Conceptualising equity in basic medical education accreditation standards: A qualitative study of expert perspectives

Abstract

Objectives: Accreditation systems play a crucial role in shaping medical education programs globally; however, there are concerns about the equitable application of standards across diverse contexts. This study explored expert perspectives on the conceptualisation of equity in basic medical education accreditation standards.

Methodology: This study employed a qualitative theory-informed analysis design, conducted over the period from January 2024 to April 2025. Semi-structured one-to-one interviews were conducted with 14 experts from various geographical locations, all of whom were involved in accreditation as researchers, surveyors, or members of national or international accrediting bodies. The data were analysed using thematic analysis guided by Aristotle's theory of equity.

Results: Experts emphasised the need for context-responsive standards that maintain quality while allowing flexibility in implementation. Five key themes emerged: 1) Equity or equality; what should be preferred 2) Quality over quantity and contextualisation 3) Equity is not lowering the standards 4) Equity is flexibility in achieving the standards 5) Striking balance between equity and equality; the way forward.

Conclusions: By incorporating equity principles, accreditors can foster inclusive excellence across diverse medical education landscapes by embracing flexibility (equity to achieve equality), contextualisation, systematic surveyor training, and collaborative improvement without compromising the quality of medical education.