ACGME President and Chief Executive Officer Debra F. Weinstein, MD opened her 2026 President’s Plenary reflecting that, as the health care and education communities navigate “unrelenting challenges,” the work of graduate medical education (GME) has never been more important.” Against that backdrop, her talk focused on the ways in which the community can shape the future of GME together, to improve health – and lives – across society.
Recapping the ACGME’s Progress in Addressing Initial Priorities
Dr. Weinstein shared concrete examples of work accomplished over the past year relating to challenges that she articulated in her President’s Plenary at the 2025 Annual Educational Conference, as she was joining the ACGME:
- Burden reduction. Examples included reduction in reporting requirements, process simplification, and elimination or suspension of enforcement for selected requirements.
- Strengthening engagement with the GME community. This is initially being advanced through the ACGME LINC series, office hours focused on site visits and Non-Standard Training programs, Rural and Underserved GME interest group sessions, and stakeholder summits.
- Reassessing ACGME activities – to ensure continuous quality improvement of the ACGME and GME. This began with the ACGME’s Clinical Learning Environment Review (CLER) Program, which was lauded for accomplishing key improvements in GME that will sustain into the future, though the program itself has now been sunsetted.
- Promoting innovation. This is playing out on several fronts, but the launch of a multi-site pilot of competency-based, time-variable GME, entitled “Promotion in Place,” was discussed as an exciting example.
Dr. Weinstein also emphasized that longer-term goals, such as evidence-based, outcomes-focused standards for GME, are being incorporated into efforts like the revisions of Common Program Requirements and Institutional Requirements that are currently underway. Upcoming activities were also previewed, including:
- The Competency-Based Medical Education (CBME) Learning Community Symposium, co-sponsored by American Board of Medical Specialties and the ACGME (May)
- A summit focusing on the transition to a single accreditation system (June)
- A second Nutrition Summit (October)
Intersection Between Federal Activities and the ACGME
Dr. Weinstein gave an overview of federal activities directed toward and/or impacting the ACGME, including an Executive Order about accreditation, Congressional inquiry from the House Judiciary Committee’s Antitrust Subcommittee, the Center for Medicare and Medicaid Services rulemaking process, and nutrition education priorities articulated by the Department of Health and Human Services. While the plenary setting didn’t allow for a detailed discussion of specific issues, Dr. Weinstein reflected that the ACGME Board and administration’s responses focused on the importance of carrying forward the ACGME’s role as a steward of accreditation, while participating thoughtfully in national conversations affecting GME and public health.
She noted the ACGME’s expanded effort to strengthen nutrition-related education and training, as well as competency assessment. In addition to the upcoming Nutrition Summit, Dr. Weinstein highlighted a new essay contest designed to encourage creative expression and engagement around how nutrition education can translate into clinical impact. (Look for more information soon on the ACGME website, in the e-Communication, and on our social media channels.)
Addressing the Physician Shortage with Clarity and Compassion
Dr. Weinstein spoke candidly about the national physician shortage, sharing a personal/family story related to delayed care that underscored for her the inevitable difficulty and potential peril confronted more frequently and intensely by those trying to access health care without privilege or know-how.
She addressed common misconceptions about the ACGME’s role in the shortage, and emphasized the following:
- The ACGME does not set the number of GME positions in the US; rather it responds to requests from programs and institutions to ensure the availability of sufficient resources to support the requested quota.
- There are more than enough PGY positions for all US medical school graduates, with thousands in excess.
- Approximately 14 percent of GME positions are vacant, with multiple contributing factors (e.g., creation of new programs that haven’t yet filled; program/Sponsoring Institution decisions not to fill all approved positions for financial reasons; difficulty attracting candidates to fill some positions).
- The number of ACGME-accredited programs and resident/fellow positions in them have been steadily increasing. In 2024-2025, 369 NEW programs (163 residencies; 206 fellowships) and nine NEW Sponsoring Institutions were accredited.
She acknowledged the need for greater clarity and proactive communication from the ACGME to ensure that the GME community – and the public – have a better understanding of these issues.
Dr. Weinstein also highlighted initiatives designed to support rural and underserved GME. These include educational outreach, cultivating partnerships, explaining new opportunities related to recent legislation, identifying and reducing rural‑specific barriers associated with accreditation, and keeping ACGME Review Committees informed about these efforts. Together, these efforts reflect a comprehensive strategy to strengthen GME where it is needed most.
Maximizing the ACGME’s Impact into the Future
Dr. Weinstein concluded by discussing the importance of clearly defining and measuring the desired outcomes of GME, so that the education of residents and fellows can be continually refined – with innovation and research – in ways that enhance those outcomes. She noted prior efforts toward these goals, which will require continued commitment and extensive collaboration to fully realize. She emphasized the need for humility and a sustained commitment to large‑scale research to improve GME, and discussed the ACGME’s role in building this future.
Dr. Weinstein closed with a request that the GME community provide input into the strategic planning process that the ACGME is currently launching. Her plenary was, overall, a call to action, empowering the GME community to collaborate, innovate, and lead the way toward a brighter, more resilient future for GME and the populations it serves.