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In the Caribbean Community (CARICOM), modern medical training began at the foundation of University College of the West Indies (then a constituent part of the University of London) in 1948 and from 1962 an independent entity, the University of the West Indies. The graduates of the UWI MBBS degree programme initially received automatic recognition from the General Medical Council (GMC) of Great Britain. Accreditation by the GMC continued over the years, with periodic visits, as various changes took place in medical education at the UWI. Other schools have been established in member countries since 1974, some of which received limited registration status from the GMC. The overriding purpose of the GMC’s accreditation was that the medical schools produce medical practitioners who were safe and competent to practise in the UK and internationally and who had an adequate basis to undertake postgraduate training. Accreditation status with the GMC normally gave graduates the ability to register to practise in most other British Commonwealth countries. As regards the USA graduates of schools in the region were entitled to take the USA’s registration examinations for graduates of foreign medical schools.
The University of the West Indies in 1989 developed as part of its Medical Sciences programme schools in Dentistry and Veterinary Science and since then other schools of Veterinary Medicine have been established in the region.
In recent years the GMC replaced their two-tier system with a single form of registration for overseas qualified doctors. The new arrangements obviated the need to continue with the reviews of the previously recognised qualifications, leaving a void of accreditation by an internationally recognised body for UWI and other schools in the region.
For the UWI and other medical, dental and veterinary schools in the region to remain attractive to regional and international students, their programmes must be recognised to be of international standard both at home and abroad. The Caribbean Accreditation Authority for Education in Medicine and other Health Professions was established in 2003 to assure that this aim could be realised. It was decided that avenues should be explored to ensure affiliations, linkages and connections with other accrediting bodies to ensure international recognition of the accrediting authority. The authority has looked at the standards of the Medical, Dental and Veterinary accreditation authorities in the UK as well as those of the USA and Canada and has developed standards comparable to those bodies, to ensure regional and international acceptance of the qualifications of persons trained in medicine at participating universities in the region.
CAAM is funded by CARICOM member states whose governments are signatories to the agreement establishing the Authority.
CARICOM Member States are: Anguilla, Antigua & Barbuda, The Bahamas, Barbados, Belize, Cayman Islands, Dominica, Grenada, Guyana, Haiti, Jamaica, Montserrat, St. Kitts & Nevis, St. Lucia, St. Vincent & The Grenadines, Suriname, Trinidad& Tobago, British Virgin Islands and Turks & Caicos Islands.
The CAAM is established to accredit medical, dental, veterinary and other health professions education programmes leading to professional degrees required for practise in CARICOM member states.
The CAAM is recognised by the participating countries as the agency for accreditation of educational programmes for qualifying degrees in Medicine, Veterinary Medicine and Dental Medicine. The CAAM is empowered to determine and prescribe standards and to accredit programmes of medical, dental and veterinary education on behalf of the contracting parties in CARICOM. The CAAM will make its own final decisions about accreditation status.
While the CAAM would not normally accredit programmes in non-CARICOM Member States, it has sought to change this and is making adjustments to provide for the accreditation of medical, dental and veterinary education programmes of schools in such countries.
The current membership of the CAAM is as follows:
- three (3) persons nominated jointly by academic institutions in the Community offering training in medicine (other than dental medicine and veterinary medicine): Dr. Carl Hanoman, University of Guyana (Vice-Chairman of the Authority), Professor Phyllis Pitt-Miller, University of the West Indies, Dr. Ruben del Prado, University of Suriname;
- one (1) person nominated jointly by academic institutions in the Community offering training in dental medicine: Dr. J. Ebenezer Scipio, University of the West Indies;
- one (1) person nominated jointly by academic institutions in the Community offering training in veterinary medicine: Dr. Winthrop Harewood, University of the West Indies;
- two (2) persons nominated jointly by regional organisations representing civil society: Professor E. R. Walrond (Chairman of the Authority), Mr. Leroy Gibbs;
- two (2) students enrolled in training programmes in medicine at academic institutions in the Community and nominated by the institutions: Ms. Emma Greenaway, University of the West Indies, Mr. Tarik Davidson, University of Guyana;
- two (2) persons from outside the region who have expertise in the accreditation of training programmes in medicine or other health professions: Dr. David Hawkins, University of Ottawa, Professor Peter Rubin, University of Nottingham and Chairman of the GMC Education Committee;
- one person representing the Caribbean Association of Medical Councils (CAMC): Dr. Trevor McCartney (Chairman of CAMC);
- three (3) representatives, each appointed by a Contracting Party selected by the Secretary-General on a rotational basis: Dr. Rohit Doon, Chief Medical Officer, Trinidad & Tobago, Dr. Marthalise Eersel, Chief Medical Officer, Suriname, Dr. Joy St. John, Chief Medical Officer, Barbados;
- the Executive Director, who shall be an ex-officio member: Mrs. Lorna Parkins.
- where the Authority specifies which professions are to be treated as other health professions, membership of the Authority shall be extended to include:–
- two (2) persons nominated jointly by academic institutions offering training in other health professions in the Community;
- two (2) students enrolled in training programmes in other health professions in institutions in the Community nominated jointly by those institutions.
A secretariat is responsible for appointing survey teams on an ad hoc basis. The composition of a survey team is determined by the characteristics of the school to be visited. The Secretariat includes a representative cross-section of basic science and clinical educators and medical practitioners in each ad hoc survey team. Survey teams include one member of the CAAM or of the Secretariat.
At present, the activities of the CAAM are administered by a small Secretariat headed by an Executive Director with headquarters in Kingston, Jamaica.
Through accreditation, the CAAM provides assurance to medical, dental and veterinary students, graduates, the medical, dental and veterinary professions, healthcare institutions and the public that undergraduate programmes leading to qualifications in medicine, dentistry and veterinary medicine meet appropriate national and international standards for educational quality, and that the graduates have a sufficiently complete and valid educational experience. Accreditation standards and the general policies of the CAAM are described in Standards for the Accreditation of Medical, Dental, and Veterinary Schools in the Caribbean Community, available from the CAAM secretariat office.
Acting independently of the participating countries, the CAAM makes periodic evaluations of the medical, dental and veterinary education programmes in CARICOM countries. A list of medical, dental and veterinary schools offering CAAM accredited programmes can be obtained from the CAAM secretariat. The list is made available to the public through the CAAM web site available at caam-hp.org along with the date of each programme's next accreditation review.
Programmes judged by the CAAM to meet the standards of quality are designated as Accredited for a term of five years. Programmes judged to be not in substantial compliance with CAAM standards are designated as accredited on 'Probation'. Programmes on probation that on review fail to meet the appropriate standards, or those never applying for accreditation, are considered 'Not Accredited'. Approved new programmes under development and those applying for accreditation and not meeting all of the standards are designated as 'Provisionally Accredited'.
An educational programme once accredited, remains accredited until the CAAM terminates the programme formally or the programme itself terminates its accreditation status. If it is brought to the attention of the CAAM that an accredited programme has ceased to exist and has not formally terminated its accreditation status, the secretariat should investigate the matter and report on the matter as soon as possible.
Accreditation does not end merely because a certain period of time has passed. Programmes typically are subject to review on a six-year cycle. The CAAM may determine that an earlier review is necessary, in which case the accreditation status does not change until a formal action is taken by the CAAM.
In the event that the CAAM determines that accreditation should be withdrawn, the letter transmitting that decision will specify the date at which accreditation ceases. Withdrawal or other determinations other than full accreditation may be appealed using the procedures described in Appendix F 'Appeal Procedure related to Accreditation Status' of the Procedures of the Caribbean Accreditation Authority for Education in Medicine and Other Health Professions.
CAAM members, staff, and surveyors must sign a statement agreeing to treat as confidential any information they receive or generate in connection with accreditation activities.
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