In the Middle East and Africa, the Sudan Medical Council (SMC) has been a trailblazer in medical education and accreditation. By being the first Middle Eastern accrediting body to receive official recognition from the World Federation for Medical Education (WFME), an international organization that advocates for high standards in medical education globally, the SMC accomplished a significant milestone in 2018

1. The Accreditation System in Sudan

The accreditation system adopted by the SMC is based on global best practices for quality assurance in medical education. It includes:

- Institutional self-assessment

- External peer review and site visits

- Full compliance with WFME standards across domains such as institutional mission and objectives, curriculum design, student assessment, faculty development, and institutional governance.

Among the prominent Sudanese universities that have undergone this process or operate in alignment with its standards are

- University of Khartoum – Faculty of Medicine: The oldest and most prestigious medical school in Sudan, considered a regional reference.

- University of Gezira: Known for its innovative community-oriented education model, and actively engaged in quality improvement.

- Omdurman Islamic University—Faculty of Medicine: Offers a unique blend of academic medical education and Islamic ethical principles; actively participates in development and quality initiatives.

- Sudan University of Science and Technology—Faculty of Medicine: Continuously developing its programs to meet national and international standards.

- University of Medical Sciences and Technology (UMST): A distinguished private university with strong medical education programs and involvement in quality projects.

- University of Shendi and University of Dongola: Regional universities that have committed to accreditation and institutional development processes.

. WFME Recognition:

The Sudan Medical Council received formal recognition from WFME in 2018, which means

- Graduates of SMC-accredited institutions are eligible to apply for certification by international bodies like the Educational Commission for Foreign Medical Graduates (ECFMG) in the United States (starting 2024).

- This boosts the credibility of Sudanese medical qualifications globally and improves career opportunities for graduates.

Sudan’s Regional Role:

Sudan's leadership in medical education accreditation has encouraged neighboring countries in the Middle East and Africa to develop similar systems. SMC has also supported other countries, such as

- Ethiopia

- Chad

- South Sudan

- Yemen

In addition, Sudan has hosted regional conferences in collaboration with WHO EMRO and AFREHealth to build capacity in health professions education.

. Impacts and Future Directions

- Academic Quality Improvement: The accreditation process has helped institutions enhance their academic practices and program quality.

- International Opportunities: Recognition by WFME opens doors for Sudanese graduates to pursue training and specialization abroad.

- Regional Leadership: Sudan is now seen as a model country in accreditation and medical education reform.

Conclusion

The recognition of the Sudan Medical Council by WFME has established Sudan as a leader in medical education accreditation in the region. Major Sudanese universities, including Omdurman Islamic University, play an essential role in upholding these standards through continuous quality development. This benefits students, strengthens healthcare education, and enhances Sudan’s reputation internationally.

References

-. AFREHealth. African Forum for Research and Education in Health. Available at: https://afrehealth.org

- Educational Commission for Foreign Medical Graduates (ECFMG). 2024 Accreditation Requirement. Available at: https://www.ecfmg.org/accreditation/ 

- Omdurman Islamic University—Faculty of Medicine. Available at: https://oiu.edu.sd/

- Sudan Medical Council. Official Website. Available at: http://www.sudmc.org/

. University of Gezira—Faculty of Medicine. Available at: https://med.uofg.edu.sd/

- University of Khartoum—Faculty of Medicine. Available at: https://medicine.uofk.edu/

University of Medical Sciences and Technology (UMST). Available at: https://www.umst-edu.sdWH

EMRO. World Health Organization Regional Office for the Eastern Mediterranean. Available at: http://www.emro.who.int/

. World Federation for Medical Education (WFME). Recognition Program. Available at: https://wfme.org/accreditation/recognition-programme/

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Here are examples of Sudanese medical universities accredited by the Sudan Medical Council (SMC), recognized for meeting national and WFME-aligned standards:

1. University of Khartoum (UofK) – Faculty of Medicine  

   - Established: 1924 (oldest medical school in Sudan)  

   - Accreditation Status: Fully accredited by SMC  

   - Key Features:  

     - Follows competency-based curriculum  

     - Affiliated with major teaching hospitals (e.g., Khartoum Teaching Hospital)  

     - Recognized internationally for research in tropical medicine. 

2. Sudan University of Science & Technology (SUST) – College of Medicine  

   - Accreditation Status: SMC-accredited  

   - Key Features:  

     - Strong focus on clinical training and community medicine  

     - Partners with SMC for continuous quality improvement  

3. Al-Neelain University – Faculty of Medicine  

   - Accreditation Status: SMC-accredited  

   - Key Features:  

     - Integrates Islamic medical ethics into curriculum  

     - Emphasizes primary healthcare training  

4. University of Gezira – Faculty of Medicine  

   - Established: 1975 (pioneer in community-based education)  

   - Accreditation Status: SMC-accredited  

   - Key Features:  

     - Innovative "Gezira Model" of medical education  

     - Focus on rural healthcare delivery  

5. Omdurman Islamic University – Faculty of Medicine 

   - Accreditation Status: SMC-accredited  

   - Key Features:  

     - Combines modern medicine with Islamic medical ethics  

     - Accredited clinical training sites  

6. National Ribat University – Faculty of Medicine  

   - Accreditation Status: SMC-accredited  

   - Key Features:  

     - Emphasis on research and postgraduate training  

7. Ahfad University – School of Medicine  

   - Accreditation Status: SMC-accredited  

   - Key Features:  

     - Focus on women’s health and gender-sensitive medical training.

Resources 

 [http://www.smc.gov.sd] 

The Sudan Medical Council (SMC) holds a pioneering position in medical education accreditation, being the first in the Middle East to establish a system recognized by the World Federation for Medical Education (WFME). 

This recognition underscores Sudan’s leadership in ensuring high standards in medical training and its alignment with global benchmarks.  

The Accreditation System  

The SMC’s accreditation system evaluates medical schools based on:  

- Curriculum standards (alignment with WFME guidelines)  

- Faculty qualifications (expertise and teaching capacity)  

- Clinical training facilities (hospital partnerships and hands-on learning)  

- Assessment methods (fair and competency-based evaluations)  

- Research and community engagement(contribution to healthcare development)  

This structured approach ensures that medical graduates meet international competency levels, enhancing Sudan’s reputation in medical education.  

Role of the Sudan Medical Council

1. Regulation & Quality Assurance: The SMC oversees medical schools, ensuring compliance with national and WFME standards.  

2. Continuous Monitoring: Regular evaluations and audits maintain educational quality.  

3. Licensing & Professional Development: It grants licenses to graduates and promotes continuing medical education (CME).  

4. Global Recognition: WFME recognition allows Sudanese medical graduates to pursue careers worldwide, as many countries (including the U.S. through ECFMG) require WFME-approved accreditation.  

Relationship with WFME

- Recognition: WFME’s endorsement validates that Sudan’s accreditation meets global standards.  

- Collaboration: The SMC aligns its policies with WFME’s framework, ensuring continuous improvement.  

- Impact: This partnership enhances mobility for Sudanese doctors and attracts international students.  

Conclusion:

Sudan’s early adoption of a WFME-recognized accreditation system highlights its commitment to excellence in medical education. The SMC’s rigorous standards and collaboration with WFME strengthen the quality of healthcare training in Sudan and the region.  

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References:

- World Federation for Medical Education (WFME). (2023). Recognition of Accreditation Systems. https://wfme.org  

- Sudan Medical Council. (2022). Accreditation Standards for Medical Schools.  

- Karle, H. (2006). Global standards and accreditation in medical education: A view from the WFME. Academic Medicine.

Any one who already contributed in this forum question does not need to contribute again

The Sudan Medical Council established the first medical education accreditation system in the Middle East that has been recognized by WFME. 

Based on Sudan's pioneering role in medical education and accreditation in the Middle East, discus the accreditation system and the role of the Sudan Medical Council and its relation with WFME.

                                       INTRODUCTION

Medical education in Sudan started in 1924 with the establishment of the Gordon School of Medicine, currently known as Faculty of Medicine at the University of Khartoum. In the late 1970s, two other medical schools were established. All of these schools were public schools. The number of intake of students per year to the three medical schools was 250 students. This small scale and well-balanced education within the available resources ensured that the graduates were well-trained and learning at a good and high standard.

Sudan Medical Council (SMC) bylaw 1993 (amended 2004) mandated the SMC to set standards of under graduate medical education for medical, pharmacy and dental schools and ascertain that they are comparable to regional and international standards. It also mandat ed SMC to monitor quality of basic medical education through implementing an accreditation system. A national policy for accreditation was formulated and adopted. Standards based on WFME and national stan dards of Ministry of Higher Education and Scientific Re search (MOHE&SR), and adapted to the local context were formulated and adopted. Standard procedures for accreditation were identified and implemented. The first round of accreditation of medical schools was conducted using the basic standards in the period 2008 2012. In 2013-2015, SMC held a series of consultative meetings and conducted a national workshop to update the standards based on acquired local and regional ex periences, the national and international directions in medical education and the international guidance pro vided by the WFME. Medical education experts from WFME and UK were invited to attend and contribute to the national workshop as resource persons. The updated standards are based on the updated WFME standards (2012) and are compatible with the updated national standards of MOHE&SR (The model college of Medicine). These references were used and adapted to suit the local context of medical education and practice in the Sudan.

Explosion in the number of medical schools                              and the challenge of resources

In 1991, the government announced the so called ‘Revolution in Higher Education’. This led to opening of new public and private medical schools for the first time. As a result, we now have 72 medical schools in the country [1,2], and the intake per year is more than 5,000 students.

This increased number of medical schools and the increased intake was not accompanied by a parallel increase in the number of training facilities and trained trainers. This has resulted in teaching large numbers of students without having the adequate resources for support, and not having enough well-trained mentors. This has in turn affected the amount of hand on training the students are receiving [1-3].

 Currently, medical schools are facing great challenges in maintaining the quality of medical education and fulfilling the Sudan Medical Council (SMC) standards for accreditation for medical schools [4]. In spite of these challenges, Sudanese medical graduates are maintaining reasonable regional and international competitiveness both academically and professionally, as evident by their achievements in international professional examinations in UK, Ireland, USA and the Gulf region. 

Situation of teaching professionalism in                                         medical schools in Sudan

  The professionalism curriculum of the medical schools in Sudan was reviewed by Galil [5]. His review had showed little evidence of teaching and training in this area and the few courses that existed were mainly theoretical courses, with no practical training to encourage the development of the desired skills, with no objective assessment of professionalism skills. SMC conducted a number of advocacy activities addressing the importance of teaching professionalism and its positive impact on the medical practice of graduates. The outcome of these activities was publication of the guideline on teaching professionalism in medical schools in 2009 [3], and this was later updated in 2011 [6].

 A study by Imam and Kheir [7] looked into undergraduate medical students knowledge, attitude and practice regarding professionalism. The study involved 504 students from two universities in Khartoum, Sudan. The study showed that 30% of the students had high knowledge, 56% had fair knowledge and 14% had poor knowledge. Thirty four percent of the students were found to have good professional attitude, 57% had fair attitude and 9% had poor attitude towards the concept of medical professionalism and its regulations. Twenty seven percent of students showed good practice in professionalism (i.e., professional behaviour), 40% showed fair practice and 33% showed poor practice.

The study by Husain et al. [8] included 675 final year medical students from six different medical schools. Of them, 666 (98.8%) acknowledged that medical professionalism and ethics were taught in their schools, only 60.3% of the respondents perceived that the course contents are enough. The study concluded that the professional knowledge, attitude and behaviour of Sudanese medical students are satisfactory. 

Mohamed and Karrar [9] looked into the situation of teaching professionalism in Sudanese medical schools using SMC guidelines [3,6] as a benchmark. The study included 39 medical schools. They found that 7 medical schools (17.9%) had no formal teaching; 14 medical schools (35.8%) taught professionalism and allocated adequate time for teaching as recommended by the SMC guides, but only three medical schools (7.7%) addressed all objectives and concepts of professionalism. 

Mohamed and Karrar [10] had published another study in 2019 exploring the students and teaching staffs’ perception regarding the teaching of professionalism and the challenges of its application. They found that the overall perception of medical ethics, good professional practice and communication skills is positive for both students and teaching staff alike. They identified some areas that needed to be addressed to improve the quality of the course.

The identified weak areas were that unprofessional behaviours were not well addressed, the learning environment was not suitable to promote professionalism, insufficient number of trained teaching staff, not having enough time allocated to the course, the lack of resources and the difficulty in integrating the course within the curriculum. Notably, 71.4% of the teaching staff had felt that the teachers did not always offer a good example of role modelling [10]. 

The identified weak areas were that unprofessional behaviours were not well addressed, the learning environment was not suitable to promote professionalism, insufficient number of trained teaching staff, not having enough time allocated to the course, the lack of resources and the difficulty in integrating the course within the curriculum. Notably, 71.4% of the teaching staff had felt that the teachers did not always offer a good example of role modelling [10]. 

We can see that generally professionalism teaching in Sudan is satisfactory; however, there is still room for improvement and some challenges that need to be addressed.

Challenges facing enhancement of                                                     professionalism

                            Cultural and social challenges

  Scholars continue to emphasize that professionalism is context-dependent and is a social construct. This social construct is defined within a sociocultural context at a particular time. Some sociologists are concerned that medical professionalism literature is dominated by influential scholars, groups and organizations based in North America and Europe, while there is a scarcity of literature on the universal applicability of this framework in the other parts of the world.

Professionalism perspectives in the Arabian [12,13] and Islamic [14] cultures and the challenges in adaptation have been acknowledged. The main principles of professionalism, the concept of the social contract, and the ten commitments of the physicians as set in the Physicians Charter [15] are consistent with the Islamic values that are based on respect to human values and sanctity of human life. 

Sudan, like in any other country, has to adapt teaching of professionalism to the social and cultural context, especially as Sudanese culture is a diverse multi-ethnic society with a plethora of unique cultures, heritages, religions and beliefs. A number of resources published by scholars in the local Arabic language have provided excellent resources for concepts of professionalism and communication skills in the local setting [16-20]. 

Professional challenges: training environment and role models (hidden curriculum)

Studies from Sudan had shown the detrimental effect of the poorly resourced health care system on the training environment. This is compounded by weak clinical governance and accountability, the lack of policies ensuring the patients’ safety and rights, poor leadership and the declining number of trainers. All of these factors in unison are responsible for undermining professionalism and its enhancement [8-10]. 

Hafferty [21] reflected on teaching and training of medical professionalism, arguing that a great deal of learning occurs within the hidden curriculum. Since then, educational research had confirmed the power of the ‘hidden curriculum’ in shaping the values and behaviours of learners during their clinical training. Discordance between the teaching in the formal and the informal (hidden) curriculum faced in the reality of clinical practice is confusing to the students, and can have a negative impact on the acquired professionalism competencies [22]. 

The medical students and trainees’ perception should be assessed and used as tools for identifying any gaps and lapses, to allow remedial actions for improvements of the learning and training environments [11,23]. 

The significant impact of role models on the professional development of medical students, residents and medical team members, was addressed by many studies both locally and globally [10,12,24-26]. 

                                 Role of the SMC 

The SMC is an independent, autonomous body that was established in 1968. The purpose of the SMC is to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine, dentistry and pharmacy, by laying down a sound code of conduct and disciplinary measures.

The mission of the SMC is to help raise standards in medical education and practice by developing our standards and our guidance. This is done by focusing on ethical practice, professionalism and patient safety, to maintain the confidence of the public and the medical field in the Council’s processes. The SMC has developed training courses in professionalism for postgraduate as well as training courses for mentors, in order to promote and ensure the sustainability of the program. Working closely with other partners to improve standards of medical practice, the SMC has developed mutually beneficial partnerships with medical regulatory and accreditation authorities nationally, regionally and internationally. 

                                 Accreditation of medical schools

  The curricula of medical schools in Sudan are diverse and are based on different educational philosophies and teaching strategies; to sustain the high professional standards of the medical graduates.

In 2008, the SMC started the accreditation and external evaluation process of the medical schools [4]. The standards of accreditation introduced were based on the adaptation of the World Federation for Medical Education (WFME) and the national standards of the medical colleges issued by the Ministry of Higher Education and Scientific Research (MOHE & SR). 

The latest update of the standards included satisfying the requirement of teaching and training courses of professionalism as mandatory requirement [27]. The SMC issued guidelines on teaching professionalism in medical schools in 2009 [3] which were updated in 2011 [6]. 

       Accreditation of the SMC by the WFME

  The SMC eventually obtained international recognition as the national accrediting body by the WFME in June 2018, becoming one of the first 10 regulatory authorities to obtain this recognition internationally and the first in the region [28].

These advances have improved the quality of medical education in Sudan through the use of oversight and regular monitoring of the SMC and its partners; enhancing the different professional teaching and training areas including professionalism [6,29].

  Teaching and training of professionalism is a focus of scrutiny during the accreditation process. This accreditation process has given the SMC the power and authority to improve teaching and training of professionalism within medical schools [3,6,29].

As the result of these changes, the medical schools in Sudan have made alterations and improvements to their curriculum, teaching and the learning environment, in order to meet SMC accreditation standards. 

                                      Partnerships

  The vision of the SMC would have been unattainable without the commitment and dedicated support of its partners and stake holders. The main partners are the MOHE & SR, the Ministry of Health (MOH), medical schools, the Sudan Medical Specialisation Board and the medical professional associations of the World Health Organization (WHO), and WFME.

] The partners’ input was mainly in planning and implementing training courses, training of trainers’ activities, support for teaching and training at all levels and ensuring its sustainability through legislations and bylaws.

                                        Role of the partners

  The MOHE & SR is the regulatory body that is responsible for all the higher education in the country, including medical education. It is the licensing body and it grants new medical schools the permission required to start. It is also a monitoring and oversight authority, through its legislation and bylaws on all the colleges and universities in the country.

The MOH: 

The Ministry runs the hospitals in the country and employs all grades of doctors. The training of undergraduate and postgraduate doctors occurs within this, and it is responsible for improving the training environment. The SMC and MOH run professionalism courses for both trainees and trainers regularly.

  The medical schools: These are responsible for teaching and training the undergraduate students within the college.

The Medical Specialisation Board: This independent body is responsible for the postgraduate education of doctors in all the specialities. 

Medical Professional Associations: These are associations for different specialities within the f ield, e.g., for physicians, surgeons, cardiologists. They work in tandem with the SMC and Medical Specialisation Board to oversee the training in their respective speciality. 

Medical Students Associations: They represent the students and make sure that the students voices are heard by the administration. 

Regional and international collaborations with the WHO, WFME and international experts in medical education have provided the much needed professional and technical support. 

REFERENCES:

1. Fahal AH. Medical education in the Sudan: its Teach. strengths and weaknesses. Med 2007;29(9):910–4. org/10.1080/01421590701812991 .

2. https://doi. Al Mahdi TA. The path of undergraduate medical education in Sudan. Sudan J Med Sci. 2019;14(4):188 201. https://doi.org/10.18502/sjms.v14i4.5899 

3. 114 Karrar Z. Professionalism and good medical practice: the role of Sudan Medical Council. Sudan Med J. 2009;45(2):1–4. 

4.Sukkar M. Accreditation of medical schools in the Sudan. Khartoum Med J. 2008;1(1):49–50. 

5.Galil M. Report on curricula of medical schools in Sudan. Khartoum, Sudan: WHO report; 1997.

6. Sudan Medical Council. Teaching and assessing professionalism- a guide to course development. Khartoum, Sudan: Sudan Medical Council; 2011.