EMRA Board of Directors letter to the ACGME Board

April 30, 2025

Accreditation Council for Graduate Medical Education
401 North Michigan Avenue, Suite 2000
Chicago, IL 60611

Subject: Proposed Changes to ACGME Requirements for GME in EM

Dear ACGME Board of Directors,

The Emergency Medicine Residents’ Association (EMRA) is an independent, resident‑governed professional organization that serves as the voice of emergency physicians‑in‑training and the future of the specialty. We represent 18,000+ members, including more than 90% of current emergency medicine residents.

We urge the withdrawal of the proposed program requirements from consideration and the reintroduction of a subsequent, evidence‑based proposal that would allow for the continued accreditation of both 3‑ and 4‑year programs. When it comes to length of training, our members are clear: We can strengthen emergency medicine training without mandating a 4‑year model.

We ask that you consider the following while making your decision:

• There is no evidence to support mandating four years, nor is there evidence that this change would improve EM residents’ training or patient outcomes.
• The proposed requirements do not align with the ACGME’s push for competency‑based medical education.
• One size does not fit all. EM is unique in that there are multiple pathways to the same destination, and that flexibility should not be eliminated for the sake of uniformity alone.
• The house of medicine needs a strong ACGME that upholds its commitment to evidence‑based decision‑making and transparency.

EMRA recognizes the value of choice in emergency medicine residency training formats and urges the continued accreditation of three‑ and four‑year formats. EMRA has publicly posted our comments to the ACGME’s proposed EM program requirements, which include a suggested alternative structure. (Please see EMRA's detailed responses here.)

We appreciate your careful consideration of our concerns and requests as you review the proposed changes to our training. We recognize our shared goal of making emergency medicine the best specialty it can be, and we welcome further conversations and collaboration with you.

With respect,

EMRA Board of Directors