Authors:  Alyson Wohlleber & Kauser Siddiqui

The ACGME updates the specialty requirements regularly; we need to ensure that programs are compliant with the most updated requirements. The new Internal Medicine requirements will take effect July 1, 2022. It is imperative to know the upcoming Internal Medicine requirement changes and to begin any necessary program transition planning to achieve the new requirements.

The full requirements are here; We will highlight the most significant changes for Internal Medicine:

Core Faculty
Previous Requirements 2022 Requirements
Approved Resident Positions Minimum Number of Core Faculty Members
<60 4
60-75 5
76-90 6
91-105 7
106-120 8
121-135 9
136-150 10
151-165 11
166-180 12
>180 13
Approved Resident Positions Minimum Number of Core Faculty Members
<30 3
30-39 4
40-49 5
50-59 6
60-69 7
70-79 8
80-89 9
90-99 10
100-109 11
110-119 12
120-129 13
130-139 14
140-149 15
150-159 16
160-169 17
170-179 18
180-189 19
190-199 20
200-209 21


Supervising faculty
Previous Requirements 2022 Requirements
  • Faculty with credentials appropriate to the care setting must supervise all clinical experiences
  • Inpatient Medicine: it is appropriate for family medicine physicians with the American Board of Family Medicine’s Designation of Focused Practice in Hospital Medicine to teach and supervise internal medicine residents
  • Inpatient Critical Care: it is appropriate for a non-internist approved by the program director and medical intensive care unit director to teach and supervise internal medicine residents
  • Outpatient Experiences: it is appropriate for a non-internist with documented expertise (e.g., a family medicine physician with extensive outpatient/ambulatory experience or procedural proficiency) to teach and supervise internal medicine residents


Previous Requirements 2022 Requirements
  • The Internal Medicine residency curriculum must include each internal medicine subspecialties and emergency medicine and neurology
  • The Internal Medicine residency curriculum must include internal medicine subspecialties and geriatric medicine, hospice and palliative medicine, addiction medicine, emergency medicine, and neurology


Curriculum and Resident Experiences
Previous Requirements 2022 Requirements
  • At least 1/3 of the residency training must occur in the ambulatory setting, and at least 1/3 must occur in the inpatient setting
  • The educational progress must include at least 30 months of clinical experiences, a longitudinal team-based continuity experience for the duration of the program, at least six months of individualized educational experiences relevant to their future practice, or further skill/competency development in foundational areas
  • The Internal Medicine foundational experience must include at least ten months in outpatient settings, at least ten months in inpatient and critical care settings, and critical care experiences must be a minimum of 2 months and a maximum of 6 months and cannot only be in PGY-1


Previous Requirements 2022 Requirements
  • The didactic program may include lectures, web-based content, podcasts, etc. The program must afford each resident an opportunity to review all of the core curriculum topics
  • Residents must participate in various teaching conferences or didactic sessions, including those dedicated to quality improvement. Programs must provide access to all conference content for residents who are unavailable to attend


Resident Appointment
Previous Requirements 2022 Requirements
  • The program must have a minimum of 15 residents continuously enrolled and participating in the training program
  • The program should offer a minimum of 9 positions


Previous Requirements 2022 Requirements
  • On inpatient rotations, second- or third-year internal medicine residents or other appropriate supervisory physicians (e.g., subspecialty residents or attendings) with documented experience relevant to the acuity, complexity, and severity of patient illness must be available at all times on-site to supervise first-year residents
  • On inpatient rotations, a supervising physician must be immediately available to be physically present for PGY-1 residents who have demonstrated the skills sufficient to progress to indirect supervision


If you have any questions regarding the changes to the Internal Medicine requirements, please get in touch with Germane Solutions.

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