Accreditation in practice
From reactive to ready
Site visit readiness works best as a year-round habit, not a sprint that starts when the notice arrives.
Every GME office knows the scramble. The site visit notice arrives, and suddenly everyone is hunting for meeting minutes, reconciling rosters, and rebuilding evidence that should have been easy to find.
After enough of those weeks, I stopped seeing readiness as an event and started treating it as a routine.
What reactive looks like
Reactive preparation has a few telltale signs. Documentation lives in personal inboxes. The one person who knows where everything is happens to be on vacation. Action items from the last annual program evaluation were written down and then forgotten. Data in the Accreditation Data System was accurate once, at the last annual update.
None of this means a program is weak. It means the program depends on memory and effort instead of systems.
What ready looks like
A ready program can pull its evidence in an afternoon. That doesn't take a bigger team. It takes a few habits, repeated.
- Anchor a calendar to the academic year. Map recurring tasks, including committee meetings, evaluations, the annual program evaluation, and the ADS annual update, to the months they belong in.
- Keep evidence where others can find it. Store minutes, policies, agreements, and curricula in one shared location with consistent names.
- Track action plans like projects. Give every improvement item an owner, a due date, and a status someone actually checks.
- Audit small and often. A short monthly check of rosters, faculty data, and agreements catches problems while they're still small.
- Close the loop in writing. When a committee acts, the minutes should show what it decided and who follows up.
When I built a tracking system for program letters of agreement, the goal wasn't a prettier spreadsheet. It was making sure the answer to "is this current?" never depended on one person's memory.
Readiness isn't a binder you build before a visit. It's a set of habits you keep between visits.
Keep an eye on what's changing
Requirements don't stand still. On September 8, 2026, the ACGME posted a major revision of the Common Program Requirements for review and comment, with comments due October 22, 2026. Read the proposed changes and consider commenting. Programs that follow changes while they're proposed have far less to catch up on later.
The shift from reactive to ready is mostly quiet work. It rarely gets noticed. That's usually the sign it's working.