The Accreditation Council for Graduate Medical Education (ACGME) recognizes the public's need for a physician workforce capable of meeting the challenges of a rapidly evolving health care environment.

The ACGME has responded to this need by implementing the CLER program as a part of its Next Accreditation System. The CLER Program is designed to provide US teaching hospitals, medical centers, health systems, and other clinical settings affiliated with ACGME-accredited institutions with periodic feedback that addresses the following six Focus Areas: Patient Safety; Health Care Quality; Teaming; Supervision; Well-Being; and Professionalism.

The feedback provided by the CLER Program is designed to improve how clinical sites engage resident and fellow physicians in learning to provide safe, high quality patient care.

The only accreditation requirement associated with this program is that each Sponsoring Institution must complete a CLER site visit if contacted as part of the sample list.

News and Announcements

Just Released: CLER Pathways to Excellence Version 3.0

March 2024 - The CLER Program is pleased to announce the release of the CLER Pathways to Excellence Version 3.0. The Pathways outline expectations for optimizing the clinical learning environment across the six CLER Focus Areas, and serve to guide and promote dialog between graduate medical education leaders and executive leaders of clinical sites. Version 3.0 introduces the new Focus Area of Diversity, Equity, and Inclusion.

The CLER Pathways to Excellence Version 3.0  will be the basis for the next cycle of CLER visits anticipated to launch in mid-2025.

Click here to view the report.


New! The CLER Program Launches the Patient Perspective Subprotocol

March 2024 - The CLER Program’s Patient Perspective Subprotocol is officially launched. The new subprotocol assesses the clinical learning environment from the patient perspective as related to the six CLER focus areas. Use the link below to access a recorded webinar in which Drs. Kevin Weiss, Robin Newton, and Robin Dibner describe the subprotocol’s design and provide information on key logistics for site visits. The webinar also highlights some of the questions asked during patient interviews.

Click here to access the recording. Note: A free Learn at ACGME account is required to access the recording.

Click here to access the full patient questionnaire.


Teaming in the Clinical Learning Environment Virtual Workshop

August 2023 - A recording of a CLER workshop that explores the concept, purpose, and value of teaming in the clinical learning environment as defined in the CLER Pathways to Excellence framework is now available. The session explores the characteristics of effective teaming while providing patient care, and the benefits of optimizing teaming in rapidly evolving health care environments.

Click here to access the recording.


Just Released: CLER National Report of Findings 2022: The COVID-19 Pandemic and Its Impact on the Clinical Learning Environment

December 2022 - The CLER Program is pleased to release CLER National Report of Findings 2022: The COVID-19 Pandemic and Its Impact on the Clinical Learning Environment, which details results from an 18-month site visit protocol that assessed the impact of the COVID-19 pandemic on the clinical learning environment. This report identifies opportunities to optimize patient care and graduate medical education in addressing challenges that are likely to persist as clinical sites recover from the pandemic’s acute phases.

Click here to view the report


CLER National Report of Findings 2021

October 2021 - The CLER Program is pleased to announce the release of the CLER National Report of Findings 2021. This report presents findings from the third cycle of CLER visits conducted from June 2017-February 2020. It is the first CLER report to include data from the clinical learning environments (CLEs) of both large and small Sponsoring Institutions in the same document (encompassing 566 Sponsoring Institutions in total). The report features an enhanced section on trend data as well as information on the new CLER Focus Area of Well-being. Of note, the report presents a snapshot of our nation’s CLEs in the years leading up to the start of the Covid-19 pandemic—an important lens through which to view the current opportunities and challenges facing those US healthcare care organizations that serve as CLEs.

Click here to view the report


CLER Zoom Call Series

October 2021 - Recordings are available for the ACGME National Learning Community for Sponsoring Institutions’ special CLER Zoom Call Series highlighting findings and trends from the various CLER site visit protocols. These recordings are available to watch in Learn at ACGME. Click the title of each presentation to watch the recordings.

CLER National Report of Findings 2021
Wednesday, October 13, 2021
Catherine Kuhn, MD; Robin Newton, MD; Robin Wagner, RN, MHSA; Kevin Weiss, MD

CLER COVID-19 Protocol Interim Findings
Thursday, November 18, 2021
Staci Fischer, MD; Nancy Koh, PhD; Robin Wagner, RN, MHSA; Elizabeth Wedemeyer, MD; Kevin Weiss, MD

CLER Subprotocol for Operative and Procedural Areas
Tuesday, December 7, 2021
Stanley Ashley, MD; Marian Damewood, MD; Alice Krumm, RN, DNP; Robin Newton, MD; M. Christine Stock, MD; James Zaidan, MD

Email questions to CLER@acgme.org.


CLER Report of Findings 2021: Subprotocol for Operative and Procedural Areas

February 2021 - The CLER Program is pleased to announce the release of a special report of findings from the CLER Subprotocol for Operative and Procedural Areas. The report provides new insights into these key clinical areas through the lens of their roles as clinical learning environments for our nation’s resident and fellow physicians. As with the larger CLER national reports, the key findings of the subprotocol highlight a mixture of strengths and opportunities for improvement, some unique to the perioperative environment, and some that are similar to other places the clinical learning environment.

Click here to view the report


Issue Briefs, Presentations, and Other Resources

Contact CLER Staff

Senior Vice President, Clinical Learning Environment Review (CLER)
Robin Wagner, RN, MHSA
rwagner@acgme.org
312.755.5054

CLER@acgme.org