Recognition of Non-Standard Training for Exchange Visitor (J-1) Physicians to Transition to the ACGME

April 19, 2021

Today, the Educational Commission for Foreign Medical Graduates (ECFMG®), American Board of Medical Specialties (ABMS®), and Accreditation Council for Graduate Medical Education (ACGME®) announced a change in the process for recognition of non-standard training as it relates to the J-1 visa program administered by ECFMG. The term “non-standard training” refers to advanced clinical subspecialty disciplines or pathways for which there is no ACGME accreditation and/or ABMS Member Board certification available. Currently, all non-standard disciplines must be endorsed by an appropriate ABMS Member Board to be considered for J-1 sponsorship. The role of the ABMS Member Boards in providing this approval is detailed in federal regulation 22 CFR §62.27(e)(4)(i).

While the ABMS and its Member Boards have historically played a role in recognizing non-standard disciplines, ABMS initiated discussions several years ago with ECFMG about relinquishing that role. The rationale is that oversight of non-standard training does not fit with the mission of the ABMS and its Member Boards, which are responsible for certification of individuals; and, as such, the Member Boards are not structured to provide oversight of training programs and institutions. It was the consensus of the two organizations that the ACGME, as the primary national accreditor of graduate medical education programs and the institutions that sponsor them, is well suited to provide recognition of Sponsoring Institutions offering non-standard training opportunities to exchange visitor (J-1) physicians. At the request of the ECFMG and ABMS, the ACGME agreed to assume this responsibility. The ECFMG, ABMS, and ACGME jointly submitted a proposal to the United States Department of State (DOS) to substitute Sponsoring Institution “recognition” by the ACGME for the current ABMS endorsement role, with a transition period during which either organization’s recognition process may be honored based on criteria currently being developed. With publication of a Federal Register Notice on April 19, 2021, the DOS officially acknowledges the administrative change proposed by the ECFMG, ABMS, and ACGME. 

Under the new model, the ACGME will offer recognition of Sponsoring Institutions that offer non-standard training programs for exchange visitor physicians. This recognition has been designed to ensure that institutions are providing appropriate oversight of the non-standard training program(s) they offer. The ACGME will not recognize individual non-standard training programs. A working group has been formed to develop Recognition Requirements and, upon ACGME Board approval of those Requirements, a new Recognition Committee will be formed to review and monitor institutions seeking to achieve and maintain this recognition.

Detailed information regarding the ACGME recognition process will be provided in the coming months, including notification when the proposed Recognition Requirements are posted on the ACGME website for a 45-day public comment period.

Questions regarding the release of the proposed Recognition Requirements should be directed to either Kathy Malloy, ACGME vice president, Accreditation Standards (312.755.5061 or or Tracy Wallowicz, assistant vice president, US Graduate Medical Education Services (215.823.2120 or

Questions regarding the recognition process should be directed to Paul Johnson, ACGME executive director, Institutional Accreditation (312.755.5005 or


William W. Pinsky, MD, FAAP, FACC
President and Chief Executive Officer, ECFMG 

Richard E. Hawkins, MD
President and Chief Executive Officer, ABMS 

Thomas J. Nasca, MD, MACP
President and Chief Executive Officer, ACGME