Guidelines for Implementation of

Accreditation Standards for Medical

and Dental Colleges

Pakistan Medical & Dental Council (PM&DC)

Islamabad, Pakistan
January, 2019
Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

Preamble

The Pakistan Medical and Dental Council (PM&DC) developed the standards for
accreditation of medical and dental colleges in 2018. The standards for
accreditation were sent to all medical and dental colleges for their review and
feedback. The relevant feedback was incorporated in the accreditation standards
for medical and dental colleges. The feedback also included a request by majority
of colleges for developing implementation guidelines for the accreditation
standards. The stakeholders including Ministry of National Health Services,
Regulations and Coordination, and Higher Education Commission (HEC) of Pakistan
were in agreement and part of the process.
The final document with twelve standards for accreditation was approved by the
PM&DC and the work on developing guidelines for implementation ensued. The
Medical Education Committee (MEC) of the PM&DC constituted a sub-committee to
develop guidelines for accreditation standards. The sub-committee reviewed the
document of accreditation standards and identified seven standards that required
guidance for implementation.
The guidelines document was sent to the members of MEC for review and approval
and was further sent to the Executive Council. The Executive Council approved the
document in its meeting in January, 2019, and advised to provide the guidelines
document as a supplement to help the colleges in implementation of the
accreditation standards.

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

Members of the Medical Education Committee

1. Prof. Arshad Javiad
(Chair of the Committee)
Vice Chancellor
Khyber Medical University
13. Dr Usman Mahboob
(Secretary of the Committee)
Director
Institute of Health Professions Education &
Research
Khyber Medical University

2. Dr Gohar Wajid 14. Dr Ahsan Sethi

Technical Officer Health Professions Assistant Professor in Medical Education
Education Institute of Health Professions Education &
EMRO Office Research
World Health Organization Khyber Medical University

3. Mr Raza Chohan 15. Dr Ayesha Rauf

Director General Academics Additional Director & Assistant Dean Health
Higher Education Commission Professions Education
National University of Medical Sciences

4. Prof. Lubna Baig 16. Mr Muhammad Idrees

Pro Vice Chancellor Curriculum Coordinator
Jinnah Sindh Medical University Higher Education Commission

5. Prof. Eice Mohammad

Professor of Medicine
Islam Medical College, Sialkot

6. Prof Rehan Ahmed Khan

Assistant Dean Medical Education
Riphah International University

7. Prof Syed Imran Mehmood

Director Medical Education
Dow University of Health Sciences

8. Prof Muhammad Tariq

Associate Dean Medical Education
Aga Khan University

9. Prof Rahila Yasmeen

Director Medical Education
Riphah International University

10. Prof Abdul Qadir Sikandar Riaz

Director
Institute of Public Health, Quetta

11. Assoc. Prof Rukhsana Ayub

Department of Medical Education
National University of Medical
Sciences

12. Dr Syed Moyn Aly

Director Medical Education
Jinnah Sindh Medical University

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

Coordination and Support

The following members of the Pakistan Medical & Dental Council coordinated and

provided logistics support to develop the Pakistan Standards for Accreditation of

Medical and Dental Colleges.

• Justice (R) Mian Shakirullah Jan

President
Pakistan Medical & Dental Council
• Dr Sitara Hassan
Registrar
Pakistan Medical & Dental Council
• Dr Waseem Hashmi
Secretary
Pakistan Medical & Dental Council
• Dr Imdad Ali
Assist. Registrar, & Officer In-charge Medical Education
Pakistan Medical & Dental Council
• Mr Khalid Shabbir
Registration Officer
Pakistan Medical & Dental Council
• Mr Azhar Kamal
Superintendent, Council
Pakistan Medical & Dental Council
• Mr Muhammad Saqib Ajmal
Steno, Council
Pakistan Medical & Dental Council
• Mr Tassawar Hussain Shah
Internal Auditor
Pakistan Medical & Dental Council
• Mr Jaffar
Operator
Pakistan Medical & Dental Council

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

Table of Contents
Preamble ........................................................................................................................... 2
Members of the Medical Education Committee.................................................................. 3
Coordination and Support .................................................................................................. 4
List of Tables...................................................................................................................... 6
List of Abbreviations .......................................................................................................... 7
Standards for Accreditation of Medical and Dental Colleges .............................................. 8
Standard 1: Mission Statement .......................................................................................... 9
Standard 2: Outcomes/Competencies and Objectives ........................................................ 9
Standard 3: Institutional Autonomy and Academic Freedom .............................................. 9
Standard 4: Curriculum Organisation ............................................................................... 10
Distribution of Hours ............................................................................................................... 10
Standard 5: Educational Contents .................................................................................... 12
Standard 6: Curriculum Management .............................................................................. 12
Standard 7: Assessment ................................................................................................... 13
Policies governing pass/fail/promotion.................................................................................... 13
Freezing or students taking a gap in their medical education ................................................... 14
Standard 8: Student ......................................................................................................... 17
Standard 9: Faculty .......................................................................................................... 17
Standard 10: Program Evaluation and Continuous renewal ............................................. 17
Standard 11: Governance, Services and Resources ........................................................... 18
Standard 12: Research and Scholarship............................................................................ 18

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

List of Tables
Table 1: Distribution of hours in an MBBS programme. __________________________________________ 11

Table 2: Weight given to Assessment in MBBS program. _________________________________________ 14

Table 3: Professional Examinations. __________________________________________________________ 15

Table 4: Subjects/Disciplines to be assessed in a professional exam. ________________________________ 16

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

List of Abbreviations

DCI Data Collection Instrument

HEC Higher Education Commission

PM&DC Pakistan Medical and Dental Council

SAR Self-Assessment Report

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

Standards for Accreditation of Medical and Dental Colleges

Standard 1: Mission Statement

Standard 2: Outcomes
Standard 3: Institutional Autonomy and Academic Freedom
Standard 4: Curriculum Organisation
Standard 5: Educational Contents
Standard 6: Curricular Management
Standard 7: Assessment
Standard 8: Student
Standard 9: Faculty
Standard 10: Program Evaluation and Continuous renewal
Standard 11: Governance, Services and Resources
Standard 12: Research and Scholarship

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

Standard 1: Mission Statement

Develop and review the mission statement of the institution and ensure that
essential standards are met for accreditation.

Standard 2: Outcomes/Competencies and Objectives

The word outcome and competency is interchangeably used in the literature. The
PM&DC uses both the words however, the medical/dental colleges can further
elaborate them as per their needs.

Standard 3: Institutional Autonomy and Academic

Freedom

Every medical/dental college should develop its curriculum according to university

guidelines, conforming to the PM&DC curricular requirements.

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

Standard 4: Curriculum Organisation

This could be discipline-based (traditional), outcome-based, competency-based,

integrated, etc. according to the resources and expertise of the medical and dental
college. However, the curriculum design should meet the standards given by PM&DC.
Examples of horizontal (concurrent) integration would be integrating basic sciences
such as anatomy, biochemistry and physiology or integrating disciplines of medicine
and surgery such as medical and surgical gastroenterology or nephrology and urology.
Examples of vertical (sequential) integration would be integrating metabolic
disorders and biochemistry or cardiology and cardio-vascular physiology.

Distribution of Hours

The following are the required minimum hours for each discipline/activities for the
05-Years MBBS programme.
The universities have the autonomy to distribute the disciplines and their hours as
per their curriculum organisation in different years.

Total duration = 5-Years MBBS

Single academic year = 36 weeks of Teaching (minimum)
Working Hours in a week = 35 hours (minimum)
Hours in MBBS programme= 6300
Hours in single academic year = 1260

The table 1 provides distribution of hours for different disciplines.

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

Table 1: Distribution of hours in an MBBS programme.

# Disciplines/Subjects Hours
1. Anatomy 500
2. Physiology 500
3. Biochemistry 200
4. Pharmacology 300
5. Pathology 500
6. Forensic Medicine 100
7. ENT 150
8. Eye 150
9. Gynae and Obstetrics 300
10. Community Medicine – 150 hours
300
Research Methods, Evidence Based Medicine – 150 hours
11. Surgery and Allied
• General Surgery – 500 hours
• Anesthesiology – 25 hours
• Orthopedics and Trauma – 100 hours
1000
• Urology – 50 hours
• Neurosurgery – 25 hours
• Radiology – 50 hours
• Early clinical exposure/clinical skills- 250 hours
12. Medicine and Allied
• General Medicine (including cardiology, pulmonology,
gastroenterology, nephrology, rheumatology, oncology,
neurology, etc.) – 500 hours
• Family Medicine – 100 hours 1000
• Psychiatry – 50 hours
• Emergency Medicine – 50 hours
• Dermatology – 50 hours
• Early clinical exposure/clinical skills - 250 hours
13. Pediatrics 200
14. Islamiyat 25
15. Pakistan Studies 25
16. Communication Skills 100
17. Behavioral Sciences 75
18. Medical Ethics 100
19. Professionalism 150
20. Leadership and Management 100
21. Patient Safety 100
22. Study Skills 25
23. Co-Curricular Activities 200
24. Library (including IT) 100
Total 6300
Note: 20% of the time should be provided for self-directed learning.

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

Standard 5: Educational Contents

Education contents that have been defined by PM&DC should be considered as the
minimum criteria

Standard 6: Curriculum Management

Develop and review the curricular management system of the institution and
ensure that essential standards are met for accreditation.
A study guide should minimally contain:
1)Title of Module of a System, or Topic of a Subject
2) Learning Outcomes/Objectives
3) Allocated Time in weeks/Hours (Time Table)
4) Name of the Coordinator
5) Teaching Faculty
6) Learning Sites
7) Teaching & learning Methods/strategies (for example lecture, small group
teaching, practical, clinical rotation)
8) List of the Recommended Books
9) Assessment strategies
10) Course Evaluation

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

Standard 7: Assessment

Policies governing pass/fail/promotion

• The university professional exam will be in form of Annual Professional exam.

• All assessments must be done using valid, reliable and standard modalities of
assessment
• No student should be eligible for any examination without having attended
75% of the lectures, demonstrations, tutorials, and practical or clinical work
both in-patients and out-patients.
• This policy should be clearly communicated to the students at the beginning
of training and posted on the website.
• Institutions may have their own policies which are within the boundaries of
PM&DC.
• The candidate, in order to be declared successful in the examination, will
have to obtain minimum 50% marks, in both theory and practical part of the
examination SEPARATELY, as per PM&DC rules, in the final scoring. Failure in
any one part of the examination will be considered failure in the whole
examination.
• Students must pass all exams to move to the next year. This applies to passing
both the theory and the practical parts of the examinations as defined above.
• In accordance with the PM&DC rule, any student who does not pass the 1st
year and 2nd year of MBBS examination separately in four chances (availed or
un-availed) after becoming eligible for each examination, shall cease to
become eligible for further medical education in Pakistan. This means they
have to pass in a total of 4 attempts for each exam in year one and two. If
they are declared unsuccessful they will not be allowed to continue in any
medical college of Pakistan.
• Marks allocation of each subject/module would be the prerogative of the
respective University
• Appropriate marks in exams should be given to each subject/module as per
the allocated time.

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

Freezing or students taking a gap in their medical/dental education

• As per the admission regulations for MBBS (admissions, house job and
internship) a student is allowed to take a break for a maximum of five years.
• As per the admission regulations for BDS (admissions, house job and
internship) a student is allowed to take a break for a maximum of four years.
• For a study gap of three years or more the student will have to retake
examinations of the last professional year even if he/she was declared
successful in that professional year of MBBS/BDS.
Table 2 shows the distribution of internal and university exam weight.

Table 2: Weight given to Assessment in MBBS/BDS program.

Representation of
Type of Assessment Weightage Formative & Examination Body
Summative
Assessment
Internal Assessment 10-40% Formative +++ Medical College
/Continuous Assessment Summative +
(Low/Mid Stakes)
End of year exam /Professionals 60-90% Summative +++ University
(High Stake Assessment)

Definitions of Formative and summative: Formative assessment is assessment for

learning and summative assessment is assessment of learning.1,2
Low stake and medium stakes assessment are done as continuous assessments i.e.
throughout the academic year and have both formative and summative
component.1,2
Formative assessment can be formal and informal, and would have feedback.
Formal formative assessments should be given marks and counted towards
pass/fail decision.
Foot note:
1. Schuwirth LW, Van der Vleuten CP. Programmatic assessment: from assessment of learning
to assessment for learning. Med Teach. 2011;33(6):478-485. 6.
2. van der Vleuten CPM, Schuwirth LWT, Driessen EW, Dijkstra J, Tigelaar D, Baartman LKJ, et
al. A model for programmatic assessment fit for purpose. Med Teach. 2012;34(3):205–214.

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

Table 3 shows end of year professional exams.

Table 3: Professional Examinations.

Year Exam
1st Year MBBS 1st Professional Examination
2nd Year MBBS 2nd Professional Examination
3rd Year MBBS 3rd Professional Examination
4t Year MBBS 4th Professional Examination
5th Year MBBS Final Professional Examination

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

The table 4 shows the subjects/disciplines assessed in the professional exam.

Table 4: Subjects/Disciplines to be assessed in a professional exam.
# Subjects/Categories
1. Anatomy
2. Physiology
3. Biochemistry
4. Pharmacology
5. Pathology
6. Forensic Medicine
7. ENT
8. Eye
9. Gynae and Obstetrics
10. Community Medicine, Research Methods, Evidence Based Medicine
11. Surgery and Allied
• General Surgery
• Anesthesiology
• Orthopedics and Trauma
• Urology
• Neurosurgery
• Radiology
• Early clinical exposure
12. Medicine and Allied
• General Medicine (including cardiology, pulmonology, gastroenterology,
nephrology, rheumatology, oncology, neurology, etc.)
• Family Medicine
• Psychiatry
• Emergency Medicine
• Dermatology
• Early clinical exposure
13. Pediatrics
14. Islamiyat
15. Pakistan Studies
16. Communication Skills
17. Behavioral Sciences
18. Medical Ethics
19. Professionalism
20. Leadership and Management
21. Patient Safety
Total assessed hours = 5,975

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

Standard 8: Student

Develop and review the student admission policies and procedures, support system
and services; and ensure that essential standards are met for accreditation.

Standard 9: Faculty

Develop and review the faculty induction, promotion, development and support
services and ensure that essential standards are met for accreditation.

Standard 10: Program Evaluation and Continuous renewal

• Develop and review program evaluation and continuous renewal system; and
ensure that essential standards are met for accreditation.
• Institutes should have a policy for program evaluation developed in consensus
with all stake holders.
• Regular feedback should be collected for all courses/programs and results
should be discussed with to make improvements.
• All improvements made should be documented and stakeholders should be
informed of the changes.
• Formal and mandatory evaluation shall be Internal and External:
Internal evaluation
i. Each institute should evaluate itself using the self-assessment proforma
developed by the PM&DC. This will be endorsed by the affiliating university
every two years.
ii. Internal evaluation of every program of every medical college will be
done using the Self-Assessment Reports (SAR). This should be supported by
proformas or Data Collection instrument (DCI).
External Evaluation
PM&DC would monitor and evaluate the colleges on regular basis. In
addition , PM&DC may also seek evaluation reports of the college from the
concerned Universities.

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Guidelines for Implementation of Accreditation standards for Medical and Dental Colleges

Standard 11: Governance, Services and Resources

Develop and review governance, services and resources of medical/dental college

and ensure that essential standards are met for accreditation. All the stakeholders
must be involved in developing policies, rules, regulations, procedures for standard
11. The process for developing policies should be documented and produced as and
when required by the PM&DC and university.

Standard 12: Research and Scholarship

Develop and review research and scholarship policies, process and procedures and
ensure that essential standards are met for accreditation. The institute should
ensure that every student must be involved in at least one research project. The
documentary proof of this involvement includes a research manuscript
accepted/published by a journal.

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