May 8, 2025
Social Accountability of Medical Schools
According to the World Health Organization (WHO), the social accountability of medical schools is “the obligation to direct their education, research and service activities towards addressing the priority health concerns of the community, region, and/or nation they have a mandate to serve.”
Canadian medical schools therefore have an important role to play in ensuring that the highly valued Canadian health care system continues to provide accessible, quality care that meets the evolving needs of Canada’s diverse populations.
To this end, accreditation standards around equity, diversity and inclusion (EDI) are essential to the Canadian medical landscape. These standards ensure medical education curriculum covers core topics related to health equity, and they also help ensure that qualified candidates from a variety of populations can access medical training and ultimately shape a health care system that meets the needs of Canadians.
AFMC prioritizes initiatives that will enable medical schools and the health care system to better support equity-deserving populations.
U.S. Executive Order
On April 23, 2025, U.S. President Donald Trump issued an executive order making it illegal for accrediting bodies in the U.S. to include equity, diversity and inclusion requirements in the accreditation process for American medical schools (Reforming Accreditation to Strengthen Higher Education, Section 2(c).
As the voice of academic medicine in Canada, AFMC is gravely concerned by this decision and the negative impact it will have on access to education, diversity in the medical profession, and access to care for equity-deserving populations in the United States.
President Trump’s executive order stands in direct opposition to the AFMC Statement Against Discrimination and the Anti-Racism Commitment Statement for Canadian Medical Schools.
Accreditation Standards for Canadian Medical Schools
Prior to 1979, Canadian MD Programs received accreditation from the American Liaison Committee on Medical Education (LCME). In 1979, Canada formed its own accrediting body, called the Committee on Accreditation of Canadian Medical Schools (CACMS).
The World Federation of Medical Education (WFME) recognizes CACMS as an independent accreditation body for Canadian MD Programs. Canadian Faculties of Medicine are thus included in the World Directory of Organizations that recognize/accredit medical schools.
As a historical carryover, Canadian MD programs continued to receive dual accreditation from both CACMS and the LCME, enabling Canadian medical graduates to pursue residency and fellowships in the United States.
Social accountability became a formal accreditation standard in Canada in 2015, with the first application of these standards being implemented in 2017. This change in undergraduate accreditation standards signaled an important shift toward Canadian medical schools taking greater responsibility for addressing the health needs of their communities.
Subsequently, the LCME stopped accrediting Canadian medical schools. Effective July 1st, 2025, Canadian medical schools will only carry CACMS accreditation.
Individuals who graduate from Canadian medical schools on or after July 1st, 2025 will be considered international medical graduates (IMGs) for the purpose of entry into graduate medical education in the United States, including individuals seeking fellowship positions.
Impact on Learners
President Trump’s recent executive order is widely troubling and will have grave impacts across health care systems in the U.S.
The most recent data shows that less than 0.1% of Canadian physicians pursue residency outside the country (Canadian Institute for Health Information. Supply, Distribution and Migration of Physicians in Canada, 2022 — Data Tables. Ottawa, ON: CIHI; 2023).
Over the past five years, there has been a decline in the number of Canadian medical graduates (CMGs) pursuing residency in the United States. In 2021, only 22 CMGs applied for residency in the United States and seven were matched. In 2025, only 15 CMGs applied for residency in the United States and ten were matched (Advance Data Tables for the 2025 Main Residency Match, Table 4).
AFMC remains proud of the Canadian medical education system, confident in the CACMS accreditation standards, and committed to the importance of social accountability to our health care systems.
Any questions or ideas related to this evolving landscape may be directed to: communications@afmc.ca
