Program Leadership Dedicated Time by Specialty Updated 10/2023
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Specialty-Specific Program Requirements: Program Leadership Dedicated Time
Effective as of October 18, 2023
Common Program Requirements are in bold
In addition to the specialty- and subspecialty-specific program requirements below, the following Common Program
Requirements Background and Intent addresses program leadership support:
Background and Intent: To achieve successful graduate medical education, individuals serving as education and
administrative leaders of residency programs, as well as those significantly engaged in the education, supervision,
evaluation, and mentoring of residents, must have sufficient dedicated professional time to perform the vital
activities required to sustain an accredited program.
The ultimate outcome of graduate medical education is excellence in resident education and patient care.
The program director and, as applicable, the program leadership team, devote a portion of their professional effort to
the oversight and management of the residency program, as defined in II.A.4.-II.A.4.a).(12). Both provision of support
for the time required for the leadership effort and flexibility regarding how this support is provided are important.
Programs, in partnership with their Sponsoring Institutions, may provide support for this time in a variety of ways.
Examples of support may include, but are not limited to, salary support, supplemental compensation, educational
value units, or relief of time from other professional duties.
Program directors and, as applicable, members of the program leadership team, who are new to the role may need to
devote additional time to program oversight and management initially as they learn and become proficient in
administering the program. It is suggested that during this initial period the support described above be increased
as needed.
In addition, it is important to remember that the dedicated time and support requirement for ACGME activities is a
minimum, recognizing that, depending on the unique needs of the program, additional support may be warranted.
The need to ensure adequate resources, including adequate support and dedicated time for the program director, is
also addressed in Institutional Requirement II.B.1. The amount of support and dedicated time needed for individual
programs will vary based on a number of factors and may exceed the minimum specified in the applicable
specialty/subspecialty-specific Program Requirements. It is expected that the Sponsoring Institution, in partnership
with its accredited programs, will ensure support for program directors, core faculty members, and program
coordinators to fulfill their program responsibilities effectively.
Program Leadership Dedicated Time by Specialty Updated 10/2023
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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
Program Leadership Dedicated Time by Specialty Updated 10/2023
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Specialty/
Subspecialty Name
Program Requirement Language
Anesthesiology
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
Total Minimum
Program
Leadership
Support
1-20
0.2
0.2
0.4
21-30
0.4
0.2
0.6
31-40
0.4
0.3
0.7
41-50
0.4
0.4
0.8
51-60
0.4
0.5
0.9
61-70
0.4
0.6
1.0
71-80
0.4
0.7
1.1
Over 80
0.4
0.8
1.2
Specialty-Specific Background and Intent: In determining the required minimum support for program leadership, the
Review Committee considered the following goals: 1) sufficient total administrative time for leadership; 2) sufficient
clinical exposure to the program director and associate program directors in the operating room; and 3) succession
planning and faculty development. The Review Committee recommends the program director be clinically active for a
minimum of 40 percent FTE.
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Specialty/
Subspecialty Name
Program Requirement Language
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)
Minimum Support
Required (FTE)
0.1
0.125
0.15
0.175
0.2
Colon and Rectal
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) 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)
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Specialty/
Subspecialty Name
Program Requirement Language
Dermatology
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 or fewer
0.2
13-18
0.3
19 or more
0.4
Micrographic Surgery
and Dermatologic
Oncology
Pediatric Dermatology
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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Diagnostic 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. 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
Pediatric Radiology
Neuroradiology
Nuclear Radiology
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
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
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Specialty/
Subspecialty Name
Program Requirement Language
II.A.2.b) From the support table listed above, program directors of programs approved for 18-35 residents must be
provided no less than 35 percent support and program directors of programs approved for 36 or more residents must be
provided no less than 50 percent support.
(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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Family 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. 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)
Program size
Minimum Support Required
(Percent Time/FTE) for
Program Director
Additional Minimum Support
Required (Percent Time/FTE)
for Program Leadership
1-6
20%
N/A
7-10
40%
N/A
11-15
50%
N/A
16-20
50%
10%
21-25
50%
20%
26-30
50%
30%
31-35
50%
40%
36-40
50%
50%
41-45
50%
60%
46-50
50%
70%
51-55
50%
80%
56-60
50%
90%
61-65
50%
100%
66-70
50%
110%
71-75
50%
120%
76-80
50%
130%
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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
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:
Number of Approved
Resident Positions
Minimum Support
Required (FTE)
<15
0
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
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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Adult Congenital Heart
Disease
Advanced Heart
Failure/Transplant
Cardiology
Interventional
Cardiology
Transplant Hepatology
Currently in Effect (7/1/2023)
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
0.20
7-9
0.25
10-12
0.30
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
0.13
10-12
0.14
Future Effective Date (7/1/2024)
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
0.20
7-9
0.25
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Specialty/
Subspecialty Name
Program Requirement Language
10-12
0.30
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s).
(Core)
II.A.2.c) The associate program director(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 Aggregate
Support Required
(FTE)
<7
Refer to PR II.B.4.c)
7-9
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
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Cardiovascular Disease
Currently in Effect (7/1/2023)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
19-21
0.45
>21
0.50
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
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
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28-30
0.30
31-33
0.36
34-36
0.42
37-39
0.48
40-42
0.54
43-45
0.60
46-48
0.66
Future Effective Date (7/1/2024)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
19-21
0.45
>21
0.50
II.B.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s).
(Core)
II.B.2.c) The associate program director(s) must be provided with support equal to a dedicated minimum time for
administration of the program as follows:
(Core)
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Specialty/
Subspecialty Name
Program Requirement Language
Number of Approved
Fellow Positions
Minimum Aggregate
Support Required
(FTE)
<7
Refer to PR II.B.4.c)
7-9
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
28-30
0.30
31-33
0.36
34-36
0.42
37-39
0.48
40-42
0.54
43-45
0.60
46-48
0.66
49-51
0.72
52-54
0.78
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Critical Care Medicine
Currently in Effect (7/1/2023)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
19-21
0.45
>21
0.50
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
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
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28-30
0.30
31-33
0.36
34-36
0.42
37-39
0.48
40-42
0.54
43-45
0.60
46-48
0.66
Future Effective Date (7/1/2024)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
19-21
0.45
>21
0.50
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s).
(Core)
II.A.2.c) The associate program director(s) must be provided with support equal to a dedicated minimum time for
administration of the program as follows:
(Core)
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Specialty/
Subspecialty Name
Program Requirement Language
Number of Approved
Fellow Positions
Minimum Aggregate
Support Required
(FTE)
<7
Refer to PR II.B.4.c)
7-9
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
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Clinical Cardiac
Electrophysiology
Endocrinology,
Diabetes and
Metabolism
Hematology
Medical Oncology
Rheumatology
Currently in Effect (7/1/2023)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
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
0.13
10-12
0.14
13-15
0.15
16-18
0.16
Future Effective Date (7/1/2024)
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)
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Specialty/
Subspecialty Name
Program Requirement Language
Number of Approved
Fellow Positions
Minimum Support
Required (FTE)
<7
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s).
(Core)
II.A.2.c) The associate program director(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 Aggregate
Support Required
(FTE)
<7
Refer to PR II.B.4.c)
7-9
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
Program Leadership Dedicated Time by Specialty Updated 10/2023
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Gastroenterology
Currently in Effect (7/1/2023)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
19-21
0.45
>21
0.50
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
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
28-30
0.30
31-33
0.36
Program Leadership Dedicated Time by Specialty Updated 10/2023
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34-36
0.42
Future Effective Date (7/1/2024)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
19-21
0.45
>21
0.50
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s).
(Core)
II.A.2.c) The associate program director(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 Aggregate
Support Required
(FTE)
<7
Refer to PR II.B.4.e)
7-9
0.13
10-12
0.14
13-15
0.15
Program Leadership Dedicated Time by Specialty Updated 10/2023
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Specialty/
Subspecialty Name
Program Requirement Language
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
28-30
0.30
31-33
0.36
34-36
0.42
37-39
0.48
40-42
0.54
43-45
0.60
46-48
0.66
49-51
0.72
52-54
0.78
Program Leadership Dedicated Time by Specialty Updated 10/2023
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Hematology and
Medical Oncology
Currently in Effect (7/1/2023)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
19-21
0.45
>21
0.50
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
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
28-30
0.30
31-33
0.36
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34-36
0.42
37-39
0.48
40-42
0.54
43-45
0.60
46-48
0.66
49-51
0.72
52-54
0.78
55-57
0.84
58-60
0.90
Future Effective Date (7/1/2024)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
19-21
0.45
>21
0.50
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s).
(Core)
II.A.2.c) The associate program director(s) must be provided with support equal to a dedicated minimum time for
administration of the program as follows:
(Core)
Program Leadership Dedicated Time by Specialty Updated 10/2023
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Specialty/
Subspecialty Name
Program Requirement Language
Number of Approved
Fellow Positions
Minimum Aggregate
Support Required
(FTE)
<7
Refer to PR II.B.4.d)
7-9
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
28-30
0.30
31-33
0.36
34-36
0.42
37-39
0.48
40-42
0.54
43-45
0.60
46-48
0.66
49-51
0.72
52-54
0.78
Program Leadership Dedicated Time by Specialty Updated 10/2023
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Infectious Disease
Nephrology
Currently in Effect (7/1/2023)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
19-21
0.45
>21
0.50
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
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
Future Effective Date (7/1/2024)
Program Leadership Dedicated Time by Specialty Updated 10/2023
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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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
19-21
0.45
>21
0.50
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s).
(Core)
II.A.2.c) The associate program director(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 Aggregate
Support Required
(FTE)
<7
Refer to PR II.B.4.c)
7-9
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
Program Leadership Dedicated Time by Specialty Updated 10/2023
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Specialty/
Subspecialty Name
Program Requirement Language
25-27
0.24
Interventional
Pulmonology
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
0.20
7-9
0.25
10-12
0.30
II.A.2.b) Programs must appoint at least one of the interventional pulmonology core faculty members to be associate
program director(s).
(Core)
II.A.2.c) The associate program director(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
Refer to PR II.B.4.c)
7-9
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
Program Leadership Dedicated Time by Specialty Updated 10/2023
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Pulmonary Disease
Currently in Effect (7/1/2023)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
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
0.13
10-12
0.14
13-15
0.15
Future Effective Date (7/1/2024)
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
Minimum Support
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Specialty/
Subspecialty Name
Program Requirement Language
Fellow Positions
Required (FTE)
<7
0.20
7-9
0.25
10-12
0.30
13-15
0.35
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s).
(Core)
II.A.2.c) The associate program director(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 Aggregate
Support Required
(FTE)
<7
Refer to PR II.B.4.c)
7-9
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
Program Leadership Dedicated Time by Specialty Updated 10/2023
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Pulmonary Disease and
Critical Care Medicine
Currently in Effect (7/1/2023)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
19-21
0.45
>21
0.50
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
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
28-30
0.30
31-33
0.36
Program Leadership Dedicated Time by Specialty Updated 10/2023
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34-36
0.42
37-39
0.48
Future Effective Date (7/1/2024)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
19-21
0.45
>21
0.50
II.A.2.b) Programs must appoint at least one of the subspecialty-certified core faculty members to be associate program
director(s).
(Core)
II.A.2.c) The associate program director(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 Aggregate
Support Required
(FTE)
<7
Refer to PR II.B.4.d)
7-9
0.13
10-12
0.14
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Specialty/
Subspecialty Name
Program Requirement Language
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
28-30
0.30
31-33
0.36
34-36
0.42
37-39
0.48
40-42
0.54
43-45
0.60
46-48
0.66
49-51
0.72
52-54
0.78
Program Leadership Dedicated Time by Specialty Updated 10/2023
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Specialty/
Subspecialty Name
Program Requirement Language
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
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
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)
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Specialty/
Subspecialty Name
Program Requirement Language
Laboratory Genetics
and Genomics
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
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
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
Program Leadership Dedicated Time by Specialty Updated 10/2023
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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
Program Leadership Dedicated Time by Specialty Updated 10/2023
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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
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%
>70
55%
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Specialty/
Subspecialty Name
Program Requirement Language
Adult Reconstructive
Orthopaedic Surgery
Foot
and Ankle
Orthopaedic Surgery
Musculoskeletal
Oncology
Orthopaedic Sports
Medicine
Orthopaedic Surgery of
the Spine
Orthopaedic Trauma
Pediatric Orthopaedic
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) 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%
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
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%
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Specialty/
Subspecialty Name
Program Requirement Language
Neurotology
Pediatric
Otolaryngology
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)
Pathology
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.
II.A.2.b) Programs with 16 or more approved resident positions should have an associate (or assistant) program
director to assist the program director with administration of the program.
(Core)
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Specialty/
Subspecialty Name
Program Requirement Language
Blood
Banking/Transfusion
Medicine
Forensic Pathology
Pediatric Pathology
Selective Pathology
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)
Subspecialty-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)
Subspecialty-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
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)
Subspecialty-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
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
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
91-95
2.1
96-100
2.2
101-105
2.3
106-110
2.4
111-115
2.5
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Specialty/
Subspecialty Name
Program Requirement Language
116-120
2.6
121-125
2.7
126-130
2.8
131-135
2.9
136-140
3.0
141-145
3.1
146-150
3.2
151-155
3.3
156-160
3.4
161-165
3.5
166-170
3.6
171-175
3.7
176-180
3.8
181-185
3.9
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Specialty/
Subspecialty Name
Program Requirement Language
Adolescent Medicine
Child Abuse Pediatrics
Developmental-
Behavioral Pediatrics
Pediatric Cardiology
Pediatric Critical Care
Medicine
Pediatric Endocrinology
Pediatric
Gastroenterology
Pediatric Hematology-
Oncology
Pediatric Hospital
Medicine
Pediatric Infectious
Diseases
Neonatal-
Perinatal
Medicine
Pediatric Nephrology
Pediatric Pulmonology
Pediatric 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) 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
0.2
7-10
0.4
11-15
0.5
>15
0.6
Pediatric 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) 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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Specialty/
Subspecialty Name
Program Requirement Language
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) 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
0.2
0
7-10
0.2
0.2
11-15
0.2
0.3
16-20
0.2
0.4
21-25
0.2
0.5
26-30
0.2
0.6
31-35
0.2
0.7
36-40
0.2
0.8
41-45
0.2
0.9
46-50
0.2
1.0
51-55
0.2
1.1
Pediatric Rehabilitation
Medicine
Spinal Cord Injury
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) 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
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
0.20
7-10
0.25
11-20
0.30
21-30
0.35
31-35
0.40
>36
0.45
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
Aerospace Medicine
Occupational and
Environmental
Medicine
Public Health and
General 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) 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)
Number of Approved Resident
Positions
Minimum Support
Required (FTE)
1-6
20 percent
7-15
30 percent
16 or more
40 percent
Specialty-specific background and intent: As stated above, the program requirements specify the minimum dedicated
time and support required for oversight and administration of the program. In determining the appropriate level of
support for the program’s leadership, programs are encouraged to consider additional administrative responsibilities,
such as applying for and managing multiple grant funding award requirements.
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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)
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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
0.20
7-8
0.36
9-10
0.40
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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
0.20
7-8
0.36
9-10
0.40
11-12
0.44
13-14
0.48
15-16
0.52
17-18
0.56
19-20
0.60
21-22
0.64
23-24
0.68
25-26
0.72
27-28
0.76
Radiation 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 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
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
0.20
n/a
7-10
0.25
n/a
11-20
0.30
n/a
21-30
0.30
0.10
31-40
0.40
0.10
41-50
0.40
0.20
51-60
0.50
0.20
61-70
0.50
0.30
71-80
0.50
0.40
81-90
0.50
0.50
≥91
0.50
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
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
0.20
7-10
0.25
11 or more
0.30
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
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
0.10
7-10
0.15
11 or more
0.20
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Specialty/
Subspecialty Name
Program Requirement Language
Vascular Surgery –
Integrated
Vascular Surgery –
Independent
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) for the
Program Director
Minimum Additional
Support Required (FTE)
for Program Leadership
in Aggregate
1-6
0.20
n/a
7-10
0.30
n/a
11-20
0.30
0.10
21 or greater
0.30
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)
Specialty-Specific Background and Intent: Programs are advised that the Common Program Requirements specify that
protected time is specifically for the administration of the program and not for clinical activities. The program is further
advised that the Program Requirements for independent and integrated vascular surgery programs are two distinct sets
of requirements. If a single program director has responsibility for both program formats, the applicable protected time is
outlined in II.A.2. of both sets of Program Requirements.
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Thoracic Surgery –
Integrated
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
0.20
7-10
0.35
11-15
0.40
16-20
0.45
21-25
0.50
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
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
0.20
7-10
0.35
11-15
0.40
16-20
0.45
21-25
0.50
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
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)
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)
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)
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
0.20
7-9
0.25
10-12
0.30
>12
0.35
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
0.13
10-12
0.14
>12
0.15
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)
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)
Neuroendovascular
Intervention
(S
ubspecialty of Child
Neurology,
Neurological
Surgery, Neurology, or
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
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)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
>18
0.45
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
0.13
10-12
0.14
13-15
0.15
16-18
0.16
>18
0.17
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)
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)
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
0.20
7-9
0.25
10-12
0.30
13-15
0.35
16-18
0.40
>18
0.45
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
0.13
10-12
0.14
13-15
0.15
16-18
0.16
>18
0.17
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)
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)
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.
Neurocritical Care
(Subspecialty of Neurology
and Neurological 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
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Specialty/ Subspecialty
Name
Program Requirement Language
Neuromuscular Medicine
(S
ubspecialty of 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 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
0.10
3-5
0.15
6 or more
0.20
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Specialty/ Subspecialty
Name
Program Requirement Language
Pediatric Emergency
Medicine
(subspecialty of Pediatrics
and Emergency 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) 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
0.2
7-10
0.4
11-15
0.5
>15
0.6
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Sleep Medicine
(S
ubspecialty of Child
Neurology, Internal
Medicine, Neurology,
Pediatrics, or Psychiatry)
Currently in Effect (7/1/2023)
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
0.20
7-9
0.25
10-12
0.30
>12
0.35
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
0.13
10-12
0.14
>12
0.15
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
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delegated by and at the discretion of the program director.
Future Effective Date (7/1/2024)
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
0.20
7-9
0.25
10-12
0.30
>12
0.35
II.A.2.b) Program must appoint at least one of the subspecialty-certified core faculty members to be associate
program director(s).
(Core)
II.A.2.c) The associate program director(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 Aggregate
Support Required
(FTE)
<7
Refer to PR II.B.4.c)
7-9
0.13
10-12
0.14
13-15
0.15
16-18
0.16
19-21
0.17
22-24
0.18
25-27
0.24
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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)
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)