Clinical Learning Environment Review (CLER)

The Accreditation Council for Graduate Medical Education (ACGME) recognizes the public's need for a physician workforce capable of meeting the challenges of a rapidly evolving health care environment.

The ACGME has responded to this need by implementing the CLER program as a part of its Next Accreditation System. The CLER Program is designed to provide US teaching hospitals, medical centers, health systems, and other clinical settings affiliated with ACGME-accredited institutions with periodic feedback that addresses the following six Focus Areas: Patient Safety; Health Care Quality; Care Transitions; Supervision; Well-Being; and Professionalism.

The feedback provided by the CLER Program is designed to improve how clinical sites engage resident and fellow physicians in learning to provide safe, high quality patient care.

The only accreditation requirement associated with this program is that each Sponsoring Institution must undergo a CLER site visit every 24 months (+/-6) to maintain accreditation.

News and Announcements

CLER Report of Findings 2021: Subprotocol for Operative and Procedural Areas

February 2021 - The CLER Program is pleased to announce the release of a special report of findings from the CLER Subprotocol for Operative and Procedural Areas. The report provides new insights into these key clinical areas through the lens of their roles as clinical learning environments for our nation’s resident and fellow physicians. As with the larger CLER national reports, the key findings of the subprotocol highlight a mixture of strengths and opportunities for improvement, some unique to the perioperative environment, and some that are similar to other places the clinical learning environment.

Click here to view the report

CLER Pathways to Excellence 2.0

December 2 - The Accreditation Council for Graduate Medical Education’s (ACGME’s) Clinical Learning Environment Review (CLER) Program is pleased to announce the publication of CLER Pathways to Excellence: Expectations for an Optimal Clinical Learning Environment to Achieve Safe and High-Quality Patient Care, Version 2.0. The CLER pathways, organized according to the six CLER Focus Areas of Patient Safety, Health Care Quality, Teaming, Supervision, Well-being, and Professionalism, serve as a tool to promote discussions and actions to optimize the clinical learning environment.

CLER Pathways to Excellence

Press Release

Contact CLER Staff:
Director, CLER Site Visit Program
Kristen Ward Hirsch
Senior Vice President, Clinical Learning Environment Review (CLER)
Robin Wagner, RN, MHSA
Other CLER Resources