The PRWG cannot simply bulldoze the many experienced PDs, chairs, and other education leaders who have serious concerns about the rationale, feasibility, and effects of this mandate.

Emergency medicine educators are highly invested in ensuring the competency of our residency graduates. We also believe in raising the minimum standards for emergency medicine training programs. However, the PRWG has not yet done the work to demonstrate that a significant problem with graduate competency exists, and to show that a time-dependent format change would be the appropriate evidence-based intervention to improve training standards.

To be effective in managing a change of this magnitude, you must engage the people affected and provide robust evidence and rationale before pushing ahead with a burdensome and risky change. The ask is simple: The ACGME and PRWG should pause this mandate, seek more data, and engage the broader group of emergency medicine educators who are rightfully concerned.

We all want to ensure excellent emergency medicine education for the future, so let’s work together to get it right.

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Dr. Healy is a professor of clinical emergency medicine and residency program director at the Lewis Katz School of Medicine at Temple University.

References

1. Regan L, McGee D, Davis F, Murano T. Building the future curriculum for emergency medicine residency training. J Grad Med Educ. 2025;17(2):248-253.
2. Nikolla DA, Zocchi MS, Pines JM, et al. Four- and three-year emergency medicine residency graduates perform similarly in their first year of practice compared to experienced physicians. Am J Emerg Med. 2023;69:100-107.
3. Beeson MS, Barton MA, Reisdorff EJ, et al. Comparison of performance data between emergency medicine 1-3 and 1-4 program formats. J Am Coll Emerg Physicians Open. 2023;4(3):e12991.