The ACCME and the Globalization of Continuing Medical Education

The ACCME Task Force on Globalization Reports to ACCME
Chicago, IL
October 7, 2003

In January 2002, the Chair of the ACCME, Dr. Ronald Franks, appointed the Globalization Task Force (Robert Raszkowski, MD, PhD AMA, Chair; Linda Casebeer, PhD; Jerilyn Glass, MD, PhD; Kay Mitchell, MD; and Rosiland Whitehead) to fulfill the following charge:

With respect to the ACCME and the Globalization of CME --
  1. Identify the national and international factors acting as barriers to, or facilitating, the integration of the world's CME systems and
  2. Make recommendations on what actions the ACCME could take to facilitate this integration and thereby
  3. Identify opportunities within this integration for ACCME to advance its purpose and mission.

In order to facilitate its work, the Task Force adopted the following as working definitions in the context of the Globalization of CME.
Globalization: Refers to free trade in goods and services and the free movement of people. In this context, the globalization of CME is about the unconstrained movement of learners and educational activities between nations.
Internationalization: Refers to what would be the case if ACCME began accrediting around the world using its domestic accreditation standards.
Localization: Refers to the adapting of ACCME accreditation to meet the needs of a number of various locales around the world.

The Task Force began and concluded its work by focusing on "globalization" as defined above based on the assumption that ACCME would not plan on becoming involved in the "internationalization" or "localization" of ACCME accreditation. This assumption fit with the charge to the Task Force, which explicitly referenced the integration of the world's CME systems, as opposed to their assimilation into one or the further separation of these systems. Several accrediting bodies from around the world (European Accreditation Council for CME, the Catalan Council on Continuing Medical Education and the Committee on the Accreditation of Continuing Medical Education of the Association of Canadian Medical Colleges) were identified as organizations for evaluation. Their diverse accreditation policies and processes were compared and contrasted to those of the ACCME.

Additional research regarding the globalization of different medical education fields was gathered to build an understanding of the concept of globalization and how it is a factor across accreditation and higher education. Such information encompassed the principles that are intended to strengthen the working relationship among U.S. accreditors and international quality assurance agencies to encourage and enhance ongoing cooperation and communication and the different options for accreditation schemes open to European higher education aimed at ensuring comparability of degrees and promoting student mobility at both the European and the international levels. (In addition, how accreditation organizations function in different professional fields such as the Accreditation Board for Engineering and Technology was examined.)

Other accrediting organizations were compared to the ACCME's Substantial Equivalency Document demonstrating to the Task Force that there are many similarities as well as some differences with the ACCME accreditation system. The three organizations, EACCME, CCCME and the CACME, have essentially similar missions or purposes, which contribute to improving the health of the public through continuing medical education. Each organization has created a system of quality assurance that reviews and ensures such educational programs so that they meet a set of criteria based on quality and effectiveness.

The Task Force reviewed the mission and strategic imperatives of the ACCME to determine how and where its new knowledge about Globalization fits. The ACCME's mission states:

"The purposes of the ACCME shall be to promote, develop, and encourage the development of principles, policies, and standards for continuing medical education; to relate continuing medical education to medical care and the continuum of medical education; to apply these principles, policies, and standards in the accreditation of institutions and organizations offering continuing medical education, and to deal with such other matters relating to continuing medical education as are appropriate."

The ACCME fulfills its purpose and mission through the implementation of its current strategic plan, the following sections of which have been determined by the ACCME to be relevant to Globalization.

Elements of ACCME 2003 Strategic Plan

ACCME Accreditation Goal 2.2 : To innovate new, credible, and measurable standards that affect desirable outcomes for both the ACCME and our multiple markets and constituents.

ACCME Leadership Goal 2.4: To ensure ACCME's relevance and responsiveness.

ACCME Leadership Goal 2.5: To remain the most respected and credible source for CME accreditation.

ACCME Leadership Goal 2.6: To facilitate active dialogue in the CME community on "quality" and the future "best practices" for physician life-long learning.

ACCME Leadership Goal 2.7: To promote CME and accreditation as priorities to select organizations and their physician constituents.

ACCME Infrastructure Goal 2.8: To be fiscally solvent and increase revenues to meet future needs.

ACCME Strategic Imperative 3.2: Expand ACCME's outreach and its collaborative role to select and relevant markets and constituents within the CME community.


ACCME Adopts the Globalization Task Force Report July 2003

Based on the July 2003 report of the ACCME Globalization Task Force and its discussions, the ACCME adopted the following values, goals and strategic imperatives so that the ACCME can fulfill its mission with respect to the globalization of CME:


  1. The ACCME values the globalization of CME, which is the unconstrained movement of learners and educational activities between nations. Globalization is not internationalization or localization.
  2. The ACCME believes that globalization extends beyond accreditation systems to providers of continuing medical education and physician learners.


  1. While there are obstacles to globalization of CME, barriers can be overcome as demonstrated by current global efforts (e.g., Internet CME, specialty society activities, AMA's international initiatives).
  2. Because of its experience in accreditation, an appropriate role for the ACCME is to:
    • Support the unconstrained movement of learners and educational activities between nations;
    • Decrease barriers to this unconstrained movement; and
    • Share accreditation knowledge and experience,

    in order to facilitate globalization of CME at the levels of

    • Accrediting systems,
    • Accredited providers of CME, and
    • Physician learners.

Strategic Imperatives:

  1. The ACCME will seek out and collaborate in outreach opportunities with non-U. S. CME systems.
  2. The ACCME will become enabled and empowered by our national, U.S. colleagues (e.g., AMA-PRA, AAFP, specialty society CME providers, AOA) to participate with them and their international colleagues in the integration of the world's CME systems.
  3. The ACCME will ensure that the accreditation system facilitates the globalization of CME on behalf of accredited providers and physician learners.

The Future

The ACCME looks forward to collaborating and cooperating with other CME accreditors. We look forward to sharing our experience and being of assistance - when our assistance is requested and the resources are available to supply it. We recognize that CME systems develop in the context of many national and local factors. We look forward to working with and learning from our accreditation colleagues from around the world. We look forward to working towards an international network of CME accreditation systems that support "the unconstrained movement of learners and educational activities between nations."

Contact Info: