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Who Does What

Understand the journey from medical school through residency, licensure, and board certification.

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Who is Responsible for What?

Understand the journey from medical school through residency, licensure, and board certification.

Accreditation

Ensuring residency and fellowship programs meet educational standards.

Licensure

Granting physicians legal authority to practice medicine.

Certification

Recognizing specialty-specific expertise and qualifications.

Employment

Hiring, compensating, and supervising resident and fellow physicians.

Funding

Supporting physician training through Medicare, Medicaid, and other funding sources.

Matching & Placement

Connecting applicants with residency and fellowship positions.

Understanding the System

No Single Organization Controls Physician Training

Many people assume one organization oversees physician education, licensing, certification, and employment. In reality, responsibility is shared across multiple independent organizations, each serving a different role within the healthcare system.

Accreditation

The ACGME Accredits Programs, Not Physicians

The ACGME establishes educational standards and accredits residency and fellowship programs. Its role is to evaluate training environments and ensure programs meet established requirements. It does not license physicians, certify specialists, or employ residents.

Shared Accountability

Different Organizations, Different Responsibilities

State medical boards license physicians, specialty boards certify expertise, and hospitals employ residents and fellows. Understanding these distinctions helps clarify where decisions are made and who is responsible for different aspects of physician training.

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Responsibility Matrix

Responsibility
Area
Primary Owner
Who Handles It
Accreditation’s Role
Scope Defined
Responsibility
Medical School Quality
Primary Owner
LCME (MD) / COCA (DO)
Accreditation’s Role
Separate accreditation system
Responsibility
Residency Program Standards
Primary Owner
GME Accrediting Body
Accreditation’s Role
Sets standards, evaluates compliance, makes decisions
Responsibility
Resident Placement
Primary Owner
NRMP & Matching Services
Accreditation’s Role
No role
Responsibility
Number of Residency Positions
Primary Owner
Congress · CMS · Teaching Institutions
Accreditation’s Role
No role
Responsibility
Resident Employment
Primary Owner
Hospitals & Sponsoring Institutions
Accreditation’s Role
No role
Responsibility
Daily Scheduling & Operations
Primary Owner
Hospitals & Sponsoring Institutions
Accreditation’s Role
Standards guide education, not daily operations
Responsibility
Medical Licensure
Primary Owner
State Medical Boards
Accreditation’s Role
Separate responsibility
Responsibility
Board Certification
Primary Owner
Specialty Boards
Accreditation’s Role
Separate responsibility
Responsibility
Federal GME Funding
Primary Owner
CMS · HHS · Congress
Accreditation’s Role
No role
Next: Understanding Accreditation

Next: Understanding Accreditation

Learn how physicians are trained, who oversees the process, and how accreditation supports high-qualin across the United States.