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In the era of higher competition, less clinical clerkship sites and a tighter budget, many off-shore and on-shore medical schools resort to multiple training sites to meet the needs of GMC requirements. The greatest hurdle is to maintain comparable training sites while providing the reliability and validity standards of the accreditation bodies. The lack of direct supervision and the dilution of visible accountability despite any existing organizational hierarchy structure has minimized the effectiveness of the educational program. In this paper, I have simplified and refocused the chain of command by identifying the pillars of a medical school; reiterate the importance of organizational hierarchy, communication between the pillars and within the departments, recharge the accountability directives, motivate self improvement, on-going research and individual responsibilities within and between each of the multiple sites achieving competitiveness and comparable One-University.

Principles for designing accountability and responsibility plan in medical education that spreads across multiple sites