In April 2002, the Foundation for Advancement of International Medical Education and Research (FAIMER) introduced the International Medical Education Directory (IMED). IMED is a Web-based resource on the world’s medical schools. As of Feb. 13, 2004, IMED contained information on 1,858 medical schools worldwide.
FAIMER is a nonprofit foundation of the Educational Commission for Foreign Medical Graduates (ECFMG). The foundation was established in 2000 to support ECFMG’s aims and missions, thereby advancing ECFMG’s overall purpose of promoting excellence in international medical education.
In addition to FAIMER’s charge of tracking medical education worldwide, most notably evidenced by its implementation and maintenance of IMED, FAIMER’s activities include the education of educators, i.e., providing educational programs for international medical school faculty that provide opportunities for the cross-cultural exchange of educational expertise and experiences. These programs allow faculty members to serve as local resources for educational improvements, which can enhance health outcomes. FAIMER’s educational programs fulfill ECFMG’s commitment to assist international medical schools and other organizations concerned with health professions education as they engage in program development, standard setting and evaluation.
Additional FAIMER activities are concerned with the theme of discovering and disseminating knowledge. FAIMER is committed to understanding the impact of physician migration on the functioning of health care systems. It is also dedicated to studying which aspects of medical education lead to improved patient outcomes. To these ends, FAIMER will support research and collaborations that yield meaningful knowledge on medical education and international medical graduates, and will disseminate this information broadly.
THE DEVELOPMENT OF IMED
In developing IMED, FAIMER sought to build an accurate, objective informational resource on the world’s medical schools and share this resource with physicians, patients, students, researchers, medical schools and organizations concerned with credentialing and medical licensure.
IMED is a Web-based directory of the world’s medical schools, available at no cost on the FAIMER website, www.faimer.org. The information in IMED is derived from the extensive and historical data developed by ECFMG throughout its history of verifying the medical education credentials of international medical graduates (IMGs), graduates of medical schools outside the United States and Canada. Using these data as a starting point, FAIMER initiated the development of IMED in 2001 and introduced the directory in April 2002.
The medical schools listed in IMED are recognized by the government agencies in the countries where the schools are located, usually the ministry of health. The information listed for each medical school is provided by the appropriate government agency and by officials of the medical school. IMED’s Web-based format allows updated information to be incorporated as it is received by FAIMER, providing current information to its users. FAIMER updates IMED continuously as new information is received from these agencies concerning their recognition of medical schools and from officials of the medical schools that are listed in IMED. FAIMER itself is not an accrediting agency. The listing of a medical school in IMED does not denote recognition, accreditation or endorsement of the school by FAIMER.
Since April 2002, ECFMG’s medical education credential policy has required that an international medical graduate’s medical school be listed in IMED. The individual’s year of graduation must be included in the medical school’s IMED listing. The medical education credential requirements for ECFMG Certification also require that the IMG must have had at least four credit years (academic years for which credit has been given toward completion of the medical curriculum) in attendance at a medical school that is listed in IMED.
Prior to the introduction of IMED in April 2002, ECFMG required a graduate’s medical school be listed in the World Directory of Medical Schools published by the World Health Organization (WHO). The WHO listed medical schools and information on medical education in the World Directory of Medical Schools as provided to it by member states. As with FAIMER, the WHO does not accredit medical schools, and its listing of a medical school does not imply recognition or accreditation by the WHO.
NUMBERS OF COUNTRIES AND MEDICAL SCHOOLS IN IMED
As stated previously, the information in IMED is updated continuously. As of Feb. 13, 2004, there were 1,858 medical schools listed in IMED. Of that number, 1,757 (95 percent) were medical schools that, based on the most recent information available, were currently in operation. These 1,757 medical schools were located in 165 different countries. The remaining 101 (5 percent) of the 1,858 medical schools listed in IMED are schools that are no longer in operation, whether due to closing or merger with another medical school. Since IMED seeks to be both historical and current, IMED maintains information on medical schools that no longer exist, such as the Universidad CETEC, Dominican Republic.
Exhibit 1, which indicates the distribution of the 1,757 medical schools currently in operation, shows there are 120 medical schools in Africa (6.8 percent), 619 in Asia (35.2 percent), 71 in Central America and the Caribbean (4 percent), 418 in Europe (2.4 percent), 87 in the Middle East (5.5 percent), 225 in North America (12.8 percent), 19 in Oceania and the Pacific Islands (1 percent) and 198 in South America (11.3 percent).
Number of Medical Schools with “Current” Graduation Years in IMED by Geographic Region.
Of the 40 countries in Africa with one or more medical schools currently in operation, four countries have 10 or more medical schools: Algeria (11), Sudan (14), and Nigeria and Egypt (15 each). In Asia, India has the largest number of medical schools (156), followed by China (130), Japan (80) and South Korea (49). There are two countries in Central America and the Caribbean with 10 or more medical schools: Cuba (14) and the Dominican Republic (10). In Europe, the countries with the largest numbers of medical schools are Russia (60), France (45), Germany (38) and Italy and Turkey (34 each). Iran and Iraq have the largest numbers of medical schools in the Middle East, Iran with 46 and Iraq with 12. In North America, the United States has 145 medical schools, Mexico has 64 and Canada has 16. Australia has the largest number of medical schools in Oceania and the Pacific Islands, with 11 medical schools. In South America, Brazil has the largest number of medical schools (83), followed by Colombia (29) and Peru (20).
INFORMATION ON COUNTRIES AND MEDICAL SCHOOLS
The information that IMED currently contains on each country in which there is at least one IMED-listed medical school includes the name of the country, its capital, current population, the geographic region in which the country is located, the official language(s) and the number of medical schools that are listed in IMED.
For each medical school, IMED provides the:
Medical school name
Name of the university with which the medical school is affiliated (if applicable)
Medical school address, telephone/fax numbers and email address
Medical school website address
Former official names of the medical school (if applicable)
Degree title (title of the medical degree currently awarded by the medical school or university)
Graduation years, which are calendar years for which the medical school has been recognized by the government agency in the country where the school is located. Graduation years for many schools begin in 1953, although individual medical schools may have been recognized prior to that date.
Year instruction began
Language of instruction
Duration of the curriculum
Entrance examination requirement
Eligibility of foreign (non-national) students
Total enrollment
The “Graduation years” listed for each medical school indicate the years for which the school is or was recognized by the government of the country. Medical schools that have “Graduation years” that are “current” are schools that are currently recognized by the government agency in the countries in which the medical schools are located.
“Graduation years” that are not “current” indicate that the medical school is no longer recognized by the government or that the medical school was closed or no longer exists. Examples of medical schools that do not have “current” graduation years are Guy’s Hospital Medical School, St. Thomas’s Hospital Medical School, King’s College School of Medicine and United Medical and Dental Schools of Guy’s and St. Thomas’s, United Kingdom. These four medical schools no longer exist as individual medical schools due to mergers. IMED provides an explanation, indicating Guy’s Hospital Medical School and St. Thomas’s Hospital Medical School merged, forming United Medical and Dental Schools of Guy’s and St. Thomas’s. King’s College of Medicine merged with the United Medical and Dental Schools of Guy’s and St. Thomas’s, to form Guy’s, King’s and St. Thomas’s School of Medicine. The medical school that resulted from these mergers, and which is the one currently recognized in United Kingdom, the Guy’s, King’s and St. Thomas’s School of Medicine, has “Graduation years” that are “current.”
IMED also includes such other historical information on medical schools as changes of medical school name. An example is Ross University School of Medicine, Dominica. IMED notes that former names of this medical school were the University of Dominica and Windward Islands University.
Users of IMED have the ability to search the IMED database for a medical school in several ways, including geographic region, country, the name of the medical school or its affiliated university and the city in which the medical school is located.
FUTURE INITIATIVES FOR IMED
Because FAIMER’s goal for IMED is for the directory to be accurate and up-to-date as well as serve as a resource of detailed, objective information on medical schools, FAIMER is currently completing a survey of international ministries of health, ministries of education and medical councils. The survey asks about items not currently in IMED. These items include whether there is a national system of evaluation or accreditation of medical school programs and, if so, the name and contact information for the responsible evaluation or accrediting authority. The survey also requests information on whether there is a requirement in the country for medical schools to engage in periodic, comprehensive reviews of their educational programs, whether such review utilizes criteria established by an external body and, if so, what agency or agencies establish these criteria. Much of the information gathered in this survey will be reflected in IMED in the future.
The current FAIMER survey also focuses on medical licensure, requesting the name of the authority responsible for physician licensure and contact information for that agency. The section of the survey on licensure also asks whether there is a period of internship and/or social/government service required for licensure, whether the internship and/or social/government service is required of both citizens and non-citizens, whether there is a licensing examination and if the government has agreements with other countries for mutual recognition of medical qualifications and, if so, to specify the country or countries. Finally, the survey asks that the agency provide for each medical school in the country currently listed in IMED updated information on the year each medical school was granted recognition in the country and to list any recognized medical schools that are not currently in IMED.
FAIMER is also in the final stages of designing a survey to be completed by all the medical schools listed in IMED that are currently in operation. The survey will be a detailed cataloguing of objective information on each medical school, focusing on institutional characteristics (e.g., academic year, length of curriculum, sources of funding, admissions requirements, numbers of students and teaching staff), curriculum organization and process (e.g., number of hours of study in various subjects and percentages of curriculum time in preclinical and clinical phases) and facilities and equipment (e.g., research and teaching laboratories, computers, library facilities and holdings). The medical school survey also focuses on medical schools’ educational and assessment methods.
FAIMER believes that by providing detailed, objective information on medical education and medical schools, IMED will be a model resource for the public, the international medical licensing community and others who seek and use such information.
