As Trump targets DEI in education, Canadian med school accreditors celebrate ‘decoupling’ from U.S. standards

With U.S. President Donald Trump targeting diversity, equity and inclusion (DEI) policies in education, Canada recently firmed up its own system for accrediting medical schools. For the first time, Canada has its own accreditation system for medical schools that is not tied to the U.S. Liaison Committee on Medical Education (LCME).Since 1979, medical schools in Canada have been accredited by the Committee on Accreditation of Canadian Medical Schools (CACMS), which was jointly established by the Canadian Medical Association (CMA) and the Association of the Faculties of Medicine of Canada (AFMC). However, Canadian medical school programs continued to receive dual accreditation from both CACMS and the LCME until July 1, when the “decoupling” was finalized.“The LCME was, very, very supportive,” Dr. Anna Karwowska, vice-president of education of AFMC, told the Medical Post. “It was a very collegial separation and both the CACMS and LCME and their sponsoring organizations remain very, very collegial.”Back in April, Trump issued an executive order that banned “DEI-based standards” in higher education accreditation. Subsequently in May, the LCME eliminated Element 3.3, which required medical schools to have a “mission-appropriate diversity policy.” However, the efforts to “decouple” the accreditation standards away from the LCME predate the current Trump administration. Dr. Karwowska says conversations between the LCME and CACMS on how to decouple began in around 2019-20. Nonetheless, the AFMC and the CMA say the recent executive orders from the White House underscore the importance of having a made-in-Canada system for accrediting Canadian medical schools. “As time moved on, it became apparent that CACMS was perfectly capable of accrediting Canadian medical schools,” Dr. Karwowska.The AFMC and CMA say the decoupling of standards allows CACMS to protect its “social accountability” standards for accreditation that were introduced in 2013. “We have a very diverse population in Canada that we serve, and so we felt that it was critical to ensure that was part of the accreditation of medical schools,” Dr. Margot Burnell, president of the CMA, told the Medical Post.“It was as slow and steady process. But I think more importantly, it allows us to include the social accountability, and it allows us to be sovereign in that, and to really reflect the patients that we are serving,” Dr. Burnell added.Carrying LCME accreditation did allow for Canadian medical graduates to more easily apply for residencies in the U.S. However, with the decoupling, a Canadian medical graduate seeking residencies in the U.S. now has to apply as an international medical graduate and go through the same process as applicants from other countries. But Dr. Karwowska says data from 2025 showed that only 15 medical graduates applied for residency in the U.S., and just 10 were accepted.“It has made it more difficult for the small number of students who wish to pursue residencies in the U.S. They still can. They just have a few more a few more administrative things they need to need to do,” she said. “The reality is that less than 0.1% of Canadian students apply for residency in the U.S, and we've seen a steady decline over the last 10 years.”

As Trump targets DEI in education, Canadian med school accreditors celebrate ‘decoupling’ from U.S. standards

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