Abstract
BACKGROUND: Engaged graduate medical trainees are essential for an effective healthcare system influencing retention, job satisfaction, and patient outcomes, necessitating the need for a supportive educational environment. ACGME has expanded international accreditation efforts, but diverse programs might risk ACGME-I standard implementation. This study explores the impact of ACGME-I accreditation on educational environments and engagement among trainees and faculty, as well as strategies to enhance that engagement. METHODS: This study utilized a mixed-methods design to analyze data from 62% (434) of the trainees and 68%, (389) of the faculty in ACGME-I accredited and non-accredited programs at Hamad Medical Corporation in Qatar. Quantitative data were collected using validated instruments: the Postgraduate Hospital Educational Environment Measure (PHEEM) and the Utrecht Work Engagement Scale (UWES-9), which assessed aspects of autonomy, teaching quality, social support, vigor, dedication, and absorption. Qualitative insights were obtained from three discussion rounds at two World Café events, with thematic analysis identifying key perspectives on enhancing work engagement. RESULTS: ACGME-I accreditation was significantly linked to increased autonomy scores (p < 0.001) and teaching scores (p = 0.008) as well as overall PHEEM scores (p = 0.004). Social support also significantly improved (p = 0.049). Trainees in accredited programs reported higher work engagement across the UWES-9 subscales, particularly in absorption (p = 0.026) and dedication scores (p = 0.012). Faculty work engagement was closely linked to holding official titles like program director or core faculty, enhancing their vigor, dedication, and satisfaction with teaching. Qualitative themes highlighted mentorship, structured career development, and collaboration as key to fostering engagement. Faculty in leadership roles reported increased engagement, emphasizing the need for clear responsibilities in training programs. CONCLUSION: ACGME-I accreditation is positively associated with an improved trainees' educational environment and work engagement. Faculty engagement is linked to having official program titles, highlighting the importance of structured roles in trainees' education. These findings support the continued expansion of accreditation as a means to enhance both engagement and the educational environment.