The Accreditation Council for Graduate Medical Education (ACGME), which accredits graduate medical residency and fellowship programs, will require programs to offer six weeks of paid leave for residents/fellows, beginning on the first day of their ACGME-accredited programs. ACGME’s amended Institutional Requirements (effective July 1, 2022) require Sponsoring Institutions (those that administer ACGME-accredited residency/fellowship programs) to have policies for resident/fellow leaves that:

• Allow at least six weeks medical, parental, and caregiver leave;
• Make the leave available at least once and at any time during a resident/fellow’s ACGME-accredited program, beginning on the day the resident/fellow is required to report;
• Provide 100% of the resident/fellow’s salary for the first six weeks of the first leave;
• Also provide at least one additional week of paid time off;
• Continue health/disability insurance during the leave;
• Provide a process for requesting and approving leaves; and
• Ensure that each ACGME-accredited program provides residents/fellows with information about the impact of extended leaves on program completion and eligibility to participate in relevant certifying board exams.

(IV.H.1). An institution’s Graduate Medical Education Committee (GMEC) is responsible for implementing these policies (I.B.4.a).(5)). In addition, resident/fellow applicants must be informed about—and appointment agreements must directly reference—the policies (IV.B.2.a).(2)); IV.C.2.i)).

In addition to publishing the 2022 Institutional Requirements, ACGME has published FAQs discussing additional nuance around its expectations for resident/fellow leave. In the FAQs, ACGME assures institutions that it “will not cite Sponsoring Institutions for new elements of vacation and leave policies described in Institutional Requirements” before July 1, 2023.

The new ACGME rule follows a July 2021 policy change from the American Board of Medical Specialties (ABMS), whose Member Boards certify physicians in medical specialties. With some exceptions, ABMS’s policy now calls for Member Boards to have policies allowing a minimum of six weeks of parental, caregiver and medical leave at least once during training that do not exhaust other leave time or extend training. “Member Boards must allow all new parents, including birthing and non-birthing parents, adoptive/foster parents, and surrogates to take parental leave.”

What this means to you

Many ACGME-accredited institutions provide residents and fellows with standard employee—often Family Medical Leave Act—leave, which may or may not be paid, and may or may not be effective on the resident/fellow’s first day. If your healthcare and/or academic institution offers ACGME-accredited programs, consider reviewing your relevant leave policies to ensure timely alignment with regulator updates and other employment laws and policies.

For more information on compliance in residency and fellowship programs, contact the authors or Husch Blackwell’s Academic Medical Centers team.