Globalisation of medicine and medical education, as manifested in the migration rate of medical doctors and growth of cross-border education providers, has inflicted a wave of quality assurance efforts, and underlined the need for definition of standards and for effective and transparent accreditation systems. Important in this development was the World Federation for Medical Education (WFME) Global Standards programme, initiated in 1997 and widely endorsed. The Trilogy of WFME Global Standards are now being used in all six WHO/WFME regions as a basis for quality improvement of medical education throughout its continuum and as a template for accreditation criteria. In 2005, the WHO/WFME partnership published Guidelines for accreditation of basic medical education recommending proper accreditation systems that are effective, independent, transparent and based on medical education-specific criteria. Promotion of national accreditation systems will have a pivotal influence on future international appraisal of medical education. Information about accreditation status - the agencies involved and the criteria and procedure used - will be an essential component of the new Register of Academic Health Professions Educational Institutions (Avicenna Directories), established in 2007 according to an agreement between the WHO, the University of Copenhagen and WFME. From the beginning, the Directories cover medical schools giving comprehensive information about the schools and educational conditions such as identifying information, structure and affiliations, resources and facilities, quality assurance mechanisms, student admission, duration and structure of the academic programme as well as teaching and learning methods, and will be a foundation for international meta-recognition of educational institutions and their programmes.