ACGME Common Program Requirements: Four Proposed Changes GME Leaders Should Know

The ACGME has released proposed major revisions to the Common Program Requirements for Residency, representing a significant update to the standards that shape residency education and program operations. Among the most notable aspects of the proposal is an approximately 43% reduction in the number of Common Program Requirements, reflecting a broader effort to streamline the requirements while maintaining expectations for high-quality physician education.

The proposed requirements are currently open for review and comment through October 22, 2026, giving GME leaders and other members of the academic medicine community an opportunity to evaluate the changes and provide feedback before they are finalized. While the revisions span multiple areas of residency education, four proposed changes warrant particular attention as programs consider their potential operational and educational impact.

Expanding Support for Pregnant Residents

One notable addition is proposed Requirement 1.8.g., which would require programs to establish a program-specific policy addressing the needs of pregnant residents, including appropriate duty and schedule modifications and management of unique occupational exposures.

The proposed requirement builds upon existing efforts to support residents throughout training, including requirements related to lactation accommodations and paid medical, parental, and caregiver leave. For programs, however, the change could introduce a new policy development responsibility.

If finalized as proposed, programs should be prepared to establish a formal policy and consider how accommodations would be implemented across scheduling, rotations, clinical responsibilities, and occupational exposures. Sponsoring Institutions may also want to consider how program-specific policies align with broader institutional policies and practices to support consistency across programs. Beginning conversations among GME leadership, program leadership, human resources, and other appropriate stakeholders can help organizations understand how existing processes may need to evolve.

Reconsidering Program Director Experience Requirements

The proposed revisions would also modify requirements related to Program Director qualifications. Current language requiring at least three years of educational and/or administrative experience would be removed. Instead, under the proposed requirements, Program Directors who have less than three years of experience must have a mentoring plan that specifies the assigned mentor, meeting frequency, and duration of the mentorship period. This plan must be developed, documented, and overseen by the DIO or GMEC.

This change could be particularly significant for organizations establishing new GME programs. Hospitals entering GME for the first time may have physicians who are qualified and interested in program leadership but have not yet accumulated three years of GME experience.

Removing the required three-year threshold could provide greater flexibility when identifying Program Director candidates while maintaining an expectation that leaders possess appropriate experience and receive support where needed. For organizations developing new programs, this may broaden the pool of physicians who can be considered for leadership roles and reduce a potential barrier during program development, especially for more rural or underserved locations.

However, programs should keep in mind that specialty-specific requirements may continue to establish additional experience or qualification expectations for Program Directors. Organizations considering new Program Director candidates should review both the Common Program Requirements and applicable specialty-specific requirements before making hiring or leadership decisions based on the proposed flexibility.

Recognizing a Change in Program Coordinator Terminology

The proposed revisions would also substitute “Program Coordinator” for “GME Administrative Professional” as the terminology used to describe the individual(s) responsible for supporting the Program Director in the administration of a residency program. While the terminology itself represents a notable change, programs should review the proposed language to understand how the role is defined and consider how it aligns with their existing GME team structures and position titles.

As the GME community reviews the proposed requirements, this terminology change is another area where Program Coordinators and other GME professionals may wish to provide feedback based on their experience and perspective.

Shifting the Focus of the ACGME Competencies

Proposed revisions to Requirements 4.3 through 4.9 would make an important change in how the six ACGME Competencies are framed. Rather than stating that residents “must demonstrate” specified abilities, the proposed language places greater emphasis on the program’s responsibility to provide instruction and assess residents' understanding and abilities.

At the same time, detailed lists of what residents must demonstrate under each competency have been removed from the proposed requirements. Instead, supplementary ACGME guidance identifies components of each competency that can help programs determine what should be taught and evaluated.

Together, these changes may signal greater emphasis on how programs integrate the competencies into clinical and educational experiences and how resident development is assessed over time. Programs may want to examine where each competency is currently taught, how learning is evaluated, and whether their curricula and assessment processes provide sufficient evidence of ongoing instruction and evaluation.

Strengthening Oversight of Clinical and Educational Work Hours

The proposed revisions also include important changes to clinical and educational work-hour requirements. The 80-hour weekly maximum would remain, but the proposed language specifies that the limit must be averaged over a maximum of four weeks and within the span of a single clinical assignment or rotation.

For programs, this could require closer attention to how work hours are monitored across individual rotations rather than relying solely on broader four-week averaging. Programs may need to evaluate scheduling practices and monitoring processes to ensure each clinical assignment remains within the proposed parameters.

The revisions would also remove the provision allowing Review Committees to grant rotation-specific exceptions of up to 10%, or a maximum of 88 clinical and educational work hours, based on a sound educational rationale. Programs currently relying on these exceptions would therefore need to evaluate scheduling and coverage models if the revisions are finalized as proposed.

Taken together, these changes reinforce continued attention to resident well-being, patient safety, and the learning environment while potentially creating operational implications for programs responsible for scheduling and work-hour oversight.

Preparing for Potential Change

Although these requirements have not yet been finalized, GME leaders do not need to wait to begin evaluating their potential impact. Reviewing the proposed language now can help organizations identify policies, curricula, leadership structures, scheduling practices, and administrative processes that could require modification if the changes move forward.

This review should extend beyond the GME office. Depending on the proposed requirement, Program Directors, DIOs, coordinators, faculty, human resources, occupational health, clinical operations, and other institutional leaders may offer important perspectives on how the revisions could affect day-to-day operations.

Most importantly, the current review period gives the GME community an opportunity to contribute directly to the process. The ACGME states that proposed revisions are posted for community review and comment before requirements are finalized.

Make Your Voice Part of the Conversation

The proposed Common Program Requirements will influence how residency programs structure education, leadership, resident support, and clinical operations. GME professionals who work with these requirements every day bring an important practical perspective to understanding how proposed changes may function within real-world training environments.

GME leaders, Program Directors, coordinators, faculty members, residents, and other stakeholders are encouraged to review the proposed Common Program Requirements and submit feedback to the ACGME by October 22, 2026.

Review the proposed requirements and submit comments here.

At Germane Solutions, we continue to monitor evolving accreditation requirements and help Sponsoring Institutions and programs understand how regulatory changes may affect GME strategy and operations. Contact us to learn how our accreditation experts can help your organization prepare for evolving requirements and strengthen its approach to ongoing compliance