91¶ÌÊÓƵ

Adopted by the 57^th 91¶ÌÊÓƵ General Assembly, Pilanesberg, South Africa, October 2006,
revised by the 68th 91¶ÌÊÓƵ General Assembly, Chicago, United States, October 2017,
and by the 77th 91¶ÌÊÓƵ General Assembly, Rotterdam, the Netherlands, October 2026

PREAMBLE

Introduction

1. Medical education encompasses basic medical education (undergraduate), and all stages of postgraduate medical education, including specialty medical training, and continuing medical education (CME) / continuing professional development (CPD). It is a lifelong, evolving process commencing with entry to undergraduate medical education and extending until the cessation of active professional practice or retirement.
2. The primary aim of medical education is to equip medical students and cultivate physicians with scientific knowledge, clinical skills, ethical judgment, contributing to improve medicine and healthcare, and adaptive capacities to master new technologies to promote health, prevent and treat disease, and relieve suffering.
3. Physicians bear an individual and collective responsibility – to their patients and the profession – to maintain high standards of professionalism, competence, medical education system, and integrity throughout their careers. In accordance with the 91¶ÌÊÓƵ International Code of Medical Ethics, they are obliged to engage in continuous learning throughout professional life in order to maintain and develop professional knowledge and skills. Institutions, regulators, and governments share the duty to enable and support physicians in fulfilling these responsibilities.
4. Medical education, at every stage of a physician’s career, exists ultimately to serve the best interest of the patient. While physicians are the direct beneficiaries of medical education and continuing professional development, the true purpose and justification of medical education lies in its capacity to ensure safe, competent, and high-quality care for those who entrust their health to the profession. Any investment in medical education systems must therefore be understood not as a benefit conferred upon physicians, but as a fundamental obligation owed to patients. This principle is consistent with the physician’s foundational duty to act always in the best interest of the patient.

Basic Principles of Medical Education

5. Medical education must foster not only knowledge and skills, but also professionalism, ethics, humanism, basis of contributing to improve medicine and healthcare, cultural awareness, and Physicians must be prepared to care for diverse populations, function in team-based care, and respond to evolving health challenges.
6. The quality of medical education is a shared responsibility of educators, students, physicians, medical schools, universities, accreditation agencies, professional organisations, and governments. These stakeholders must commit to continuous improvement, transparency, and accountability across the educational continuum.

Basic Medical Education

7. Purpose and outcome goals: The goal of basic medical education is to lay the foundation for clinical practice, professional autonomy, future specialisation, scholarly activity, public health engagement, leadership, and education. Graduates should be equipped with core competencies in clinical reasoning, communication, empathy, professional ethics, health systems understanding, and self-directed learning.
8. Contextual relevance and alignment: Curriculum design, admissions policies, assessment strategies, and educational objectives must reflect local, regional, and national health priorities, while drawing inspiration from global standards for quality and equity. Decisions must be transparent, evidence-informed, and open to contributions from stakeholders.

Selection of Students

9. Pre-admission preparation: Ideally, prior to admission, applicants should have received a broad foundational education encompassing science, humanities, social sciences, and ethics. Medical schools, universities, and relevant centralised admissions institutions should assess candidates on intellectual ability, skills, motivation, integrity, communication, empathy, and service orientation. A single factor (e.g., intellectual ability or scholarly criteria) should not be used to select candidates. Integrity, empathy and service orientation should be accurately evaluated and considered during selection processes. Attention should be paid to preventing fraud enabled by modern technology.
10. Equitable admission process: Selection must be equitable, non-discriminatory, contextualised, and mission-driven. Schools should promote diversity, inclusion, and representation in the medical workforce. Support mechanisms, including bridging programs, should reduce financial or structural barriers.
11. Alignment of intake with workforce needs: The number of admitted students should correlate with projected health workforce needs. Medical associations and governments should collaborate to ensure sustainable financing and manage supply to avoid imbalance or oversupply. Governments, regulators, and educational institutions should ensure that increases in undergraduate medical student intake are accompanied by adequate internship, residency, and specialist training positions.
12. Transparency: Medical schools should make their goals and objectives known to prospective students and premedical counsellors in order that applicants may apply to medical schools whose programs are most in accord with their career goals. In publications, medical schools should explicitly state admission requirements and the methods they employ in the selection of students.
13. Admissions testing: Although the results of standardised admission testing may be an important predictor of the ability of students to complete courses in the preclinical sciences successfully, medical schools should utilise such tests as only one of several criteria for the selection of students. Continuing review of admission tests is encouraged because the subject content of such examinations has an influence on premedical education and counselling.

Curriculum and Assessment

14. Educational objectives and curriculum design: Educational objectives should be explicit, mapped to competencies, and developed in close contact with stakeholders (patients, community, clinicians). Curriculum must integrate basic sciences, behavioural and social sciences, population health, health systems, ethics, human rights, and planetary health in a spiral, integrated fashion.
15. Pedagogical strategies: Instruction should consider and evaluate appropriate educational methodologies – evidence-based, efficient, flexible teaching methods.
16. Research and inquiry: Students should be introduced early to research methodology, critical appraisal, evidence-based practice, and opportunities for inquiry or participation in academic projects. This will help foster a lifelong culture of curiosity and improvement.
17. Clinical education, training and experiential learning: Clinical exposure must be supervised, progressive, and competency-based across diverse settings (primary, secondary, tertiary, rural, urban). Medical schools should establish standards and apply them to all components of the clinical educational program regardless of where they are conducted. Interprofessional collaboration and team-based care should be embedded. Responsibilities should increase with demonstrated competence.
18. Assessment and progression: Valid, reliable, transparent assessment methods (formative, summative, objective structured clinical examination, portfolios, workplace-based assessment) must be used. Decisions about progression and remediation should be data-driven, with clear support and feedback systems. Faculties of medical schools have the responsibility to evaluate the cognitive abilities of their students. Extramural examinations may be used for this purpose, but never as the sole criterion for promotion or graduation of a student. Faculties also have the obligation to evaluate as thoroughly as possible the non-cognitive abilities of their medical students.

Student Support and Well-Being

19. Medical schools must provide comprehensive support systems addressing academic, psychological, social, and career dimensions. Services include mentorship, career advising, counselling, stress management, peer support, and monitoring of well-being. These services should be confidential, timely, accessible, and free from academic or professional repercussions.
20. Institutions have an obligation to foster a positive, respectful, physically, psychologically, and culturally safe learning environment. Educational culture must mitigate burnout risks, support a zero-tolerance policy towards violence or discriminatory behaviour in the workplace, promote feedback, respect diversity, and encourage help-seeking without stigma.

Faculty and Institutional Resources

21. Faculty qualifications and roles: Faculty must be appropriately qualified – clinically and pedagogically – and recognised through non-discriminatory recruitment and promotion processes. Adequate faculty numbers must support educational, research, and service missions.
22. Faculty development, evaluation, and scholarship: Each medical school should establish, or review already established, criteria for the initial appointment, continuation of appointment, and promotion of all categories of faculty. Regular evaluation of the contribution of all faculty members should be conducted in accordance with institutional policy and practice. Institutions must provide structured faculty development in teaching, assessment, research, leadership, mentorship, and educational innovation. Faculty should be engaged in ongoing evaluation and improvement of the curriculum.
23. Academic culture and research infrastructure: A vibrant academic environment must promote inquiry, innovation, cross-disciplinary research, and collaboration. Institutions should support infrastructure and protected time for scholarly work and translational activity, and educational excellence.
24. Resources and infrastructure: Sufficient and up-to-date physical, digital, simulation, clinical, library, and administrative resources must be available. Infrastructure must support the educational mission in scale and quality. Implementation of global educational standards should be accompanied by technical support, capacity building, and contextual adaptation for resource-constrained settings while maintaining universal principles of quality and patient safety.

Financing

25. Sustainable, transparent financing models must support institutions and students. Collaboration among governments, national medical associations, philanthropic bodies, and educational institutions is needed. Equity in financial support (scholarships, subsidies, loans) is essential to avoid barriers to entry or attrition.

Postgraduate Medical Education

26. Purpose and scope: Postgraduate medical education, mainly residency and specialty medical training, must follow basic education and prepare physicians for general or specialised practice. It should consolidate clinical competence, professionalism, and leadership.
27. Program design and structure: Postgraduate medical education must combine structured didactics, supervised clinical care, scholarly activity, and quality improvement. Education should occur in high-functioning clinical settings that align learning and training with service and care.
28. Balance, supervision, and responsibility: Programs must protect physicians in postgraduate education from excessive service burdens, allow progressive responsibility, educational development and maintain balance with personal and social wellness. This requires compliance with applicable national working-time regulations and occupational health and safety standards. Physicians in postgraduate education occupy a structurally vulnerable position, given their dependence on the training institution for progression and certification; reporting channels for unsafe working or training conditions must therefore remain separate from those processes. Supervision must be robust, feedback frequent, and assessment longitudinal.
29. Assessment, progression, and certification: Assessment systems must support decision-making about progression. Certification for generalist or specialist practice must require demonstrable attainment of specialty competencies.
30. Accreditation and quality review: All postgraduate programs should be subject to external accreditation and periodic quality review, aligned with international standards. Compliance with applicable national working-time regulations and occupational health and safety standards governing clinical training should be a condition of accreditation.

Continuing Medical Education (CME) / Continuing Professional Development (CPD)

31. Definition and scope: CME/CPD includes all lifelong activities that sustain and enhance a physician’s knowledge, skills, ethics, attitudes, and professional relationships. This may include teaching, leadership, digital health / artificial intelligence, research, and community engagement.
32. Principles for CME/CPD: CME/CPD must rely on existing evidence, be accessible, learner-centered, free from commercial and other undue interest, and responsive to emergent developments in medicine, technology and community/population needs.
33. Shared responsibility: Medical societies, academic institutions, hospitals, medical organisations, and governments must collaborate to encourage and ensure equitable access to CME/CPD, regional programs, and incentives for participation.
34. Recognition and accountability: Systems for recognition, accreditation, and periodic certification of CME/CPD should be transparent and aligned with universally accepted standards. Participation should be encouraged.
35. Systems for CME and CPD should be practicable also for physicians working in small practices, and in rural areas with limited spare capacities, and not only for physicians attached to large institutions or academia.

RECOMMENDATIONS

1. As stated in its Resolution on WFME Global Standards for Quality Improvement of Medical Education, the 91¶ÌÊÓƵ recognises the need and importance of robust global standards for quality improvement of medical education. The 91¶ÌÊÓƵ:

• Supports the WFME leadership in further developing and implementing global standards for medical education, in consultation with relevant stakeholders (medical organisations, medical schools, accreditation bodies, health ministries).
• Calls for a regular revision of medical education and accreditation standards based on evidence review. For post-graduate medical education CME and periodic certification, the competent medical organisations should take a lead in consultation with relevant stakeholders.
• Urges relevant stakeholders to ensure that national and regional education policies to comply with global standards in medical education, supporting necessary adaptations while ensuring that fundamental principles are upheld.
• Calls for support for countries with insufficient resources enabling them to comply with global standards in medical education. Support should include facilitation of knowledge exchange, capacity building and technical assistance.
• Strongly advocates for the rights of medical students, residents, and fellows to have physician-led clinical training, supervision, and evaluation while recognizing the contribution of non-physicians to medical education.

2. The 91¶ÌÊÓƵ endorses the 2025 , advocating for improved learning conditions and environments in each phase of medical education and professional development, including for ageing physicians, in line with its Statement on Ageing Physicians.