INTERNATIONAL STANDARDS AND PRACTICE GUIDELINES FOR MEDICAL MISSIONS Question: Should Short-term healthcare mission team members obtain licenses to practice within a host country? Participants in discussion Background (perspective) Peter Yorgin, MD

Team leader and participant for 9 healthcare mission trips to Ukraine, China and Mexico, Academic physician at Loma Linda University, Harvest Christian Fellowship

Arnold Gorske, MD Navy pediatrician in the Vietnamese refugee camps, and has also had over 25 years experience with the development of health education/training programs.

Why is this important? This is an issue of trust, safety and perceptions. Consensus Statement BEST Obtain appropriate licensing in the host country for each team member. Although time consuming, it places the team on a firm footing within the country. BETTER Obtain approval through local authorities who are in a position to approve team practice. GOOD Proceed with caution in countries where there is no stable government or health ministry/licensing organ. Biblical Basis for obtaining licensing in the host country Fairness and reciprocity

Matthew 7:12 12So in everything, do to others what you would have them do to you, for this sums up the Law and the Prophets.

Following the laws set down by the government Matthew 22:21"Caesar's," they replied. Then he said to them, "Give to Caesar what is Caesar's, and to God what is God's." Romans 13:3 For rulers hold no terror for those who do right, but for those who do wrong. Do you want to be free from fear of the one in authority? Then do what is right and he will commend you.

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Titus 3:1 Remind the people to be subject to rulers and authorities, to be obedient, to be ready to do whatever is good,

1 Peter 2:13 Submit yourselves for the Lord's sake to every authority instituted among men: whether to the king, as the supreme authority,

Could this happen to your team? A local doctor arrested this month in Zimbabwe on charges of practicing without a license during a mission trip was released this week, say officials. Dr. Ed Montgomery and his wife, Sara Jane, a nurse, have both been given back their passports, confirmed Senator Mitch McConnell's office Tuesday. The pair had been relieved of their passports approximately two weeks ago while on a medical mission trip in the African country. According to his friends, Dr. Montgomery had been looking forward to the trip with friends. A retired urologist, Dr. Montgomery and his wife had participated in several other medical missions around the world.According to Dr. Montgomery's former partner, Dr. Scott Scutchfield, after Dr. Montgomery's charges were dropped he headed with his wife to South Africa.Julie Adams, deputy press secretary for McConnell's office, said the doctor had worked with the embassy and Zimbabwe officials to obtain a license to practice in that country and hence the charges were dropped. It was definitely a happy ending, said Adams. For the friends and family waiting at home for the Montgomerys, the couple's release comes after days of prayer and concern. "I'm thankful to God," said Scutchfield, after many prayers and well wishes were sent their way from the medical community. "Everyone will be relieved. "Family friend Dr. Chris Jackson also applauded the good news, and those who had helped to bring it about. "We're very pleased for all the efforts made for us," said Jackson, including the help of the newspapers and politicians.The recent news was "wonderful," said Jackson. "I can't wait to get him home."1 BACKGROUND Care provided by medical missions must meet the legal requirements and medical standards and practice guidelines of the host country. Until relatively recently, very few standards and guidelines were available, and those were rarely enforced. Over the past several years, numerous international standards and guidelines have been established for the care of patients in developing countries. Host countries are in various stages of adopting and enforcing these standards.

In most cases, medical standards for host developing countries are based on World Health Organization (WHO) standards and guidelines. Even when not officially adopted by host country governments, they are now being used by Ministry of Health officials to evaluate the quality of care provided in their country.

The WHO requires that practice guidelines be “systematically developed evidence-

based statements which assist providers, recipients and other stakeholders to make informed decisions about appropriate health interventions” Although these are often

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considered “secular” standards, it should be noted that faith-based organizations were often the initiators and were responsible for their development.

It should also be noted that compliance with current WHO standards and

guidelines for patient centered, evidence-based, high quality, holistic and community care will simultaneously result in compliance with nearly all Biblical as well as “U.S. Standards of Excellence in Short-Term Mission” requirements in this area.

Medical missions that wish to continue to provide care in developing countries will

need to meet rapidly changing and expanding WHO and host country requirements for quality care. There are a number of reasons for this change. One reason is that host country Ministry of Health Officials are much better trained than in the past. But most important has been the world-wide availability of the internet, with instantaneous transmission of the latest WHO and other International Standards and Guidelines to developing countries throughout the world. In addition, guidelines contained in “Key WHO Publications” such as World Health Reports are now simultaneously made available free for downloading in Arabic, Chinese, English, French, Russian and Spanish.

Because other organizations have created numerous standards and guidelines our

goal is to reference, but not duplicate their work. The number of documents related to international health care standards and guidelines available through the WHO website is already almost overwhelming (See appendix 1). Our purpose is simply to assist medical missions in meeting their requirements for compliance with international standards and guidelines that already exist.

From those standards and guidelines that already exist we will address only those

that have been shown to be of critical importance to the safety and quality of patient care provided by short term medical missions (STMM). In this document we will further limit our review to those standards and guidelines where serious problems have been reported that could result in refusal or removal of a STMM organization’s privileges to provide host country patient care. Health Professional Regulatory Agencies

A Christian physician would never think about practicing medicine in the United States without a license due to the potential consequences including a felony conviction. So why do medical mission teams routinely expect to practice medicine in a developing country without any governmental approval or licensing? Would we be accepting of the following hypothetical example? Hypothetical Example: A group of doctors from Myanmar came to the United States and started holding medical clinics at a local church. How would we respond?

One of the central tenants held by the patient in the healer-patient relationship is that the healer is skilled and trustworthy. In developed countries there is an increased

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emphasis on licensing and competency assessment so that the patient can be assured that a healer has at least the basic knowledge needed to successfully manage health-related problems.

End of training examinations, board and sub-board examinations have long been a

standard to assess competency. Boards act to screen-out individuals who need to study more or may be poorly suited for medicine. In a study by Hechel and Bowles concluded that “Failure rates on American boards generally varied between 8 and 61 percent”2.

Nursing, Psychology, Dental and Medical Boards regulate professional licenses. In

some countries, like the United States, the regulatory bodies function at the state/province level making it such that a healthcare professional’s license is only valid in the state in which it was issued3,4. Professional boards not only provide the initial license, but ensure that a practitioner participates in continuing education on a yearly basis. Demonstrating one’s current license to an employer is the only means by which one will be allowed access to provide care in a hospital or clinic setting. Without the license the individual cannot be employed in the United States. Some physicians wait for more than 3 months to obtain a license. It takes 90 days for the Board of Medical Examiners in California to review the documents submitted by a physician.

In the United States there are now recertification tests for almost all health professionals. Some insurance companies now insist on only board certified/recertified physicians to provide care for their patients.

In developed countries, it is illegal to practice healthcare history-taking, diagnosis

and management without a license. In the developing world, the distinction between trained physicians and traditional healers is blurred. A recent study of medical quackery in Nigeria by Ndububa concluded that: Medical quackery is rampant in Nigeria; Culprits cut across the whole strata of medical and health practitioners. The so called alternative/natural health practice has particularly assumed great popularity lately and the Federal Government seems to turn the other way in spite of their unsubstantiated, largely placebo 'Cures'. Homeopathy, in particular, is a medical quackery par excellence and should be banned5. Some of the developing countries are working harder to crack-down on fraudulent healthcare providers. There have been rare situations where healthcare mission team members have been expelled from countries due to the lack of host contry licenses (see story, paragraph 1). The primary ways that teams practice legally in country are to obtain a temporary license in–country or to practice under another physician’s license (as in Mexico). In most countries, the Ministry of Health is responsible for providing temporary licenses. A list of Ministries of Health and their contact information is provided in IAMRA Directory Spreadsheets (attached) MISTM GRID

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Sender Before Churches and sending organizations may want to proactively discuss in-country licensing expectations with the short-term healthcare mission team leaders to make sure that expectations are clearly agreed upon. It is the church/sending organization’s advantage if the team obtains licenses; however, this requirement imposes a greater amount of work. Is it possible that church/sending organization staff can be assigned the responsibility of obtaining licensing rather than the team leader? During Should a team decide to go without proper licensing, and have problems related to licensing in-country, the church/sending organization will need to take responsibility for the problem. After Should there be problems with a team over the issue of in-country licensing the mission partner and local churches can be profoundly impacted. Goer Before Obtaining in-country licenses can be time consuming due to document submission and review times, so early planning is necessary. Team members may need to be selected 3-6 months before the team plans to leave so that there is time for early document acquisition and transmission.

The primary arguments against obtaining in-country licenses are: 1. It takes too much time 2. The in-country partner should take responsibility 3. Some partners suggest that obtaining licenses are too difficult and

make their activities to “high profile” 4. Better to ask for forgiveness if there are problems, than go through all

of the work Given the coordination requirements, it would be best if the team leader(s) and

the Church/sending organization both took responsibility for this task. Sometimes in-country partners can be responsible for making sure that licensing issues are handled (BETTER Consensus statement); however, it is inappropriate to assume that in-country partner automatically takes responsibility for licensing. It is important to discuss this issue with the in-country partner early.

Some partners, particularly in creative access countries, may indicate that

obtaining licenses brings greater scrutiny to their work/organization than they would like. They may have local governmental contacts that provide coverage should there be any questions or problems. In these cases, the Goer must assess the risk-benefit ratio. It is important to factor into the equation relationships between the sender and receiving

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countries. Governments may express their displeasure by expelling missionaries, even medical mission teams to make a political point.

Some team leaders would rather go without licenses, thinking that should there

be a problem, they can plead ignorance and ask for forgiveness. This strategy can still lead to problems.

During Should there be a problem with in-country licensing it is important for the team leader to take responsibility for the problem and determine if there is potential solution with the appropriate governing authorities. Determine if your in-country partner has any leverage in the situation. As a short-term healthcare mission team, we never want to place our in-country partners in danger. Remember in-country partners can be persecuted or even imprisoned in some countries, therefore, be sensitive as to how helpful they should be. Early contact with the church/sending organization is likely to be beneficial. After If short-term healthcare team leaders have unilaterally have decided not to obtain in-country licensing and had problems related to this issue, their will be significant discussion of this issue in the church/sending organization. Recipeint Before It is wise for churches, participating local doctors, partners and governmental officials in-country to make sure that the short-term healthcare missions team has in-country licenses prior to visiting. During Should there be problems over the lack of licenses for a short-term healthcare mission team, there can be significant amount of fall out for the people served, churches, participating local doctors, partners and governmental officials in-country.

For the people served, the exposure of the team’s lack of licensing may lead to concerns about the adequacy of their care. They may even wonder if their participation in such a situation may negatively impact them.

Churches can be negatively impacted by the perception of wrong-doing by short-

term healthcare mission team.

For the participating local doctors, the disclosure that their short-term mission team partners have not followed the law, can create a perception of loss of reputation within the community. Additionally trust in the mission partner can be negatively impacted.

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For partners, the disclosure that their short-term mission team partners have not followed the law, can cause profound problems. From the government’s perspective, the partner is primarily responsible for the short-term mission team. Licensing for the partnership organization may be lost or even missionaries may be imprisoned or deported. For the governmental officials, the disclosure that their short-term mission team has not followed the law, creates a question of who is responsible. If a mission partner is responsible, then prosecution of the mission partner is a possible route. If a governmental official is thought to be responsible, then they are at risk of losing credibility or even their position. For this reason, local governmental officials may be skittish about approving mission team visits. There can be a perception that there is more to lose than to gain unless the mission partner has a very strong relationship with the governmental official. After The major impact of problems related to no in-country licensing is a lack of trust that can destroy relationships.

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References 1. Burton, E. Dr. Montgomery released in Zimbabwe, charges dropped. in The

ZIMBABWE Situation (2004). 2. Hechel, H. & Bowles, L.T. Specialty certification in North America: a comparative

analysis of examination results. J Med Educ 54, 69-74 (1979). 3. Johnson, D.A., Austin, D.L. & Thompson, J.N. Role of state medical boards in

continuing medical education. J Contin Educ Health Prof 25, 183-9 (2005). 4. Miller, S.H. et al. Continuing medical education, professional development, and

requirements for medical licensure: a white paper of the Conjoint Committee on Continuing Medical Education. J Contin Educ Health Prof 28, 95-8 (2008).

5. Ndububa, V.I. Medical quackery in Nigeria; why the silence? Niger J Med 16, 312-7 (2007).

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Appendix 1 1. INTERNATIONAL STANDARDS AND GUIDELINE REQUIREMENTS FOR PROVIDING MEDICAL CARE IN HOST COUNTRIES INCLUDE THE FOLLOWING: 1.1. WHO INTERNATIONAL STANDARDS: AUTHORITY AND GUIDELINES. 1.1.1. Authority: “WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends…” www.who.org. 1.1.1.2 Governance: The World Health Assembly is the supreme decision-making body for WHO. It generally meets in Geneva in May each year, and is attended by delegations from all 193 Member States. Its main function is to determine the policies of the Organization. The Health Assembly appoints the Director-General, supervises the financial policies of the Organization, and reviews and approves the Proposed programme budget. It similarly considers reports of the Executive Board, which it instructs in regard to matters upon which further action, study, investigation or report may be required. The Executive Board is composed of 34 members technically qualified in the field of health. Members are elected for three-year terms. The main Board meeting, at which the agenda for the forthcoming Health Assembly is agreed upon and resolutions for forwarding to the Health Assembly are adopted, is held in January, with a second shorter meeting in May, immediately after the Health Assembly, for more administrative matters. The main functions of the Board are to give effect to the decisions and policies of the Health Assembly, to advise it and generally to facilitate its work. The Secretariat of WHO is staffed by some 8000 health and other experts and support staff on fixed-term appointments, working at headquarters, in the six regional offices, and in countries. The Organization is headed by the Director-General, who is appointed by the Health Assembly on the nomination of the Executive Board. Resolutions of the World Health Assembly and the Executive Board are contained on the following WHO website link: www.who.int/gb/ This site also contains other important Documents related to the World Health Assemblies (WHA) and Executive Board (EB) sessions in all six official languages of the WHO. 1.1.1.3. Constitution of the WHO: (See APPENDIX A)

1.1.2. General Guidelines: Two of the six current WHO agenda items specifically address the development of international standards and guidelines:

“4. Harnessing research, information and evidence: Evidence provides the foundation for setting priorities, defining strategies, and measuring results. WHO

generates authoritative health information, in consultation with leading experts, to set norms and standards, articulate evidence-based policy options and monitor the evolving global heath situation.

5. Enhancing partnerships: WHO carries out its work with the support and collaboration of many partners, including UN agencies and other international organizations, donors, civil society and the private sector. WHO uses the strategic power of evidence to encourage partners implementing programmes within countries to align their activities with best technical guidelines and practices, as well as with the priorities established by countries.”

1.1.3. WHO Practice Guidelines: Recommended Processes--Version10

March 2003: “Definition: Guidelines are systematically developed evidence-based

statements which assist providers, recipients and other stakeholders to make informed decisions about appropriate health interventions…

WHO’s mandate comes from the constitution adopted by member states and the primary audience it serves is composed of governments, more specifically, the ministries or agencies concerned with health…WHO takes a global perspective in addressing the needs of 193 member states...

For WHO guidelines, the traditional approach of reviewing and reporting evidence on efficacy and safety is certainly crucial, but not sufficient…

WHO needs to assess the implications for population health of any recommendation as well. This requires explicit recognition that resources to provide health interventions are limited. This involves considering the cost-effectiveness of alternative interventions, the opportunity costs of investing in one intervention versus another, the affordability of the interventions, and the feasibility of applying a set of recommendations in different settings.”

1.1.4. WHO-Publications www.who.org. 1.1.4.1. Key WHO Publications: The World Health Report./ International

Health Regulations./ International Travel and Health./ The International Classification of Diseases./ International Pharmacopoeia.

1.1.4.2. WHO Journals: Bulletin of the World Health Organization./ Eastern

Mediterranean Health Journal. /Pan American Journal of Public Health. /Weekly Epidemiological Record./ WHO Drug Information.

1.1.4.3. WHO Regional Publications: African Region./ Region of the

Americas–PAHO./ South-East Asia Region./ European Region./ Eastern Mediterranean Region./ Western Pacific Region.

1.1.5. WHO-Programs and Projects www.who.org. Provides links to

numerous WHO programmes, partnerships and other projects listed in alphabetical order. Also includes the six WHO regional offices and their practice guidelines: Regional Office for Africa www.afro.who.int Regional Office for

Europe www.euro.who.int Regional Office for South-East Asia www.searo.who.int Regional Office for the Americas/Pan American Health Organiz (PAHO) www.paho.org Regional Office for the Eastern Mediterranean www.emro.who.int Regional Office for the Western Pacific www.wpro.who.int

1.1.6. WHO-Health Topics www.who.org. Contains links to WHO projects,

initiatives, activities, information products, and contacts, organized by health and development topics.

1.1.7. WHO-Countries www.who.org. Members of WHO are grouped

according to regional distribution (193 Member States). Contains a wealth of country-specific information necessary for STMM priority planning and operations.

1.1.8. WHO-Data and Statistics www.who.org. Enables STMM to provide

services in accordance with host country’s actual needs. Includes Databases such as: WHOSIS, the WHO Statistical Information System, is an interactive database bringing together core health statistics for the 193 WHO Member States. It comprises more than 70 indicators, which can be accessed by way of a quick search, by major categories, or through user-defined tables. The data can be further filtered, tabulated, charted and downloaded. 1.2. INTERNATIONAL PROFESSIONAL STANDARDS AND GUIDELINES: As noted in 1.1.2., the WHO carries out its work with the support and collaboration of many partners. The following international organizations represent the professions and services most often provided by STMM. These organizations often work in partnership with the WHO as well as their corresponding nationally based (including U.S.) organizations to establish international standards and guidelines which may be found on their respective websites. The international professional organizations most relevant to services provided by medical missions include the following: 1.2.1 The World Health Professions Alliance (WHPA) brings together the International Council of Nurses, the International Pharmaceutical Federation, the World Dental Federation and the World Medical Association and speaks on behalf of more than 25 million health care professionals worldwide. The WHPA aims to facilitate collaboration between key health professionals and major international stakeholders such as governments, policy makers and the World Health Organization to advocate and work for the highest possible standards of health care for all people. www.whpa.org 1.2.2 The International Council of Nurses (ICN) is a federation of national nurses' associations in 129 countries, representing the 13 million nurses working worldwide. Founded in 1899, ICN works to ensure quality nursing care for all, sound health policies globally, the advancement of nursing knowledge, and the

presence worldwide of a respected nursing profession and a competent and satisfied nursing workforce. www.icn.ch 1.2.3 The International Pharmaceutical Federation (FIP) is the global federation of 114 national organizations of pharmacists and pharmaceutical scientists. Pharmacists are health professionals dedicated to improving the access to and value of appropriate medicine use. www.fip.org 1.2.4 The FDI World Dental Federation (FDI) is the authoritative, worldwide voice of dentistry with more than 150 member associations in 134 countries around the world, representing more than 900,000 dentists internationally. Its main roles are to bring together the world of dentistry; to represent the dental profession of the world and to stimulate and facilitate the exchange of information across all borders with the aim of optimal oral health for all people. www.fdiworldental.org 1.2.5 The World Medical Association (WMA) is the global federation of national medical associations, representing millions of physicians worldwide. Its membership is made up of national medical associations from around the world, directly and indirectly representing the views of more than seven million physicians. The WMA was founded in 1946 and endeavours to achieve the highest possible standards of medical science, education, ethics and health care for all people. In order to achieve this ideal, the WMA is active in the fields of policy development and the setting of professional standards. www.wma.net 1.3 OTHER WHO COLLABORATING PARTNERS: As noted in 1.1.2 the WHO also frequently collaborates with organizations such as UNICEF, UNESCO, USAID, The Centers for Disease Control and Prevention (CDC) and other partners; and evidence-based and best practice guidelines for patients of developing countries may be found on their respective websites. WHO funded studies on evidence-based guidelines for developing countries are also published in professional medical journals such as The Lancet. The organizations most relevant to care provided by medical missions include the following:

1.3.1 United Nations Children's Fund (UNICEF) UNICEF is a member of the United Nations family of organizations, mandated by the United Nations General Assembly to work to protect children's rights, help meet their basic needs and expand their opportunities to reach their full potential. UNICEF works in 191 countries through country programmes and national committees focusing on five major areas: 1.Survival and development; 2. Basic education and gender equality; 3. HIV and AIDS; 4.Protection from violence, exploitation and abuse; 5. Policy advocacy and partnerships for children's rights. Information available: The web site provides access to reports and databases which are organized by themes. Those primarily related to health include children's rights; debt, poverty and development; HIV/AIDS; immunization; childhood development; nutrition;

water, environment and sanitation. Audience: Inter/national decision makers, policy makers, health professionals and general public.

1.3.2 The United Nations Educational, Scientific and Cultural

Organization (UNESCO) UNESCO promotes international co-operation among its 193 Member States … in the fields of education, science, culture and communication. Numerous health education guidelines are available through programs such as:

FRESH (Focusing Resources on School Health): Four core components: 1.School health policies 2. Water, sanitation and the environment 3.Skills-based health education 4.School-based health services. Three supporting strategies: 1.Partnerships between education and health 2. Community partnerships 3.Pupil awareness and participation

1.3.3 The United States Agency for International Development (USAID)

www.usaid.gov WHO collaborates with USAID in a number of areas. USAID's history goes back to the Marshall Plan reconstruction of Europe after World War Two. In 1961, the Foreign Assistance Act was signed into law and USAID was created by executive order. Since that time, USAID has been the principal U.S. agency to extend assistance to countries recovering from disaster, trying to escape poverty, and engaging in democratic reforms. USAID is an independent federal government agency that receives overall foreign policy guidance from the Secretary of State. Our Work supports long-term and equitable economic growth and advances U.S. foreign policy objectives by supporting: economic growth, agriculture and trade; global health; and, democracy, conflict prevention and humanitarian assistance. With headquarters in Washington, D.C., USAID's strength is its field offices around the world. We work in close partnership with private voluntary organizations, indigenous organizations, universities, American businesses, international agencies, other governments, and other U.S. government agencies. USAID has working relationships with more than 3,500 American companies and over 300 U.S.-based private voluntary organizations. International health related programs include: Environmental Health, Family Planning, Health Systems, HIV/AIDS, Infectious Diseases, Maternal and Child health, and Nutrition.

1.3.4 The Centers for Disease Control and Prevention (CDC) One of the

CDC’s 6 strategic imperatives is “Globalization: Extend CDC’s knowledge and tools to promote health protection around the world. CDC guidelines concerning care in the following areas are therefore directly applicable to care in developing countries. Health Protection Goals: Criteria and Objectives:

71. Prevent and control infectious diseases and their consequences globally. 72. Prevent infant and child morbidity and mortality globally. 73. Prevent non-communicable diseases and their consequences globally. 74. Prevent injuries and their consequences globally. 75. Promote safe, healthy, and accessible physical environments globally.

76. Prepare for, prevent, detect, respond to, and contain health threats globally.

77. Support achievement of international and national goals for the acceleration of control, and the eradication and elimination of diseases.

78. Develop sustainable public health capacity among partner organizations and governments globally.

79. Prevent maternal morbidity and mortality globally. 80. Improve response to natural and manmade disasters, including complex humanitarian emergencies globally”

1.3.5. Joint Commission and Joint Commission International (JCI)

Collaborating Center on Patient Safety Solutions During 2005, the Joint Commission and JCI were officially designated as a WHO Collaborating Center for Patient Safety Solutions…The Collaborating Centre has commenced building an international network to identify, evaluate, adapt and disseminate patient safety solutions worldwide…The nine inaugural patient safety solutions available for use by WHO Member States in May 2007 are: 1. Look-Alike, Sound-Alike Medication Names. 2. Patient Identification. 3.Communication During Patient Hand-Overs. 4. Performance of Correct Procedure at Correct Body Site. 5. Control of Concentrated Electrolyte Solutions. 6. Assuring Medication Accuracy at Transitions in Care. 7. Avoiding Catheter and Tubing Mis-Connections. 8. Single Use of Injection Devices. 9. Improved Hand Hygiene to Prevent Health Care-Associated Infections.

Note re Joint Commission International (JCI) and Additional

International Standards: JCI has recently (August, 2005) published additional international standards for ambulatory care. JCI is not yet listed as an official WHO Collaborating Center for these standards (which are not available online and hard copies must be purchased from JCI). However government agencies may also increasingly utilize the “Joint Commission International Accreditation Standards for Ambulatory Care” and Medical Missions Organizations may also find them useful. “JCI is a client-focused, results oriented, premier source of knowledge for health care organizations, government agencies, and third party payers throughout the world. It provides educational services, consulting services and publications to assist in improving the quality, safety, and efficiency of health care services. JCI offers international and country specific accreditation programs and other assessment tools to provide objective evaluations of the quality and safety of health care organizations.

“Joint Commissions International Accreditation Standards for

Ambulatory Care 2005” JCI has developed a set of international accreditation standards for those offering care in ambulatory settings. This first edition presents both patient-centered and organizational management core and not-core standards, along with the applicable intent statements and measurable elements for each standard. Patient-focused standards address five key functional areas: Access to Care and Continuity of Care; Patient and Family

Rights; Assessment of Patients; and Patient and Family Education. An additional six areas center on standards relating to management of the organization: Quality Improvement and Patient Safety; Prevention and Control of Infections; Governance, Leadership, and Direction; Facility Management and Safety; Staff Qualifications and Education; and Management of Information. Based on accreditation standards developed by an international task force, JCI Accreditation Standards for Ambulatory Care has been created to meet the needs of organizations pursuing either performance improvement or accreditation.”

1.3.6 Additional Collaborating Centers: These are institutions such as

research institutes, parts of universities or academies, which are designated by the Director-General to carry out activities in support of the Organization's programmes. Currently there are over 900 WHO collaborating centres in 99 Member States working with WHO on areas such as nursing, occupational health, communicable diseases, nutrition, mental health, chronic diseases and health technologies.

Note: Evidence-based Guidelines created for care of patients in

developed countries. These can be somewhat similar to those created for patients of developing countries. For example, evidence-based guidelines for most conditions of patients of developed countries emphasize first and foremost patient education and counseling. In this they are similar to guidelines created for patients of developing countries. However, as noted in 1.1.3., recommendations concerning drug and other therapy often differ significantly from those created for developing countries. 1.4 GUIDELINES FOR CARE OF PATIENTS EVALUATED IN THE STMM SETTING: Pending

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

COUNTRY ORGANIZATION FULL NAME, TITLE EMAIL ADDRESS ADDRESS LINE 1

ADDRESS LINE 2

ADDRESS LINE 3 PHONE NUMBER FAX NUMBER

Albania Order of Physicians of Albania

Din Abazaj, President albmedorder@albmail.com NATIONAL COUNCIL RR. QEMAL STAFA NO 1

TIRANA ALBANIA 3554224281 Same

Argentina Confederacion Medica Argentina

Jorge Ochoa, Secretary General

AVE. BELGRANO 1235

BUENOS AIRES 1093

ARGENTINA 541143838414 541143835511

Australia Australian Medical Council

Ian Frank, Executive Officer

amc@amc.org.au PO BOX 4810 KINGSTON, ACT 2604

AUSTRALIA 61262709704 61262709799

Australia Medical Board of Australian Capital Territory

Robert Bradford, Registrar

bob.bradford@act.gov.au SCALA HOUSE 11 TORRENS STREET

BRADDON,ACT 2612

AUSTRALIA 61262051598 61262051602

Australia Medical Board of Northern Territory

Colette Pethick, Policy Officer and Registrar

Colette.Pethick@nt.gov.au PO BOX 4221 DARWIN, NT 5792 AUSTRALIA 61889994157 61889994196

Australia Medical Board of Queensland

Jim O'Dempsey, Executive Officer

medical@healthregboards.qld.gov.au

GPO BOX 2438 BRISBANE, QUEENSLAND 4001

AUSTRALIA 61732252512 61732252527

Australia Medical Board of South Australia

Joe Hooper, Registrar admin@medicalboardsa.asn.au

PO BOX 359 STEPNEY, ADELAIDE 5069

AUSTRALIA 61881326444 61883627906

Australia Medical Board of Western Australia

Frank Fiorillo, Registrar

ffiorillo@wa.medicalboard.com.au

GPO BOX 2754 PERTH, WESTERN AUSTRALIA 6001

AUSTRALIA 61894811011 61893211744

Australia Medical Council of Tasmania

Annette McLean-Aherne, Registrar/CEO

registrar@medicalcounciltas.com.au

PO BOX 8 SOUTH HOBART, TASMANIA 7004

AUSTRALIA 61362335499 61362337986

Australia Medical Practitioners Board of Victoria

Ian Stoney, Chief Executive Officer

info@medicalboardvic.org.au

GPO BOX 773 MELBOURNE, VICTORIA 3001

AUSTRALIA 61396550500 61396550580

Australia New South Wales Medical Board

Andrew Dix, Registrar

nswmb@nswmb.org.au PO BOX 104 GLADESVILLE, NSW 1675

AUSTRALIA 61298792200 61298165307

Austria Austrian Medical Chamber

Otto Pjeta, President international@aek.or.at WEIHBURGGASSE 10-12

A-1010 VIENNA AUSTRIA 43151406931 43151406933

Bahamas Bahamas Medical Council Vernell Allen, Registrar

PO BOX N-9802 NASSAU BAHAMAS 2423260538 2423260537

Bahrain Ministry of Health Office of Licensure and Registration

Mohamed Alkhateeb, Chief of Licensure Office

salman_neo@yahoo.com PO BOX 12 MANAMA BAHRAIN 97317531556 97317535860

Bangladesh Bangladesh Medical and Dental Council

MD. Z. H. Basunia, Registrar

bmdc_mh@bangla.net 86 BIZOY NAGAR DHAKA 1000 BANGLADESH 88029555538 88029555236

Barbados Barbados Medical Council

Barbados Secretary OLD HOSPITAL BUILDING, JEMMOTTS LANE

ST. MICHAEL BARBADOS 2464275130 2464265570

Page: 1

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

Belgium National Council of the Order of Physicians

Denis Holsters, President

international@ordomedic.be

PLACE JAMBLINNE DE MEUX 34-35

BRUXELLES 1030 BELGIUM 3227430400 3227353563

Belize Belize Medical Council Carl Meggs, Chairman

navaron69@yahoo.com NORTHERN REGIONAL HOSPITAL, HOLY TRINITY STREET

ORANGE WALK TOWN

BELIZE 5013222072 5013222143

Bermuda Bermuda Medical Council Bermuda Executive Officer

MINISTRY OF HEALTH AND FAMILY SERVICES, PO BOX HM11 95

HAMILTON HM EX BERMUDA 14412360224

Bolivia Colegio Medico de Bolivia

Bolivia Chief Executive Officer

CALLE BALLIVIAN 1266

LA PAZ BOLIVIA

Botswana Medical Council of Botswana

P Mazonde, Registrar tgasemotho@gov.bw PRIVATE BAG 0038 GABORONE BOTSWANA 267352000 267353100

Brazil Conselho Federal de Medicina

Livia Barros Garcao, Secretary General

cfm@cfm.org.br SGAS 915 Lote 72, CEP: 70390-150

BRASILIA DF BRAZIL 55-61-3445-5900 55-61-3346-0231

Bulgaria Ministry of Health Services

Bulgaria Chief Executive Officer

NO. 5 SVETA NEDELYA SQUARE

SOSIA 1000 BULGARIA

Burma Burma Medical Council Burma Chief Executive Officer

36 THEINPHYU STREET, BOTAHTAUNG YANGON

MYANMAR BURMA

Cambodia Cambodian Medical Association

S. Sokkhonn, President

#73 BOULEVARD PREAH MONIVONG

PHNOM PENH CAMBODIA

Canada College des Medecins du Quebec

Yves Robert, Secretary

yrobert@cmq.org 2170 RENE-LEVESQUE BLVD WEST

MONTREAL, QUEBEC H3H 2T8

CANADA 5149334441 5149333112

Canada College of Physicians and Surgeons of Alberta

Dr. Trevor Theman, Registrar

ttheman@cpsa.ab.ca 900, 10180 101 STREET

EDMONTON, ALBERTA T5J 4P8

CANADA 7804234764 7804200651

Canada College of Physicians and Surgeons of British Columbia

Morris Vanandel, Registrar

drvanandel@cpsbc.ca 400-858 BEATTY STREET

VANCOUVER, BRITISH COLUMBIA V6B 1C1

CANADA 6047337758 6047333503

Canada College of Physicians and Surgeons of Manitoba

William Pope, Registrar

bpope@cpsm.mb.ca 1000-1661 PORTAGE AVENUE

WINNIPEG, MANITOBA R3J 3T7

CANADA 2047744344 2047740750

Canada College of Physicians and Surgeons of New Brunswick

Ed Schollenberg, Registrar

info@cpsnb.org 1 HAMPTON ROAD, STE 300

ROTHESAY, NB E2E 5K8

CANADA 5068495050 5068495069

Page: 2

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

Canada College of Physicians and Surgeons of Newfoundland and Labrador

Robert Young, Registrar

cpsnl@cpsnl.ca 139 WATER STREET, SUITE 603

ST. JOHN'S, NEWFOUNDLAND A1C 1B2

CANADA 7097268546 7097264725

Canada College of Physicians and Surgeons of Nova Scotia

Cameron Little, Registrar

clittle@cpsns.ns.ca SENTRY PLACE, 1559 BRUNSWICK ST, SUITE 200

HALIFAX, NOVA SCOTIA B3J 2G1

CANADA 9024225823 9024225035

Canada College of Physicians and Surgeons of Ontario

Rocco Gerace, Registrar

rgerace@cpso.on.ca 80 COLLEGE STREET

TORONTO, ONTARIO M5G 2E2

CANADA 4169672600 4169672618

Canada College of Physicians and Surgeons of Prince Edward Island

Cyril Moyse, Registrar

mmacdonald@collegeofphysicians.pe.ca

199 GRAFTON STREET

CHARLOTTETOW, PEI C1A 1L2

CANADA 9025663861 9025663861

Canada College of Physicians and Surgeons of Saskatchewan

Dennis Kendel, Registrar

cpss@quadrant.net 211 4TH AVENUE SOUTH

SASKATOON, SASKATCHEWAN S7K 1N1

CANADA 3062447355 3062442600

Canada Federation of Medical Regulatory Authorities of Canada

Fleur-Ange Lefebvre, Executive Director and CEO

info@fmrac.ca 2283 BOUL., ST. LAURENT BLVD, SUITE 103

OTTAWA, ONTARIO K1G 5A2

CANADA 6137380372 6137389169

Canada Government of the Northwest Territories

Jeannette Hall, Registrar, Professional Licensing

jeannette_hall@gov.nt.ca CENTRE SQUARE TOWER, 8TH FL, P.O. BOX 1320

YELLOWKNIFE, NWT X1A 2L9

CANADA 8679208058 8678730484

Canada Government of the Yukon

Elsie Bagan, Registrar, Medical Practitioners

dale.kozmen@gov.yk.ca P.O. BOX 2703 WHITEHORSE, YUKON Y1A 2C6

CANADA 8676675257 8676673609

Canada Medical Council of Canada

Ian Bowmer, Executive Director

ibowmer@mcc.ca (cc: carole@mcc.ca)

PO BOX 8234, STATION T

OTTAWA, ONTARIO K1G 3H7

CANADA 6135218787 6135218831

Cape Verde Ordem dos Medicos de Cabo Verde

Luis de Sousa Nobre Leite, President

omecab@cvtelecom.cv AV. OUA-ACHADA SANTO ANTONIO

PRAIA 421 CAPE VERDE 238622503 238623099

Chile Colegio Medico de Chile Juan Luis Castro, Presidente

ESMERALDA 678 SANTIAGO CHILE 5624277849 5626330940

Coit d'Ivoire Conseil National de l'Ordre des Medecins

Kroo Florent Aka, Executive Chairman

onmci@yahoo.fr 01 BOITE POSTALE 1584

ABIDJAN 01 COIT D'IVOIRE 22522486153 22522486153

Colombia Ministry of Public Health Juan Luis Londono de la Westa, Minister of Health

CARRERA 13 NO. 32-76

BOGOTA COLOMBIA 5713365066 5713368007

Costa Rica Colegio de Medicos y Cirujanos de Costa Rica

Costa Rica Chief Executive Officer

APARTADO NO. 548

SAN JOSE COSTA RICA

Croatia Croatian Medical Chamber

Hrvoje Minigo, President

9, SUBICEVA ZAGREB 10000 CROATIA 38514657810 38514655465

Page: 3

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

Cuba Ministerio de Salud Publica

Cuba Chief Executive Officer

CALLE N. 310 ESQ. A 23

VEDADO, HABANA 4

CUBA

Czech Republic Ministry of Health Czech Republic Chief Executive Officer

mzcr@mzcr.cz PALACKEHO NAM. 4

CZ-12801 PRAHA 2

CZECH REPUBLIC

420224971111 420224972111

Denmark Danish National Board of Health

Soren Thorning, Chief Legal Advisor

sst@sst.dk ISLANDS BRYGGE 67 POSTBOKS 1881

2300 KOBENHAVN S.

DENMARK 4572227400 4572227401

Dominica Dominica Medical Board Dorian Shillingford, Chairman

shillingfordd@cwdom.dm MINISTRY OF HEALTH

ROSEAU 00100 DOMINICA 7674484839 7674487826

Ecuador Ministerio de Salud Publica

Ecuador Chief Executive Officer

QUITO ECUADOR

Egypt Egyptian Medical Syndicate

Ossama Rasslan, Secretary General

orasslan@gmail.com 32 MOHAMED TALAAT SALEM ST

NASR CITY, CAIRO EGYPT 2027962751 2027962751

Eritrea Ministry of Health Bernando Kifleyesus, Director General

PO BOX 212 ASMARA ERITREA 2911122417 2911122899

Fiji Fiji Medical Council Fiji Secretary MINISTRY OF HEALTH

PO BOX 2223, GOVERNMENT BLDGS

SUVA, FIJI 679306177 679306163

Finland National Authority for Medicolegal Affairs

Finland Chief Executive Officer

PO BOX 265 FIN-00531 HELSINKI

FINLAND 3589772920 358977292138

France Conseil National de l'Ordre des Medecins

Jacques Lucas, Secretary General

uguen.olivia@cn.medecin.fr

180 BOULEVARD HAUSSMANN

F-75389 PARIS CEDEX 07

FRANCE 33153893313 33153893344

Germany Behoerde fuer Arbeit, Gesundheit/Soziales der Freien/Hansestadt

Hamburg Chief Executive Officer

RECHT/BERUFE-GESUNDHEITSWESEN

WINTERHUDER WEG, 29 22085 HAMBURG

GERMANY 4940428633795

Germany Bezirksregierung Arnsberg

Arnsberg Chief Executive Officer

DEZERNAT 24 SEIBERTZSTR. 1

59821 ARNSBERG GERMANY

Germany Bezirksregierung Braunschweig

Braunschweig Chief Executive Officer

DEZERNAT 108 BOHLWEG 38

38100 BRAUNSCHWEIG

GERMANY

Germany Bezirksregierung Detmold

Detmold Chief Executive Officer

DEZERNAT 24 LEOPOLDSTR. 13-15

32756 DETMOLD GERMANY

Germany Bezirksregierung Duesseldorf

Duesseldorf Chief Executive Officer

DEZERNAT 24 FISCHERSTR. 10

DUESSELDORF 40477

GERMANY

Germany Bezirksregierung Hannover

Hannover Chief Executive Officer

AM WATERLOOPLATZ 11 DEZERNAT 108

30169 HANNOVER GERMANY 495111067857

Page: 4

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

Germany Bezirksregierung Koeln Andreas Hein, Chief Executive Officer

andreas.hein@bezreg-koeln.nrw.de

DEZERNAT 24 ZEUGHAUSSTR. 2-10

KOELN 50667 GERMANY

Germany Bezirksregierung Lueneburg

Luneburg Chief Executive Officer

DEZERNAT 108 AUF DER HUDE 2

21339 LUNEBURG GERMANY 494131152383

Germany Bezirksregierung Muenster

Muenster Chief Executive Officer

DEZERNAT 24 ALTER STEINWEG 44

MUENSTER 48143 GERMANY

Germany Bezirksregierung Weser-Ems

Weser-Ems Chief Executive Officer

DEZERNAT 108 26106 OLDENBURG

GERMANY 494417992452

Germany Fragen der Anerkennung von AiP Zeiten im Ausland

Hildesheim Chief Executive Officer

DOMHOF 1 31134 HILDESHEIM

GERMANY

Germany Hessisches Landespruefungsamt fuer Heilberufe

Hessen Chief Executive Officer

ADICKESALLEE 36 60322 FRANKFURT/MAIN

GERMANY 49691535463 49691535315

Germany Landesamt fuer Gesundheit und Arbeitssicherheit

Kiel Chief Executive Officer

SCHLESWIG-HOLSTEIN ADOLF-WESTPHAL-STRABE 4

24143 KIEL GERMANY

Germany Landesamt fuer Soziales und Versorgung Brandenburg

Brandenburg Chief Executive Officer

DEZERNAT BERUFSRECHT WUNSDORFER PLATZ 3

15838 WUNSDORF GERMANY 493370271117

Germany Landesamt fuer Soziales, Jugend und Versorgung

Koblenz Chief Executive Officer

ABTEILUNG 5 BAEDEKER STRABE 2-10

56073 KOBLENZ GERMANY

Germany Landesamt fuer Versorgung und Soziales des Landes Sachsen-Anhalt

Isa Weiss, Chief Executive Officer

DEZERNAT 34 NEUSTADTER PASSAGE 15

06112 HALLE GERMANY

Germany Ministerium fuer Frauen, Arbeit, Gesundheit/Soziales des Saar

Homburg Chief Executive Officer

LANDESPRUFUNGSAMT FUR MEDIZIN WARBURGRING 78

66242 HOMBURG GERMANY

Germany Regierung von Oberbayern

Bayern Chief Executive Officer

MAXIMILIANSTRABE 39

80538 MUNCHEN GERMANY 498921760

Page: 5

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

Germany Regierungspraesidium Chemnitz

Chemnitz Chief Executive Officer

post@rpc.sachsen.de ALTCHEMNITZER STRASSE 41

CHEMNITZ 09120 GERMANY 493715321220 493715321229

Germany Regierungspraesidium Dresden

Dresden Chief Executive Officer

REFERAT 71 STAUFFENBERGALLEE 2

01099 DRESDEN GERMANY

Germany Regierungspraesidium Leipzig

Leipzig Chief Executive Officer

REFERAT 71 BRAUSTRABE 2

LEIPZIG GERMANY

Germany Regierungspraesidium Stuttgart

Baden-Wurttemberg Chief Executive Officer

REFERAT 26 ROPPMANN STR. 21

70565 STUTTGART

GERMANY 497119040

Germany Sozialministerium Mecklenburg-Vorpommern Chief Executive Officer

ABT. IX 302 WERDERSTRABE 124

19055 SCHWERIN GERMANY 493855889342

Germany Thueringer Landesverwaltungsamt Abteilung VII

Weimar Chief Executive Officer

WEIMARPLATZ 4 99423 WEIMAR GERMANY

Ghana Ghana Medical and Dental Council

Eli Atikpui, Chief Executive Officer mdcaccra@yahoo.co.uk

PO BOX AN 10586 GREATER ACCRA, ACCRA

GHANA 23321661626 23321661626

Greece Ministry of Health and Welfare

Greece Chief Executive Officer

223 MESOGEION AVENUE

115 25 ATHENS, HELLAS

GREECE 30105232820

Grenada Grenada Medical Registration Board

Grenada Registrar MINISTRY OF HEALTH

ST. GEORGE'S GRENADA

Guatamala Colegio de Medicas y Cirujanos de Guatemala

Guatamala Chief Executive Officer

17 CALLE 1-61 ZONA 1 GUATAMALA

Guyana Medical Board of Guyana Guyana Chief Executive Officer

MINISTRY OF HEALTH

BRICKDAM, GEORGETOWN 11

GUYANA 5922250113

Haiti Department de la Sante Haiti Chief Executive Officer

PORT-AU-PRINCE HAITI

Hong Kong Medical Council of Hong Kong

Robert Cheung, Secretary

crol@dh.gov.hk 17/F WU CHUNG HOUSE, 213 QUEEN'S RD EAST

WANCHAI HONG KONG 85229618648 85228917946

Hungary Office of Health Authorisation and Administrative Procedures

Hanna Pava ZRINYI UTCA 3 BUDAPEST, H-1051

HUNGARY 3612357982 3612693794

Iceland Ministry of Health and Social Security

Iceland Minister of Health

postur@htr.stjr.is VEGMULA 3 IS-150 REYKJAVIK ICELAND 3545458700 3545519165

India Andhra Pradesh Medical Council

K. Sanjeeva Rao, Registrar

apmc@apmedicalcouncil.com

SULTANBAZAR, KOTI

HYDERABAD, ANDHRA PRADESH -500095

INDIA 4055577343 4024657639

Page: 6

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

India Assam Council of Medical Registration

J.K. Saharia, Registrar

C/O DIRECTORATE OF HEALTH SERVICES

HENGERABRI, ASSAM, GUWAHATI - 781006

INDIA 913612598000

India Bihar Council of Medical Registration

Surya Bhushan, Registrar

ROAD NO. 11-D RAJENDRA NAGAR

PATNA - 800016, BIHAR

INDIA 916122670913

India Chattisgarh Medical Council

D.P. Akhand, Registrar

C/O DIRECTORATE OF HEALTH SERVICES, OLD NURSES HOSTEL, RM 20 MANTRALAYA PARISAR

RAIPUR, CHATTISGARH

INDIA 917712235754 917712221622

India Delhi Medical Council Dr. R.N. Baishya, Registrar

delhimedicalcouncil@vsnl.net

MAULANA AZAD MED COLLEGE #357

BAHADUR SHAH ZAFAR MARG, NEW DELHI - 110002

INDIA 911123235177 911123234416

India Goa Medical Council Dr. Dilip Bhandare FACULTY BLOCK, G.M.C. COMPLEX

BAMBOLIM, GOA - 403202

INDIA 918322458723 918322225602

India Gujarat Medical Council Parmanand Patel, Registrar

mail@gmcgujarat.org COUNCIL HOUSE, MANIBEN AYURVEDIC HOSPITAL

AHMEDABAD - 380016, GUJARAT

INDIA 917922680534

India Haryana State Dental & Medical Councils

K.K. Kapoor, Registrar

S.C.O. NO. 32, SECTOR 20-D DAKSHINI MARG, NEAR LABOUR CHOWK

CHANDIGARH INDIA 911722706094

India Himachal Pradesh Medical Council

Dr. Ratola, Registrar DIR MED EDUC & RESEARCH, 18B, SDA COMPLEX

KUSUMPTI, SHIMLA -171009, HIMACHAL PRADESH

INDIA 911772620733

India Jammu & Kashmir Medical Council

Muzaffar Ahmed, Registrar

C/O DIRECTORATE OF HEALTH SERVICES NEAR MLA HOSTEL

JAMMU INDIA 911912549632

India Jharkhand State Medical Council

Amar Kumar Singh, Registrar

BARIATU ROAD RANCHI - 834009, JHARKHAND

INDIA 916512541316

Page: 7

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

India Karnataka Medical Council

N Vidyasagar, Registrar

NO 70, VAIEYAKEE BHAWAN, KR RD, HB SAMAJA RD

BASAYANAGUDI, BANGALORE - 560002, KARNATAKA

INDIA 918026620292 918026620292

India Madhya Pradesh Medical Council

B.M. Paranjpe, Registrar

F-7, SANCHI COMPLEX, SHIVAJI NAGAR

BHOPAL - 462016, MADHYA PRADESH

INDIA 917552551568

India Maharashtra Medical Council

S.B. Patel, Administrator

189-A, ANAND COMPLEX, SANE GURUJI MARG ARTHUR ROAD NAKA

MUMBAI - 400011, MAHARASHTRA

INDIA 912223010668 912223072464

India Medical Council of India A.R.N. Setalvad, Secretary

mci@bol.net.in POCKET 14, SECTOR-8

DWARKA-NEW DELHI-110 075

INDIA 911125367033 911125367025

India Meghalaya Medical Council

B. Linda, Director of Health Services

C/O DIRECTORATE OF HEALTH SERVICES

SHILLONG - 793001, MEGHALAYA

INDIA 913642224354

India Orissa Council of Medical Registration

H.N. Patnaik, Registrar

HEALTH EDUCATION BUREAU BLOCK

BHUBANESHWAR - 751001, ORISSA

INDIA 916742402847

India Punjab Medical Council A.S. Thind, Registrar S.C.O. NO. 25, PHASE-I

MOHALI (S.A.S. NAGAR), PUNJAB

INDIA 911722266913

India Rajasthan Medical Council

Sanjay Sharma, Registrar

SARDAR PATEL MARG, 22 GODAM CIR, C-SCHEME

JAIPUR - 302001, RAJASTHAN

INDIA 911412225102

India Tamil Nadu Medical Council

S. Kandasamy, Registrar

D-BLOCK, TNHB COMPLEX, 100 FEET INNER RING RD

VADAPALANI CHENNAI - 600026, TAMIL NADU

INDIA 914424727603 9144248301390

India Travancore Cochin Medical Council

K. Rajeevakshan, Registrar

RED CROSS ROAD THIRUVANTHAPURAM -695035, KERALA

INDIA 914712307227 914712307227

India Uttar Pradesh Medical Council

Rajesh Jain, Registrar 5, SARVEPALLI MALL, AVENUE ROAD

LUCKNOW - 226001, UTTAR PRADESH

INDIA 915222238846

Page: 8

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

India Uttaranchal Medical Council

Y.S. Bisht, Registrar C/O DIRECTORATE OF GENERAL MEDICAL HEALTH CAMPUS, 107

CHANDER NAGAR DEHRADUN, UTTARANCHAL

INDIA 911352623723 911352729897

India West Bengal Medical Council

D.K. Ghosh, Registrar wbmc@vsnl.net 8, LYONS RANGE, 3RD FLOOR

KOLKATA - 700001, WEST BENGAL

INDIA 913322202674

Indonesia Indonesian Medical Association

Indonesia Chief Executive Officer

J1 SAM RATULANGI

JAKARTA - 29 INDONESIA

Indonesia NIHRD Indonesia Chief Executive Officer

J1 PERCETAKAN NEGARA 2G

JAKARTA - 10560 INDONESIA

Ireland Medical Council of Ireland

John Lamont, Registrar

info@mcirl.ie LYNN HOUSE, PORTOBELLO COURT, LOWER RATHMINES ROAD

DUBLIN 6 IRELAND 35314983100 35314983102

Israel Ministry of Health Amir Shanon, Director, Department of Medical Professions

pniot@matat.health.gov.il 2, BEN TABI STREET POB 1176

JERUSALEM 93591 ISRAEL 97226705820 97226790846

Italy National Federation for the Orders of Doctors and Dentists

Giovanni Maria Righetti, General Secretary

estero@fnomceo.it PIAZZA COLA DI RIENZO 80/A

ROME 00192 ITALY 39636203232 3963222429

Jamaica Caribbean Association of Medical Councils (CAMC)

Muriel Lowe, Chairperson

medcojam@cwjamaica.com

C/O MEDICAL COUNCIL OF JAMAICA

OLD OCEANA COMPLEX, 9TH FLOOR, 2-4 KING STREET

KINGSTON JAMAICA

8769223116 8769271326

Jamaica Medical Council of Jamaica

John McHardy, Registrar

OLD OCEANA COMPLEX, 9TH FLOOR

2-4 KING STREET KINGSTON 5 JAMAICA

8769223116 8769271326

Japan Ministry of Health, Labour and Welfare, Medical Professions Division, Health Policy Bureau

Shuichiro Hayashi, MD, MPH, Deputy Director

1-2-2 KASUMIGASEKI

CHIYODA-KU TOKYO 100-45 JAPAN

81335952204 81335033559

Jordan Directorate of Medical Institutions and Professions

Faleh Al-Naser, Minister

PO BOX 86 AMMAN 11118 JORDAN 96265665131 96265688373

Kenya Medical Practitioners and Dentists Board

Daniel Yumbya, Executive Officer

PO BOX 44839 NAIROBI KENYA 2542711478 2542715239

Korea (South) National Health Personnel Licensing Examination Board

Moon-Shik Kim, President

mskim@kuksiwon.or.kr 679-30 JAYANG-DONG

GWANGJIN-KU, SEOUL, 143-873

KOREA 8224780332 8224890331

Page: 9

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

Latvia Ministry of Health U. Likops, State Secretary

vm@vm.gov.lv 72 BRIVIBAS STREET

RIGA LV 1011 LATVIA 3717876000 3717876002

Lesotho Lesotho Medical, Dental and Pharmacy Council

Mamotena Phakoana, Registrar

PO BOX MS 726 MASERU 100 LESOTHO 266322450 266322450

Libya Libyan General Medical Council

Ibrahim Alsharf, Secretary General

gmclibya.org PO BOX 7768 AINZARA, TRIPOLI LIBYA 218214623241 218214621694

Lithuania State Inspectorate of Medical Audit

Vitale Vinickiene, Director

vmai@takas.lt SILTNAMIU 29 VILNIUS LT-2001 LITHUANIA 3702169934

Madagascar National Order of Physicians of Madagascar

Jean-Louis Robinson, President

onmmada@simicro.mg PLACE CHARLES RENEL BP 1147

ANTANANARIVO 101

MADAGASCAR 9261202220757 9261202237986

Malawi Medical Council of Malawi

Rex Moyo, Registrar medcom@malawi.net PO BOX 30787 LILONGWE 3 MALAWI 2651727048 2651727255

Malaysia Malaysian Medical Council

Mohd. Khairi bin Yakub, Secretary

MINISTRY OF HEALTH

50590 KUALA LUMPUR

MALAYSIA 6032935077 6032938569

Mali Ordre National des Medecins du Mali

Dr Alhousseini Ag Mohamed, Président

BPE:674 - BAMAKO MALI 2232230320

Malta Medical Council of Malta Herbert Guillaumier, Registrar

181 MELITA STREET

VALLETTA CMR 02 MALTA 35621255538 35621226349

Mauritius Medical Council of Mauritius

Deepak Heeraman, Registrar

medcom@intnet.mu 101, FLOREAL ROAD

MANGALKHAN FLOREAL MAURITIUS

2306988403 2306988004

Mongolia Ministry of Health Tumendemberel Bolormaa, Director, International Cooperation Dept.

bolormaa@moh.mn OLYMPIC STREET-2, GOVERNMENT BUILDING-8

ULAANBAATAR 210648

MONGOLIA 97611263822 97611263822

Mozambique Ministry of Health Mozambique Chief Executive Officer

MAPUTO MOZAMBIQUE 2581427131 2581427133

Namibia Interim Medical and Dental Council of Namibia

Ena Barlow, Registrar/CEO

ebarlow@hpcna.com.na PO Box 50021 BACHBRECHT, WINDHOEK

NAMIBIA 26461245586 26461271891

Nepal Nepal Medical Council Shri Krishna Giri, Registrar

nmc@healthnet.org.np PO BOX NO. 13890 BANSBARI KATHMANDU, NEPAL

9914371566 9914372318

Netherlands Ministry of Health, Welfare and Sport

R. Bekker, Chief Executive Officer

P.O. BOX 20350 DEN HAAG 2500 EJ

THE NETHERLANDS

31703407400 31703407372

Netherlands Royal Dutch Medical Association, Department of Postgraduate Training and Registration

Lourens R. Kooij, General Secretary

l.kooij@fed.knmg.nl LOMANLAAN 103, PO BOX 20065

UTRECHT 3502 LB THE NETHERLANDS

31302823248 31302823318

New Zealand Medical Council of New Zealand

Philip Pigou, Chief Executive Officer

ppigou@mcnz.org.nz PO BOX 11-649, LEVEL 13, MID CITY TOWER

WELLINGTON NEW ZEALAND 6443847635 6443858902

Page: 10

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

Nigeria Medical and Dental Council of Nigeria

Festus Oshoba (Registrar/ Secretary)

medicalcouncil@yahoo.com BLOCK II, F-CLOSE, FHA

GWARIMPA, PMB 458, ABUJA

NIGERIA 2348023113025 23418979131

Norway Norwegian Registration Authority for Health Personnel

Per Haugum, Director peh@safh.no POSTBOX 8053 DEP

0031 OSLO NORWAY 4721529700 4721529703

Pakistan Pakistan Medical & Dental Council

M. Sohail Karim Hashmi, Secretary & Registrar

pmdcsec@isb.paknet.com.pk

MAUVE AREA, SECTOR G-10/4

ISLAMABAD FEDERAL CAPITAL

PAKISTAN 92519266428 92519266427

Papua New Guinea

Papua New Guinea Medical Board

Veari Maha, Registrar PO BOX 841 PORT MORESBY, NATIONAL CAPITAL DISTRICT

PAPUA NEW GUINEA

6753013983 6753013604

Paraguay Ministerio de Salud Publica y Bienestar Social

Paraguay Chief Executive Officer

CALLE PETTIROSSE Y BRASIL

ASUNCION PARAGUAY

Peru Ministry of Health Peru Chief Executive Officer

AVE SALAVERRY S-N, CUDRA 7

LIMA PERU

Philippines Philippines Board of Medicine

Edgardo Fernando, Chief Executive Officer

P PAREDES STREET

SAMPALOC, MANILA

PHILIPPINES 6327416061

Poland Ministry of Health Marzena Drewniacka, Acting Deputy Director

UL. MIODOWA 15 00-520 WARSZAWA

POLAND 48228260947 48228262103

Poland Poland Chamber of Physicians and Dentists

Konstanty Radziwill, President

sekretariat@hipokrates.org UL. SOBIESKIEGO 110

00-764 WARSZAWA

POLAND 48228517150 48228517136

Portugal Portuguese Medical Association

Isabel Caixeiro, President

intl.omcne@omsul.com AV. ALMIRANTE GAGO COUTINHO, NO. 151

LISBON 1749-084 PORTUGAL 351218427111 351218427101

Russia Ministry of Public Health & Social Development

Michael Zurabov, Minister

3/25 RAKHMANINOVSKY PEREULOK

MOSCOW 127994 RUSSIA 7959284453

Samoa Western Samoa Medical Association

Samoa Chief Executive Officer

CL-DR LTE ENOSA APIA 0685 SAMOA

Seychelles Seychelles Medical and Dental Councils

Gaetane Rose, Registrar

PO BOX 982 VICTORIA MAHE SEYCHELLES 248323548 248324190

Sierra Leone Sierra Leone Medical and Dental Council

E.C. Cummings, President

NEW ENGLAND, PO BOX 932

FREETOWN SIERRA LEONE 23222220753 23222220753

Page: 11

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

Singapore Singapore Medical Council

Lee Suan Yew, President

moh_smc@moh.gov.sg 16 COLLEGE ROAD #01-01 COLLEGE OF MEDICINE BUILDING

169854 SINGAPORE 6563723061 6562210558

Slovenia Medical Chamber of Slovenia

Slovenia Chief Executive Officer

zdravniska.zbornica@zzs-mcs.si

DALMATINOVA 10 1000 LJUBLJANA SLOVENIA 38613072100 38613072109

Solomon Islands

Solomon Islands Medical and Dental Board

Solomon Islands Chief Executive Officer

MINISTRY OF HEALTH PO BOX 349

HONIARA SOLOMON ISLANDS

67720830 67720085

South Africa Health Professions Council of South Africa

Boyce Mkhize, Registrar

boycem@hpcsa.co.za PO BOX 205 PRETORIA GAUTENG 0001

SOUTH AFRICA 27123389320 27123241594

Spain Spanish Council of the Colleges of Physicians

Guillermo Sierra, Chief Executive Officer

presidencia@cgcom.org VILLANUEVA, 11 MADRID 28001 SPAIN 34914317780 34915764388

Sri Lanka Sri Lanka Medical Council

P.S.S. Panditharatne, Registrar

slmc@lankabellnet.com 31, NORRIS CANAL ROAD

COLOMBO 10 SRI LANKA 94112691848 94112674787

St. Kitts Medical Board of St. Christopher and Nevis

Thelma Phillip-Browne, Chief Medical Officer & Chairman

minhwa@caribsurf.com PO BOX 186 BASSETERRE ST. KITTS WEST INDIES

8694652521 8694668574

St. Lucia Medical Council of St. Lucia

St. Lucia Registrar MIN OF EDUCATION & HEALTH

CASTRIES ST. LUCIA

St. Vincent Medical Board of St. Vincent and the Grenadines

Harold Rampersaud, Chair

MINESTRY OF HEALTH & ENVIRONMENT

KINGSTON ST. VINCENT 7844571612 7844572684

Sudan Sudan Medical Council Imam Muati, Secretary General

sudamedic@yahoo.com PO Box 800 KHARTOUM 800 KHR

SUDAN 249912302895 249183788946

Suriname Geneeskundige Inspektie Ministerie Van

Suriname Chief Executive Officer

VOIKSGEZONDHEID GRAVENSTRAAT 64

PARAMARIBO SURINAME

Sweden Medical Responsibility Board

Sweden Chief Executive Officer

hsan@hsan.se BOX 3539 STOCKHOLM 103 69

SWEDEN 087831900 087831910

Sweden National Board of Health and Welfare

Kjell Asplund, Director General

socialstyrelsen@sos.se RALAMBSVAGEN 3 SE 106 30 STOCKHOLM

SWEDEN 46855553000 46855553252

Switzerland Swiss Medical Association

Jacques de Haller, President

fmh@hin.ch ELFENSTRASSE 18, POSTFACH 170

CH - 3000 BERN 15

SWITZERLAND 41313591111 41313591112

Page: 12

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

Taiwan (Rep. of China)

Department of Health Sheng-Mou Hou, Minister

shengmou@doh.gov.tw 13 F. NO. 100 AIGUO E. RD., JHONGIHENG DIST

TAIPEI, TAIWAN 100

TAIWAN (REP. OF CHINA)

886223967166 886223418994

Tajikistan Health Sector Reform Project Management Unit

Ibragimov Sobirjon, Domestic Consultant for Licensing and Accreditation

solim2000@mail.ru 8, CHAPAEV STR. DUSHANBE TAJIKISTAN 992372219924 992372219925

Tanzania Medical Council of Tanzania

N Swai, Registrar mct@moh.go.tz PO BOX 9083 DAR-ES-SALAAM TANZANIA 255741607345

Thailand Medical Council of Thailand

Thailand General Secretary

7TH FLOOR, OFFICE OF PERMANENT SECRETARY BUILDING, MINISTRY OF PUBLIC HEALTH

TIWANOND ROAD, NONTHABURI 11000

THAILAND 66259018801 6625918614

Tonga Health Practitioners Registration Council

T Ahio, Registrar MINISTRY OF HEALTH, PO BOX 59

NUKU'ALOFA TONGA 67623200 67624291

Trinidad Medical Board of Trinidad andTobago

Steve Smith, Chairman & President

mbtt@tstt.net.tt ERIC WILLIAMS MEDICAL SCIENCE COMPLEX, URIAH BUTLER HIGHWAY

CHAMPS FLEURS TRINIDAD W.I. 8686455223 8686455826

Turkey Turkey Medical Association

Turkey Chief Executive Officer

MITHATPASA CAD. NO: 62/15-18

YENISEHIR, ANKARA 06420

TURKEY 903124183156 903124172672

Uganda Uganda Medical and Dental Practitioners Council

John Ndiku, Registrar umdpc@infocom.co.ug MINISTRY OF HEALTH, PO BOX 16115

WANDEGEYA, KAMPALA

UGANDA 25677432129 25641345844

United Arab Emirates

Center for Healthcare Planning and Quality, Dubai Healthcare City Licensing Board

Dr. Omar AlMuthanna, Sr. Manager, Prof. Lic. Dept.

omar.almuthanna@dhcc.ae

PO BOX 505001 DUBAI UNITED ARAB EMIRATES

97143622798 97143624770

United Arab Emirates

Ministry of Health Abdulkarim Al Zarouni, Director of Hospitals

azarouni@moh.gov.ae PO BOX 848 ABU DHABI UNITED ARAB EMIRATES

97126314811 97126313525

United Arab Emirates

Health Authority Abu Dhabi

H.E. Dr. Ahmed Al Mazrouei, Chairman

rkabbara@gahs.ae PO BOX 5674 ABU DHABI UNITED ARAB EMIRATES

971241934333 97124449822

United Kingdom

General Medical Council Finlay Scott, Chief Executive and Registrar

finlayscott@gmc-uk.org 2ND FLOOR, REGENT`S PLACE, 350 EUSTON ROAD

LONDON, ENGLAND NW1 3JN

UNITED KINGDOM

442071895015 442071895009

Page: 13

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

United States Alabama State Board of Medical Examiners

Larry Dixon, Executive Director

ldixon@albme.org cc: mlmeredith@albme.org

PO BOX 946 MONTGOMERY, AL 36101-0946

USA 3342424116 3342424155

United States Alaska State Medical Board

Leslie Gallant, Executive Administrator

leslie.gallant@alaska.gov

550 WEST 7TH AVE, SUITE 1500

ANCHORAGE, AK 99501

USA 9072698163 9072698196

United States American Association of Osteopathic Examiners

Gary Clark, Executive Director (Tim Kowalski - Pres. & Jim Andriole - VP)

margar788@aol.com 2542 ORCHARD LANE

JEFFERSON CITY, MO 64109

USA 573-415-1851 (Alt. Cell 405-834-9922)

United States American Samoa Health Services Regulatory Board

Toaga Atuatasi Seumalo, Executive Secretary

LBJ TROPICAL MEDICAL CENTER

PAGO PAGO, AMERICAN SAMOA

USA 6846331222 6846331869

United States Arizona Board of Osteopathic Examiners in Medicine and Surgery

Jack Confer, Executive Director

jack.confer@azdo.gov 9535 E. DOUBLETREE RANCH ROAD

SCOTTSDALE, AZ 85258

USA 480-657-7703 480-657-7715

United States Arizona Medical Board Lisa Wynn, Executive Director

lwynn@azmd.gov 9545 E DOUBLETREE RANCH ROAD

SCOTTSDALE, AZ 85258

USA 480-551-2704 480-551-2704

United States Arkansas State Medical Board

Peggy Pryor Cryer, Executive Secretary

ppc@armedicalboard.org

2100 RIVERFRONT DR.

LITTLE ROCK, AR 72202-1793

USA 5012961802 5012961805

United States Colorado Board of Medical Examiners

Cheryl Hara, Program Director

cheryl.hara@dora.state.co.us

1560 BROADWAY, SUITE 1350

DENVER, CO 80202-5140

USA 303-894-7690 303-894-7692

United States Northern Mariana Islands Healthcare Professions Licensing Board

Florence Sablan, Executive Director

mplb@pticom.com PO BOX 502078 SAIPAN, MP 96950 USA 6706644811 6706644813

United States Connecticut Medical Examining Board

Jeffrey Kardys, Board Liaison

jeffrey.kardys@ct.gov P.O. BOX 340308 HARTFORD, CT 06134-0308

USA 8605097648 8605097553

United States Delaware Board of Medical Practice

Gayle MacAfee, Executive Director

gayle.macafee@state.de.us CANNON BUILDING 861 SILVER LAKE BLVD., SUITE 203

DOVER, DE 19904 USA 3027444520 3027392711

United States District of Columbia Board of Medicine

James Granger, Executive Director

james.granger@dc.gov 717 14TH STREET NW, ROOM 1007

WASHINGTON DC, 20005

USA 2027244900 2027278471

United States Educational Commission for Foreign Medical Graduates

James Hallock, President & Chief Executive Officer

jhallock@ecfmg.org 3624 MARKET STREET, 4TH FLOOR

PHILADELPHIA, PA 19104

USA 2158232101 2153868151

Page: 14

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

United States Federation of State Medical Boards of the United States

James Thompson, President & Chief Executive Officer

jthompson@fsmb.org PO BOX 619850 DALLAS, TX 75261 USA 8178684044 8178684097

United States Florida Board of Medicine

Larry McPherson, Executive Director

larry_mcpherson@doh.state.fl.us

DEPT. OF HEALTH MEDICAL QUALITY ASSURANCE 4052 BALD CYPRESS WAY, BIN#C03

TALLAHASSEE, FL 32399-3253

USA 850-245-4131 850-488-9325

United States Florida Board of Osteopathic Medicine

Pamela King, Board Director

pamela_king@doh.state.fl.us

4052 BALD CYPRESS WAY, BIN#C06

TALLAHASSEE, FL 32399-1753

USA 850-245-4161 850-487-9874

United States Georgia Composite State Board of Medical Examiners

LaSharn Hughes, Executive Director

lhughes@dch.ga.gov 2 PEACHTREE ST., N.W., 36TH FLOOR

ATLANTA, GA 30303

USA 404-656-3913 404-656-9723

United States Guam Board of Medical Examiners

MaryLou Loualhati, Acting Administrator

marylou.loualhati@dphss.guam.gov

HEALTH PROFESSIONAL LICENSING OFFICE 123 CHALAN KARETA SOUTH ROUTE 10

MANIGILAO, GU 96913-6304

GUAM 671-475-0251 671-477-4733

United States Hawaii Board of Medical Examiners

Constance Cabral, Executive Officer Ahlani Quiogue, Executive Officer

constance.l.cabral@dcca.hawaii.gov ahlani.k.quiogue@dcca.hawaii.gov

PO BOX 3469 HONOLULU, HI 96801

USA 808-586-3000 808-586-2874

United States Idaho State Board of Medicine

Nancy Kerr, Executive Director

nkerr@bom.state.id.us 1755 WESTGATE DRIVE, SUITE 140

BOISE, ID 83704 USA 208-327-7000 208-327-7005

United States Illinois Department of Financial and Professional Regulation

Daniel Bluthardt, Director

daniel.bluthardt@illinois.gov

320 W. WASHINGTON, 3RD FLOOR

SPRINGFIELD, IL 62786

USA 312-814-4500 312-814-1837

United States Iowa Board of Medical Examiners

Ann Mowery, Executive Director

ann.mowery@iowa.gov 400 SW 8TH STREET, SUITE C

DES MOINES, IA 50309-4686

USA 5152423268 5152425908

United States Kansas State Board of Healing Arts

Lawrence Buening, Executive Director

lbuening@ink.org 235 SW TOPEKA BLVD

TOPEKA, KS 66603-3068

USA 785-296-7413 785-296-0852

United States Kentucky Board of Medical Licensure

C. William Schmidt, Executive Director

Bill.Schmidt@ky.gov HURSTBOURNE OFFICE PARK 310 WHITTINGTON PKWY., SUITE 1B

LOUISVILLE, KY 40222

USA 5024297150 5024297158

United States Louisiana State Board of Medical Examiners

Robert Marier, Executive Director

rmarier@lsmbe.louisiana.gov

630 CAMP STREET NEW ORLEANS, LA 70130

USA 5045246763 5045688893

Page: 15

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

United States Maine Board of Licensure in Medicine

Randal Manning, Executive Director

randal.c.manning@maine.gov

137 STATE HOUSE STATION

AUGUSTA, ME 04333-0137

USA 2072873601 2072876590

United States Maine Board of Osteopathic Licensure

Susan Strout, Executive Secretary

susan.e.strout@maine.gov 161 CAPITOL ST., SUITE 200

AUGUSTA, ME 04333-0142

USA 2072872480 2072873015

United States Maryland Board of Physicians

C. Irving Pinder, Executive Director

ipinder@dhmh.state.md.us 4201 PATTERSON AVENUE 3RD FLR

BALTIMORE, MD 21215-0095

USA 4107644757 4103582252

United States Massachusetts Board of Registration in Medicine

Nancy Achin Audesse, Executive Director

nancy.achin.audesse@state.ma.us

560 HARRISON AVENUE, SUITE G4

BOSTON, MA 02118

USA 6176549847 6174518701

United States Medical Board of California

Barbara Johnston, Executive Director

bjohnston@mbc.ca.gov 2005 EVERGREEN ST., STE. 1200

SACRAMENTO, CA 95815

USA 9162632389 9162632387

United States Medical Licensing Board of Indiana

Michael Rinebold, Director

mrinebold@pla.in.gov 402 WEST WASHINGTON STREET, ROOM W072

INDIANAPOLIS, IN 46204

USA 317-232-2960 317-233-4236

United States Michigan Board of Medicine

Melanie Brim, Director, Bureau of Health Professions

mbbrim@michigan.gov BUREAU OF HEALTH PROFESSIONS, PO BOX 30670

LANSING, MI 48909

USA 5173350918 5172413082

United States Michigan Board of Osteopathic Medicine and Surgery

Melanie Brim, Director, Bureau of Health Professions

mbbrim@michigan.gov BUREAU OF HEALTH PROFESSIONS, PO BOX 30670

LANSING, MI 48909

USA 5173350918 5172413082

United States Minnesota Board of Medical Practice

Robert Leach, Executive Director

Rob.Leach@state.mn.us 2829 UNIVERSITY AVE SE, SUITE 500

MINNEAPOLIS, MN 55414-3246

USA 6126172149 6126172166

United States Mississippi State Board of Medical Licensure

H. Vann Craig, Executive Director

vcraig@msbml.state.ms.us

1867 CRANE RIDGE DRIVE, SUITE 200B

JACKSON, MS 39216

USA 6019873079 6019874159

United States Missouri State Board of Registration for the Healing Arts

Tina Steinman, Executive Director

tina.steinman@pr.mo.gov 3605 MISSOURI BLVD.

JEFFERSON CITY, MO 65109

USA 5737510104 5737513166

United States Montana Board of Medical Examiners

Jeannie Worsech, Executive Director

jworsech@mt.gov PO BOX 200513 HELENA, MT 59620-0513

USA 4068412364 406-841-2363

United States National Board of Medical Examiners

Donald Melnick, President

dmelnick@nbme.org 3750 MARKET STREET

PHILADELPHIA, PA 19104-3190

USA 2155909546 2155909755

United States Nebraska Board of Medicine and Surgery

Becky Wisell, Executive Director

becky.wisell@hhss.ne.gov PO BOX 94986 LINCOLN, NE 68509-4986

USA 4024712118 4024713577

Page: 16

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

United States Nevada State Board of Medical Examiners

Drennan Clark, Executive Director/Special Counsel

dacnsbme@medboard.nv.gov

PO BOX 7238 RENO, NV 89510 USA 7756882559 7756882321

United States Nevada State Board of Osteopathic Medicine

Larry Tarno, Executive Director

ljtarnodo@bom.nv.gov 2860 E FLAMINGO RD, SUITE D

LAS VEGAS, NV 89121

USA 7027322147 7027322079

United States New Hampshire State Board of Medicine

Penny Taylor, Administrator

ptaylor@nhsa.state.nh.us 2 INDUSTRIAL PARK DR, SUITE 8

CONCORD, NH 03301

USA 6032711205 6032716702

United States New Jersey State Board of Medical Examiners

William Roeder, Executive Director

roederb@dca.lps.state.nj.us

PO BOX 183 TRENTON, NJ 08625-0183

USA 6098267112 6098267117

United States New Mexico Board of Osteopathic Medical Examiners

Liz Montoya, Board Administrator

liz.montoya@state.nm.us

2550 CERRILLOS RD.

SANTA FE, NM 87505

USA 5054764695 5054764655

United States New Mexico Medical Board

Lynn Hart, Executive Director

lynns.hart@state.nm.us 2055 S. PACHECO, BLDG. 400

SANTA FE, NM 87505

USA 505-476-7220 505-476-7237

United States New York State Board for Medicine

Walter Ramos, Acting Executive Secretary

medbd@mail.nysed.gov 89 WASHINGTON AVE., WEST WING, 2ND FLOOR

ALBANY, NY 12234

USA 5184743817 5184864846

United States New York State Board for Professional Medical Conduct

Keith Servis, Director kws04@health.state.ny.us

NEW YORK STATE DEPT. OF HEALTH 433 RIVER ST., SUITE 303

TROY, NY 12180 USA 5184020855 5184020866

United States North Carolina Medical Board

R. David Henderson, Executive Director

david.henderson@ncmedboard.org

PO BOX 20007 RALEIGH, NC 27619

USA 9193261100 9193261130

United States North Dakota State Board of Medical Examiners

Duane Houdek, Executive Secretary

dhoudek.ndbme@midconetwork.com

CITY CENTER PLAZA 418 E. BROADWAY AVE., SUITE 12

BISMARCK, ND 58501-4086

USA 7013286500 7013286505

United States Oklahoma Board of Osteopathic Examiners

Deborah Bruce, Executive Director

dbruce@osboe.ok.gov 4848 N LINCOLN BLVD, SUITE 100

OKLAHOMA CITY, OK 73105-3335

USA 4055288625 4055570653

United States Oklahoma State Board of Medical Licensure and Supervision

Lyle Kelsey, Executive Director

lkelsey@okmedicalboard.org

5104 N. FRANCIS AVE., SUITE C

OKLAHOMA CITY, OK 73118

USA 4058486841 4058484999

United States Oregon Medical Board Kathleen Haley, Executive Director

kathleen.haley@state.or.us 1500 SW FIRST AVENUE, SUITE 620

PORTLAND, OR 97201

USA 9716732700 9716732670

United States Osteopathic Medical Board of California

Donald Krpan, DO, Executive Director

donald_krpan@dca.ca.gov 2720 GATEWAY OAKS DR, #350

SACRAMENTO, CA 95833-3500

USA 9162633100 9162633117

Page: 17

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

United States Pennsylvania State Board of Medicine

Tammy Radel, Administrative Officer

tradel@state.pa.us PO BOX 2649 HARRISBURG, PA 17105-2649

USA 7177872381 7177877769

United States Pennsylvania State Board of Osteopathic Medicine

Gina Bittner, Administrator

gbittner@state.pa.us PO BOX 2649 HARRISBURG, PA 17105-2649

USA 7177834858 7177877769

United States Puerto Rico Board of Medical Examiners

Ivonne Fernandez Colon, Executive Director

PO BOX 13969 SAN JUAN, PR 00908

USA 787-782-8937 787-792-4436

United States Rhode Island Board of Medical Licensure and Discipline

Bruce McIntyre, J.D., Board Counsel

bruce.mcintyre@health.ri.gov

CANNON BUILDING THREE CAPITOL HILL, ROOM 205

PROVIDENCE, RI 02908-5097

USA 4012227890 4012222158

United States South Carolina Board of Medical Examiners

Bruce F. Duke, Administrator

dukeb@llr.sc.gov DEPT. OF LABOR, LICENSING AND REGULATION 110 CENTERVIEW DR., SUITE 202

COLUMBIA SC 29210

USA 8038964500 8038964515

United States South Dakota State Board of Medical and Osteopathic Examiners

Margaret B. Hansen, PA-C, MPAS, Executive Director

Margaret.Hansen@state.sd.us

125 S. MAIN AVE. SIOUX FALLS, SD 57104

USA 605-367-7781 605-367-7786

United States State Medical Board of Ohio

Richard Whitehouse, Executive Director

Richard.Whitehouse@med.state.oh.us

30 E. BROAD ST., 3RD FLOOR

COLUMBUS, OH 43215-6127

USA 6147283673 6147285946

United States Tennessee Board of Medical Examiners

Rosemarie Otto, Executive Director

rosemarie.otto@state.tn.us HERITAGE PLACE METROCENTER 227 FRENCH LANDING, SUITE 300

NASHVILLE, TN 37243

USA 615-532-3202 6152534484

United States Tennessee Board of Osteopathic Examiners

Rosemarie Otto, Executive Director

rosemarie.otto@state.tn.us HERITAGE PLACE METROCENTER 227 FRENCH LANDING, SUITE 300

NASHVILLE, TN 37243

USA 615-532-3202 6152534484

United States Texas Medical Board Donald Patrick, M.D., J.D., Executive Director

donald.patrick@tmb.state.tx.us

333 GUADALUPE, TOWER 3, #610

AUSTIN, TX 78701 USA 5123057015 5123057051

United States Utah Osteopathic Physician and Surgeons Licensing Board

Noel Taxin, Bureau Manager

ntaxin@utah.gov HEBER M. WELLS BLDG., 160 E. 300 SOUTH, 4TH FLOOR

SALT LAKE CITY, UT 84114

USA 8015306179 8015306511

Page: 18

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

United States Utah Physicians Licensing Board

Noel Taxin, Bureau Manager

ntaxin@utah.gov HEBER M. WELLS BLDG., 160 E. 300 SOUTH, 4TH FLOOR

SALT LAKE CITY, UT 84114-6741

USA 8015306179 8015306511

United States Vermont Board of Medical Practice

Bill Wargo, J.D., Director

bwargo@vdh.state.vt.us PO BOX 70 BURLINGTON, VT 05402-0070

USA 8026574222 8026574227

United States Vermont Board of Osteopathic Physicians and Surgeons

Christopher Winters, Esq., Director

cwinters@sec.state.vt.us NATIONAL LIFE BLDG., NORTH FLOOR 2

MONTPELIER, VT 05620-3402

USA 8028282367 802-828-2465

United States Virgin Islands Board of Medical Examiners

Lydia Scott, Executive Assistant

lydia.scott@usvi-doh.org DEPT. OF HEALTH 48 SUGAR ESTATE, 2ND FLOOR

ST THOMAS, VI 00802

USA 3407768311 3407774001

United States Virginia Board of Medicine

William Harp, M.D., Executive Director

william.harp@dhp.virginia.gov

DEPT. OF HEALTH PROFESSIONS PERIMETER CENTER 9960 MARYLAND DR., SUITE 300

RICHMOND, VA 23233-1463

USA 804-662-7423 804-662-9517

United States Washington Board of Osteopathic Medicine and Surgery

Blake T. Maresh, MPA, Executive Director

blake.maresh@doh.wa.gov PO BOX 47860 TUMWATER, WA 98504-7860

USA 3602364760 360-236-4768

United States Washington Medical Quality Assurance Commission

Blake T. Maresh, MPA, Executive Director

blake.maresh@doh.wa.gov PO BOX 47865 TUMWATER, WA 98504-7865

USA 360-236-4760 360-236-4768

United States West Virginia Board of Medicine

Robert C. Knittle, Executive Director

bobknittle@wvdhhr.org 101 DEE DR, SUITE 103

CHARLESTON, WV 25311-1620

USA 3045582921 3045582084

United States West Virginia Board of Osteopathy

Cheryl Schreiber, Executive Secretary

cschreib1952@comcast.net

334 PENCO ROAD WEIRTON, WV 26062-3813

USA 3047234638 3047236723

United States Wisconsin Medical Examining Board

Thomas Ryan, Bureau Director

thomas.ryan@drl.state.wi.us

DEPT. OF REGULATION AND LICENSING 1400 E. WASHINGTON AVE., RM. 178

MADISON, WI 53703

USA 608-266-8098 608-261-7083

United States Wyoming Board of Medicine

Kevin Bohnenblust, Executive Secretary

kbohne@state.wy.us 320 WEST 25TH ST., STE. 103

CHEYENNE, WY 82002

USA 3077787053 3077782069

Page: 19

Updated July 1, 2008 INTERNATIONAL DIRECTORY OF MEDICAL REGULATORY AUTHORITIES

Uruguay Sindicato Medico del Uruguay

Uruguay Chief Executive Officer

COLONIA 1938 PISO 2

CP 11200 MONTEVIDEO

URUGUAY

Vanuatu Ministry of Health Johnson Wabaiat, Director General

HEALTH PRACTITIONERS BOARD, PRIVATE MAIL BAG 009

PORT VILA VANUATU

Venezuela Ministerio de Sanidad y Asistencia Social

Venezuela Chief Executive Officer

RECURSOS HUMANOS

CARACAS VENEZUELA

Zambia Medical Council of Zambia

Wilfred Weluzani Banda, Registrar

mcz@zamtel.zm PO BOX 32554 LUSAKA 10101 ZAMBIA 26012393178 2601239317

Zimbabwe Medical and Dental Practitioners Council of Zimbabwe

Josephine Mwakutuya, Registrar

mdpcz@ecoweb.co.zw 192 H. CHITEPO AVE., PO BOX CY2817

HARARE, MASHONACANO

ZIMBABWE 2634792192 2634792197

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Appendix 1 1. INTERNATIONAL STANDARDS AND GUIDELINE REQUIREMENTS FOR PROVIDING MEDICAL CARE IN HOST COUNTRIES INCLUDE THE FOLLOWING: 1.1. WHO INTERNATIONAL STANDARDS: AUTHORITY AND GUIDELINES. 1.1.1. Authority: “WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends…” www.who.org. 1.1.1.2 Governance: The World Health Assembly is the supreme decision-making body for WHO. It generally meets in Geneva in May each year, and is attended by delegations from all 193 Member States. Its main function is to determine the policies of the Organization. The Health Assembly appoints the Director-General, supervises the financial policies of the Organization, and reviews and approves the Proposed programme budget. It similarly considers reports of the Executive Board, which it instructs in regard to matters upon which further action, study, investigation or report may be required. The Executive Board is composed of 34 members technically qualified in the field of health. Members are elected for three-year terms. The main Board meeting, at which the agenda for the forthcoming Health Assembly is agreed upon and resolutions for forwarding to the Health Assembly are adopted, is held in January, with a second shorter meeting in May, immediately after the Health Assembly, for more administrative matters. The main functions of the Board are to give effect to the decisions and policies of the Health Assembly, to advise it and generally to facilitate its work. The Secretariat of WHO is staffed by some 8000 health and other experts and support staff on fixed-term appointments, working at headquarters, in the six regional offices, and in countries. The Organization is headed by the Director-General, who is appointed by the Health Assembly on the nomination of the Executive Board. Resolutions of the World Health Assembly and the Executive Board are contained on the following WHO website link: www.who.int/gb/ This site also contains other important Documents related to the World Health Assemblies (WHA) and Executive Board (EB) sessions in all six official languages of the WHO. 1.1.1.3. Constitution of the WHO: (See APPENDIX A)

1.1.2. General Guidelines: Two of the six current WHO agenda items specifically address the development of international standards and guidelines:

“4. Harnessing research, information and evidence: Evidence provides the foundation for setting priorities, defining strategies, and measuring results. WHO

generates authoritative health information, in consultation with leading experts, to set norms and standards, articulate evidence-based policy options and monitor the evolving global heath situation.

5. Enhancing partnerships: WHO carries out its work with the support and collaboration of many partners, including UN agencies and other international organizations, donors, civil society and the private sector. WHO uses the strategic power of evidence to encourage partners implementing programmes within countries to align their activities with best technical guidelines and practices, as well as with the priorities established by countries.”

1.1.3. WHO Practice Guidelines: Recommended Processes--Version10

March 2003: “Definition: Guidelines are systematically developed evidence-based

statements which assist providers, recipients and other stakeholders to make informed decisions about appropriate health interventions…

WHO’s mandate comes from the constitution adopted by member states and the primary audience it serves is composed of governments, more specifically, the ministries or agencies concerned with health…WHO takes a global perspective in addressing the needs of 193 member states...

For WHO guidelines, the traditional approach of reviewing and reporting evidence on efficacy and safety is certainly crucial, but not sufficient…

WHO needs to assess the implications for population health of any recommendation as well. This requires explicit recognition that resources to provide health interventions are limited. This involves considering the cost-effectiveness of alternative interventions, the opportunity costs of investing in one intervention versus another, the affordability of the interventions, and the feasibility of applying a set of recommendations in different settings.”

1.1.4. WHO-Publications www.who.org. 1.1.4.1. Key WHO Publications: The World Health Report./ International

Health Regulations./ International Travel and Health./ The International Classification of Diseases./ International Pharmacopoeia.

1.1.4.2. WHO Journals: Bulletin of the World Health Organization./ Eastern

Mediterranean Health Journal. /Pan American Journal of Public Health. /Weekly Epidemiological Record./ WHO Drug Information.

1.1.4.3. WHO Regional Publications: African Region./ Region of the

Americas–PAHO./ South-East Asia Region./ European Region./ Eastern Mediterranean Region./ Western Pacific Region.

1.1.5. WHO-Programs and Projects www.who.org. Provides links to

numerous WHO programmes, partnerships and other projects listed in alphabetical order. Also includes the six WHO regional offices and their practice guidelines: Regional Office for Africa www.afro.who.int Regional Office for

Europe www.euro.who.int Regional Office for South-East Asia www.searo.who.int Regional Office for the Americas/Pan American Health Organiz (PAHO) www.paho.org Regional Office for the Eastern Mediterranean www.emro.who.int Regional Office for the Western Pacific www.wpro.who.int

1.1.6. WHO-Health Topics www.who.org. Contains links to WHO projects,

initiatives, activities, information products, and contacts, organized by health and development topics.

1.1.7. WHO-Countries www.who.org. Members of WHO are grouped

according to regional distribution (193 Member States). Contains a wealth of country-specific information necessary for STMM priority planning and operations.

1.1.8. WHO-Data and Statistics www.who.org. Enables STMM to provide

services in accordance with host country’s actual needs. Includes Databases such as: WHOSIS, the WHO Statistical Information System, is an interactive database bringing together core health statistics for the 193 WHO Member States. It comprises more than 70 indicators, which can be accessed by way of a quick search, by major categories, or through user-defined tables. The data can be further filtered, tabulated, charted and downloaded. 1.2. INTERNATIONAL PROFESSIONAL STANDARDS AND GUIDELINES: As noted in 1.1.2., the WHO carries out its work with the support and collaboration of many partners. The following international organizations represent the professions and services most often provided by STMM. These organizations often work in partnership with the WHO as well as their corresponding nationally based (including U.S.) organizations to establish international standards and guidelines which may be found on their respective websites. The international professional organizations most relevant to services provided by medical missions include the following: 1.2.1 The World Health Professions Alliance (WHPA) brings together the International Council of Nurses, the International Pharmaceutical Federation, the World Dental Federation and the World Medical Association and speaks on behalf of more than 25 million health care professionals worldwide. The WHPA aims to facilitate collaboration between key health professionals and major international stakeholders such as governments, policy makers and the World Health Organization to advocate and work for the highest possible standards of health care for all people. www.whpa.org 1.2.2 The International Council of Nurses (ICN) is a federation of national nurses' associations in 129 countries, representing the 13 million nurses working worldwide. Founded in 1899, ICN works to ensure quality nursing care for all, sound health policies globally, the advancement of nursing knowledge, and the

presence worldwide of a respected nursing profession and a competent and satisfied nursing workforce. www.icn.ch 1.2.3 The International Pharmaceutical Federation (FIP) is the global federation of 114 national organizations of pharmacists and pharmaceutical scientists. Pharmacists are health professionals dedicated to improving the access to and value of appropriate medicine use. www.fip.org 1.2.4 The FDI World Dental Federation (FDI) is the authoritative, worldwide voice of dentistry with more than 150 member associations in 134 countries around the world, representing more than 900,000 dentists internationally. Its main roles are to bring together the world of dentistry; to represent the dental profession of the world and to stimulate and facilitate the exchange of information across all borders with the aim of optimal oral health for all people. www.fdiworldental.org 1.2.5 The World Medical Association (WMA) is the global federation of national medical associations, representing millions of physicians worldwide. Its membership is made up of national medical associations from around the world, directly and indirectly representing the views of more than seven million physicians. The WMA was founded in 1946 and endeavours to achieve the highest possible standards of medical science, education, ethics and health care for all people. In order to achieve this ideal, the WMA is active in the fields of policy development and the setting of professional standards. www.wma.net 1.3 OTHER WHO COLLABORATING PARTNERS: As noted in 1.1.2 the WHO also frequently collaborates with organizations such as UNICEF, UNESCO, USAID, The Centers for Disease Control and Prevention (CDC) and other partners; and evidence-based and best practice guidelines for patients of developing countries may be found on their respective websites. WHO funded studies on evidence-based guidelines for developing countries are also published in professional medical journals such as The Lancet. The organizations most relevant to care provided by medical missions include the following:

1.3.1 United Nations Children's Fund (UNICEF) UNICEF is a member of the United Nations family of organizations, mandated by the United Nations General Assembly to work to protect children's rights, help meet their basic needs and expand their opportunities to reach their full potential. UNICEF works in 191 countries through country programmes and national committees focusing on five major areas: 1.Survival and development; 2. Basic education and gender equality; 3. HIV and AIDS; 4.Protection from violence, exploitation and abuse; 5. Policy advocacy and partnerships for children's rights. Information available: The web site provides access to reports and databases which are organized by themes. Those primarily related to health include children's rights; debt, poverty and development; HIV/AIDS; immunization; childhood development; nutrition;

water, environment and sanitation. Audience: Inter/national decision makers, policy makers, health professionals and general public.

1.3.2 The United Nations Educational, Scientific and Cultural

Organization (UNESCO) UNESCO promotes international co-operation among its 193 Member States … in the fields of education, science, culture and communication. Numerous health education guidelines are available through programs such as:

FRESH (Focusing Resources on School Health): Four core components: 1.School health policies 2. Water, sanitation and the environment 3.Skills-based health education 4.School-based health services. Three supporting strategies: 1.Partnerships between education and health 2. Community partnerships 3.Pupil awareness and participation

1.3.3 The United States Agency for International Development (USAID)

www.usaid.gov WHO collaborates with USAID in a number of areas. USAID's history goes back to the Marshall Plan reconstruction of Europe after World War Two. In 1961, the Foreign Assistance Act was signed into law and USAID was created by executive order. Since that time, USAID has been the principal U.S. agency to extend assistance to countries recovering from disaster, trying to escape poverty, and engaging in democratic reforms. USAID is an independent federal government agency that receives overall foreign policy guidance from the Secretary of State. Our Work supports long-term and equitable economic growth and advances U.S. foreign policy objectives by supporting: economic growth, agriculture and trade; global health; and, democracy, conflict prevention and humanitarian assistance. With headquarters in Washington, D.C., USAID's strength is its field offices around the world. We work in close partnership with private voluntary organizations, indigenous organizations, universities, American businesses, international agencies, other governments, and other U.S. government agencies. USAID has working relationships with more than 3,500 American companies and over 300 U.S.-based private voluntary organizations. International health related programs include: Environmental Health, Family Planning, Health Systems, HIV/AIDS, Infectious Diseases, Maternal and Child health, and Nutrition.

1.3.4 The Centers for Disease Control and Prevention (CDC) One of the

CDC’s 6 strategic imperatives is “Globalization: Extend CDC’s knowledge and tools to promote health protection around the world. CDC guidelines concerning care in the following areas are therefore directly applicable to care in developing countries. Health Protection Goals: Criteria and Objectives:

71. Prevent and control infectious diseases and their consequences globally. 72. Prevent infant and child morbidity and mortality globally. 73. Prevent non-communicable diseases and their consequences globally. 74. Prevent injuries and their consequences globally. 75. Promote safe, healthy, and accessible physical environments globally.

76. Prepare for, prevent, detect, respond to, and contain health threats globally.

77. Support achievement of international and national goals for the acceleration of control, and the eradication and elimination of diseases.

78. Develop sustainable public health capacity among partner organizations and governments globally.

79. Prevent maternal morbidity and mortality globally. 80. Improve response to natural and manmade disasters, including complex humanitarian emergencies globally”

1.3.5. Joint Commission and Joint Commission International (JCI)

Collaborating Center on Patient Safety Solutions During 2005, the Joint Commission and JCI were officially designated as a WHO Collaborating Center for Patient Safety Solutions…The Collaborating Centre has commenced building an international network to identify, evaluate, adapt and disseminate patient safety solutions worldwide…The nine inaugural patient safety solutions available for use by WHO Member States in May 2007 are: 1. Look-Alike, Sound-Alike Medication Names. 2. Patient Identification. 3.Communication During Patient Hand-Overs. 4. Performance of Correct Procedure at Correct Body Site. 5. Control of Concentrated Electrolyte Solutions. 6. Assuring Medication Accuracy at Transitions in Care. 7. Avoiding Catheter and Tubing Mis-Connections. 8. Single Use of Injection Devices. 9. Improved Hand Hygiene to Prevent Health Care-Associated Infections.

Note re Joint Commission International (JCI) and Additional

International Standards: JCI has recently (August, 2005) published additional international standards for ambulatory care. JCI is not yet listed as an official WHO Collaborating Center for these standards (which are not available online and hard copies must be purchased from JCI). However government agencies may also increasingly utilize the “Joint Commission International Accreditation Standards for Ambulatory Care” and Medical Missions Organizations may also find them useful. “JCI is a client-focused, results oriented, premier source of knowledge for health care organizations, government agencies, and third party payers throughout the world. It provides educational services, consulting services and publications to assist in improving the quality, safety, and efficiency of health care services. JCI offers international and country specific accreditation programs and other assessment tools to provide objective evaluations of the quality and safety of health care organizations.

“Joint Commissions International Accreditation Standards for

Ambulatory Care 2005” JCI has developed a set of international accreditation standards for those offering care in ambulatory settings. This first edition presents both patient-centered and organizational management core and not-core standards, along with the applicable intent statements and measurable elements for each standard. Patient-focused standards address five key functional areas: Access to Care and Continuity of Care; Patient and Family

Rights; Assessment of Patients; and Patient and Family Education. An additional six areas center on standards relating to management of the organization: Quality Improvement and Patient Safety; Prevention and Control of Infections; Governance, Leadership, and Direction; Facility Management and Safety; Staff Qualifications and Education; and Management of Information. Based on accreditation standards developed by an international task force, JCI Accreditation Standards for Ambulatory Care has been created to meet the needs of organizations pursuing either performance improvement or accreditation.”

1.3.6 Additional Collaborating Centers: These are institutions such as

research institutes, parts of universities or academies, which are designated by the Director-General to carry out activities in support of the Organization's programmes. Currently there are over 900 WHO collaborating centres in 99 Member States working with WHO on areas such as nursing, occupational health, communicable diseases, nutrition, mental health, chronic diseases and health technologies.

Note: Evidence-based Guidelines created for care of patients in

developed countries. These can be somewhat similar to those created for patients of developing countries. For example, evidence-based guidelines for most conditions of patients of developed countries emphasize first and foremost patient education and counseling. In this they are similar to guidelines created for patients of developing countries. However, as noted in 1.1.3., recommendations concerning drug and other therapy often differ significantly from those created for developing countries. 1.4 GUIDELINES FOR CARE OF PATIENTS EVALUATED IN THE STMM SETTING: Pending