When Accreditation Retreats: The ACGME’s Suspension of DEI Requirements—and What It Means for Healthcare

October 17,2025 Dr. Sharon G.E. Washington

In spring 2025, the Accreditation Council for Graduate Medical Education (ACGME) announced it would suspend enforcement of its Diversity, Equity, and Inclusion (DEI) Common Program Requirements. This decision came in response to new federal directives, including executive orders and proposed CMS rules, that restrict accrediting bodies from requiring DEI practices in programs receiving federal funding.

While ACGME maintains its Equity Matters™ initiative and internal DEI efforts, this suspension marks a profound shift in the culture of graduate medical education. The standards that once held programs accountable for creating inclusive learning environments, recruiting and retaining diverse cohorts, and cultivating cultural humility are no longer enforceable.

This moment represents not only a bureaucratic adjustment—but a retreat from one of the most essential levers for health equity in medicine.

What Was Lost: The Value of Enforceable Standards

Before the suspension, ACGME’s DEI Common Program Requirements were clear and measurable. They called for institutions to:

• Recruit and retain diverse residents, fellows, faculty, and staff.

• Ensure learning environments were free from harassment, discrimination, or abuse.

• Train learners to provide respectful care across differences in race, gender, culture, disability, and more.

• Demonstrate cultural humility as a professional competency.

These were not symbolic aspirations—they were structural expectations tied to accreditation. Programs that met them saw tangible benefits. Research showed that:

• DEI-aligned healthcare organizations improved patient trust and engagement, particularly in underserved populations where cultural concordance improves outcomes.

• Family medicine programs demonstrated measurable progress on DEI milestones within curriculum, evaluation, and faculty development.

• Workforce diversity increased through targeted recruitment and retention strategies, strengthening the pipeline of underrepresented physicians.

These efforts didn’t just enhance education—they advanced public health by narrowing disparities and improving quality of care for historically excluded communities.

The Legal and Political Crossfire

The ACGME’s decision came amid an increasingly hostile political environment. According to a National Institutes of Health commentary, accrediting bodies like ACGME faced an impossible tension: comply with federal funding restrictions or risk violating emergent state and federal anti-DEI laws.

This legal pressure intensified under the current administration’s directives, which introduced potential penalties for organizations promoting DEI under the guise of “discriminatory practices.” Conservative legal groups even leveraged the False Claims Act—traditionally used to prosecute fraud—to target DEI initiatives at academic and healthcare institutions.

Meanwhile, the White House and far-right media celebrated ACGME’s retreat. Fox News reported the administration’s approval, framing the suspension as a “win against discrimination”.

Yet for many in medicine, this narrative distorts the truth: DEI in graduate medical education has always been about equitable access, safe environments, and excellence in patient care—not preferential treatment.

(There have also been early court challenges and mixed outcomes around anti-DEI orders generally, underscoring how fluid the landscape remains.)

Why It Matters—For Learners, Institutions, and Patients

Suspending DEI enforcement undermines progress at every level:

For Learners: Without enforceable DEI requirements, residents and fellows from marginalized backgrounds lose critical structural protections. They become more vulnerable to bias, exclusion, and retaliation in environments already fraught with hierarchy and stress. The absence of accountability threatens psychological safety, impeding both learning and well-being. This exacerbates systemic and historical exclusion of learners who identify as Indigenous, Black, and Latino, as well as the disproportionate firing, forcing out, or withdrawal of Black residents under duress. 

For Institutions: Accreditation once provided necessary leverage to keep DEI on the leadership agenda. Without enforcement, institutions—particularly in politically regressive states—may scale back initiatives out of fear of litigation or funding loss. The long-term consequence? Reversing the hard-earned progress toward inclusive recruitment, retention, and promotion in academic medicine.

For Patients: Patients in medically underserved areas face the steepest consequences. Diverse, culturally competent care teams are strongly correlated with improved communication, trust, and adherence. The ACGME itself has emphasized that a representative physician workforce is essential for improving outcomes in these populations. Removing DEI accountability undermines this goal—and risks deepening structural inequities in access to care.

Practical Signals to Watch (Real-World Indicators):

Learners: rising remediation requests tied to climate, decreased case-conference participation, spikes in schedule change requests after incidents, increased anonymous feedback about belonging/retaliation risk.

Institutions: slowing applicant diversity, higher time-to-fill for roles in underserved rotations, committee fatigue (cancelled DEI meetings, frozen budgets), HR/Compliance receiving more climate-related “FYI” reports that do not escalate.

Patients: lower HCAHPS communication scores on high-acuity units, missed interpreter utilization, higher AMA (Against Medical Advice) discharge rates in specific populations, repeat ED visits for ambulatory-sensitive conditions.

The Broader Implications for Health Equity

Suspending DEI requirements sends a chilling message: that diversity and inclusion are negotiable rather than necessary for healthcare excellence.

The American Medical Association has warned that dismantling or weakening DEI requirements in training programs “would jeopardize efforts to reduce health inequities and undermine progress in achieving a healthcare workforce reflective of the diverse patient population physicians serve” and compromises both equity and quality in patient care.

Moreover, this rollback erodes trust—not only among marginalized learners who see their safety deprioritized, but also among communities that have fought for generations to be seen and heard within healthcare systems. When accreditation bodies retreat from equity, it fractures the relationship between medicine and the public it serves.

What Can Be Done: Upholding Integrity Without Enforcement

Suspension of enforcement does not mean suspension of responsibility. Institutions, educators, and leaders still have both the moral and professional mandate to uphold equity and inclusion.

Healthcare and medical education leaders can:

• Voluntarily maintain DEI structures within training and evaluation—even if no longer required.

• Embed equity into clinical curricula and mentorship, using reflection, case-based learning, and coaching to model inclusive care.

• Invest in leadership and wellness coaching, ensuring that faculty and learners—especially those from underrepresented backgrounds—have tools for regulation, resilience, and courageous accountability.

• Partner with DEI consultants who can support compliance, communication, and systems redesign in ways that align with institutional mission and values.

At Sharon Washington Consulting, we work with healthcare institutions to sustain DEI progress through:

• Grounding Assessments to reveal systemic inequities and organizational blind spots.

• Leadership and resilience coaching to support faculty and learners navigating trauma and change.

• Somatic awareness training to strengthen emotional regulation, trust, and collaboration across differences.

• The BRIDGE Framework, a structured approach to embedding reflection, impact, grounding, and ecological alignment into organizational wellness strategy, conflict management, and burnout prevention.

Moving Forward

The ACGME’s suspension of DEI enforcement is not simply an administrative adjustment—it’s a turning point in the moral and civic trajectory of medical education. It tests whether institutions will uphold equity as an ethical imperative, even without external enforcement.

If we allow fear of political retaliation to dictate our values, we risk losing the very essence of medicine: compassion, justice, and respect for human dignity.

At Sharon Washington Consulting, I remain committed to helping healthcare institutions stay anchored in these principles—through evidence-based coaching, trauma-informed leadership development, and equity-centered system design.

We must not forget, equity isn’t optional. It’s the heartbeat of healthcare—and the foundation of trust between institutions and the communities they serve.