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.

Hidden Curriculum

Over time, expectations for faculty participation have evolved, emphasizing the need for structured involvement in governance. Faculty play a crucial role in shaping medical education and should be actively involved in institutional decision-making. How they are involved is key. The verbiage in the element “relevant medical school administrators” was added recently to ensure that committees retained those that are knowledgeable about educational issues.  As an aside – remember that you will want to be sure that the school’s various committees have ways for faculty to self-nominate, be nominated or be voted onto committees. Committee membership does not need to be 100% done this way – you can still have some appointed members but the key is committees should rarely, if ever, be 100% appointed. Getting back to this particular element – it is specifically looking for a committee (s) where faculty get to be informed about what is going on and have some input directly with the dean.

Best Practice

To meet these expectations, medical schools should establish a formal committee often led by the dean and administrative leadership that includes faculty representation. It is important to have a dedicated group focused on broad institutional matters. This may be an executive level advisory committee – the important part is to have some “rank and file” faculty on it- or – representatives from your Faculty Senate/Council or the like.

For institutions with large or geographically dispersed faculty, ensuring a collective faculty voice can be challenging. Factors such as faculty track, employment status, and rank can influence representation. To effectively integrate faculty perspectives, medical schools should implement a structured approach, such as designating a set number of faculty representatives on decision-making committees. This ensures that faculty voices are formally included and aligned with accreditation expectations.

Continuous Quality Improvement

The only CQI needed for this element is to ensure that the committee exists and has the requisite constitution of members. Over time, as attrition occurs, people forget why committees were formed and who was needed to be on them. So, ensure that this doesn’t happen.