Diversity and Accreditation

The Liaison Committee on Medical Education accredits medical education programs leading to the M.D. degree in the United States and Canada. Several LCME accreditation standards are relevant to cultural competence, disparities and diversity in a medical school setting.

Standard 3: Academic and Learning Environments
A medical school ensures that its medical education program occurs in professional, respectful, and intellectually stimulating academic and clinical environments, recognizes the benefits of diversity, and promotes students’ attainment of competencies required of future physicians.

3.3: Diversity/Pipeline Programs and Partnerships
A medical school has effective policies and practices in place, and engages in ongoing, systematic, and focused recruitment and retention activities, to achieve mission-appropriate diversity outcomes among its students, faculty, senior administrative staff, and other relevant members of its academic community. These activities include the use of programs and/or partnerships aimed at achieving diversity among qualified applicants for medical school admission and the evaluation of program and partnership outcomes.

3.4: Anti-Discrimination Policy
A medical school does not discriminate on the basis of age, creed, gender identity, national origin, race, sex, or sexual orientation.

Standard 7: Curricular Content
The faculty of a medical school ensure that the medical curriculum provides content of sufficient breadth and depth to prepare medical students for entry into any residency program and for the subsequent contemporary practice of medicine.

7.1: Biomedical, Behavioral, Social Sciences
The faculty of a medical school ensure that the medical curriculum includes content from the biomedical, behavioral, and socioeconomic sciences to support medical students' mastery of contemporary scientific knowledge and concepts and the methods fundamental to applying them to the health of individuals and populations.

7.2: Organ Systems/Life Cycle/Primary Care/Prevention/Wellness/Symptoms/Signs/Differential Diagnosis, Treatment Planning, Impact of Behavioral and Social Factors
The faculty of a medical school ensure that the medical curriculum includes content and clinical experiences related to each organ system; each phase of the human life cycle; continuity of care; and preventive, acute, chronic, rehabilitative, end-of-life, and primary care in order to prepare students to:

• Recognize wellness, determinants of health, and opportunities for health promotion and disease prevention
• Recognize and interpret symptoms and signs of disease
• Develop differential diagnoses and treatment plans
• Recognize the potential health-related impact on patients of behavioral and socioeconomic factors
• Assist patients in addressing health-related issues involving all organ systems

7.5: Societal Problems
The faculty of a medical school ensure that the medical curriculum includes instruction in the diagnosis, prevention, appropriate reporting, and treatment of the medical consequences of common societal problems.

7.6: Cultural Competence and Health Care Disparities
The faculty of a medical school ensure that the medical curriculum provides opportunities for medical students to learn to recognize and appropriately address gender and cultural biases in themselves, in others, and in the health care delivery process. The medical curriculum includes instruction regarding the following:

• The manner in which people of diverse cultures and belief systems perceive health and illness and respond to various symptoms, diseases, and treatments
• The basic principles of culturally competent health care
• The recognition and development of solutions for health care disparities
• The importance of meeting the health care needs of medically underserved populations
• The development of core professional attributes (e.g., altruism, accountability) needed to provide effective care in a multidimensional and diverse society

The Accreditation Council for Graduate Medical Education accredits postgraduate training of residents and fellows. ACGME program requirements state, "Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals." ACGME standards also mandate the following:

“Residents are expected to communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds (IV.A.5.d.1). Residents must demonstrate a commitment to carrying out professional responsibilities and adherence to ethical principles (IV.A.5.e.).”

“Residents are expected to demonstrate compassion, integrity, and respect for others; responsiveness to patient needs that supersedes self-interest; respect for patient privacy and autonomy; accountability to patients, society, and the profession; and sensitivity and responsiveness to a diverse patient population, including, but not limited to, diversity in gender, age, culture, race, religion, disabilities, and sexual orientation (IV.A.5.e.1-5).”

The Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) accredits physician assistant educational programs within the territorial United States to ensure their compliance with those standards. The introduction to the ARC-PA standards states,

"The ARC-PA acknowledges ongoing changes in the delivery of health care and in the education of health professionals. The needs of patients and society must be considered by the ARC-PA, the sponsoring institutions and the programs. Education should be provided in a manner that promotes interprofessional education and practice. An environment that fosters and promotes diversity is considered essential to preparing PAs to provide service to others that is not exclusionary of any group, race, or culture. The various insights and resources offered by a diverse faculty, staff and student body increase the overall impact the PA profession can have on the future of the global community."

ARC-PA standards also mandate the following:

B1.06 The curriculum must include instruction to prepare students to provide medical care to patients from diverse populations.

ANNOTATION: Quality health care education involves an ongoing consideration of the constantly changing health care system and the impact of racial, ethnic and socioeconomic health disparities on health care delivery. Instruction related to medical care and diversity prepares students to evaluate their own values and avoid stereotyping. It assists them in becoming aware of differing health beliefs, values and expectations of patients and other health care professionals that can affect communication, decision-making, compliance and health outcomes.

The Council on Accreditation of Nurse Anesthesia Educational Programs (COA) is the accrediting agency for nurse anesthesia programs in the United States, its territories, and protectorates. The COA publishes the “Standards for Accreditation of Nurse Anesthesia Programs – Practice Doctorate.” The following standards pertain to cultural competence:

Section D. Graduate Standards. 6. Deliver culturally competent perianesthesia care (see Glossary, “Culturally competent”). Culturally competent – Cultural competency is demonstrated by effectively utilizing various approaches in assessing, planning, implementing, and administering anesthesia care for patients based on culturally relevant information.

Section E. Curriculum Standards. 2.2. The curriculum is designed to focus on the full scope of nurse anesthesia practice including: ethical and multicultural healthcare.