Sponsoring Institution Initial 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 singleGME@acgme.org.


A status of Initial Accreditation is conferred when the Institutional Review Committee determines that an application for a new Sponsoring Institution substantially complies with the Institutional Requirements.

What Sponsoring Institutions with Initial Accreditation Should Know

1. Letter of Notification (LON) and Response to Citations

The Executive Director of the Institutional Review Committee sends the Sponsoring Institution a Letter of Notification (LON) detailing the accreditation decision and any citations or areas for improvement (AFIs) given by the Committee at the time of the application review. While the Institutional Review Committee does not expect or encourage direct written responses to the LON, or to citations or AFIs, Sponsoring Institutions are expected to begin addressing the citations or AFIs upon receipt of the LON. Each year, Sponsoring Institutions must provide a response to all institutional citations during the Accreditation Data System (ADS) Annual Update. Any questions regarding an Institutional Review Committee decision or LON should be directed to the staff of the Institutional Review Committee (whose contact information can be found on the Institutional Review Committee section of the website). 

2. Initial Accreditation Contingent upon Sponsoring Institution Initial Accreditation Programs

A program with a status of Initial Accreditation Contingent upon Sponsoring Institution Initial Accreditation automatically receives a status of Initial Accreditation when its Sponsoring Institution achieves Initial Accreditation. An LON is sent to the program with notification of the status change.

3. ADS Annual Update

Sponsoring Institutions must participate in the ADS Annual Update, reviewing all information in ADS for accuracy during a specific, assigned time period.

4. Next Sponsoring Institution Review

Sponsoring Institutions are reviewed by the Institutional Review Committee approximately two years after the effective date of their Initial Accreditation status. A Sponsoring Institution undergoes a full site visit prior to this review. If the Sponsoring Institution demonstrates substantial compliance with the Institutional Requirements, the Institutional Review Committee grants a status of Continued Accreditation. Sponsoring Institutions with Continued Accreditation status are reviewed annually by the Institutional Review Committee, and are subject to the ACGME institutional self-study and the 10-year institutional accreditation site visit.

5. Clinical Learning Environment Review (CLER) Program

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 focus areas: patient safety; health care quality; care transitions; supervision; clinical experience and education (formerly duty hours), fatigue management, and mitigation; and professionalism. Sponsoring Institutions participate in the CLER Program once they have Continued Accreditation status.

Learn more about the CLER Program.