For years, you’ve worked to perfect your application to medical school (or other health professional program). You’ve taken the tests, gotten the grades, and aced your interview, and are thrilled when you get accepted by your dream program. Then, an announcement comes out: The accrediting body has announced that your school is “On Probation.” What does accreditation even mean? Should you worry your school is on probation?
This article will help you understand the accreditation process: what it is, why it exists, what the different statuses mean, where you can find the information on the status of the school you attend (or would like to attend), and when you should be concerned about the accreditation status for a professional school. (TLDR: Generally, not often).
What is Accreditation?
According to the International Laboratory Accreditation Cooperation (ILAC), an international organization for accreditation bodies, accreditation is defined as: “the independent evaluation of conformity assessment bodies against recognised standards to carry out specific activities to ensure their impartiality and competence. By applying national and international standards, government, procurers, and consumers can have confidence in the calibration and test results, inspection reports, and certifications provided.”
In basic terms, accreditation means that a health professional school has been measured against defined standards to provide confidence that the education is adequate. This assures the public that the doctors who graduate from these programs will be well-trained and that the students who complete these programs will receive the quality education they are paying for.
Why Does Medical School Accreditation (and that of other Health Professional Schools) Exist?
Accreditation assures the public that the services they receive from graduates meet minimum standards. As far back as medieval times, guilds or associations oversaw the training of craftsmen and merchants through an apprenticeship system.
Higher education accreditation began in the late 19th century as a peer review process with other regional institutions. In 1904, the American Medical Association created the Council on Medical Education to review physician education and commissioned the Flexner Report (1910), which recommended reforms for medical schools to increase standards and partner with hospitals for clinical training (The Flexner Report | Perspectives Of Change). The LCME was founded in 1942 after many medical schools that were unable to meet the standards outlined in the Flexner Report were closed or consolidated.
Who Accredits Schools?
Most accreditation bodies are part of an associated professional association. For example, the American Dental Association (ADA) is the parent organization of the Commission on Dental Accreditation (CODA).
Below is a list of the major accreditation agencies for doctoral-level health professions.
- MD schools – Liason Committee on Higher Education
- DO schools – Commission on Osteopathic College Accreditation
- MD/DO residencies – Accreditation Council for Graduate Medical Education
- DDS/DMD – Commission on Dental Accreditation
- PharmD – Accreditation Council for Pharmacy Education
- DVM – AVMA Council on Education
- DPM – Council on Podiatric Medical Education
- PsyD/PhD – APA Commission on Accreditation
- DPT – Commission on Accreditation in Physical Therapy Education
- OD – Accreditation Council on Optometric Education
- OTD – Accreditation Council for Occupational Therapy Education
What Is the Accreditation Process?
At a high level, a school must complete an application that provides information on its curriculum, processes, facilities, and faculty. The accrediting body will then conduct one or more site surveys to inspect the school and interview students and faculty to ensure they meet the defined standards.
The survey team from the accrediting body will generate a report with any recommendations for improvement and the status assigned to the institution. These outcomes may be reported publicly (Accreditation Resources and Directories of Programs | ACOE).
What Do Different Accreditation Statuses Mean?
Each accrediting body has slightly different processes and procedures to define a school’s accreditation status. Here, we provide a breakdown of the process used by the LCME, which accredits allopathic medical institutions that offer the degree of Medical Doctor (MD).
There are two types of accreditation processes: one for a new school seeking its initial accreditation, and a renewal process for institutions that have been accredited previously.
The accreditation process for new schools has multiple steps and requires several site visits to move from Applicant Status to Full Accreditation:
- Applicant and Candidate Status: New schools must apply to the LCME and pay a fee to initiate the process. Programs submit a self-study plan that the LCME approves to achieve “Candidate” status.
- Preliminary Accreditation: Candidate-status schools must obtain preliminary accreditation before beginning to recruit students. The LCME visits the program looking for compliance with the accreditation standards before allowing the program to start recruiting a charter class. The LCME returns to evaluate progress before the charter class M2 year and determines if the school should be approved for Provisional status.
- Provisional Accreditation: Once a school has moved to Provisional accreditation, the LCME conducts another survey visit early in the charter class M4 year, after which the LCME can approve the school for Full accreditation or deny accreditation. If accreditation is denied, then the LCME can allow the school to continue in Provisional accreditation status or withdraw Provisional accreditation.
- Full Accreditation: Fully accredited medical schools undergo LCME site visits on an ongoing basis (five years after initial accreditation and up to every eight years thereafter) to maintain their accreditation. Schools lose accreditation if the program voluntarily terminates its status or the LCME terminates its accreditation following future site survey visits.
Once a school has obtained Full Accreditation, they are subject to ongoing survey visits, which can result in a renewal of the Full Accreditation status or a “Full, on Probation” status. Schools placed on probation will be subject to additional site surveys to determine if they have remedied the deficiencies cited by the LCME.
LCME Accreditation
The LCME posts this infographic about its accreditation process. It recently defended its process in response to a Wall Street Journal 2024 editorial (LCME defends med school accreditation process).
Should I Be Concerned If My School Is Not Fully Accredited?
Every school’s dean is responsible for ensuring its program achieves or maintains accreditation. Under the direction of the program’s academic curriculum dean, programs spend countless hours to successfully navigate the process, as they are aware of the reputational hit if their program is placed on probation. An expert admissions committee forum member describes the intensity as “like having a second full-time job.” As early as four years before the expected scheduled site visit, an accreditation committee begins to design a self-study review, collect data to show compliance with updated standards and schedule mock site visits to identify possible problems. This committee pays attention to any innovations in processes and curriculum that could improve education but have not yet yielded outcomes such as the number of students remediated, retained, and graduated.
Accreditors submit comments to programs about significant concerns that could affect their final evaluation; if they are not adequately addressed, the schools are placed on probation or monitoring until the deficiencies are addressed. Programs that subsequently fail to address those concerns may be placed on “warning” or have their accreditation withdrawn.
Students express concerns about schools that have yet to receive full accreditation or are on probation. For newer schools, Preliminary or Provisional Accreditation statuses are part of the standard accreditation process. As long as the school progresses along the standard pathway, these initial statuses are not a reason for concern.
Existing schools occasionally run into accreditation issues. If this happens to your school or a school you are considering applying to, you can request additional information from the administrators and get insights from current students. Schools are required to post their accreditation status publicly and progress to address the accreditors’ concerns (for example, LSU Shreveport).
You will need to analyze the risk of the situation and your comfort level with the status. For example, a public school that has previously been accredited and receives a probationary status will likely remedy the situation quickly, as the school must answer to state oversight. A new private school with initial accreditation issues would constitute a higher risk.
Understanding the accreditation process and the different potential accreditation statuses protects your educational investment. By ensuring the programs you pursue meet established educational standards, you can trust that your training will prepare you well for the challenges of your chosen healthcare career.
Laura Turner, MS, is the Executive Director of the Health Professional Student Association (HPSA), which publishes the Student Doctor Network (SDN). Prior to working with HPSA, she served for eight years as the Executive Director of SDN. At HPSA and SDN, Laura has been instrumental in providing students with tools and resources to pursue their aspirations in healthcare. Her previous roles include business analyst positions at The Capital Group and product management and marketing roles at software companies Paciolan, Adexa, and MSC Software.
In her current role at HPSA, Laura continues to drive innovation and forge partnerships to better support aspiring healthcare professionals. She is grateful for the opportunity to help countless individuals to achieve their dreams.