Updated Feb. 11, 2026
The Accreditation Council for Graduate Medical Education (ACGME) released the proposed emergency medicine program requirements and rationale for the updates in February 2025.
Key proposed changes include:
- Length of training – recommended at 48 months for all programs
- Curricular building blocks
- Rotations
- Increased EM time overall
- Added requirement for low-resource ED, low acuity setting
- Increased Critical Care and Pediatric time
- Added time for obstetrics, toxicology and addiction medicine, administration and EMS
- Structured Experiences
- Acute Psychiatric Emergencies
- Airway Management
- Non-Laboratory Diagnostics (Ultrasound Procedural/Diagnostic and EKG/Radiology Interpretation
- Observation Medicine
- Ophthalmology
- Perform Sensitive Exams
- Primary Decision Maker in Multidisciplinary Teams
- Telemedicine
- Transfers and Transitions of CareCurricular building blocks.
- Rotations
- Resource requirements (volume of patients, critical care patients and faculty)
- Procedural requirements
- Scholarly requirements
- Didactics
The ACGME developed these proposed program requirements based on data collected and feedback from stakeholders including program directors, residents, and the larger EM community. These requirements are designed to equip trainees with the knowledge and skills to practice for the next 25 years.
Once finalized, the requirements would be effective no earlier than July of 2027. Residents who start in July of 2026 would complete their training under the old requirements.
ACEP Makes Sure Your Voice is Heard
ACEP has participated in the process from the start to make sure your voice is heard. ACEP President Alison Haddock, MD, FACEP held two town halls in March and April 2025 to gather your input to inform ACEP's response.
ACEP also encouraged everyone to submit their comments directly to the ACGME so they can hear from individuals. The comment period closed May 1.
On February 10, 2026, the ACGME notified the EM community that it had decided to defer a decision on the proposed Requirements, including consideration of the move to a four-year program format. They are identifying a process to collect additional information and continue this review. A timeline has not yet been established, but as details are finalized, it will be shared.
ACEP Related Resources
ACEP Frontline Podcast about the proposed changes
CORD Resources
CORD’s response letter to the proposed ACGME changes (March 20)
Slides from the ACGME RRC update at CORD AA25
