ACGME Going Global – Finally

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We need to stop treating our highly-skilled international colleagues as second-class physicians and be quick to learn from one another.

Last week, many of us received great news from our good friend Antoine Kazzi, MD, founding chair of the Department of Emergency Medicine at the American University of Beirut (AUB). After a decade-long process, AUB achieved ACGME-International (ACGME-I) accreditation. This paves the way for five AUB residencies, including emergency medicine, to gain accreditation for their specific programs.

AUB joins institutions in three other countries – Qatar, Oman, and Singapore – all with emergency medicine residencies, that have ACGME-I accreditation. Tan Tock Seng Hospital / National Healthcare Group in Singapore, the Oman Medical Specialty Board (Muscat, Oman), and the Sultan Qaboos University Hospital have also received ACGME-I accreditation. All four programs are based upon British, Canadian, or American systems of training.


This is a major step forward given that organized American medicine has had a track record of relegating international training to ‘second-class status’. ACGME-I Accreditation should open opportunities for cross-fertilization in fellowship training, research, and academic practice. This is much needed.

But there is more to be done. At the present time, none of the physicians from ACGME-I accredited programs can sit for ABMS boards. American faculty spending time in academic pursuits at these institutions may or may not have the experience recognized in terms of faculty development or promotion at U.S. institutions.

In my experience, some of the best prehospital, cardiac, resuscitative, ID, toxicology and intensive care work has originated with our colleagues at these and other international institutions. And yet, as of this writing, I’ll bet that medical graduates of the ACGME-I programs are still recognized as ‘FMGs’ – foreign medical graduates – or ‘IMGs’ – International Medical Graduates. ACGME-I accreditation should convince us that accredited training programs are of the same high caliber as – and maybe even better than – some American programs. International training in these or similar programs would greatly enhance the experience and breadth of knowledge of US medical students, residents and faculty. Time to think global, act global!



Dr. Tintinalli is currently a professor and Chair Emeritus of Emergency Medicine at the University of North Carolina. In addition to teaching in the emergency medicine department, she is an adjunct professor at the UNC Gillings School of Global Public, and a frequent lecturer in the School of Journalism and Mass Communication. Dr. Tintinalli is double boarded in emergency medicine and internal medicine. She was the founder and first president of the Council of Emergency Medicine Residency Directors. She is a former president of ABEM as well as the Association of Academic Chairs in Emergency Medicine. She is a past winner of ACEP's James Mills award as well as ACEP's National Education Award. And of course, she is the Editor-in-Chief of 7 editions of her eponymous textbook, which is arguably the best-known EM text in the world.

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