Society expects a physician to be selfless, kind and sympathetic, a good communicator with understanding, professionally competent, wise and alert. Physicians are also expected to be socially accountable. Social accountability refers to the obligations of medical professionals and medical institutes to direct education, research and service towards addressing priority health concerns of the community that they have a mandate to serve.

For this purpose, health personnel should think about their professional competence, legal and ethical conduct and financial performance. They must consider whether there is adequate access to health care, whether public health is promoted and whether the community benefits.

Medical colleges have defined goals and objectives but do they assure social accountability? Do our medical colleges produce graduates who are competent to achieve the objectives mentioned above?

An accreditation process can protect the quality of education, provide a guarantee of the qualification granted, and encourage improvements in the curriculum. Accreditation is the process of conducting an external evaluation of an institute and its associated activities, usually by a national body. This is done to assure the public that the qualification granted by the institution to its products is of a standard that will result in safe practice.

Educational programmes of medical institutes are accredited by external assessors to ensure that they satisfy the institution’s objectives. They must have resources to achieve these objectives, evaluation systems to test the appropriate knowledge, skills and attitudes, and the ability to produce competent graduates.

The following areas can benefit from standards for accreditation: organisation and administration; faculty and staff; physical, clinical, library and financial resources; curriculum and degrees; and experimentation and evaluation.

The process of setting up an accreditation system

The formation of a national accreditation committee is the first step. Other processes that are required are: identifying the areas that the committee will check and fixing the criteria or gold standards for evaluation. Political commitment, the motivation of the medical and allied health science institutes and support by a well-equipped office in terms of human resources and logistics are essential for success.

Methods for evaluation of an accreditation system

Methods for evaluation of an accreditation system can vary from institute to institute and country to country. It is preferable to have a national accreditation body, which follows pre-set national criteria.

In Bangladesh, a formal accreditation system is yet to be set up. But there are affiliating agencies like the ministry of health and family welfare, the director general of health services, and medical universities. The concerned institute fills up a standard inspection form and the nominated members of the concerned organisations conduct a one-day visit and prepare a report.

What needs to be done?

Every medical institute should regularly practise reporting the annual performance, quality assurance, and a teaching audit. A unique evaluation system is necessary. Faculty development, a review for continuing professional development, and a reflection of concerned ethical issues in all these areas, are a requisite of an effective accreditation system.

For better performance of the medical institutes, the country should establish a joint committee for accreditation. It should develop standards for accreditation based on educational objectives, curriculum, teaching-learning strategies, skills that graduates should possess, community orientation and the structure of the local health system. The evaluation should consider not only knowledge but also skills and attitude.

The joint committee for accreditation should assess medical education. The report can be utilised for ranking institutes, affiliation and certification, allocation of funds, incentives and improvement in educational programmes.

The reflection of related ethical issues in the whole process will ultimately lead to better ethical practices by medical graduates in their future professional life. Accreditation will ensure social accountability through better logical and ethical practices that will ultimately enhance future ethical medical practices.