Accreditation Process Overview

Stages of Accreditation

Below are the stages of accreditation (applicant, candidate, preliminary, provisional, and full) and what is needed to move from one stage to the next, until a program is granted full accreditation. For more details about LCME policies, refer to the LCME Rules of Procedure. Questions about the stages of accreditation should be directed to the LCME Co-Secretaries.

In order to obtain applicant status, the following must occur:
1) Program has a consultation with the LCME Secretariat.
2) Program submits application and fee.
3) Application is reviewed and the LCME Secretariat gives the program applicant status.
4) Program is added to Applicant and Candidate Programs on the LCME website.

In order to move from applicant to candidate status, the following must occur:
1) Program submits a DCI and self-study within 18 months of receiving applicant status.
2) The LCME reviews the DCI and self-study and determines sufficient progress has been made to warrant an on-site survey.
3) The LCME grants candidate status and schedules a survey visit for preliminary accreditation.
4) School is changed to “Candidate” on the Applicant and Candidate Programs page.

Prior to receiving preliminary accreditation (next stage), programs must not recruit or advertise for students, solicit or collect application fees, collect applicant information, initiate a process for reviewing applications for admission, schedule applicant interviews, or issue letters of admission. Programs engaging in any of those activities, or any similar actions directed toward admission of new students, will forfeit their eligibility for consideration as a new program and will not be permitted to apply for LCME preliminary accreditation until the medical education program is complete and at least one class has graduated.

If program does not submit a DCI and planning self-study within 18 months of the LCME’s initial granting of applicant status, that status will lapse, and the program must re-apply for applicant status and pay the LCME a reapplication fee.

Programs granted applicant status may have a total of three reviews for candidate status. If the LCME does not grant candidate status after the third review, the program must re-apply for applicant status and pay a resubmission fee. Denial of candidate status with an opportunity to reapply is not subject to appeal.

In order to move from candidate status to preliminary accreditation, the following must occur:
1) Program submits a DCI, DCI appendix, self-study, and teach-out plan prior to the visit.
2) Preliminary survey visit is conducted.
3) The LCME reviews the final survey report materials and teach-out plan and determines the program has made sufficient progress toward compliance with relevant accreditation standards/satisfactory performance in accreditation elements and has developed satisfactory plans for its educational program and teach-out process.
4) The LCME grants preliminary accreditation and schedules a survey visit for provisional accreditation.
5) School is changed to “Preliminary, Accredited” on moved to the Accredited Programs page.

Once the LCME grants preliminary accreditation, the program may begin reviewing and accepting applications for enrollment. Preliminary accreditation becomes effective as of the date that the LCME acts to grant preliminary accreditation status. Preliminary accreditation status will never be applied retroactively.

If the LCME determines there are gaps in the teach-out process, the LCME may ask for a revised teach-out plan to be reviewed at its next regularly scheduled meeting. If minor issues related to performance in accreditation elements are noted, the LCME may grant preliminary accreditation but require written status reports addressing the issue(s).

If the LCME denies preliminary accreditation, the decision may be appealed. A program that has been finally denied preliminary accreditation may not reapply for a period of one year from the time of the final decision to deny accreditation. If students are admitted after preliminary accreditation has been denied, the program will forfeit its eligibility for reapplication for preliminary accreditation until its medical educational program has graduated at least one class.

A medical education program granted preliminary accreditation during or after calendar year 2021 must achieve provisional LCME accreditation within five years from the date that the LCME granted preliminary accreditation. If this does not occur, the LCME will withdraw the current accreditation status achieved by the medical education program and require the program to wait one year to submit a new application for accreditation, along with a new application fee. Withdrawal of accreditation is subject to appeal.

In order to move from preliminary to provisional accreditation, the following must occur:
1) Program submits a DCI, DCI appendix, and independent student analysis (ISA) prior to the visit.
2) Provisional survey visit is conducted. The visit typically occurs when the first entering class is in the second year of the curriculum.
3) The LCME reviews the final survey report materials and determines the program shows no significant areas of concern related to performance in accreditation elements, compliance with standards, and planning for the later stages of the medical education program. The LCME may require one or more written status reports if there are minor areas that require follow-up.
4) The LCME grants provisional accreditation and schedules a survey visit for full accreditation.
5) School is changed to “Provisional, Accredited” on the Accredited Programs page.

Provisional accreditation becomes effective as of the date that the LCME acts to grant provisional accreditation status.

If the LCME determines that there are significant issues related to performance in accreditation elements and/or compliance with standards that could be resolved within a relatively short period of time, it may continue the program’s preliminary accreditation instead of granting provisional accreditation. If the LCME continues a program’s preliminary accreditation, it may expect the program to delay plans for a class size increase and focus its resources on students already enrolled. The LCME may also place the program on warning or on probation. The specific actions taken by the LCME will determine the nature and timing of further reviews. The LCME will require the program to submit a status report or schedule a limited survey visit to address the cited areas, bearing in mind the need for the program to demonstrate compliance with all standards within two years. If the program demonstrates satisfactory performance and compliance based on review of the status report or limited survey visit, the LCME may then grant provisional accreditation, which will never be applied retroactively.

If the LCME determines that a program has failed to remedy the problems identified at the time that its preliminary accreditation was continued, it will give notice to the medical school that it intends to withdraw preliminary accreditation. A decision to withdraw preliminary accreditation is subject to appeal. If the LCME withdraws preliminary accreditation after an appeal or after the program has waived its right to appeal, the program may not reapply for LCME accreditation for a period of one year from the date that the final decision to withdraw accreditation was communicated in writing to the institution. At that time, the program may reapply by submitting a new application and an application fee.

In order to move from provisional to full accreditation, the following must occur:
1) Program submits a DCI, DCI appendix, self-study report, independent student analysis (ISA), and AAMC GQ prior to the visit.
2) First full survey visit is conducted. The visit typically occurs when the first entering class is in the final year of the curriculum.
3) The LCME reviews the final survey report materials and determines the program demonstrates satisfactory performance in accreditation elements and compliance with accreditation standards. The LCME may find minor performance/noncompliance issues and grant full accreditation but require additional status reports.
4) The LCME grants full accreditation for a period of five years (the subsequent full survey will initiate the typical eight-year cycle).
5) School is changed to “Full, Accredited” on the Accredited Programs page.

Full accreditation becomes effective as of the date the LCME votes to grant full accreditation status and will never be applied retroactively.

If the LCME determines that there are performance and noncompliance issues that could be resolved within a relatively short period of time, it may continue the program’s provisional accreditation status for a specific period of time and schedule a status report or a limited survey visit to address compliance/performance issues. If the LCME continues provisional accreditation, the program may be expected to delay plans for a class size increase and focus its resources on students already enrolled. If the program demonstrates satisfactory performance and compliance based on LCME review of the status report or survey visit, the LCME may then grant full accreditation.

If the LCME determines that performance and noncompliance issues remain that cannot be resolved within a relatively short period of time, it will give notice that it intends to withdraw provisional accreditation. A decision to withdraw provisional accreditation is subject to appeal. If the LCME withdraws provisional accreditation after an appeal or after the program has waived its right to appeal, the program may not reapply for LCME accreditation for a period of one year from the date the final decision to withdraw was communicated in writing to the institution. At that time, the program will be required to submit a new application for accreditation, along with a new application fee.

A medical education program must achieve full LCME accreditation within five years from the date that the LCME granted provisional accreditation. If this does not occur, the LCME will withdraw the current accreditation status achieved by the medical education program and require the program to wait one year to submit a new application for accreditation, along with a new application fee. Withdrawal of accreditation is subject to appeal.

Maintaining LCME Accreditation

After full accreditation has been granted, there are activities that medical education programs must perform to maintain their accredited status. For more details, refer to the LCME Rules of Procedure. Direct questions about this information to the LCME Co-Secretaries.

Established medical education programs typically undergo the self-study process and a full survey visit every eight years. The LCME may request a full survey visit in less than eight years if there are questions about the sustainability or quality of the medical education program.

Following review of the survey team report and findings from each full survey visit, the LCME may require one or more follow-up activities (e.g., limited survey visits, consultations, status reports) if it determines that the program is not in compliance with one or more accreditation standards or has unsatisfactory performance in one or more accreditation elements, or if the LCME has identified areas in compliance that require monitoring where the final outcome could result in noncompliance with one or more accreditation standards.

In addition, prior notification to the LCME is required when an accredited program plans any of the following:

A change in ownership or governance
Creation of a new or expansion of an existing regional campus
A new parallel curriculum (track) or major curricular modification
A change in the balance of educational resources and class size, including increases in the size of the entering class or the acceptance of transfer students if
- one or more class size increases will result in a cumulative increase in the size of the entering class at the main campus and/or in one or more existing regional campuses of 10% or 15 students, whichever is smaller, starting at the entering class size/campus yearly enrollment in place at the time of the medical school’s last full survey visit and/or
- the program plans to accept a total of at least 10 transferring medical students into any year(s) of the curriculum.

See Notification Forms for submission instructions, and due dates. The LCME may request an unplanned consultation, survey visit, or status report depending on the circumstances related to any of the items above.

Types of Accreditation Actions

Accreditation actions are effective as of the date of the LCME meeting at which the action was taken. No change to an accreditation status will be applied retroactively.

When considering the accreditation status of a medical education program leading to the MD degree, the LCME may at any time take any of the following actions:

Grant an accreditation status (accredited; accredited, preliminary status; accredited, provisional status)
Continue an accreditation status
Continue an accreditation status, with a shortened accreditation term
Continue accreditation, but place the program on warning
Continue accreditation, but place the program on probation
Deny accreditation
Withdraw accreditation

The LCME may also require one or more follow-up activities (limited survey visits, completion of an action plan, and/or completion of status reports, with or without accompanying consultations by the LCME Secretariat) if it determines that the program has unsatisfactory performance in one or more elements, is not in compliance with all accreditation standards, and/or if the LCME has identified areas that require monitoring where the final outcome could result in noncompliance with one or more accreditation standards or unsatisfactory performance in one or more elements.

For more details, refer to the LCME Rules of Procedure.