ACGME program accreditation is the Accreditation Council for Graduate Medical Education's review of a residency or fellowship against the Common Program Requirements and the Program Requirements for its specialty. This page is for hospitals, health systems and Sponsoring Institutions starting a new residency or fellowship, and for program directors keeping an existing program aligned. Integral Healthcare Solutions (IHS) organizes the program policies and application evidence for ACGME accreditation; your program director and faculty own the education.
Last reviewed: October 2026.
What is ACGME program accreditation?
The governing text for a residency is the ACGME Common Program Requirements (Residency), in the edition marked "Frequently asked questions (FAQs) incorporated into the Requirements July 1, 2026; effective July 1, 2026," with an "ACGME-approved interim revision February 9, 2026; effective immediately" that suspended enforcement of several requirements pending a major revision (ACGME, CPR Residency 2026). ACGME publishes companion Common Program Requirements for Fellowship, One-Year Fellowship and Post-Doctoral programs, each listed as "Program Requirements and FAQs Effective 7/1/2026," along with a "List of Suspended Common Program Requirements, effective February 2026" (ACGME, Common Program Requirements). Each specialty and subspecialty also has its own Program Requirements, which a program works from alongside the common set.
Program accreditation sits on top of institutional accreditation. ACGME states: "For an institution to apply for accreditation of a program, it must be accredited by the ACGME as a Sponsoring Institution" (ACGME, Program Application Information). The Common Program Requirements define that institution as "the organization or entity that assumes the ultimate financial and academic responsibility for a program of graduate medical education, consistent with the ACGME Institutional Requirements" (ACGME, CPR Residency 2026, Section 1).
The application has a fixed structure. In ACGME's words: "There are three parts to the application: 1) the common application (housed in the ACGME's Accreditation Data System (ADS)); 2) the specialty-specific application (a Word document the program must complete and upload into ADS); and 3) attachment documents (policies and sample evaluations that are uploaded into ADS)" (ACGME, Program Application Information).
Who needs it and what triggers it
The buyers are Sponsoring Institutions and program directors establishing or maintaining specialty training. The triggers come from ACGME's own process:
- A decision to start a program. "An ACGME-accredited Sponsoring Institution interested in seeking ACGME accreditation for a program must initiate, prepare, and submit a program application" (ACGME).
- A target start date. ACGME states it "typically takes six to 12 months to gather the necessary information and complete the program application," and that after submission "it may take four to 12 months for the relevant Review Committee to make an accreditation decision" (ACGME).
- A required site visit. "All new specialty (residency) programs, and some subspecialty (fellowship) programs, must undergo an accreditation site visit prior to review by the applicable Review Committee," and "It can take approximately three to six months to schedule the visit" (ACGME).
- The July 1, 2026 requirements and the February 9, 2026 interim revision, which change what a program is held to and which requirements are currently enforced (ACGME).
- A new institution in a rural or underserved area. ACGME runs a "Concurrent Application Pilot" for "concurrent submission of new institutional and program applications for up to 12 new Sponsoring Institutions," running "from July 1, 2025 to June 30, 2027" (ACGME). The ACGME page we reviewed caps the pilot at 12 institutions and does not say whether slots remain; confirm availability before planning around it.
How IHS helps
Your institution decides whether to start the program, and your DIO and program director own the application. IHS works through it with them:
- A gap assessment of the planned program against the Common Program Requirements and the Program Requirements for your specialty, using questionnaires on faculty, rotations, supervision and evaluation.
- Document and evidence mapping: a crosswalk from each requirement to the record that shows the program meets it, with an owner for each item.
- Drafting: supervision, evaluation and other program policies, written for your program director to review and approve. These become the attachment documents ACGME describes as "policies and sample evaluations that are uploaded into ADS."
- Application production support: organizing the content your program director enters in the common application and the specialty-specific Word document.
- A mock review of the full application before your DIO submits it, since ACGME states "Once the DIO submits the program application in ADS, it cannot be altered or amended" (ACGME).
What you supply: the current Common and specialty-specific Program Requirements, faculty and rotation data, participating site information, and the physician educators who own curriculum, supervision and evaluation.
The limit: medical education content and supervision are physician decisions. IHS has not previously done graduate medical education work; what we bring is a gap-assessment, crosswalk and mock-review process used across healthcare accreditation. IHS does not enter or submit anything in ADS and does not correspond with ACGME. Your DIO and program director do.
What to have ready
This is the list we would ask for first, each item tied to what ACGME publishes.
- Confirmation that your institution is an ACGME-accredited Sponsoring Institution, or that it is in the Concurrent Application Pilot (ACGME, Program Application Information).
- The Common Program Requirements for your program type, effective July 1, 2026 (ACGME, Common Program Requirements).
- ACGME's "List of Suspended Common Program Requirements, effective February 2026," read against your plan (ACGME).
- The Program Requirements and FAQs for your specialty or subspecialty.
- Your DIO's access to ADS, since "The DIO of the ACGME-accredited Sponsoring Institution must initiate the program application in ADS" (ACGME).
- The specialty-specific application, the Word document "the program must complete and upload into ADS" (ACGME).
- Draft policies and sample evaluations for the attachment documents (ACGME).
- A list of participating sites and a program letter of agreement for each one providing a required assignment, per CPR Residency 1.3 (ACGME, CPR Residency 2026).
- Faculty and rotation data that the program director and faculty have confirmed.
- A timeline that allows for site visit scheduling of "approximately three to six months" where a visit is required (ACGME).
If most of this is in place, the introductory call is the place to start.
How it compares
| Route | What the sources say |
|---|---|
| Sponsoring Institution accreditation, then program accreditation | The standard sequence: a program application requires an ACGME-accredited Sponsoring Institution (ACGME). |
| Concurrent Application Pilot | Concurrent institutional and program applications for up to 12 new Sponsoring Institutions, "particularly those serving rural and/or underserved areas," July 1, 2025 to June 30, 2027 (ACGME). |
| ACGME Non-Standard Training (NST) Recognition | "NST programs provide clinical training for foreign national physicians in advanced subspecialty programs for which there is no ACGME accreditation or American Board of Medical Specialties member board certification," and "NST Recognition will be conferred upon Sponsoring Institutions only" (ACGME, NST Recognition). |
Each route has its own eligibility and purpose. This page does not recommend one over another.
What it costs
ACGME publishes its fees and states "The fees for 2026 remain the same as for 2025" (ACGME, Fees).
| Fee | ACGME's published amount |
|---|---|
| Application for Initial Accreditation (or re-accreditation after any Withdrawal status) | $7,380 |
| Annual accreditation fee per program, five or fewer residents | $5,125 |
| Annual accreditation fee per program, more than five residents | $6,200 |
| Sponsoring Institution annual accreditation fee | 2.5% of total program fees |
| Cancellation of a previously scheduled site visit | $3,200 |
Verify current fees with ACGME.
IHS scopes each engagement after a free introductory call.
What this is not
- IHS is not an accrediting body and does not grant, influence or predict a Review Committee decision.
- IHS does not submit the application, enter data in ADS or correspond with ACGME on your behalf. IHS drafts; your DIO and program director submit.
- This page is not legal or medical education advice. Curriculum, supervision and evaluation belong to your physician educators.
Frequently asked questions
How do we start a new ACGME-accredited residency program?
The Sponsoring Institution initiates, prepares and submits a program application, and the DIO starts it in ADS. ACGME says gathering the information and completing the application typically takes six to 12 months. The application has three parts: the common application in ADS, the specialty-specific application, and attachment documents such as policies and sample evaluations.
Does our hospital need to be an ACGME Sponsoring Institution before applying for a program?
Yes, under the standard process. ACGME states that for an institution to apply for accreditation of a program, it must be accredited by the ACGME as a Sponsoring Institution. The exception is the Concurrent Application Pilot for up to 12 new Sponsoring Institutions.
How long does it take to get a new residency or fellowship ACGME accredited?
ACGME says completing the application typically takes six to 12 months. After submission, the Review Committee decision may take four to 12 months. Where a site visit is required, ACGME says scheduling it can take approximately three to six months.
What documents and policies go into an ACGME program application in ADS?
ACGME lists the common application in ADS, the specialty-specific application as a Word document uploaded into ADS, and attachment documents, which are policies and sample evaluations uploaded into ADS. Once the DIO submits the application, ACGME says it cannot be altered or amended.
How much does ACGME accreditation cost per program and for the Sponsoring Institution?
ACGME lists a $7,380 application fee for programs seeking Initial Accreditation. The annual fee is $5,125 for programs with five or fewer residents and $6,200 for programs with more than five. Sponsoring Institutions pay an annual fee of 2.5% of total program fees. ACGME says 2026 fees are the same as 2025; verify current fees with ACGME.
What changed in the Common Program Requirements effective July 1, 2026, and which requirements are suspended?
The July 1, 2026 edition incorporates ACGME's FAQs into the Requirements. An ACGME-approved interim revision dated February 9, 2026 suspended enforcement of several requirements pending a major revision. ACGME posts a List of Suspended Common Program Requirements, effective February 2026, which is the document to check.
Does a new fellowship program need a site visit?
Some do. ACGME states that all new specialty (residency) programs, and some subspecialty (fellowship) programs, must undergo an accreditation site visit before Review Committee review. The specialty's own requirements and ACGME's application information govern which fellowships are included.
What is a program letter of agreement and which participating sites need one?
CPR Residency 1.3 requires a program letter of agreement between the program and each participating site that governs the relationship with a site providing a required assignment. The February 9, 2026 interim revision lists 1.3.a among the requirements whose enforcement is suspended, so check the current suspended list.
What happens if the Review Committee withholds accreditation?
ACGME states that if the program is not in substantial compliance with the Program Requirements, the Review Committee will confer Accreditation Withheld. The program then needs to submit a new application to keep pursuing accreditation. Substantial compliance results in Initial Accreditation.
Can a rural hospital apply for institutional and program accreditation at the same time?
ACGME runs a Concurrent Application Pilot for concurrent submission of new institutional and program applications for up to 12 new Sponsoring Institutions, particularly those serving rural or underserved areas. The pilot runs from July 1, 2025 to June 30, 2027. The ACGME page we reviewed caps the pilot at 12 institutions and does not say whether slots remain; confirm availability before planning around it.