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.

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Photo of Anne D. Cartwright Anne D. Cartwright

Focusing exclusively on legal issues related to educational institutions, Annie centers her practice on considerations tied to compliance with Title IV Federal Student Aid and student funding requirements. She advises higher education clients on regulatory, consumer disclosure, accreditation, governance, risk management, nondiscrimination (including…

Focusing exclusively on legal issues related to educational institutions, Annie centers her practice on considerations tied to compliance with Title IV Federal Student Aid and student funding requirements. She advises higher education clients on regulatory, consumer disclosure, accreditation, governance, risk management, nondiscrimination (including Title IX), and operations issues confronted in college and university environments. Annie regularly works closely with institutions responding to regulatory actions brought by the U.S. Department of Education, including Federal Student Aid program reviews, and she performs in-depth compliance audits, policy reviews and training.

Photo of Barbara Grandjean Barbara Grandjean

Barb represents employers and employees inside and outside the courtroom. She frequently consults with employers regarding workplace issues, such as hiring, discipline and terminations, privacy and social media matters, medical and non-medical leave matters, reductions in force, executive employment, wage and hour matters…

Barb represents employers and employees inside and outside the courtroom. She frequently consults with employers regarding workplace issues, such as hiring, discipline and terminations, privacy and social media matters, medical and non-medical leave matters, reductions in force, executive employment, wage and hour matters, and employment handbooks, policies and training