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In 2013, the Accreditation Council for Graduate Medical Education (ACGME) implemented a new accreditation model that emphasized annual datadriven reviews and accreditation decisions, targeted feedback, and the freedom for thriving programs to innovate. Review Committees (RCs) are provided annual data in September and October of each year that allow them to identify overall performance, assess trends, and identify specialty and subspecialty programs that may be underperforming. Data reviewed include program characteristics, participating teaching sites, the clinical learning and work environment, changes in faculty and program leadership, resident attrition, scholarly activities, faculty and resident surveys, resident clinical experience, and programlevel performance on the certification examination of the American Board of Medical Specialties member boards. RCs use this information to give each program an updated accreditation status annually. When the annual data suggest potential problems in a program, the RC may request clarifying information or schedule the program for a site visit. If problems are confirmed, RCs may issue citations for noncompliance or suggest areas for improvement. Programs are required to write a formal response to each citation, which is reviewed by the RC the following year. The ACGME implemented the Next Accreditation System (NAS) using a phased-in approach. The 2015– 2016 annual review cycle is the third review cycle for the 7 Phase I RCs, and the second review cycle for the 20 RCs in Phase II. It represents the first year of a stable state for NAS, as every RC had issued accreditation decisions through the annual review process for at least 1 prior year. Our work previously captured the outcomes associated with the transition of accreditation decisions in NAS and the presence or absence of citations. In this article, we study the accreditation decisions and citation resolution and/or extension for the 2015–2016 annual review cycle.

Program Performance in the Next Accreditation System (NAS): Results of the 2015–2016 Annual Data Review