CLER Program History

Between 2012 and 2025, the ACGME’s Clinical Learning Environment Review (CLER) Program conducted site visits to the hospitals, medical centers, and other clinical settings of ACGME-accredited institutions that host residency and fellowship programs to assess graduate medical education (GME) engagement in important cross-cutting areas of focus, such as patient safety and health care quality. The information gathered from these visits revealed numerous opportunities for GME to partner with clinical learning environments to improve both learning and patient care. Through constructive dialogue and collaboration, the CLER Program fostered relationships, promoted shared goals, and nurtured a culture of ongoing improvement that optimized the clinical learning environment during a critical time in the education of new physicians—a time when exposure to the concepts of patient safety and health care quality improvement are important in forming enduring practices.

Over the years, the CLER Program produced reports and resources that can be used to accelerate national conversations among educators, health care leaders, policy makers, and patients regarding the importance of continually assessing and improving the environments in which the US physician workforce learns and trains, as well as the role of GME in promoting safe, high-quality patient care.