Program Leadership Dedicated Time by Specialty Updated 04/2022
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Specialty-Specific Program Requirements: Program Leadership Dedicated Time
Effective as of July 1, 2022
*Specialties for which program leadership dedicated time requirements are proposed but not yet approved are identified
with an asterisk. These specialties are scheduled for review at the June 2022 ACGME Board meeting. This document will
be updated with final language following this meeting.
Common Program Requirements are in bold
Specialty/
Subspecialty Name
Program Requirement Language
Allergy and
Immunology
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program. Additional support for program leadership must be provided as specified below. This
additional support may be for the program director only or divided among the program director and one or more
associate (or assistant) program directors.
(Core)
Number of Approved
Resident Positions
Minimum support required
(FTE) for Program Director
Minimum Additional Support
Required (FTE) for Program
Leadership in Aggregate
1-6
0.15 FTE
0.05 FTE
7-10
0.2 FTE
0.1 FTE
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Specialty/
Subspecialty Name
Program Requirement Language
Anesthesiology*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program. Additional support for program leadership must be provided as specified below. This
additional support may be for the program director only or divided among the program director and one or more
associate (or assistant) program directors.
(Core)
Number of Approved
Resident Positions
Minimum Support
Required (FTE) for the
Program Director
Minimum Support
Required (FTE) for
Program Leadership
1-20
0.2
n/a
21-40
0.4
n/a
41-99
0.4
0.01 per approved resident
position
100 or more
0.4
1.0
Adult Cardiothoracic
Anesthesiology
Anesthesiology Critical
Care Medicine
Obstetric
Anesthesiology
Pediatric
Anesthesiology
Pediatric Cardiac
Anesthesiology
Regional
Anesthesiology and
Acute Pain Medicine
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
1-2
0.1
3
0.125
4
0.15
5
0.175
>5
0.2
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Specialty/
Subspecialty Name
Program Requirement Language
Colon and Rectal
Surgery*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum of 20 percent
FTE for administration of the program. This may be time spent by the program director only or divided among the
program director and one or more associate (or assistant) program directors.
(Core)
Dermatology*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with the dedicated minimum time specified below for
administration of the program. This may be time spent by the program director only or divided between the program
director and one or more associate (or assistant) program directors.
(Core)
Number of
Approved Resident
Positions
Minimum FTE Required
>12
0.2
13-18
0.3
19 or more
0.4
Micrographic Surgery
and Dermatologic
Oncology*
Pediatric Dermatology*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with support equal to a dedicated minimum of 0.1 FTE
for administration of the program.
(Core)
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Diagnostic Radiology*
II.A.2.a)-
II.A.2.b)
approved; II.A.2.c)
proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program. Additional support for program leadership must be provided as specified below. This
additional support may be for the program director only or divided among the program director and one or more
associate (or assistant) program directors.
(Core)
Number of Approved
Resident Positions
Minimum support
required (percent
time/FTE or number
of hours) for the
Program Director
Minimum Additional
Support Required
(FTE or Number of
Hours) for Program
Leadership in
Aggregate
Eight to 10 residents
0.25
n/a
11 to 15
0.3
n/a
16 to 23
0.4
n/a
24 to 31
0.5
n/a
32 to 39
0.6
40 to 47
0.7
48 to 55
0.8
56 to 63
0.9
64 to 71
1.0
72 or more
1.1
II.A.2.b) 60-month programs: In addition to the support requirements outlined above, 60-month programs must be
provided additional support for the administration and oversight of the clinical year as follows:
(Core)
Number of Clinical Year
Positions
Minimum Additional Program
Leadership FTE
1-3 residents
0.10
4 or more residents
0.15
II.A.2.c) There must be at least one associate/assistant program director for programs with resident complements of 32
or more.
(Core)
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Specialty/
Subspecialty Name
Program Requirement Language
Abdominal Radiology
Approved February
Pediatric Radiology
Approved February
Neuroradiology
Approved February
Nuclear Radiology
Approved February
Musculoskeletal
Radiology
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
1 to 6
0.1
7 to 8
0.2
9 or more
0.3
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Emergency Medicine*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) The program leadership, in aggregate, must be provided with support equal to a dedicated minimum time
specified below for administration of the program. This may be time spent by the program director only or divided
between the program director and one or more associate (or assistant) program directors as follows:
(Core)
Number of Approved
Resident Positions
Minimum Support
Required (FTE)
Minimum Number of
Assistant or Associate
Program Directors
18-20
0.6
1
21-25
0.7
1
26-30
0.8
1
31-35
0.85
1
36-40
1.0
2
41-45
1.10
2
46-50
1.20
2
51-53
1.20
2
54-55
1.30
3
56-60
1.40
3
61-65
1.50
3
66-70
1.55
3
71-75
1.55
3
76-80
1.55
3
81-85
1.55
3
86-90
1.55
3
91-95
1.55
3
96-100
1.55
3
II.A.2.b) Program directors of programs approved for 18-35 residents must be provided no less than 35 percent of the
aggregate support defined in the table above, and program directors of programs approved for 36 or more residents
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Specialty/
Subspecialty Name
Program Requirement Language
must be provided no less than 50 percent of the aggregate support defined in the table above.
(Core)
Emergency Medical
Services
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
0-3
0.2
4-6
0.2
7-9
0.3
10 or more
0.35
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Specialty/
Subspecialty Name
Program Requirement Language
Family Medicine*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program. Additional support for program leadership must be provided as specified below. This
additional support may be for the program director only or divided among the program director and one or more
associate (or assistant) program directors.
(Core)
Number of Approved
Residents
Minimum support required
(percent time/FTE or number of
hours) for Program Director
Additional minimum support
required (percent time/FTE or
number of hours) for Program
Leadership
1-6
20% FTE
n/a
7-12 20% FTE 10% FTE
13-18
40% FTE
10% FTE
19-30 50% FTE 20% FTE
31-45
60% FTE
30% FTE
46 or more
60% FTE
60% FTE
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Internal Medicine
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
Number of Approved
Resident Positions
Minimum Support
Required (FTE)
<7
.2
7-10
.4
>10
.5
II.A.2.b) Programs with more than 15 residents must appoint an associate program director(s). The associate program
directors(s) must be provided with support equal to a dedicated minimum time for administration of the program as
follows:
Number of Approved
Resident Positions
Minimum Support
Required (FTE)
<15
0
16-20
.1
21-25
.2
26-30
.3
31-35
.4
36-40
.5
41-45
.6
46-50
.7
51-55
.8
56-60
.9
61-65
1.0
66-70
1.1
71-75
1.2
76-80
1.3
81-85
1.4
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86-90
1.5
91-95
1.6
96-100
1.7
101-105
1.8
106-110
1.9
111-115
2.0
116-120
2.1
121-125
2.2
126-130
2.3
131-135
2.4
136-140
2.5
141-145
2.6
146-150
2.7
151-155
2.8
156-160
2.9
161-165
3.0
166-170
3.1
171-175
3.2
176-180
3.3
181-185
3.4
186-190
3.5
191-195
3.6
196-200
3.7
201-205
3.8
206-210
3.9
211-215
4.0
216-220
4.1
221-225
4.2
226-230
4.3
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Cardiovascular Disease
Approved February
Critical Care Medicine
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
.2
7-9
.25
10-12
.3
13-15
.35
16-18
.4
19-21
.45
>21
.5
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s). The associate program directors(s) must be provided with support equal to a dedicated minimum time for
administration of the program as follows:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
0
7-9
.13
10-12
.14
13-15
.15
16-18
.16
19-21
.17
22-24
.18
25-27
.24
28-30
.30
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Specialty/
Subspecialty Name
Program Requirement Language
31-33
.36
34-36
.42
37-39
.48
40-42
.54
43-45
.60
46-48
.66
Clinical Cardiac
Electrophysiology
Endocrinology,
Diabetes and
Metabolism
Hematology
Medical Oncology
Rheumatology
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
.2
7-9
.25
10-12
.3
13-15
.35
16-18
.4
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s). The associate program directors(s) must be provided with support equal to a dedicated minimum time for
administration of the program as follows:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
0
7-9
.13
10-12
.14
13-15
.15
16-18
.16
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Gastroenterology
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
.2
7-9
.25
10-12
.3
13-15
.35
16-18
.4
19-21
.45
>21
.5
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s). The associate program directors(s) must be provided with support equal to a dedicated minimum time for
administration of the program as follows:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
0
7-9
.13
10-12
.14
13-15
.15
16-18
.16
19-21
.17
22-24
.18
25-27
.24
28-30
.30
31-33
.36
34-36
.42
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Hematology and
Medical Oncology
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
.2
7-9
.25
10-12
.3
13-15
.35
16-18
.4
19-21
.45
>21
.5
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s). The associate program directors(s) must be provided with support equal to a dedicated minimum time for
administration of the program as follows:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
0
7-9
.13
10-12
.14
13-15
.15
16-18
.16
19-21
.17
22-24
.18
25-27
.24
28-30
.30
31-33
.36
34-36
.42
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Specialty/
Subspecialty Name
Program Requirement Language
37-39
.48
40-42
.54
43-45
.60
46-48
.66
49-51
.72
52-54
.78
55-57
.84
58-60
.90
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Specialty/
Subspecialty Name
Program Requirement Language
Infectious Disease
Nephrology
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
.2
7-9
.25
10-12
.3
13-15
.35
16-18
.4
19-21
.45
>21
.5
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s). The associate program directors(s) must be provided with support equal to a dedicated minimum time for
administration of the program as follows:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
0
7-9
.13
10-12
.14
13-15
.15
16-18
.16
19-21
.17
22-24
.18
25-27
.24
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Specialty/
Subspecialty Name
Program Requirement Language
Adult Congenital Heart
Disease
Advanced Heart
Failure/Transplant
Cardiology
Interventional
Cardiology
Transplant Hepatology
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
.2
7-9
.25
10-12
.3
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s). The associate program directors(s) must be provided with support equal to a dedicated minimum time for
administration of the program as follows:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
0
7-9
.13
10-12
.14
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Specialty/
Subspecialty Name
Program Requirement Language
Pulmonary Disease
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
.2
7-9
.25
10-12
.3
13-15
.35
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s). The associate program directors(s) must be provided with support equal to a dedicated minimum time for
administration of the program as follows:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
0
7-9
.13
10-12
.14
13-15
.15
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Pulmonary Critical Care
Medicine
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
.2
7-9
.25
10-12
.3
13-15
.35
16-18
.4
19-21
.45
>21
.5
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s). The associate program directors(s) must be provided with support equal to a dedicated minimum time for
administration of the program as follows:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
0
7-9
.13
10-12
.14
13-15
.15
16-18
.16
19-21
.17
22-24
.18
25-27
.24
28-30
.30
31-33
.36
34-36
.42
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Specialty/
Subspecialty Name
Program Requirement Language
37-39
.48
Interventional
Radiology
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the IR-independent only program director must be provided with support equal to a dedicated
minimum of 20 percent FTE for administration of the program.
(Core)
II.A.2.b) At a minimum, the 60-month IR-integrated only program director must be provided with the dedicated time and
support specified below for administration of the program:
(Core)
Number of Approved IR-
Integrated Resident Positions
Minimum support required
(FTE or number of hours)
1 to 6
0.20
7 to 12
0.25
13 to 18
0.25
19 to 24
0.30
II.A.2.b).(1) At a minimum, program directors who oversee both independent and integrated interventional radiology
programs at the same institution must be provided with an additional .1 FTE for administration of the program:
(Core)
II.A.2.c) In addition to the support requirements above, program directors of 72-month integrated programs with more
than six approved IR-integrated resident positions must be provided additional support for the administration and
oversight of the clinical year as follows:
(Core)
Number of Approved Clinical
Year Positions
Minimum Additional Support
FTE
1-3
0.10
4 or more residents
0.15
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Specialty/
Subspecialty Name
Program Requirement Language
Medical Genetics and
Genomics*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time specified
below for administration of the program. This may be time spent by the program director only or divided between the
program director and one or more associate (or assistant) program directors.
(Core)
II.A.2.a).(1) Programs with up to seven approved resident positions must be provided with a minimum of 20 percent
time. Programs with seven or more approved resident positions must be provided with a minimum of 20 percent time
and an additional two percent time for each approved position.
(Core)
Specialty-Specific Background and Intent: The additional two percent time is for each approved resident position in
the program, not just the approved resident positions over seven. For example, a program with an approved
complement of seven resident positions must be provided at least 34 percent time for program leadership. A program
approved for 10 resident positions must be provided with at least 40 percent time for program leadership; and a
program approved for 18 resident positions must be provided with at least 56 percent time for program leadership.
Clinical Biochemical
Genetics*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum of 20 percent
time. This may be time spent by the program director only or divided among the program director and one or more
associate (or assistant) program directors.
(Core)
Program Leadership Dedicated Time by Specialty Updated 04/2022
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Specialty/
Subspecialty Name
Program Requirement Language
Laboratory Genetics
and Genomics*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum of 20 percent
time. This may be time spent by the program director only or divided among the program director and one or more
associate (or assistant) program directors. Programs with seven or more approved post-doctoral fellow positions must
provide a minimum of 20 percent time and an additional two percent time for each approved position.
(Core)
Specialty-Specific Background and Intent: The additional two percent time is for each approved post-doctoral fellow
position in the program, not just the approved post-doctoral fellow positions over seven. For example, a program with
an approved complement of seven post-doctoral fellow positions must be provided at least 34 percent time for program
leadership. A program approved for 10 post-doctoral fellow positions must be provided with at least 40 percent time for
program leadership; and a program approved for 18 post-doctoral fellow positions must be provided with at least 56
percent time for program leadership.
Medical Biochemical
Genetics*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum of 20 percent
time for administration of the program, which may be time spent by the program director only or divided among the
program director and one or more associate (or assistant) program directors.
(Core)
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Specialty/
Subspecialty Name
Program Requirement Language
Neurological Surgery*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program. Additional support for program leadership must be provided as specified below. This
additional support may be for the program director only or divided among the program director and one or more
associate (or assistant) program directors.
(Core)
Number of Approved
Resident Positions
Minimum Support
Required (FTE for the
Program Director
Minimum Additional
Support Required (FTE)
for Program Leadership
in Aggregate
1-7
20%
n/a
8-14
20%
10%
15-20
20%
15%
21 or more
20%
20%
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Specialty/
Subspecialty Name
Program Requirement Language
Neurology
Child Neurology
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time specified
below for administration of the program. This may be time spent by the program director only or divided between
the program director and one or more associate (or assistant) program directors.
(Core)
Number of Approved
Resident Positions
Minimum support required
(FTE)
1-6
0.2
7-10
0.4
11-15
0.5
16-20
0.6
21-25
0.7
26-30
0.8
31-35
0.9
36-40
1.0
41-45
1.1
46-50
1.2
51-55
1.3
56-60
1.4
61-65
1.5
66-70
1.6
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Specialty/
Subspecialty Name
Program Requirement Language
Clinical
Neurophysiology
Epilepsy
Vascular Neurology
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time specified
below for administration of the program. This may be time spent by the program director only or divided between
the program director and one or more associate (or assistant) program directors.
(Core)
Number of Approved
Fellow Positions
Minimum FTE
1-3
0.1
4-6
0.15
7-9
0.2
10-12
0.25
13-15
0.3
Neurodevelopmental
Disabilities
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time specified
below for administration of the program. This may be time spent by the program director only or divided between the
program director and one or more associate (or assistant) program directors.
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
1-6
0.2
7-10
0.4
11-15
0.5
16-20
0.6
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Specialty/
Subspecialty Name
Program Requirement Language
Nuclear Medicine
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved Resident
Positions
Minimum support required
(FTE or number of hours)
1-6 residents
0.15
7-12 residents
0.20
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Specialty/
Subspecialty Name
Program Requirement Language
Obstetrics and
Gynecology
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program. Additional support for program leadership must be provided as specified below. This
additional support may be for the program director only or divided among the program director and one or more
associate (or assistant) program directors.
(Core)
Number of
Approved
Resident Positions
Minimum Support
Required (FTE) for the
Program Director
Minimum Additional Support
Required (FTE) for Program
Leadership in Aggregate
7-10
0.4
-
11-15
0.5
-
16-20
0.5
0.1
21-25
0.5
0.2
26-30
0.5
0.3
31-35
0.5
0.4
36-40
0.5
0.5
41-45
0.5
0.6
46-50
0.5
0.7
51-55
0.5
0.8
56-60
0.5
0.9
61-65
0.5
1.0
66-70
0.5
1.1
71-75
0.5
1.2
76-80
0.5
1.3
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Specialty/
Subspecialty Name
Program Requirement Language
Complex Family
Planning
Gynecologic Oncology
Maternal-
Fetal
Medicine
Reproductive
Endocrinology and
Infertility
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with support equal to a dedicated minimum of 0.2 FTE
for administration of the program.
(Core)
Ophthalmology
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with support equal to a dedicated minimum of 0.2 FTE
for administration of the program.
(Core)
Ophthalmic Plastic and
Reconstructive Surgery
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with support equal to a dedicated minimum of 0.1 FTE
for administration of the program.
(Core)
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Specialty/
Subspecialty Name
Program Requirement Language
Orthopaedic Surgery*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time specified
below for administration of the program. This may be time spent by the program director only or divided between the
program director and one or more associate (or assistant) program directors.
(Core)
Number of Approved
Resident Positions
Minimum Support Required
(FTE)
1-10
20%
11-20
25%
21-30
30%
31-40
35%
41-50
40%
51-60
45%
61-70
50%
Adult Reconstructive
Orthopaedic Surgery*
Foot and Ankle
Orthopaedic Surgery*
Musculoskeletal
Oncology*
Orthopaedic Sports
Medicine*
Orthopaedic Trauma*
Pediatric Orthopaedic
Surgery*
Orthopaedic Surgery of
the Spine*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time specified
below for administration of the program. This may be time spent by the program director only or divided between the
program director and one or more associate (or assistant) program directors.
(Core)
Number of Approved
Fellow Positions
Minimum Support Required
(FTE)
1-2
10%
3-4
10%
5-6
20%
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Specialty/
Subspecialty Name
Program Requirement Language
Osteopathic
Neuromusculoskeletal
Medicine
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with support equal to a dedicated minimum of 0.2 FTE
for administration of the program.
Otolaryngology –
Head and Neck
Surgery*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Resident/Fellow Positions
Minimum Support
Required (FTE)
1-10
10%
11 or more
20%
Neurotology*
Pediatric
Otolaryngology*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with support equal to a dedicated minimum of 10 percent
FTE for administration of the program.
(Core)
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Specialty/
Subspecialty Name
Program Requirement Language
Pathology*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time as
specified below for administration of the program. This may be time spent by the program director only or divided
between the program director and one or more associate (or assistant) program directors.
(Core)
II.A.2.a).(1) Programs with up to seven approved resident positions must be provided with a minimum of 20 percent
time. Programs with seven or more approved resident positions must be provided with a minimum of 20 percent time
plus an additional two percent time for each approved position.
(Core)
Specialty-Specific Background and Intent: The additional two percent time is for each approved resident position in the
program, not just the approved resident positions over seven. For example, a program with an approved complement of
eight resident positions must be provided at least 36 percent time for program leadership. A program approved for 20
resident positions must be provided with at least 60 percent time for program leadership; and a program approved for
40 resident positions must be provided with at least 100 percent time for program leadership.
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Specialty/
Subspecialty Name
Program Requirement Language
Blood
Banking/Transfusion
Medicine*
Forensic Pathology*
Pediatric Pathology*
Selective Pathology*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time as
specified below for administration of the program. This may be time spent by the program director only or divided
between the program director and one or more associate (or assistant) program directors.
(Core)
II.A.2.a).(1) Programs with up to four approved fellow positions must be provided with a minimum of 10 percent time.
Programs with five or six approved fellow positions must be provided with a minimum of 20 percent time. Programs with
seven or more approved fellow positions must be provided with a minimum of 20 percent time plus an additional 0.5
percent time for each approved position.
(Core)
Specialty-Specific Background and Intent: The additional 0.5 percent time is for each approved fellow position in the
program, not just the approved fellow positions over seven. For example, a program with an approved complement of
seven fellow positions must be provided at least 23.5 percent time for program leadership. A program approved for 10
fellow positions must be provided with at least 25 percent time for program leadership; and a program approved for 18
fellow positions must be provided with at least 29 percent time for program leadership.
II.A.2.b) Programs that do not function as a dependent subspecialty of an ACGME-accredited pathology residency
program must be provided with a minimum of 20 percent time. These programs that have seven or more approved
fellow positions must be provided with an additional one percent time for each approved position.
(Core)
Specialty-Specific Background and Intent: The additional one percent time is for each approved fellow position in the
program, not just the approved fellow positions over seven. For example, a residency-independent program with an
approved complement of seven fellow positions must be provided at least 27 percent time for program leadership. A
residency-independent program approved for 10 fellow positions must be provided with at least 30 percent time for
program leadership; and a residency-independent program approved for 18 fellow positions must be provided with at
least 38 percent time for program leadership.
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Specialty/
Subspecialty Name
Program Requirement Language
Chemical Pathology*
Cytopathology*
Hematopathology*
Medical Microbiology*
Neuropathology*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time specified
below for administration of the program. This may be time spent by the program director only or divided between the
program director and one or more associate (or assistant) program directors.
(Core)
II.A.2.a).(1) Programs with up to four approved fellow positions must be provided with a minimum of 10 percent time.
Programs with five or six approved fellow positions must be provided with a minimum of 20 percent time. Programs with
seven or more approved fellow positions must be provided with a minimum of 20 percent time and an additional 0.5
percent time for each approved position.
(Core)
Specialty-Specific Background and Intent: The additional 0.5 percent time is for each approved fellow position in the
program, not just the approved fellow positions over seven. For example, a program with an approved complement of
seven fellow positions must be provided at least 23.5 percent time for program leadership. A program approved for 10
fellow positions must be provided with at least 25 percent time for program leadership; and a program approved for 18
fellow positions must be provided with at least 29 percent time for program leadership.
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Pediatrics*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time specified
below for administration of the program. This may be time spent by the program director only or divided between the
program director and one or more associate (or assistant) program directors.
(Core)
Number of Approved
Resident Positions
Minimum Support
Required (FTE)
< 7
.2
7-10
.4
11-15
.5
16-20
.6
21-25
.7
26-30
.8
31-35
.9
36-40
1.0
41-45
1.1
46-50
1.2
51-55
1.3
56-60
1.4
61-65
1.5
66-70
1.6
71-75
1.7
76-80
1.8
81-85
1.9
86-90
2.0
91-95
2.1
96-100
2.2
101-105
2.3
106-110
2.4
>110
2.5
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Specialty/
Subspecialty Name
Program Requirement Language
Adolescent Medicine*
Child Abuse Pediatrics*
Developmental-
Behavioral Pediatrics*
Pediatric Cardiology*
Pediatric Critical Care*
Pediatric
Endocrinology*
Pediatric
Gastroenterology*
Pediatric Hematology
Oncology*
Pediatric Hospital
Medicine*
Pediatric Infectious
Diseases*
Neonatal-
Perinatal
Medicine*
Pediatric Nephrology*
Pediatric Pulmonology*
Pediatric
Rheumatology*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time specified
below for administration of the program. This may be time spent by the program director only or divided between the
program director and one or more associate (or assistant) program directors.
(Core)
Number of
Approved Fellow
Positions
Minimum Support
Required (FTE)
< 7
.2
7-10
.4
11-15
.5
>15
.6
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Specialty/
Subspecialty Name
Program Requirement Language
Pediatric Transplant
Hepatology*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum of .2 FTE for
administration of the program. This may be time spent by the program director only or divided among the program
director and one or more associate (or assistant) program directors.
(Core)
Physical Medicine and
Rehabilitation*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program. Additional support for program leadership must be provided as specified below. This
additional support may be for the program director only or divided among the program director and one or more
associate (or assistant) program directors.
(Core)
Number of Approved
Resident Positions
Minimum Support
Required (FTE) for
the Program Director
Minimum Additional
Support Required
(FTE) for Program
Leadership in
Aggregate
<7
.2
0
7-10
.2
.2
11-15
.2
.3
16-20
.2
.4
21-25
.2
.5
26-30
.2
.6
31-35
.2
.7
36-40
.2
.8
41-45
.2
.9
Pediatric Rehabilitation
Medicine*
Spinal Cord Injury
Medicine*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum of 0.2 FTE for
administration of the program. This may be time spent by the program director only or divided among the program
director and one or more associate (or assistant) program directors.
(Core
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Plastic Surgery*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time specified
below for administration of the program. This may be time spent by the program director only or divided between the
program director and one or more associate (or assistant) program directors.
(Core)
Number of Approved
Resident Positions
Minimum Support
Required FTE
1-6
.20
7-10
.25
11-20
.30
21-30
.35
31-35
.40
>36
.45
II.A.2.b) All programs must appoint an associate (or assistant) program director(s).
(Core)
II.A.2.c) Program directors who oversee both an integrated and independent plastic surgery programs, must be
provided support for administration of the programs based upon the total number of approved residents in both
programs.
(Core)
Specialty-Specific Background and Intent: The Review Committee recognizes that many institutions have both an
Independent and Integrated Plastic Surgery program and share one Program Director. The Review Committee will
allow programs with the same Program Director across both formats to count the total number of residents in both
programs to determine required dedicated time for administration of the programs. However, this time is comprehensive
and not additive, so an Institution that has a total of 20 residents across both the independent and integrated programs
would require a total of 30% FTE for program leadership which must consist of a program director and an
associate/assistant program director.
Overseeing plastic surgery residency programs requires oversight of the clinical, educational, and administrative
aspects of the program. The Review Committee feels that the addition of an associate/assistant program director
should provide residents with additional clinical and educational resources and augment the work of the program
director.
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Specialty/
Subspecialty Name
Program Requirement Language
Craniofacial Plastic
Surgery
II.A.2. The program director must be provided with support adequate for administration of the program based
upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
1-4
0.1
5 or more
0.2
Preventive Medicine*
Proposal to sunset
specialty, pending
approval of Aerospace
Medicine, Occupational
and Environment
Medicine, and Public
Health and General
Preventive Medicine as
new specialties
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time as
specified below for administration of the program. This may be time spent by the program director only or divided
between the program director and one or more associate (or assistant) program directors.
(Core)
II.A.2.a).(1) Programs with up to seven approved resident positions must be provided with a minimum of 20 percent
time. Programs with seven or more approved resident positions must be provided with a minimum of 20 percent time
and an additional one percent time for each approved position.
(Core)
Aerospace Medicine*
Occupational and
Environmental
Medicine*
Public Health and
General Preventive
Medicine*
Proposed new
specialties
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time as
specified below for administration of the program. This may be time spent by the program director only or divided
between the program director and one or more associate (or assistant) program directors.
(Core)
II.A.2.a).(1) Programs with up to seven approved resident positions must be provided with a minimum of 20 percent
time. Programs with seven or more approved resident positions must be provided with a minimum of 20 percent time
and an additional one percent time for each approved position.
(Core)
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Specialty/
Subspecialty Name
Program Requirement Language
Psychiatry
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time specified
below for administration of the program. This may be time spent by the program director only or divided between the
program director and one or more associate (or assistant) program directors.
(Core)
Number of Approved
Resident Positions
Minimum support
required (FTE)
1-6
0.2
7-10
0.4
11-15
0.5
16-20
0.6
21-25
0.7
26-30
0.8
31-35
0.9
36-40
1.0
41-45
1.1
46-50
1.2
51-55
1.3
56-60
1.4
61-65
1.5
66-70
1.6
71-75
1.7
76-80
1.8
81-85
1.9
86-90
2.0
II.A.2.b) If the FTE is shared with an associate program director, the associate program director must report directly to
the program director.
(Core)
Program Leadership Dedicated Time by Specialty Updated 04/2022
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Specialty/
Subspecialty Name
Program Requirement Language
Addiction Psychiatry
Forensic Psychiatry
Geriatric Psychiatry
Consultation-
Liaison
Psychiatry
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time specified
below for administration of the program. This may be time spent by the program director only or divided between the
program director and one or more associate (or assistant) program directors.
(Core)
Number of Approved Fellow
Positions
Minimum Support Required
(FTE)
1-6
0.2
7-8
0.36
9-10
0.4
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Specialty/
Subspecialty Name
Program Requirement Language
Child and Adolescent
Psychiatry
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time specified
below for administration of the program. This may be time spent by the program director only or divided between the
program director and one or more associate (or assistant) program directors.
(Core)
Number of Approved
Fellow Positions
Minimum support
required (FTE)
1-6
0.2
7-8
0.36
9-10
0.4
11-12
0.44
13-14
0.48
15-16
0.52
17-18
0.56
19-20
0.6
21-22
0.64
23-24
0.68
25-26
0.72
27-28
0.76
Radiation Oncology
Approved February
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with support equal to a dedicated minimum of 0.2 FTE
for administration of the program.
(Core)
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Specialty/
Subspecialty Name
Program Requirement Language
Surgery*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program. Additional support for program leadership must be provided as specified below. This
additional support may be for the program director only or divided among the program director and one or more
associate (or assistant) program directors.
(Core)
Number of Approved
Categorical and Preliminary
Resident Positions
Minimum Support Required
(FTE) for the Program Director
Minimum Additional FTE
Support Required for Program
Leadership in Aggregate
1-6
.20
n/a
7-10
.25
n/a
11-20
.30
n/a
21-30
.30
0.10
31-40
.40
0.10
41-50
.40
0.20
51-60
.50
0.20
61-70
.50
0.30
71-80
.50
0.40
81-90
.50
0.50
≥91
.50
0.60
Specialty-Specific Background and Intent: As an example, a program with 50 residents would be required to have 40
percent FTE support for the program director and an additional 20 percent FTE support for leadership (Assistant or
Associate Program Director (APD)). The additional 20 percent FTE may be allocated between one or more APDs, or
between the PD and an APD(s). The Review Committee has maxed out the required program director support at 50
percent FTE to ensure that they will have time to remain active in the clinical and scholarly domains. The Review
Committee has not specified how the remaining support should be distributed amongst leadership to allow programs, in
partnership with their Sponsoring Institution, to allocate support as they see fit.
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Specialty/
Subspecialty Name
Program Requirement Language
Complex General
Surgical Oncology*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support Required (FTE)
1-6
.20
7-10
.25
11 or more
.30
Pediatric Surgery
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with support equal to a dedicated minimum of 0.1 FTE
for administration of the program.
(Core)
Surgical Critical Care*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support Required (FTE)
1-6
.10
7-10
.15
11 or more
.20
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Specialty/
Subspecialty Name
Program Requirement Language
Vascular Surgery –
Integrated*
Vascular Surgery –
Independent*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program. Additional support for program leadership must be provided as specified below. This
additional support may be for the program director only or divided among the program director and one or more
associate (or assistant) program directors.
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE) for the
Program Director
Minimum Additional
Support Required (FTE)
for Program Leadership
in Aggregate
1-6
.20
n/a
7-10
.30
n/a
11-20
.30
0.10
21 or greater
.30
0.20
II.A.2.b) Program directors who oversee both an independent and an integrated vascular surgery program must be
provided support for administration of the programs based on the total number of approved positions across both
programs.
(Core)
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Thoracic Surgery –
Integrated*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved
Resident Positions
Minimum FTE Support Required for the
Program Director
1-6
.20
7-10
.35
11-15
.40
16-20
.45
21-25
.50
II.A.2.b) Program directors who oversee both an independent and an integrated thoracic surgery program must be
provided support for administration of the programs based on the total number of approved positions across both
programs.
(Core)
II.A.2.c) Program directors who oversee both an independent and an integrated thoracic surgery program which,
combined, have 10 or more residents/fellows must appoint an associate (or assistant) program director.
(Core)
II.A.2.d) The associate (assistant) program director must be provided with support equal to a dedicated minimum of 10
percent FTE for administration of the program.
(Core)
Specialty-Specific Background and Intent: The Review Committee recognizes that many institutions have both an
independent and integrated thoracic surgery program and share one program director. The Review Committee will
allow programs with the same program director across both formats to count the total number of residents/fellows in
both programs to determine required dedicated time for administration of the programs. However, this time is
comprehensive and not additive, so an Institution that has a total of 20 residents/fellows across both the independent
and integrated programs would require 45 percent FTE for the program director and 10 percent FTE for an
assistant/associate program director, for a total required leadership FTE of 55 percent.
Overseeing thoracic surgery residency programs requires oversight of the clinical, educational, and administrative
aspects of the program. The Review Committee feels that the addition of an associate/assistant program director once
a program director oversees more than 10 residents/fellows should provide residents/fellows with additional clinical and
educational resources and augment the work of the program director.
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Thoracic Surgery –
Independent*
Proposed
II.A.2. The program director and, as applicable, the programs leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration. (Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program:
(Core)
Number of Approved Fellow
Positions
Minimum FTE Support Required for the
Program Director
1-6
.20
7-10
.35
11-15
.40
16-20
.45
21-25
.50
II.A.2.b) Program directors who oversee both an independent and an integrated thoracic surgery program must be
provided support for the administration of the programs based on the total number of approved positions across both
programs. (Core)
II.A.2.c) Program directors who oversee both an independent and an integrated thoracic surgery program which,
combined, have 10 or more residents/fellows must appoint an associate (or assistant) program director. (Core)
II.A.2.d) The associate (assistant) program director must be provided with support equal to a dedicated minimum of 10
percent FTE for administration of the program.
(Core)
Specialty-Specific Background and Intent: The Review Committee recognizes that many institutions have both an
independent and integrated thoracic surgery program and share one Program Director. The Review Committee will
allow programs with the same Program Director across both formats to count the total number of residents/fellows in
both programs to determine required dedicated time for administration of the programs. However, this time is
comprehensive and not additive, so an Institution that has a total of 20 residents/fellows across both the independent
and integrated programs would require 45 percent FTE for the program director and 10 percent FTE for an
assistant/associate program director, for a total required leadership FTE of 55 percent.
Overseeing thoracic surgery fellowship programs requires oversight of the clinical, educational, and administrative
aspects of the program. The Review Committee feels that the addition of an associate/assistant program director once
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Specialty/
Subspecialty Name
Program Requirement Language
a program director oversees more than 10 residents/fellows should provide residents/fellows with additional clinical and
educational resources and augment the work of the program director.
Congenital Cardiac
Surgery*
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with support equal to a dedicated minimum of ten
percent FTE for administration of the program.
(Core)
Transitional Year
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified below for
administration of the program. Additional support for program leadership must be provided as specified below. This
additional support may be for the program director only or divided among the program director and one or more
associate (or assistant) program directors.
(Core)
Number of Approved
Resident/Fellow
Positions
Minimum Support Required
(FTE or Number of Hours) for
the Program Director
Minimum Additional Support
Required (FTE or Number of
Hours) for Program Leadership
in Aggregate
1-6
0.2
n/a
7-10
0.25
n/a
11-15
0.25
0.05
16-20
0.25
0.1
21-25
0.25
0.15
26 or more
0.25
0.2
Urology
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with support equal to a dedicated minimum of 0.2 FTE
for administration of the program.
(Core)
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Specialty/
Subspecialty Name
Program Requirement Language
Pediatric Urology
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with support
adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with support equal to a dedicated minimum of 10 percent
FTE for administration of the program.
(Core)
Specialty/ Subspecialty
Name
Program Requirement Language
Multidisciplinary Specialties/Subspecialties
Addiction Medicine*
(S
ubspecialty of Family
Medicine, Internal Medicine,
or Psychiatry)
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a)
Program leadership, in aggregate, must be provided with support equal to a dedicated minimum
time specified below for administration of the program. This may be time spent by the program
director only or divided between the program director and one or more associate (or assistant)
program directors.
(Core)
Number of Approved Fellow
Positions
Minimum support required
(FTE)
1-6
0.2 FTE
7-8
0.36 FTE
9-10
0.4 FTE
Brain Injury Medicine*
(S
ubspecialty of Child
Neurology, Neurology,
Physical
Medicine and
Rehabilitation, or Psychiatry)
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum of 0.2
FTE for administration of the program. This may be time spent by the program director only or divided among
the program director and one or more associate (or assistant) program directors.
(Core)
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Clinical Informatics*
(S
ubspecialty of
Anesthesiology, Family
Medicine, Internal Medicine
,
Pathology, or Pediatrics)
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified
below for administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
.2
7-9
.25
10-12
.3
>12
.35
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate
program director(s). The associate program directors(s) must be provided with support equal to a dedicated
minimum time for administration of the program as follows:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
0
7-9
.13
10-12
.14
>12
.15
Specialty-Specific Background and Intent: For instance, a program with an approved complement of eight
fellows must have at least 25 percent FTE support for the program director and at least 13 percent FTE support
for the associate program director(s). Although the associate program director(s) will also be core faculty
members, the required FTE support is not cumulative. Associate program directors must receive either support
for their position or the 10 percent FTE for the core faculty member position, but not both. For example, if one
core faculty member is named the associate program director for an eight-fellow program, the support for that
position must be at least 13 percent FTE. Further, the Review Committee allows the minimum required FTE
support to be shared among multiple associate program directors, as delegated by and at the discretion of the
program director.
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Specialty/ Subspecialty
Name
Program Requirement Language
Dermatopathology*
(S
ubspecialty of
Dermatology or Pathology)
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At
a minimum, the program director must be provided with support equal to a dedicated minimum of 0.1
FTE for administration of the program.
(Core)
Endovascular Surgical
Neuroradiology*
(
Proposed name change to
Neuroendovascular
Intervention)
(S
ubspecialty of Child
Neurology, Neurological
Surgery, Neurology, or
Radiology)
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified
below for administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
1 to 6
0.1
7 to 8
0.2
9 or more
0.3
Female Pelvic Medicine and
Reconstructive Surgery
(S
ubspecialty of Obstetrics
and Gynecology or Urology)
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with support equal to a dedicated minimum of 0.2
FTE for administration of the program.
(Core)
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Geriatric Medicine*
(S
ubspecialty of Family
Medicine or Internal
Medicine)
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified
below for administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
.2
7-9
.25
10-12
.3
13-15
.35
16-18
.4
>18
.45
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate
program director(s). The associate program directors(s) must be provided with support equal to a dedicated
minimum time for administration of the program as follows:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
0
7-9
.13
10-12
.14
13-15
.15
16-18
.16
>18
.17
Specialty-Specific Background and Intent: For instance, a program with an approved complement of eight
fellows is required to have at least two percent FTE support for the program director and at least 13 percent
FTE support for the associate program director(s). Although the associate program director (s) will also be core
faculty members, the required FTE support is not cumulative. Associate program directors must receive either
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Specialty/ Subspecialty
Name
Program Requirement Language
support for the associate program director position or the 10 percent FTE for the core faculty member position,
but not both. For example, if one core faculty member is named the associate program director for a eight-
fellow
program, the support for that position must be at least 13 percent FTE. Further, the Review Committee allows
the minimum required FTE support to be shared among multiple associate program director s, as delegated by
and at the discretion of the program director.
Hand Surgery*
(Subspecialty of Orthopaedic
Surgery, Plastic Surgery, and
Surgery)
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time
specified below for administration of the program. This may be time spent by the program director only or
divided between the program director and one or more associate (or assistant) program directors.
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
1-2
10%
3-4
10%
5-6
20%
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Hospice and Palliative
Medicine*
(S
ubspecialty of
Anesthesiology,
Family Medicine,
Internal Medicine,
Pediatrics,
Psychiatry, or
Radiation Oncology)
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified
below for administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
.2
7-9
.25
10-12
.3
13-15
.35
16-18
.4
>18
.45
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate
program director(s). The associate program directors(s) must be provided with support equal to a dedicated
minimum time for administration of the program as follows:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
0
7-9
.13
10-12
.14
13-15
.15
16-18
.16
>18
.17
Specialty-Specific Background and Intent: For instance, a program with an approved complement of eight
fellows must have at least 25 percent FTE support for the program director and at least 13 percent FTE support
for the associate program director (s). Although associate program directors will also be core faculty members,
the required FTE support is not cumulative. Associate program directors must receive either support for the
associate program director position or the 10 percent FTE for the core faculty member position, but not
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Specialty/ Subspecialty
Name
Program Requirement Language
both. For example, if one core faculty member is named the associate program director for an eight-fellow
program, the support for that position must be at least 13 percent FTE. Further, the Review Committee allows
the minimum required FTE support to be shared among multiple associate program director s, as delegated by
and at the discretion of the program director.
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Internal Medicine-
Pediatrics*
(Combined program for
Internal Medicine and
Pediatrics)
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified
below for administration of the program:
(Core)
Number of Approved
Resident Positions
Minimum Support
Required (FTE)
<7
0.2
7-10
0.4
>10
0.5
II.A.2.b) Programs with more than 15 residents must appoint an associate program director(s). The associate
program directors(s) must be provided with support equal to a dedicated minimum time for administration of the
program as follows:
(Core)
Number of Approved
Resident Positions
Minimum Aggregate
APD Support
Required (FTE)
<15
n/a
16-20
0.1
21-25
0.2
26-30
0.3
31-35
0.4
36-40
0.5
41-45
0.6
46-50
0.7
51-55
0.8
56-60
0.9
61-65
1.0
> 65
1.1
Specialty-Specific Background and Intent: For instance, a program with an approved complement of 24
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Specialty/ Subspecialty
Name
Program Requirement Language
residents is required to have 50 percent FTE support for the program director and 20 percent FTE support for
the associate program director(s). The Review Committee decided not to specify how the support should be
distributed among associate program director(s) to allow programs, in partnership with their Sponsoring
Institution, to allocate the support as they see fit.
Medical Toxicology
(
subspecialty of
Emergency Medicine
or Preventive
Medicine)
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified
below for administration of the program.
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
0-3
0.2
4-6
0.2
7-9
0.3
10 or more
0.35
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Specialty/ Subspecialty
Name
Program Requirement Language
Molecular Genetic
Pathology*
(S
ubspecialty of Medical
Genetics and Genomics or
Pathology)
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time
specified below for administration of the program. This may be time spent by the program director only or
divided between the program director and one or more associate (or assistant) program directors.
(Core)
II.A.2.a).(1) Programs with up to four approved fellow positions must be provided with a minimum of 10 percent
time. Programs with five or six approved fellow positions must be provided with a minimum of 20 percent time.
Programs with seven or more approved fellow positions must be provided with a minimum of 20 percent time
and an additional 0.5 percent time for each approved position.
(Core)
Specialty-Specific Background and Intent: The additional 0.5 percent time is for each approved fellow
position in
the program, not just the approved fellow positions over seven. For example, a program with an approved
complement of seven fellow positions must be provided at least 23.5 percent time for program leadership. A
program approved for 10 fellow po
sitions must be provided with at least 25 percent time for program leadership;
and a program approved for 18 fellow positions must be provided with at least 29 percent time for program
leadership.
Neurocritical Care
(Subspecialty of Neurology
and Neurolog
ical Surgery)
II.A.2. The program director must be provided with support adequate for administration of the program
based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with dedicated time and support, as specified
below, for administration of the program:
(Core)
Number of Approved Fellow Positions
Minimum Support Required (FTE)
1-2
0.1
3
0.125
4
0.15
5
0.175
6 or more
0.2
Program Leadership Dedicated Time by Specialty Updated 04/2022
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Specialty/ Subspecialty
Name
Program Requirement Language
Neuromuscular Medicine*
(S
ubspecialty of Child
Neurology, Neurology, or
Physical Medicine and
Rehabilitation)
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time
specified below for administration of the program. This may be time spent by the program director only or
divided between the program director and one or more associate (or assistant) program directors.
(Core)
Number of Approved
Fellow Positions
Minimum FTE
1-3
0.1 FTE
4-6
0.15 FTE
7-9
0.2 FTE
10-12
0.25 FTE
13-15
0.3 FTE
Pain Medicine
(subspecialty
of
Anesthesiology, Child
Neurology, Neurology, or
Physical Medicine and
Rehabilitation)
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time
specified below for administration of the program. This may be time spent by the program director only or
divided between the program director and one or more associate (or assistant) program directors.
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
1-2
0.1
3-5
0.15
6 or more
0.2
Program Leadership Dedicated Time by Specialty Updated 04/2022
©2022 Accreditation Council for Graduate Medical Education (ACGME) Page 59 of 61
Specialty/ Subspecialty
Name
Program Requirement Language
Pediatric Emergency
Medicine*
(subspecialty of Pediatrics
and Emergency Medicine)
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) Program leadership, in aggregate, must be provided with support equal to a dedicated minimum time
specified below for administration of the program. This may be time spent by the program director only or
divided between the program director and one or more associate (or assistant) program directors.
Number of Approved Fellow
Positions
Minimum Support Required
(FTE)
< 7
.2
7-10
.4
11-15
.5
>15
.6
Program Leadership Dedicated Time by Specialty Updated 04/2022
©2022 Accreditation Council for Graduate Medical Education (ACGME) Page 60 of 61
Sleep Medicine*
(S
ubspecialty of Child
Neurology, Internal
Medicine, Neurology,
Pediatrics, or Psychiatry)
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified
below for administration of the program:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
.2
7-9
.25
10-12
.3
>12
.35
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate
program director(s). The associate program directors(s) must be provided with support equal to a dedicated
minimum time for administration of the program as follows:
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
0
7-9
.13
10-12
.14
>12
.15
Specialty-Specific Background and Intent: For instance, a program with an approved complement of eight
fellows must have at least 25 percent FTE support for the program director and at least 13 percent FTE support
for the associate program director (s). Although the associate program director (s) will also be core faculty
members, the required FTE support is not cumulative. The associate program director must receive either
support for the associate program director position or the 10 percent FTE for the core faculty member position,
but not both. For example, if one core faculty member is named the associate program director for an eight-
fellow program, the support for that position must be at least 13 percent FTE. Further, the Review Committee
allows the minimum required FTE support to be shared among multiple associate program director s, as
delegated by and at the discretion of the program director.
Program Leadership Dedicated Time by Specialty Updated 04/2022
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Specialty/ Subspecialty
Name
Program Requirement Language
Sports Medicine*
(S
ubspecialty of Emergency
Medicine, Family Medicine,
Pediatrics, or Physical
Medicine and Rehabilitation)
Proposed
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the salary support equal to a dedicated
minimum of 20 percent FTE of non-clinical time to the administration of the program.
(Core)
Undersea and Hyperbaric
Medicine*
(subspecialty of Emergency
Medicine or Preventive
Medicine)
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with the dedicated time and support specified
below for the administration of the program.
(Core)
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
0-3
0.2
4-6
0.2
7-9
0.3
10 or more
0.35
Sponsoring Institution-Based Fellowships
Fellowship Name
Program Requirement Language
Health Care Administration,
Leadership, and
Management
II.A.2. The program director and, as applicable, the program’s leadership team, must be provided with
support adequate for administration of the program based upon its size and configuration.
(Core)
II.A.2.a) At a minimum, the program director must be provided with support equal to a dedicated minimum of
0.1
FTE for administration of the program.
(Core)
