LCME) in 2015.
In February of 2015, a team surveyed the students of the medical school. The results of the survey found 24 of 132 items were non-compliant with the standards required for accreditation. The non-compliance report stated that “The CACMS and the LCME took this action based on the constellation of standards with which the school is out of compliance. The breadth and depth of these findings have seriously compromised the quality of the medical education program.” Some of the problems identified in the non-compliance report covered topics such as:
Lack of representative diversity of student population as well as staff and instructors
Inadequate instruction in many areas of the curriculum
Lacking formative assessment and significant delays in providing summative assessments and grades
Poorly communicated health and well-being programs for students as well as workload violations
Program goals and objectives without indicators and timelines and not linked to courses and outcome measures
Students were unaware of the program objectives
Instructors were not required to obtain training in teaching skills and did not receive regular feedback
Inadequate supervision of experiential learning involving patient care
Faculty not adequately involved in program planning and admissions decisions
Culture that makes fixing problems with systemic problems in the learning environment difficult
Complaint resolution process lacking confidentiality and reporting of outcomes
Professional development opportunities not fairly distributed between campuses
Inadequate facilities and resources in some hospitals
Inadequate access to printed and online research resources
Sloppy management of affiliation agreements and lack of integration between partner institutions
The program was put on probation for a period of two years, but the institution still retained their accreditation during this period. The accreditation committee supported and monitored the school by appointing a consultant to visit the school “to assist the dean in developing an action plan to address the areas of noncompliance and areas in compliance with a need for monitoring.” David Eidelman, Dean of Medicine at McGill, responded by creating a working group on accreditation and assuring students that their degrees would be recognized around the world. The Dean also pointed out that the school was experiencing multiple challenges related to updating curriculum, moving a hospital and implementing healthcare reforms at this time, which seems to suggest that a comprehensive and realistic change management plan was not developed and/or implemented.
McGill was required to notify all current and future students, as well as potential applicants of its probation status and the accreditation body published the accreditation status for the public. The contents of the report, however, were for McGill University officials only, to be published only at the discretion of school officials. The medical school chose to publish the report on their website, perhaps to avoid speculation and gossip and to pro-actively move forward in an open and transparent manner.
On June 12, 2017, the CACMS was satisfied that McGill’s medical school had become compliant in many areas and their probation was rescinded. The Accreditation body, however, pointed out a few areas that remained noncompliant with the standards. Dean Eidelman, in a letter to staff and students, emphasized that most of the previous issues had been brought to standard and admitted that there was more work to be done to become compliant in areas related to diversity and supervision of students. Again, the medical school was open and transparent about the school’s status, and posted the 2017 accreditation report on their website. Although McGill’s accreditation had been continued for an indeterminate time, they were still being monitored for outstanding issues and would be reviewed in January of 2019 and 2020.
McGill’s medical school was held to account for allowing their standards to slip below acceptable levels. Students voiced their concerns to accreditation surveyors, those concerns were investigated, and improvements were demanded and achieved. McGill medical school ‘took their eyes off the ball’ and got caught. From my surficial investigation into this story, my hypothesis is that the school was juggling too many balls at one time and dropped some; unfortunately, the balls that they dropped were too important for the accreditation committee to ignore. Perhaps McGill got distracted from their main task of providing an outstanding education/product/experience to their students/customers. This story illustrates formative evaluation at the macro level - McGill received valuable student feedback, the accreditation organization worked with the university to reflect on and improve its practise, the university submitted an incomplete report on the due date, and they got an extension. Hopefully, this incident will remind post-secondary institutions to continually engage with staff, students and experts to ensure that they are meeting the needs and expectations in a rapidly-changing world.