Kati Reddy, Mashal Unar, Hira Unar, Sateesh B Arja Medical Education Unit, Avalon University School of Medicine, Willemstad, Netherlands AntillesCorrespondence: Kati Reddy, Email [email protected]: According to the World Directory of Medical Schools, the Caribbean region hosts around 100 medical schools, leading to variations in education programs and student performance. Accreditation is crucial for maintaining educational standards. The proliferation of accrediting agencies recognized by the World Federation of Medical Education (WFME) has led to cross-border accreditation practices and market-driven competition. Concerns about the integrity of accreditation processes in the Caribbean region have raised questions about educational quality and global implications. Establishing a framework and scrutiny of the WFME regarding cross-border accreditation is essential to preserve educational standards and prevent global implications. ECFMG’s intervention is urgently needed to investigate and restore the integrity of medical school accreditation in the Caribbean, setting a precedent for global accreditation standards.Keywords: medical education, accreditation standards, educational quality, cross-border accreditation, accreditation challenge