ACGME CEO Thomas Nasca, MD, MACP has written a letter updating the community on the outcome of negotiations to create a single accreditation system for graduate medical education in the United States. A link to the letter may be found here. The implications of this decision are not clear. Prior to the announcement of this negotiation, the ACGME attended to REQUIRE ACGME accredited training for all PGY-1 residents entering advanced PGY-2 training programs (e.g. anesthesiology, radiology) and for all fellowship applicants to ACGME accredited programs. For example, applicants to cardiology fellowships would have to complete an ACGME accredited Internal Medicine Residency. Stay tuned.