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CLER Site Visit

The CLER Program is designed to provide US teaching hospitals, medical centers, health systems, and other clinical settings affiliated with ACGME-accredited Sponsoring Institutions with periodic feedback that addresses the following six areas: patient safety; health care quality; care transitions; supervision; well-being; and professionalism.

To accomplish this, the ACGME conducts CLER site visits to the hospitals, medical centers, and other clinical settings of accredited institutions that sponsor residency and fellowship programs. During these visits, CLER Field Representatives meet with the executive leadership of the organizations; the organization’s leaders in patient safety, health care quality, and well-being; leaders of graduate medical education (GME); and groups of residents and fellows, faculty members, and program directors. Additionally, the CLER team visits various patient floors, units, and service areas to gather input from the broader range of clinical staff members as to how the organization functions as a learning environment.

At the conclusion of each visit, the CLER team meets with the organization’s executive leadership to share its observations of resident and fellow engagement in the six CLER Focus Areas. It is through this feedback that the ACGME seeks to improve both physician education and the quality of patient care within these organizations.

CLER Site Visit Scheduling

The CLER site visits are short-notice visits (no fewer than 10 days’ notice) and the Sponsoring Institution’s designated institutional official (DIO) is the primary contact. The CLER Field Representatives will visit one participating site per Sponsoring Institution. However, the site visitors may elect to go to more than one location at that site, especially if there are ambulatory clinical or specialty facilities within walking distance.

As part of the scheduling process, the Sponsoring Institution will be asked to confirm that both the DIO and the Chief Executive Officer of the participating site will be available to attend required opening and closing meetings. If a visit cannot be confirmed within 24 hours of contact, the Sponsoring Institution will receive a “pass.” The CLER team will make up to four attempts to schedule the visit (total of three passes allowed). Failure to accomplish a CLER site visit within the allotted number of attempts will result in a recommendation to the ACGME Board of Directors to confer upon the Sponsoring Institution the status of Administrative Probation ACGME policy 16.61.

To optimize the success of the scheduling process, three times a year, DIOs have the opportunity to “black out” up to five weeks on the CLER Program calendar via the Accreditation Data System. See below for more information.

Blackout Dates

Blackout Dates are now Blackout Weeks!

The Clinical Learning Environment Review (CLER) Program offers a time-limited feature allowing Sponsoring Institutions to submit up to 15 full blackout weeks every year. These 15 weeks will be comprised of five blackout weeks requested three times per year via the ACGME's Accreditation Data System (ADS).

Blackout weeks are intended to cover dates during which institutional leadership and staff members may not be available, due to retreats, religious holidays observed by the Sponsoring Institution, local holidays, board meetings, etc.

Process for Submitting Blackout Weeks – Five Weeks; Submitted Three Times per Year

Three times a year, a feature within ADS opens to allow designated institutional officials (DIOs) and institutional coordinators the option of requesting blackout weeks. During these windows, DIOs and institutional coordinators may log into ADS and click on "Blackout Dates" in the right navigation panel under the "Institution" tab to submit their requests.

This ADS feature will open:

  • November 1-28, 2017 to enter requests for January-April 2018
  • March 1-28, 2018 to enter requests for May-August 2018
  • July 3-28, 2018 to enter requests for September-December 2018


  • Only the DIO and institutional coordinator have access to this feature in ADS.
  • ADS will only allow users to enter up to five weeks per time period.

Additional Information

In 2018, the CLER Program will already avoid scheduling site visits during the following weeks:

  • CLER Blackout week (January 1-5, 2018)
  • ACGME Annual Educational Conference (February 26-March 2, 2018)
  • CLER Blackout week (March 5-9, 2018)
  • CLER Blackout week (June 25-29, 2018)
  • CLER Blackout week (July 2-6, 2018)
  • CLER Blackout week (December 24-28, 2018)

The CLER Program will also avoid scheduling on the following days (note: the CLER Program will still schedule visits during these weeks):

  • Martin Luther King Jr. Day (January 15, 2018)
  • Memorial Day (May 28, 2018)
  • Labor Day (September 3, 2018)
  • Thanksgiving (November 22-23, 2018)

To successfully schedule a CLER visit, the DIO and CEO of the site being visited must agree to participate in an initial and exit meeting. When selecting blackout dates, check with the CEO of the clinical site to be visited to identify known dates of unavailability. Also consider any other times when institutional staff members may not be available.

Sponsoring Institutions with a status of Pre-Accreditation or Initial Accreditation will not be contacted to schedule a CLER visit until their status is changed to Continued Accreditation.

The CLER Program will make every effort to comply with your requests; however, there is no guarantee that you will not be contacted for a visit during the requested blackout dates.

E-mail questions to Joshua Mirôn.

Contact CLER Staff
Vice President, Clinical Learning Environment Review (CLER)
Robin Wagner, RN, MHSA
Director, CLER Operations
Betsy Kimball, MA
Other CLER Resources
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