Standards for Accreditation of Medical Education Programs Leading to the MD Degree.
The listed standards are based on the ones published March 2023. For surveys in the
2024-25 Academic Year.
Standards and Elements Effective July 1, 2024.
Table of Contents
LCME Standards and Elements are listed below. Italic Font is used for the LCME wording. Regular Font is used for Ìð¹ÏÊÓƵ SOM details and links.
A medical school has a written statement of mission and goals for the medical education
program, conducts ongoing planning, and has written bylaws that describe an effective
organizational structure and governance processes. In the conduct of all internal
and external activities, the medical school demonstrates integrity through its consistent
and documented adherence to fair, impartial, and effective processes, policies, and
practices.
A medical school engages in ongoing strategic planning and continuous quality improvement
processes that establish its short and long-term programmatic goals, result in the
achievement of measurable outcomes that are used to improve educational program quality,
and ensure effective monitoring of the medical education program’s compliance with
accreditation standards.
Element 1.2 - Conflict of Interest Policies A medical school has in place and follows effective policies and procedures applicable
to board members, faculty members, and any other individuals who participate in decision-making
affecting the medical education program to avoid the impact of conflicts of interest
in the operation of the medical education program, its associated clinical facilities,
and any related enterprises.
Element 1.3 - Mechanisms for Faculty Participation A medical school ensures that there are effective mechanisms in place for direct faculty
participation in decision-making related to the medical education program, including
opportunities for faculty participation in discussions about, and the establishment
of, policies and procedures for the program, as appropriate.
Element 1.4 - Affiliation Agreements In the relationship between a medical school and its clinical affiliates, the educational
program for all medical students remains under the control of the medical school’s
faculty, as specified in written affiliation agreements that define the responsibilities
of each party related to the medical education program. Written agreements are necessary
with clinical affiliates that are used regularly for required clinical experiences;
such agreements may also be warranted with other clinical facilities that have a significant
role in the clinical education program. Such agreements provide for, at a minimum
the following:
The assurance of medical student and faculty access to appropriate resources for medical
student education
The primacy of the medical education program’s authority over academic affairs and
the education/assessment of medical students
The role of the medical school in the appointment and assignment of faculty members
with responsibility for medical student teaching
Specification of the responsibility for treatment and follow-up when a medical student
is exposed to an infectious or environmental hazard or other occupational injury
The shared responsibility of the clinical affiliate and the medical school for creating
and maintaining an appropriate learning environment
Element 1.5 - Bylaws A medical school promulgates bylaws or similar policy documents that describe the
responsibilities of the dean and the faculty and the charges to the school’s standing
committees.
Element 1.6 - Eligibility Requirements A medical school ensures that its medical education program meets all eligibility
requirements of the LCME for initial and continuing accreditation, including receipt
of degree-granting authority and accreditation by a regional accrediting body of either
the medical school or its sponsoring organization.
A medical school has a sufficient number of faculty in leadership roles and of senior
administrative staff with the skills, time, and administrative support necessary to
achieve the goals of the medical education program and to ensure the functional integration
of all programmatic components.
Element 2.2 Dean’s Qualifications The dean of a medical school is qualified by education, training, and experience to
provide effective leadership in medical education, scholarly activity, patient care,
and other missions of the medical school.
Element 2.3 Access and Authority of the Dean The dean of a medical school has sufficient access to the university president or
other institutional official charged with final responsibility for the medical school
and to other institutional officials in order to fulfill decanal responsibilities;
there is a clear definition of the dean’s authority and responsibility for the medical
education program.
Element 2.4 Sufficiency of Administrative Staff A medical school has in place a sufficient number of associate or assistant deans,
leaders of organizational units, and senior administrative staff who are able to commit
the time necessary to accomplish effectively the missions of the medical school.
Element 2.5 Responsibility of and to the Dean The dean of a medical school with one or more regional campuses is administratively
responsible for the conduct and quality of the medical education program and for ensuring
the adequacy of faculty at each campus. The principal academic officer at each campus
is administratively responsible to the dean.
Element 2.6 Functional Integration of the Faculty At a medical school with one or more regional campuses, the faculty at the departmental
and medical school levels at each campus are functionally integrated by appropriate
administrative mechanisms (e.g., regular meetings and/or communication, periodic visits,
participation in shared governance, and data sharing).
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.
Element 3.1 Resident Participation in Medical Student Education Each medical student in a medical education program participates in one or more required
clinical experiences conducted in a health care setting in which he or she works with
resident physicians currently enrolled in an accredited program of graduate medical
education.
Element 3.2 Community of Scholars/Research Opportunities A medical education program is conducted in an environment that fosters the intellectual
challenge and spirit of inquiry appropriate to a community of scholars and provides
sufficient opportunities, encouragement, and support for medical student participation
in the research and other scholarly activities of its faculty.
Element 3.3 Diversity 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.
Element 3.4 Anti-Discrimination Policy A medical school has a policy in place to ensure that it does not discriminate on
the basis of age, disability, gender identity, national origin, race, religion, sex,
sexual orientation or any basis protected by federal law.
Element 3.5 Learning Environment/Professionalism A medical school ensures that the learning environment of its medical education program
is conducive to the ongoing development of explicit and appropriate professional behaviors
in its medical students, faculty, and staff at all locations. The medical school and
its clinical affiliates share the responsibility for periodic evaluation of the learning
environment in order to identify positive and negative influences on the maintenance
of professional standards, develop and conduct appropriate strategies to enhance positive
and mitigate negative influences, and identify and promptly correct violations of
professional standards.
Element 3.6 Student Mistreatment A medical school develops effective written policies that define mistreatment, has
effective mechanisms in place for a prompt response to any complaints, and supports
educational activities aimed at preventing mistreatment. Mechanisms for reporting
mistreatment are understood by medical students, including visiting medical students,
and ensure that any violations can be registered and investigated without fear of
retaliation.
The faculty members of a medical school are qualified through their education, training,
experience, and continuing professional development and provide the leadership and
support necessary to attain the institution's educational, research, and service goals.
Element 4.1 Sufficiency of Faculty A medical school has in place a sufficient cohort of faculty members with the qualifications
and time required to deliver the medical curriculum and to meet the other needs and
fulfill the other missions of the institution.
Element 4.2 Faculty Appointment Policies A medical school has clear policies and procedures in place for faculty appointment,
renewal of appointment, promotion, granting of tenure, remediation, and dismissal
that involve the faculty, the appropriate department heads, and the dean and provides
each faculty member with written information about term of appointment, responsibilities,
lines of communication, privileges and benefits, performance evaluation and remediation,
terms of dismissal, and, if relevant, the policy on practice earnings.
Element 4.3 Scholarly Productivity The faculty of a medical school demonstrate a commitment to continuing scholarly productivity
that is characteristic of an institution of higher learning.
Element 4.4 Feedback to Faculty A medical school faculty member receives regularly scheduled and timely feedback from
departmental and/or other programmatic or institutional leaders on academic performance
and progress toward promotion and, when applicable, tenure.
Element 4.5 Faculty Professional Development A medical school and/or its sponsoring institution provides opportunities for professional
development to each faculty member in the areas of discipline content, curricular
design, program evaluation, student assessment methods, instructional methodology,
and research to enhance his or her skills and leadership abilities in these areas.
Element 4.6 Responsibility for Medical School Policies At a medical school, the dean and a committee of relevant medical school administrators
and faculty representatives determine the governance and policymaking processes within
their purview.
A medical school has sufficient personnel, financial resources, physical facilities,
equipment, and clinical, instructional, informational, technological, and other resources
readily available and accessible across all locations to meet its needs and to achieve
its goals.
Element 5.1 Adequacy of Financial Resources The present and anticipated financial resources of a medical school are derived from
diverse sources and are adequate to sustain a sound program of medical education and
to accomplish other programmatic and institutional goals.
Element 5.2 Dean’s Authority/Resources The dean of a medical school has sufficient resources and budgetary authority to fulfill
the dean’s responsibility for the quality and sustainability of the medical education
program.
Element 5.3 Pressures for Self-Financing A medical school admits only as many qualified applicants as its total resources can
accommodate and does not permit financial or other influences to compromise the school’s
educational mission.
Element 5.5 Resources for Clinical Instruction A medical school has, or is assured the use of, appropriate resources for the clinical
instruction of its medical students in ambulatory and inpatient settings that have
adequate numbers and types of patients (e.g., acuity, case mix, age, gender).
Element 5.6 Clinical Instructional Facilities/Information Resources Each hospital or other clinical facility affiliated with a medical school that serves
as a major location for required clinical learning experiences has sufficient information
resources and instructional facilities for medical student education.
Element 5.7 Security, Student Safety, and Disaster Preparedness A medical school ensures that adequate security systems are in place at all locations
and publishes policies and procedures to ensure student safety and to address emergency
and disaster preparedness.
A medical school provides ready access to well-maintained library resources sufficient
in breadth of holdings and technology to support its educational and other missions.
Library services are supervised by a professional staff that is familiar with regional
and national information resources and data systems and is responsive to the needs
of the medical students, faculty members, and others associated with the institution.
Element 5.9 Information Technology Resources/Staff A medical school provides access to well-maintained information technology resources
sufficient in scope to support its educational and other missions. The information
technology staff serving a medical education program has sufficient expertise to fulfill
its responsibilities and is responsive to the needs of the medical students, faculty
members, and others associated with the institution.
Element 5.10 Resources Used by Transfer/Visiting Students The resources used by a medical school to accommodate any visiting and transfer medical
students in its medical education program do not significantly diminish the resources
available to already enrolled medical students.
Element 5.11 Study/Lounge/Storage Space/Call Rooms A medical school ensures that its medical students have, at each campus and affiliated
clinical site, adequate study space, lounge areas, personal lockers or other secure
storage facilities, and secure call rooms if students are required to participate
in late night or overnight clinical learning experiences.
Element 5.12 Required Notifications to the LCME A medical school notifies the LCME of any substantial change in the number of enrolled
medical students; of any decrease in the resources available to the institution for
its medical education program, including faculty, physical facilities, or finances;
of its plans for any major modification of its medical curriculum; and/or of anticipated
changes in the affiliation status of the program’s clinical facilities. The program
also provides prior notification to the LCME if one or more class size increases will
result in a cumulative increase in the size of the entering class at the main campus
and/or in one or more existing regional campuses of 10% or 15 students, whichever
is smaller, starting at the entering class size/campus yearly enrollment in place
at the time of the medical school’s last full survey; and/or the school accepts a
total of at least 10 transfer students into any year(s) of the curriculum.
A medical school makes a public disclosure of its LCME accreditation status and must
disclose that status accurately. For developing medical schools that have not achieved
accreditation, accurate statements include, but are not limited to, the current accreditation
status of the program and the anticipated timing of review for accreditation by the
LCME. Any incorrect or misleading statements made by a program about LCME accreditation
actions or the program’s accreditation status must immediately be corrected or clarified
by an official notification announcement. For already-accredited programs, failure
to make timely correction or clarification may result in reconsideration of the program’s
accreditation status. The information provided to the public must include contact
information for the LCME so that the information can be verified. Such contact information
includes the URL of the LCME website and the LCME email address.
The faculty of a medical school define the competencies to be achieved by its medical
students through medical education program objectives and is responsible for the detailed
design and implementation of the components of a medical curriculum that enable its
medical students to achieve those competencies and objectives. Medical education program
objectives are statements of the knowledge, skills, behaviors, and attitudes that
medical students are expected to exhibit as evidence of their achievement by completion
of the program.
Element 6.1 Program and Learning Objectives The faculty of a medical school define its medical education program objectives in
outcome-based terms that allow the assessment of medical students’ progress in developing
the competencies that the profession and the public expect of a physician. The medical
school makes these medical education program objectives known to all medical students
and faculty. In addition, the medical school ensures that the learning objectives
for each required learning experience (e.g., course, clerkship) are made known to
all medical students and those faculty, residents, and others with teaching and assessment
responsibilities in those required experiences.
Element 6.2 Required Clinical Experiences The faculty of a medical school define the types of patients and clinical conditions
that medical students are required to encounter, the skills to be performed by medical
students, the appropriate clinical settings for these experiences, and the expected
levels of medical student responsibility.
Element 6.3 Self-Directed and Life-Long Learning The faculty of a medical school ensure that the medical curriculum includes self-directed
learning experiences that allow medical students to develop the skills of lifelong
learning. Self-directed learning involves medical students’ self-assessment of learning
needs; independent identification, analysis, and synthesis of relevant information;
appraisal of the credibility of information sources; and feedback on these skills
from faculty and/or staff.
Element 6.4 Inpatient/Outpatient Experiences The faculty of a medical school ensure that the medical curriculum includes clinical
experiences in both outpatient and inpatient settings.
Element 6.5 Elective Opportunities The faculty of a medical school ensure that the medical curriculum includes elective
opportunities that supplement required learning experiences and that permit medical
students to gain exposure to and expand their understanding of medical specialties,
and to pursue their individual academic interests.
Element 6.6 Service-Learning/Community Service The faculty of a medical school ensure that the medical education program provides
sufficient opportunities for, encourages, and supports medical student participation
in service-learning and/or community service activities.
Element 6.7 Academic Environments The faculty of a medical school ensure that medical students have opportunities to
learn in academic environments that permit interaction with students enrolled in other
health professions, graduate and professional degree programs, and in clinical environments
that provide opportunities for interaction with physicians in graduate medical education
programs and in continuing medical education programs.
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.
Element 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 medical science knowledge and concepts and the methods fundamental
to applying them to the health of individuals and populations.
Element 7.3 Scientific Method/Clinical/Translational Research The faculty of a medical school ensure that the medical curriculum includes instruction
in the scientific method and in the basic scientific and ethical principles of clinical
and translational research, including the ways in which such research is conducted,
evaluated, explained to patients, and applied to patient care.
Element 7.4 Critical Judgment/Problem-Solving Skills The faculty of a medical school ensure that the medical curriculum incorporates the
fundamental principles of medicine, provides opportunities for medical students to
acquire skills of critical judgment based on evidence and experience, and develops
medical students' ability to use those principles and skills effectively in solving
problems of health and disease.
Element 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.
Element 7.6 Structural Competence, Cultural Competence, and Health Inequities The faculty of a medical school ensure that the medical curriculum provides opportunities
for medical students to learn to recognize and appropriately address biases in themselves,
in others, and in the health care delivery process. The medical curriculum includes
content regarding the following:
The diverse manner in which people perceive health and illness and respond to various
symptoms, diseases, and treatments
The basic principles of culturally and structurally competent health care
The importance of health care disparities and health inequities
The impact of disparities in health care on all populations and approaches to reduce
health care inequities
The knowledge, skills, and core professional attributes needed to provide effective
care in a multidimensional and diverse society
Element 7.7 Medical Ethics The faculty of a medical school ensure that the medical curriculum includes instruction
for medical students in medical ethics and human values both prior to and during their
participation in patient care activities and require medical students to behave ethically
in caring for patients and in relating to patients' families and others involved in
patient care.
Element 7.8 Communication Skills The faculty of a medical school ensure that the medical curriculum includes specific
instruction in communication skills as they relate to communication with patients
and their families, colleagues, and other health professionals.
Element 7.9 Interprofessional Collaborative Skills The faculty of a medical school ensure that the core curriculum of the medical education
program prepares medical students to function collaboratively on health care teams
that include health professionals from other disciplines as they provide coordinated
services to patients. These curricular experiences include practitioners and/or students
from the other health professions.
The faculty of a medical school engage in curricular revision and program evaluation
activities to ensure that medical education program quality is maintained and enhanced
and that medical students achieve all medical education program objectives and participate
in required clinical experiences and settings.
Element 8.1 Curricular Management A medical school has in place , a faculty committee that has responsibility for the
overall design, management, integration, evaluation, and enhancement of a coherent
and coordinated medical curriculum.
Element 8.2 Use of Medical Educational Program Objectives The faculty of a medical school, through the faculty committee responsible for the
medical curriculum, ensure that the medical curriculum uses formally adopted medical
education program objectives to guide the selection of curriculum content, and to
review and revise the curriculum. The faculty leadership responsible for each required
course and clerkship link the learning objectives of that course or clerkship to the
medical education program objectives.
Element 8.3 Curricular Design, Review, Revision/Content Monitoring The faculty of a medical school, through the faculty committee responsible for the
medical curriculum, are responsible for the detailed development, design, and implementation
of all components of the medical education program, including the medical education
program objectives, the learning objectives for each required curricular segment,
instructional and assessment methods appropriate for the achievement of those objectives,
content and content sequencing, ongoing review and updating of content, and evaluation
of course, clerkship, and teacher quality. These medical education program objectives,
learning objectives, content, and instructional and assessment methods are subject
to ongoing monitoring, review, and revision by the responsible committee.
Element 8.4 Evaluation of Educational Program Outcomes A medical school collects and uses a variety of outcome data, including national norms
of accomplishment, to demonstrate the extent to which medical students are achieving
medical education program objectives and to enhance the quality of the medical education
program as a whole. These data are collected during program enrollment and after program
completion.
Element 8.5 Medical Student Feedback In evaluating medical education program quality, a medical school has formal processes
in place to collect and consider medical student evaluations of their courses, clerkships,
and teachers, and other relevant information.
Element 8.6 Monitoring of Completion of Required Clinical Experiences A medical school has in place a system with central oversight that monitors and ensures
completion by all medical students of required clinical experiences in the medical
education program and remedies any identified gaps.
Element 8.7 Comparability of Education/Assessment A medical school ensures that the medical curriculum includes comparable educational
experiences and equivalent methods of assessment across all locations within a given
course and clerkship to ensure that all medical students achieve the same medical
education program objectives.
Element 8.8 Monitoring Student Time The medical school faculty committee responsible for the medical curriculum and the
program’s administration and leadership ensure the development and implementation
of effective policies and procedures regarding the amount of time medical students
spend in required activities, including the total number of hours medical students
are required to spend in clinical and educational activities throughout the curriculum.
A medical school ensures that its medical education program includes a comprehensive,
fair, and uniform system of formative and summative medical student assessment and
protects medical students’ and patients’ safety by ensuring that all persons who teach,
supervise, and/or assess medical students are adequately prepared for those responsibilities.
Element 9.1 Preparation of Resident and Non-Faculty Instructors In a medical school, residents, graduate students, postdoctoral fellows, and other
non-faculty instructors in the medical education program who supervise or teach medical
students are familiar with the learning objectives of the course or clerkship and
are prepared for their roles in teaching and assessment. The medical school provides
resources to enhance residents’ and non-faculty instructors’ teaching and assessment
skills and provides central monitoring of their participation in those opportunities.
Element 9.2 Faculty Appointments A medical school ensures that supervision of medical student learning experiences
is provided throughout required clerkships by members of the school’s faculty.
Element 9.3 Clinical Supervision of Medical Students A medical school ensures that medical students in clinical learning situations involving
patient care are appropriately supervised at all times in order to ensure patient
and student safety, that the level of responsibility delegated to the student is appropriate
to the student’s level of training, and that the activities supervised are within
the scope of practice of the supervising health professional.
Element 9.4 Assessment System A medical school ensures that, throughout its medical education program, there is
a centralized system in place that employs a variety of measures (including direct
observation) for the assessment of student achievement, including students’ acquisition
of the knowledge, core clinical skills (e.g., medical history-taking, physical examination),
behaviors, and attitudes specified in medical education program objectives, and that
ensures that all medical students achieve the same medical education program objectives.
Element 9.5 Narrative Assessment A medical school ensures that a narrative description of a medical student’s performance,
including non-cognitive achievement, is included as a component of the assessment
in each required course and clerkship of the medical education program whenever teacher-student
interaction permits this form of assessment.
Element 9.6 Setting Standards of Achievement A medical school ensures that faculty members with appropriate knowledge and expertise
set standards of achievement in each required learning experience in the medical education
program.
Element 9.7 Formative Assessment and Feedback The medical school's curricular governance committee ensures that each medical student
is assessed and provided with formal formative feedback early enough during each required
course or clerkship to allow sufficient time for remediation. Formal feedback occurs
at least at the midpoint of the course or clerkship. A course or clerkship less than
four weeks in length provides alternate means by which medical students can measure
their progress in learning.
Element 9.8 Fair and Timely Summative Assessment A medical school has in place a system of fair and timely summative assessment of
medical student achievement in each course and clerkship of the medical education
program. Final grades are available within six weeks of the end of a course or clerkship.
Element 9.9 Student Advancement and Appeal Process A medical school ensures that the medical education program has a single set of core
standards for the advancement and graduation of all medical students across all locations.
A subset of medical students may have academic requirements in addition to the core
standards if they are enrolled in a parallel curriculum. A medical school ensures
that there is a fair and formal process for taking any action that may affect the
status of a medical student, including timely notice of the impending action, disclosure
of the evidence on which the action would be based, an opportunity for the medical
student to respond, and an opportunity to appeal any adverse decision related to advancement,
graduation, or dismissal.
A medical school establishes and publishes admission requirements for potential applicants
to the medical education program and uses effective policies and procedures for medical
student selection, enrollment, and assignment.
Element 10.1 Premedical Education/Required Coursework Through its requirements for admission, a medical school encourages potential applicants
to the medical education program to acquire a broad undergraduate education that includes
the study of the humanities, natural sciences, and social sciences, and confines its
specific premedical course requirements to those deemed essential preparation for
successful completion of its medical curriculum.
Element 10.2 Final Authority of Admission Committee The final responsibility for accepting students to a medical school rests with a formally
constituted admission committee. The authority and composition of the committee and
the rules for its operation, including voting privileges and the definition of a quorum,
are specified in bylaws or other medical school policies. Faculty members constitute
the majority of voting members at all meetings. The selection of individual medical
students for admission is not influenced by any political or financial factors.
Element 10.3 Policies Regarding Student Selection/Progress and Their Dissemination The faculty of a medical school establish criteria for student selection and develop
and implement effective policies and procedures regarding, and make decisions about,
medical student application, selection, admission, assessment, promotion, graduation,
and any disciplinary action. The medical school makes available to all interested
parties its criteria, standards, policies, and procedures regarding these matters.
Element 10.4 Characteristics of Accepted Applicants A medical school selects applicants for admission who possess the intelligence, integrity,
and personal and emotional characteristics necessary for them to become competent
physicians.
Element 10.5 Technical Standards A medical school develops and publishes technical standards for the admission, retention,
and graduation of applicants or medical students in accordance with legal requirements.
Element 10.6 Content of Informational Materials A medical school’s academic bulletin and other informational, advertising, and recruitment
materials present a balanced and accurate representation of the mission and objectives
of the medical education program, state the academic and other (e.g., immunization)
requirements for the MD degree and all associated joint degree programs, provide the
most recent academic calendar for each curricular option, and describe all required
courses and clerkships offered by the medical education program.
Element 10.7 Transfer Students A medical school ensures that any student accepted for transfer or admission with
advanced standing demonstrates academic achievements, completion of relevant prior
coursework, and other relevant characteristics comparable to those of the medical
students in the class that he or she would join. Transfer students who do not complete
all of their required curriculum from medical schools chartered and located in the
United States cannot be said to have graduated from an LCME-accredited medical education
program. A medical school accepts a transfer medical student into the final year of
a medical education program only in rare and extraordinary personal or educational
circumstances.
Verifies the credentials of each visiting medical student
Ensures that each visiting medical student demonstrates qualifications comparable
to those of the medical students the visiting student would join in educational experiences
Maintains a complete roster of visiting medical students
Approves each visiting medical student’s assignments
Provides a performance assessment for each visiting medical student
Establishes health-related protocols for such visiting medical students
Identifies the administrative office that fulfills each of these responsibilities
Element 10.9 Student Assignment A medical school assumes ultimate responsibility for the selection and assignment
of medical students to each location and/or parallel curriculum (i.e., track) and
identifies the administrative office that fulfills this responsibility. A process
exists whereby a medical student with an appropriate rationale can request an alternative
assignment when circumstances allow for it.
A medical school provides effective academic support and career advising to all medical
students to assist them in achieving their career goals and the school’s medical education
program objectives. All medical students have the same rights and receive comparable
services.
Element 11.1 Academic Advising and Academic Counseling A medical school has an effective system of academic advising in place for medical
students that integrates the efforts of faculty members, course and clerkship directors,
and student affairs staff with its counseling and tutorial services and provides medical
students academic counseling only from individuals who have no role in making assessment
or promotion decisions about them.
Element 11.2 Career Advising A medical school has an effective career advising system in place that integrates
the efforts of faculty members, clerkship directors, and student affairs staff to
assist medical students in choosing elective courses, evaluating career options, and
applying to residency programs.
Element 11.3 Oversight of Extramural Electives If a medical student at a medical school is permitted to take an elective under the
auspices of another medical school, institution, or organization, a centralized system
exists in the dean’s office at the home school to review the proposed extramural elective
prior to approval and to ensure the return of a performance assessment of the student
and an evaluation of the elective by the student. Information about such issues as
the following are available, as appropriate, to the student and the medical school
in order to inform the student’s and the school’s review of the experience prior to
its approval:
Potential risks to the health and safety of patients, students, and the community
The availability of emergency care
The possibility of natural disasters, political instability, and exposure to disease
The need for additional preparation prior to, support during, and follow-up after
the elective
The level and quality of supervision
Any potential challenges to the code of medical ethics adopted by the home school
Element 11.4 Provision of MSPE A medical school provides a Medical Student Performance Evaluation required for the
residency application of a medical student to align with the AAMC/ERAS residency application
timeline.
Element 11.5 Confidentiality of Student Educational Records At a medical school, medical student educational records are confidential and available
only to those members of the faculty and administration with a need to know, unless
released by the student or as otherwise governed by laws concerning confidentiality.
Element 11.6 Student Access to Educational Records A medical school has policies and procedures in place that permit a medical student
to review and to challenge the student’s educational records, including the Medical
Student Performance Evaluation, if the student considers the information contained
therein to be inaccurate, misleading, or inappropriate.
A medical school provides effective student services to all medical students to assist
them in achieving the program’s goals for its students. All medical students have
the same rights and receive comparable services.
Element 12.1 Financial Aid/Debt Management Counseling/Student Educational Debt A medical school provides its medical students with effective financial aid and debt
management counseling and has mechanisms in place to minimize the impact of direct
educational expenses (i.e., tuition, fees, books, supplies) on medical student indebtedness.
Element 12.2 Tuition Refund Policy A medical school has clear policies for the refund of a medical student’s tuition,
fees, and other allowable payments (e.g., payments made for health or disability insurance,
parking, housing, and other similar services for which a student may no longer be
eligible following withdrawal).
Element 12.3 Personal Counseling/Mental Health/Well-Being Programs A medical school has in place an effective system of counseling services for its medical
students that includes programs to promote their well-being and to facilitate their
adjustment to the physical and emotional demands of medical education.
Element 12.4 Student Access to Health Care Services A medical school provides its medical students with timely access to needed diagnostic,
preventive, and therapeutic health services at sites in reasonable proximity to the
locations of their required educational experiences and has policies and procedures
in place that permit students to be excused from these experiences to seek needed
care.
Element 12.5 Non-Involvement of Providers of Student Health Services in Student
Assessment/Location of Student Health Records The health professionals who provide health services, including psychiatric/psychological
counseling, to a medical student have no involvement in the academic assessment or
promotion of the medical student receiving those services, excluding exceptional circumstances.
A medical school ensures that medical student health records are maintained in accordance
with legal requirements for security, privacy, confidentiality, and accessibility.
Element 12.6 Student Health and Disability Insurance A medical school ensures that health insurance and disability insurance are available
to each medical student and that health insurance is also available to each medical
student’s dependents.
Element 12.7 Immunization Requirements and Monitoring A medical school follows accepted guidelines in determining immunization requirements
for its medical students and monitors students’ compliance with those requirements.
Element 12.8 Student Exposure Policies/Procedures A medical school has policies in place that effectively address medical student exposure
to infectious and environmental hazards, including the following:
The education of medical students about methods of prevention
The procedures for care and treatment after exposure, including a definition of financial
responsibility
The effects of infectious and environmental disease or disability on medical student
learning activities
All registered medical students (including visiting students) are informed of these
policies before undertaking any educational activities that would place them at risk.
Glossary of Terms for LCME Accreditation Standards and Elements
Academic advising: The process between the medical student and an academic advisor
of reviewing the services and policies of the institution, discussing educational
and career plans, and making appropriate course selections. (Element 11.1)
Academic counseling: The process between the medical student and an academic counselor
to discuss academic difficulties and to help the medical student acquire more effective
and efficient abilities in areas such as study skills, reading skills, and/or test-taking
skills. (Element 11.1)
Adequate numbers and types of patients (e.g., acuity, case mix, age, gender): Medical
student access, in both ambulatory and inpatient settings, to a sufficient mix of
patients with a range of severity of illness and diagnoses, ages, and both genders
to meet medical educational program objectives and the learning objectives of specific
courses, modules, and clerkships. (Element 5.5)
Admission requirements: A comprehensive listing of both objective and subjective criteria
used for screening, selection, and admission of applicants to a medical education
program. (Standard 10)
Admission with advanced standing: The acceptance by a medical school and enrollment
in the medical curriculum of an applicant (e.g., a doctoral student), typically as
a second or third-year medical student, when that applicant had not previously been
enrolled in a medical education program. (Element 10.7)
Affiliation agreement: A document which describes the roles and responsibilities between
a medical education program and its clinical affiliates. (Element 1.4)
Any related enterprises: Any additional medical school-sponsored activities or entities.
(Element 1.2)
Assessment: The systematic use of a variety of methods to collect, analyze, and use
information to determine whether a medical student has acquired the competencies (e.g.,
knowledge, skills, behaviors, and attitudes) that the profession and the public expect
of a physician. (Standard 9; Elements 1.4, 4.5, 6.1, 8.3, 8.7, 9.1, 9.4, 9.5, 10.3,
10.8, 11.1, 11.3, and 12.5)
Benefits of diversity: In a medical education program, the facts that having medical
students and faculty members from a variety of socioeconomic backgrounds, racial and
ethnic groups, and other life experiences can: 1) enhance the quality and content
of interactions and discussions for all students throughout the preclinical and clinical
curricula and 2) result in the preparation of a physician workforce that is more culturally
aware and competent and better prepared to improve access to healthcare and address
current and future health care disparities. (Standard 3)
Central monitoring: Tracking by institutional (e.g., decanal) level offices and/or
committees (e.g., the curriculum committee) of desired and expected learning outcomes
by students and their completion of required learning experiences. (Elements 8.6 and
9.1)
Clinical affiliates: Those institutions providing inpatient medical care that have
formal agreements with a medical school to provide clinical experiences for the education
of its medical students. (Elements 1.4 and 3.5)
Clinical research: The conduct of medical studies involving human subjects, the data
from which are intended to facilitate application of the studies’ findings to medical
practice in order to enhance the prevention, diagnosis, and treatment of medical conditions.
(Element 7.3)
Coherent and coordinated medical curriculum: The design of a complete medical education
program, including its content and modes of presentation, to achieve its overall educational
objectives. Coherence and coordination include the following characteristics: 1) the
logical sequencing of curricular segments, 2) coordinated and integrated content within
and across academic periods of study (i.e., horizontal and vertical integration),
and 3) methods of instruction and student assessment appropriate to the student’s
level of learning and to the achievement of the program's educational objectives.
(Element 8.1)
Community service: Services designed to improve the quality of life for community
residents or to solve particular problems related to their needs. Community service
opportunities provided by the medical school complement and reinforce the medical
student’s educational program. (Element 6.6)
Comparable educational experiences: Learning experiences that are sufficiently similar
so as to ensure that medical students are achieving the same learning objectives at
all educational sites at which those experiences occur. (Element 8.7)
Competency: Statements of defined skills or behavioral outcomes (i.e., that a physician
should be able to do) in areas including, but not limited to, patient care, medical
knowledge, practice-based learning and improvement, interpersonal and communication
skills, professionalism and ethics, and systems-based practice for which a medical
student is required to demonstrate mastery at an appropriate level prior to completion
of the medical education program and receipt of the MD degree. (Standards 3 and 6;
Element 6.1)
Core curriculum: The required components of a medical curriculum, including all required
courses/modules and clinical clerkships/rotations that a student must complete for
graduation. (Element 7.9)
Core standards for the advancement and graduation of all medical students across all
locations: The academic and non-academic criteria and levels of performance defined
by a medical education program and published in programmatic policies that must be
met by all medical students on all medical school campuses at the conclusion of each
academic year or curriculum phase for advancement to the next academic year/phase
or at the conclusion of the medical education program for receipt of the MD degree
and graduation. (Element 9.9)
Critical judgment: The consideration, evaluation, and organization of evidence derived
from appropriate sources and related rationales during the process of decision-making.
The demonstration of critical thinking requires the following steps: 1) the collection
of relevant evidence; 2) the evaluation of that evidence; 3) the organization of that
evidence; 4) the presentation of appropriate evidence to support any conclusions;
and 5) the coherent, logical, and organized presentation of any response. (Element
7.4)
Cultural competency: Refers to the ability of health professionals to function effectively
within the context of the cultural beliefs, behaviors, and needs of patients from
disparate environments and communities. (Element 7.6)
Curricular management: Involves the following activities: leading, directing, coordinating,
controlling, planning, evaluating, and reporting. An effective system of curriculum
management exhibits the following characteristics: 1) evaluation of program effectiveness
by outcomes analysis, using national norms of accomplishment, as available, as a frame
of reference, 2) monitoring of content and workload in each discipline, including
the identification of omissions and unplanned redundancies, and 3) review of the stated
objectives of each individual curricular component and of methods of instruction and
student assessment to ensure their linkage to and congruence with programmatic educational
objectives. (Element 8.1)
Direct educational expenses: The following educational expenses of an enrolled medical
student: tuition, mandatory fees, books and supplies, and a computer, if one is required
by the medical school. (Element 12.1)
Direct faculty participation in decision-making: Faculty involvement in institutional
governance wherein faculty input to decisions are made is provided by the faculty
members themselves or by representatives chosen by faculty members. (Element 1.3)
Diverse sources [of financial revenues]: Multiple sources of predictable and sustainable
revenues that include, but are not unduly dependent upon any one of the following:
tuition, gifts, clinical revenue, governmental support, research grants, endowment,
etc. (Element 5.1)
Effective: Supported by evidence that the policy, practice, and/or process has produced
the intended or expected result(s). (Standard 1, 10, and 12; Elements 1.1, 1.2, 1.3,
2.2, 3.3, 3.6, 7.6, 8.8, 10.3, 11.1, 11.2, and 12.3)
Eligibility requirements [for initial and continuing accreditation]: Receipt and maintenance
of authority to grant the MD degree from the appropriate governmental agency and initial
and continuing accreditation by one of the six regional accrediting bodies. (Element
1.6)
Equivalent methods of assessment: The use of methods of medical student assessment
that are as close to identical as possible across all educational sites at which core
curricular activities take place within a given discipline, but which may not occur
in the same timeframe. (Element 8.7)
Evaluation: The systematic use of a variety of methods to collect, analyze, and use
information to determine whether a program is fulfilling its mission(s) and achieving
its goal(s). (Standard 8; Elements 3.3, 3.5, 4.3, 4.5, 5.2, 8.1, 8.3, 8.4, 11.3, 11.4,
and 11.6)
Fair and formal process for taking any action that may affect the status of a medical
student: The use of policies and procedures by any institutional body (e.g., student
promotions committee) with responsibility for making decisions about the academic
progress, continued enrollment, and/or graduation of a medical student in a manner
that ensures: 1) that the student will be assessed by individuals who have not previously
formed an opinion of the student’s abilities, professionalism, and/or suitability
to become a physician; and 2) that the student has received timely notice of the proceedings,
information about the purpose of the proceedings, and any evidence to be presented
at the proceedings; the right to participate in and provide information or otherwise
respond to participants in the proceedings; and an opportunity to appeal any adverse
decision resulting from the proceedings. (Element 9.9)
Fair and timely summative assessment: A criterion-based or normative determination,
made as soon as possible after the conclusion of a curricular component (e.g., course/module,
clinical clerkship/rotation) by individuals familiar with a medical student’s performance,
regarding the extent to which he or she has achieved the learning objective(s) for
that component such that the student can use the information provided to improve future
performance in the medical curriculum. (Element 9.8)
Final responsibility for accepting students to a medical school rests with a formally
constituted admission committee: Ensuring that the sole basis for selecting applicants
for admission to the medical education program are the decisions made by the faculty
committee charged with medical student selection in accordance with appropriately
approved selection criteria. (Element 10.2)
Formative feedback: Information communicated to a medical student in a timely manner
that is intended to modify the student’s thinking or behavior in order to improve
subsequent learning and performance in the medical curriculum. (Element 9.7)
Full-time faculty: Full-time faculty includes all faculty members who are considered
by the medical school to be full-time, whether funded by the medical school directly
or supported by affiliated institutions and organizations. Reporting of full-time
faculty members should include those who meet the preceding definition and who are
based in affiliated hospitals or in schools of basic health sciences, or who are research
faculty. Residents, clinical fellows, or faculty members who do not receive full-time
remuneration from institutional sources (e.g., medical school, parent university,
affiliated hospital, or healthcare organization) should not be included as full-time
faculty. (Elements 3.3, 3.6, and 4.1)
Functionally integrated: Coordination of the various components of the medical school
and medical education program by means of policies, procedures, and practices that
define and inform the relationships among them. (Element 2.6)
Healthcare disparities: Differences between groups of people, based on a variety of
factors including, but not limited to, race, ethnicity, residential location, sex,
age, and sexual orientation, gender identity, age, socioeconomic status, educational
status, and disability status, that affect their access to health care, the quality
of the health care they receive, and the outcomes of their medical conditions. (Element
7.6)
Health inequities: Are avoidable differences in health status between different groups
of people. These widespread differences are often the result of unfair systems that
negatively affect people's living conditions, access to healthcare, and overall health
status. (Element 7.6)
Independent study: Opportunities either for medical student-directed learning in one
or more components of the core medical curriculum, based on structured learning objectives
to be achieved by students with minimal faculty supervision, or for student-directed
learning on elective topics of specific interest to the student. (Element 6.3)
Learning objectives: A statement of the specific, observable, and measurable expected
outcomes (i.e., what the medical students will be able to do) of each specific component
(e.g., course, module, clinical clerkship, rotation) of a medical education program
that defines the content of the component and the assessment methodology and that
is linked back to one or more of the medical education program objectives. (Elements
6.1, 8.2, 8.3, and 9.1)
Major location for required clinical learning experiences: A clinical affiliate of
the medical school that is the site of one or more required clinical experiences for
its medical students. (Element 5.6)
Medical education program objectives: Broad statements, in measurable terms, of the
knowledge, skills, behaviors, and attitudes (typically linked to a statement of expected
competencies) that a medical student is expected to exhibit as evidence of achievement
of all programmatic requirements by the time of medical education program completion.
(Standards 6 and 11; Elements 6.1, 8.2, 8.3, 8.4, 8.7, and 9.4)
Mental health services: A range of diagnostic, therapeutic, and rehabilitative services
used in treating mental disability or emotional disorders. (Element 12.3)
Mission-appropriate diversity: The inclusion, in a medical education program’s student
body and among its faculty and staff and based on the program’s mission, goals, and
policies, of persons from different racial, ethnic, economic, and/or social backgrounds
and with differing life experiences to enhance the educational environment for all
medical students. (Element 3.3)
Narrative assessment: Written comments from faculty that assess student performance
and achievement in meeting specific objectives of a course or clerkship, such as professionalism,
clinical reasoning. (Element 9.5)
National norms of accomplishment: Those data sources that would permit comparison
of relevant medical school-specific medical student performance data to national data
for all medical schools and medical students (e.g., USMLE scores, AAMC GQ data, specialty
certification rates). (Element 8.4)
Need to know: The requirement that information in a medical student’s educational
record be provided only to those members of the medical school’s faculty or administration
who have a legitimate reason to access that information in order to fulfill the responsibilities
of their faculty or administrative position.
(Element 11.5)
Outcome-based terms: Descriptions of observable and measurable desired and expected
outcomes of learning experiences in a medical curriculum (e.g., knowledge, skills,
attitudes, and behavior). (Element 6.1)
Parallel curriculum (track): A parallel program of study for a subset of the medical
student body that requires participating students to complete specific programmatic
learning objectives (e.g., in research, primary care, leadership) in addition to the
medical educational program objectives required of all medical students. (Elements
5.12, 9.9, and 10.9)
Pipeline program: A pipeline program is directed at students from selected level(s)
of the educational continuum (middle school-level through college) and aims to support
their becoming qualified applicants to a medical school and/or, depending upon the
level of the program, to another health professions program or a STEM/biomedical graduate
program. Personal counseling: Counseling on a small-group or individual basis for
students expressing difficulties dealing with relationships, personal concerns, or
normal developmental tasks; this includes assisting students in identifying problems,
causes, alternatives, and possible consequences to initiate appropriate action. (Element
12.3)
(Standard 3, Element 3.3)
Pre-clerkship curriculum: The curriculum year(s) before the start of required clinical
clerkships. (Standard 6; Elements 2.6, 4.1, 5.10, 5.11, 6.3, 7.2, 7.4, 7.7, 8.3, 9.5,
9.7, 9.8, and 10.9)
Primacy of the medical education program’s authority over academic affairs and the
education/assessment of medical students: The affirmation and acknowledgement that
all decisions regarding the creation and implementation of educational policy and
the teaching and assessment of medical students are, first and foremost, the prerogative
of the medical education program. (Element 1.4)
Principal academic officer at each campus is administratively responsible to the dean:
The administrator identified by the dean or the dean’s designee (e.g., associate or
assistant dean, site director) as having primary responsibility for implementation,
management, and evaluation of the components of the medical education program that
occur at that campus. (Element 2.5)
Problem-solving: The initial generation of hypotheses that influence the subsequent
gathering of information. (Element 7.4)
Programs aimed at developing a diverse pool of medical school applicants: These programs
are directed at students from selected level(s) of the educational continuum (middle
school-level through college) and intended to support their becoming qualified applicants
to a medical school and/or, depending upon the level of the program, to another health
professions program or a STEM/biomedical graduate program. (Standard 3, Element 3.3)
Publishes: Communicates in hard-copy and/or on-line in a manner that is easily available
to and accessible by the public. (Standard 10; Elements 5.7 and 10.5)
Regional accrediting body: The six bodies recognized by the U.S. Department of Education
that accredit institutions of higher education located in their regions of the U.S.:
1) Higher Learning Commission; 2) Middle States Commission on Higher Education; 3)
New England Association of Schools and Colleges Commission on Institutions of Higher
Education; 4) Northwest Commission on Colleges and Universities; 5) Southern Association
of Colleges and Schools Commission on Colleges; and 6) Western Association of Schools
and Colleges Senior Colleges and University Commission. (Element 1.6)
Regional campus: A regional campus is an instructional site that is distinct from
the central/administrative campus of the medical school and at which some students
spend one or more complete curricular years. (Standards 11 and 12; Elements 2.5, 2.6,
and 5.12)
Regularly scheduled and timely feedback: Information communicated periodically and
sufficiently often (based on institutional policy, procedure, or practice) to a faculty
member to ensure that the faculty member is aware of the extent to which he or she
is (or is not) meeting institutional expectations regarding future promotion and/or
tenure. (Element 4.4)
Scientific method: A method of procedure consisting in systematic observation, measurement,
and experiment, and the formulation, testing, and modification of hypotheses. Typically,
the method consists of the following steps: 1) identifying and defining a problem;
2) accumulating relevant data; 3) formulating a tentative hypothesis; 4) conducting
experiments to test the hypothesis; 5) interpreting the results objectively; and 6)
repeating the steps until an acceptable solution is found. (Element 7.3)
Self-directed learning: Includes all of the following components as a single unified
sequence that occurs over a relatively short time: 1) the medical student’s self-assessment
of his/her learning needs; 2) the medical student’s independent identification, analysis,
and synthesis of relevant information; and 3) the medical student’s appraisal of the
credibility of information sources; and 4) the facilitator’s assessment of and feedback
to the student on his/her information seeking skills. (Element 6.3)
Senior administrative staff: People in academic leadership roles, to include but not
limited to, associate/assistant deans, directors, academic department chairs, and
people who oversee the operation of affiliated clinical facilities and other educational
sites. Many, if not most, of these people also have faculty appointments, and for
tracking purposes should only be counted in one category when completing tables such
as those listed in the DCI under Element 3.3. (Standard 2; Elements 2.1, 2.4, and
3.3)
Service-learning: Educational experiences that involve all of the following components:
1) medical students’ service to the community in activities that respond to community-identified
concerns; 2) student preparation; and 3) student reflection on the relationships among
their participation in the activity, their medical school curriculum, and their roles
as citizens and medical professionals. (Element 6.6)
Sponsoring organization: The entity (e.g., university, health system) associated with
the functioning of the medical school.
Standards of achievement: Criteria by which to measure a medical student’s attainment
of relevant learning objectives and that contribute to a summative grade. (Element
9.6)
Structural competency: Refers to the capacity for health professionals to recognize
and respond to the role that social, economic, and political structural factors play
in patient and community health. (Element 7.6)
Technical standards for the admission, retention, and graduation of applicants or
medical students: A statement by a medical school of the: 1) essential academic and
non-academic abilities, attributes, and characteristics in the areas of intellectual-conceptual,
integrative, and quantitative abilities; 2) observational skills; 3) physical abilities;
4) motor functioning; 5) emotional stability; 6) behavioral and social skills; and
7) ethics and professionalism that a medical school applicant or enrolled medical
student must possess or be able to acquire, with or without reasonable accommodation,
in order to be admitted to, be retained in, and graduate from that school’s medical
educational program. (Element 10.5)
Transfer: The permanent withdrawal by a medical student from one medical school followed
by that student’s enrollment (typically in the second or third year of the medical
curriculum) in another medical school. (Elements 5.10 and 10.7)
Translational research: Translational research includes two areas of investigation.
In the first, discoveries generated during research in the laboratory and in preclinical
studies are applied to the development of trials and studies in humans. In the second,
the efficacy and cost-effectiveness of prevention and treatment strategies are studied
to accelerate adoption of best practices in communities and populations. (Element
7.3)
Visiting students: Students enrolled at one medical school who participate in clinical
(typically elective) learning experiences for a grade sponsored by another medical
school without transferring their enrollment from one school to the other. (Elements
5.10, 10.8, and 12.8)
Well-being program: An organized and coordinated program designed to maintain or improve
physical, emotional and mental health through proper diet, exercise, stress management,
and illness prevention. (Element 12.3)