ACGME Specialties Requiring a Preliminary Year

08/2023

(as of July 1, 2023)

Transitional Year Review Committee

Specialty

Program

Requirement(s)

Requirements for PGY-1

Aerospace Medicine

III.A.2.b)-

III.A.2.b).(1)

• Residents entering a 24-month program that does not include

education in fundamental clinical skills of medicine must have

successfully completed at least 12 months of clinical education in a

residency program accredited by the ACGME, the American

Osteopathic Association (AOA), the Royal College of Physicians and

Surgeons of Canada (RCPSC), or the College of Family Physicians

of Canada (CFPC), or ACGME International (ACGME-I) (Advanced

Specialty Accreditation).

• PGY-1 resident experience must include at least 10 months of direct

patient care in both inpatient and outpatient settings.

Anesthesiology

III.A.2.a).(1);

IV.C.3.-IV.C.3.b);

IV.C.4.

• Residents must have successfully completed 12 months of

education in fundamental clinical skills in a program accredited by

the ACGME, AOA, RCPSC, or CFPC, or in a program with ACGME-

I Advanced Specialty Accreditation.

• 12 months of education must provide education in fundamental

clinical skills of medicine relevant to anesthesiology.

o This education does not need to be in the first year, but it

must be completed before starting the final year.

o This education must include at least six months of

fundamental clinical skills education caring for inpatients in

family medicine, internal medicine, neurology, obstetrics

and gynecology, pediatrics, surgery or any surgical

specialties, or any combination of these.

• During the first 12 months, there must be at least one month (not

more than two) each of critical care medicine and emergency

medicine.

Dermatology

III.A.2.a).(1)-

III.A.2.a).(1).(a)

• Prior to appointment, residents must have successfully completed a

broad-based clinical year (PGY-1) in an emergency medicine, family

medicine, general surgery, internal medicine, obstetrics and

gynecology, pediatrics, or a transitional year program accredited by

the ACGME, AOA, RCPSC, CFPC, or ACGME-I (Advanced

Specialty Accreditation).

• During the first year (PGY-1), elective rotations in dermatology must

not exceed a total of two months.

Diagnostic Radiology

III.A.2.b)-

III.A.2.b).(1).(a)

• To be eligible for appointment to the 48-month program, residents

must have successfully completed a prerequisite year of direct

patient care in a program accredited by the ACGME, AOA, RCPSC,

CFPC, or ACGME-I (Advanced Specialty Accreditation) in

anesthesiology, emergency medicine, family medicine, internal

medicine, neurology, obstetrics and gynecology, pediatrics, surgery

or a surgical specialty, a transitional year, or any combination of

these.

• The prerequisite year must include a minimum of 36 weeks in direct

patient care.

• During the prerequisite year, elective rotations in diagnostic

radiology, interventional radiology, or nuclear medicine must only

occur in radiology departments with a diagnostic radiology,

interventional radiology, or nuclear medicine residency in a program

accredited by the ACGME, AOA, RCPSC, CFPC, or ACGME-I

(Advanced Specialty Accreditation), and must not exceed a

08/2023

Specialty

Program

Requirement(s)

Requirements for PGY-1

combined total of two months. Residents should actively participate

(not solely observe) and the rotations should be supervised by a

radiology program faculty member.

Nuclear Medicine

III.A.2.a).(1)-

III.A.2.a).(1).(a)

• Residents must have successfully completed at least one year of

graduate medical education in a program accredited by the

ACGME, AOA, RCPSC, CFPC, or ACGME-I (Advanced Specialty

Accreditation).

• A minimum of nine months of direct patient care is required.

Neurology

III.A.2.b)-

III.A.2.b).(2).(a)

• Residents entering a program that offers the 36-month format must

have completed a year of graduate medical education in a program

accredited by the ACGME, AOA, RCPSC, CFPC, or ACGME-I

(Advanced Specialty Accreditation)

and that includes at least one of

the following:

• Eight months in internal medicine with primary responsibility

in patient care; or,

• Six months in internal medicine with primary responsibility in

patient care and a period of at least two months comprising

one or more months of emergency medicine, family

medicine, internal medicine, or pediatrics.

• Residents may spend up to four months in neurology during this

year.

Occupational and

Environmental

Medicine

III.A.2.b)-

III.A.2.b).(1)

• Residents entering a 24-month program that does not include

education in fundamental clinical skills of medicine must have

successfully completed at least 12 months of clinical education in a

residency program accredited by the ACGME, AOA, RCPSC,

CFPC, or ACGME-I (Advanced Specialty Accreditation).

• PGY-1 resident experience must include at least 10 months of direct

patient care in both inpatient and outpatient settings.

Ophthalmology

III.A.2.b)-

III.A.2.c).(1);

IV.C.3.-IV.C.4.

• Residents entering a joint preliminary year/ophthalmology format

program should have completed 12 months of preliminary clinical

education in an ACGME-accredited program sponsored by the

same institution that sponsors the ophthalmology residency

program.

• The preliminary year must be in a program that includes direct

patient care experience (e.g., emergency medicine, family medicine,

internal medicine, neurology, obstetrics and gynecology, pediatrics,

or surgery, or a transitional year program), and must include:

• Nine months of broad experience in direct patient care that

takes place in diverse settings and includes the diagnosis

and treatment of patients with varied diseases and

conditions. Examples of appropriate settings include

inpatient wards, the emergency room, outpatient clinics,

and the operating room.

• Three months of experience in ophthalmology in the same

Sponsoring Institution as the ophthalmology program or at a

site acceptable to the Review Committee.

• For the joint preliminary year/ophthalmology format, the educational

program for the preliminary year must be developed by the program

director of the preliminary year program with the input and approval

of the respective ophthalmology program director.

Osteopathic

Neuromusculoskeletal

Medicine

III.A.2.c)

•

To be eligible for entry into the program at the ONMM2 level,

residents must have successfully completed, prior to appointment, a

broad-based clinical year (PGY-1) in a residency program

accredited by the ACGME, AOA, RCPSC, CFPC, or ACGME-I

(Advanced Specialty Accreditation).

Physical Medicine

and Rehabilitation

III.A.2.a).(1);

IV.C.3.d)-

IV.C.3.d).(1).(b).(iv)

• Prior to beginning PGY-2 physical medicine and rehabilitation

rotations, residents must have successfully completed 12 months of

education in fundamental clinical skills in either a transitional year

08/2023

Specialty

Program

Requirement(s)

Requirements for PGY-1

program or a residency program accredited by the ACGME, AOA,

RCPSC, CFPC, or ACGME-I (Advanced Specialty Accreditation).

• The first 12 months must include:

o At least six months must include emergency medicine, family

medicine, internal medicine, obstetrics and gynecology,

pediatrics, surgery, or any combination of these patient care

experiences.

o The remaining months of these 12 months of education may

include any combination of accredited specialty or subspecialty

education.

o Rotations in any of the specialties or subspecialties selected

must be for a period of at least four weeks.

o No more than eight weeks may be in non-direct patient care

experiences, such as pathology, radiology, and research,

and no more than four weeks may be in physical medicine

and rehabilitation.

Public Health and

General Preventive

Medicine

III.A.2.b)-

III.A.2.b).(1)

• Residents entering a 24-month program that does not include

education in fundamental clinical skills of medicine must have

successfully completed at least 12 months of clinical education in a

residency program accredited by the ACGME, AOA, RCPSC, CFPC,

or ACGME-I (Advanced Specialty Accreditation).

• PGY-1 resident experience must include at least 10 months of direct

patient care in both inpatient and outpatient settings.

Radiation Oncology

III.A.2.b)-

III.A.2.b).(2)

• Prior to entering the program, residents must have completed 12

months of post-graduate clinical education in a residency program

accredited by the ACGME, AOA, RCPSC, CFPC, or ACGME-I

(Advanced Specialty Accreditation).

o There must be a minimum of nine months of direct patient

care in family medicine, internal medicine, obstetrics and

gynecology, pediatrics, or surgery or surgical specialties, or

in a transitional year program.

o A maximum of three months can be in radiation oncology.