New ACGME Proposals Threaten Resident Rest Requirements and Shift Limits

The ACGME just opened a comment window that could fundamentally rewrite what "protected" means in graduate medical education — and if you're in a Florida residency or fellowship, this lands on your schedule before the end of the year.

The proposal, stripped down

The headline changes: eliminate the eight-hour rest requirement between shifts, cut mandatory post-call rest from fourteen hours down to twelve, and drop the rule prohibiting residents from working more than every third night over a four-week period.

The comment period closes October 22, 2026.

That's the official version. Here's the on-the-ground reality for our colleagues — especially those rotating through high-volume programs in Miami-Dade, Broward, and Orange County: looser rest rules don't free up hours for education. They free up hours for service.

Why Florida programs feel this first

The ACGME also posted proposed Program Requirements revisions specifically for Diagnostic Radiology and Interventional Radiology, with a separate comment window running through November 4, 2026, per the accreditor's own announcement.

Translation: if you're a Dominican-trained physician matching into a Florida radiology slot, or a current resident negotiating next year's rotation schedule, you now have two comment tracks to watch, not one. Academic medical centers in Gainesville, Tampa, and South Florida train a disproportionate share of our community's physicians. Whatever ACGME ratifies in these Common Program Requirements becomes the operational floor — and the ceiling — for how your program director staffs the wards.

What to actually do before October 22

You don't need to write a white paper. You need three things.

First, check whether your program has a GME committee with a resident seat — most ACGME-accredited sponsors do. That seat has a vote on how your institution responds to the comment period.

Second, ask your program director, in writing, what the institution's position will be. If they can't answer before October 22, that's your answer.

Third, if you've felt the pinch of post-call fatigue in your own clinical performance — and you know who you are — submit a comment through the ACGME portal. Anonymity is permitted. The Review Committee reads these.

The veteran move here isn't optimism about whether "patient safety language" survives the revision process. The veteran move is recognizing that work-hour protections have always been a negotiation between the clinical workforce your program depends on and the institutional appetite to cover night shifts. The comment window is the one lever residents actually control.

What's your program telling you about the proposal? Because if leadership isn't saying anything yet, that's the most telling data point of all.