Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 27;26(4):769-772.
doi: 10.5811/westjem.48840.

Letter of Concern from the Association of Academic Chairs of Emergency Medicine Regarding ACGME Proposed Changes

Richard J Hamilton  1   2 , Lance B Becker  3   4   5 , Richard E Wolfe  6   7 , D Adam Algren  8   9 , Thomas Arnold  10 , Michael Baumann  11   12 , Ross P Berkeley  13 , Terrell S Caffery  14 , Chad M Cannon  15 , Theodore J Corbin  16 , Michael E Chansky  17 , Harinder S Dhindsa  17 , Charles L Emerman  18 , David A Farcy  19   20 , Chris Fox  21 , Michael A Gibbs  22 , Christopher S Goode  23 , Steven Andy Godwin  24 , Dietrich Jehle  25   26 , David Johnson  27 , Samuel M Keim  28   29   30 , Babak Khazaeni  31 , Barry J Knapp  32 , Clint Hawthorne  33 , John D Hoyle Jr  34 , Michael Christopher Kurz  35 , Evan Leibner  36 , Robert McNamara  37 , Robert F McCormack  38   39 , Edward A Michelson  40 , Chadwick Miller  41 , Ashley Norse  42 , Andrew Nugent  43 , Brian J O'Neil  44 , David T Overton  34 , Edward A Panacek  45 , William F Paolo  46 , Denis R Pauzé  44 , Amanda L Perez  47   48 , Ralph J Riviello  49 , Scott W Rodi  50 , Peter S Pang  51 , Juan A Gonzalez Sanchez  52 , David Seaberg  53 , Adam Schwartz  54   55 , Stephen A Shiver  56 , David P Sklar  57   58 , Ben C Smith  59 , Jeffrey R Stowell  60 , Marc D Squillante  61 , J Jeremy Thomas  62 , Terry Vanden Hoek  63   64 , Gregory A Volturo  65 , E Lea Walters  66 , Thomas E Wyatt  67   68 , Donald M Yealy  69
Affiliations

Letter of Concern from the Association of Academic Chairs of Emergency Medicine Regarding ACGME Proposed Changes

Richard J Hamilton et al. West J Emerg Med. .

Abstract

This letter, signed by over 50 academic chairs of emergency medicine, urges the ACGME to reconsider a proposed mandate requiring all emergency medicine residency programs to adopt a four-year training model. The authors argue that current three-year programs are supported by data demonstrating equivalent educational and clinical outcomes compared to four-year formats. They criticize the flawed survey methodology underpinning the proposal, note the loss of milestone-based training flexibility, and highlight the lack of added scholarly or clinical value in the fourth year. The letter also outlines negative consequences for fellowship participation, workforce development, trainee debt, and diversity. The signatories advocate for maintaining the current flexible training model to preserve excellence, equity, and innovation in emergency medicine education.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

References

    1. Beeson MS, Barton MA, Reisdorff EJ, et al. Comparison of performance data between emergency medicine 1–3 and 1–4 program formats. J Am Coll Emerg PhysicianOpen. 2023;4(3):e12991. - PMC - PubMed
    1. Hayden SR, Panacek EA. Procedural competency in emergency medicine: the current range of resident experience. Acad Emerg Med. 1999;6(7):728–35. - PubMed
    1. Nikolla DA, Zocchi MS, Pines JM, et al. Four- and three-year emergency medicine residency graduates perform similarly in their first year of practice compared to experienced physicians. Am J Emerg Med. 2023;69:100–7. - PubMed
    1. Ehmann MR, Klein EY, Kelen GD, et al. Emergency medicine career outcomes and scholarly pursuits: The impact of transitioning from a three-year to a four-year niche-based residency curriculum. AEM Educ Train. 2021;5(1):43–51. - PMC - PubMed

MeSH terms