Program Pre-Accreditation and Continued Pre-Accreditation

Note: On July 1, 2020, the transition to a single GME accreditation system concluded. Some of the information on this page may no longer be relevant as a result. Direct questions regarding accreditation/application status to


Pre-accreditation is a status that signifies that an AOA-approved program or institution has submitted an application for ACGME accreditation. This status was established as part of the agreement among the ACGME, the AOA, and AACOM, and is conferred automatically upon submission of an application for accreditation in the ACGME Accreditation Data System (ADS). Pre-accreditation does not mean, or imply, that a program has been accredited by the ACGME.

Under the terms of the agreement among the ACGME, the AOA, and AACOM, there are three pathways to ACGME accreditation:

Pathway A. Programs that are AOA-approved and have matriculated residents as of July 1, 2015, and that apply for ACGME accreditation between July 1, 2015 and June 30, 2020, will be granted “pre-accreditation status.” For these programs:

  • Co-program directors may be appointed (one American Board of Medical Specialties (ABMS)-certified and one AOA-certified).
  • AOA Board certification is considered acceptable for faculty members to satisfy the requirement for faculty board certification.

Pathway B. Programs that are AOA-approved as of July 1, 2015, with no matriculated residents as of that date, that apply for ACGME accreditation between July 1, 2015 and June 30, 2020, will be granted “pre-accreditation status.”

Pathway C. AOA-approved programs that do not meet the criteria in A or B above may apply at any time for ACGME accreditation, but will not benefit from the terms of the agreement.

Pre-accreditation is not synonymous with Initial Accreditation. In order to achieve Initial Accreditation (and, ultimately, Continued Accreditation), a program or Sponsoring Institution must be determined by its ACGME Review Committee to be in substantial compliance with the applicable Program Requirements and/or the Institutional Requirements.

What Programs in Pre-Accreditation Should Know:
1. Site Visit Process

All new (core) specialty programs, and some subspecialty (fellowship) programs, must undergo a site visit prior to a review by the applicable Review Committee. Upon receipt of a completed program application, the Review Committee staff requests a site visit for the program applying. The visit entails a detailed review of the application and interviews with program and institutional leadership, faculty members, and residents/fellows. After the visit, the site visitor(s) submit an objective, factual report to the applicable specialty Review Committee.

Learn more about the accreditation site visit process here, and specifically about the site visit process in the transition to a single GME accreditation system through these presentation slides.

2. Participation in Annual Data Collection

Programs in pre-accreditation are required to participate in the ACGME’s annual data collection and reporting. Locate an overview of the ACGME’s data collection systems here.

Programs must:

  • Complete the Annual Update (in ADS) each fall and update program information any time it changes (i.e., with regards to residents/fellows, faculty members, board certification, etc.).
  • Report on the Milestones in ADS for residents listed on the program’s roster. Learn more about the Milestones here. To locate the Milestones for your specialty or subspecialty refer to this document.
  • Participate in the annual Resident and Faculty Surveys. Learn more about those surveys here.
  • Have residents and fellows begin using the ACGME Case Log System, if the specialty or subspecialty collects Case Log data. Not all specialties and subspecialties require the use of the system. Learn more about the ACGME Case Log System here.
3. Application for Osteopathic Recognition

ACGME-accredited programs and programs in pre-accreditation may initiate and submit an application for Osteopathic Recognition in ADS. Learn more about Osteopathic Recognition, and specifically about the application process.

Identify programs that have applied for and received Osteopathic Recognition.

If a program submits an application for Osteopathic Recognition while in pre-accreditation, that application is held for review by the Osteopathic Principles Committee until the program achieves Initial Accreditation. As soon as Initial Accreditation is achieved, the application is immediately placed on the next open meeting agenda for review. If the program chooses, it may update any Osteopathic Recognition application information that has changed since the original submission date.

If you have questions about Osteopathic Recognition, contact Executive Director for Osteopathic Accreditation Tiffany Moss at 312.755.5490 or

4. Fellowship Eligibility

The required clinical education for entry into an ACGME-accredited fellowship program may be completed in an ACGME-accredited residency program, AOA-approved residency program, program with ACGME International (ACGME-I) Advanced Specialty Accreditation, or Royal College of Physicians and Surgeons of Canada (RCPSC)-accredited or College of Family Physicians of Canada (CFPC)-accredited residency program located in Canada.

5. Acknowledgement of Status on the ACGME Website

Programs in pre-accreditation are immediately identified as such on the ADS public search and reports web page. This report shows all programs that have applied for accreditation during the transition to a single GME accreditation system.

6. Subspecialty Program Applications

An AOA-approved subspecialty (fellowship) program may initiate an application in ADS once the core program has pre-accreditation status; however, the application cannot be submitted for review until after the core program has achieved Initial Accreditation.

7. Application Review Process

Once an application has been finalized and submitted in ADS, the Review Committee will review the application, along with the site visit report, if a site visit occurred, for substantial compliance with the applicable requirements at its next scheduled meeting with an open agenda. If the Review Committee finds the program to be in substantial compliance with the Program Requirements, then it will confer a status of Initial Accreditation on the program. If it does not find a program in pre-accreditation to be in substantial compliance, it will confer a status of continued pre-accreditation on the program.

It may take 4-12 months after submission of an application to undergo a review and receive an accreditation decision from the Review Committee.

Continued Pre-Accreditation

Continued pre-accreditation is a status given to a program that does not achieve Initial Accreditation upon review by the Review Committee. The Review Committee will send the program a Letter of Notification (LON) with the accreditation decision, accompanied by citations that identify areas of non-compliance with the Program Requirements.

The program may reapply while maintaining continued pre-accreditation status. To do so, the program will submit an updated application that includes responses to citations given during the prior review, which provide information on how these citations have been, or are being, corrected. Another site visit may be scheduled, if deemed necessary. Using the results from the additional site visit and/or the updated application, the Review Committee will make another accreditation decision. Any questions regarding the Review Committee decision or the LON should be directed to the Review Committee Executive Director.

AOA-approved programs pursuing ACGME-accreditation must achieve Initial Accreditation before June 30, 2020, the end-date specified in the agreement among the ACGME, the AOA, and AACOM, to remain an accredited program.