UME/GME Program Resources

Fellowship Start Date

The Alliance worked with subspecialty societies and other specialty organizations (including pediatrics and surgery) to develop a recommendation on a uniform start date for fellowship.

Read the Recommendations

AAIM believes that requiring residents to report for fellowship prior to completion of residency training is disruptive to medical education, creates unnecessary stress on the residents, and risks violating federal labor laws and/or CMS graduate medical education funding rules. Adoption of July 1 as the earliest start date for all training and orientation activities would resolve conflicts for residents created by variations in timing for institutional orientation programs.

AAIM Fellowship Start Date Recommendation: No Earlier than July 1

March 2021—Based on CMS funding support of residents and backed by AAIM and subspecialty organizations in internal medicine, residents are not available to begin fellowship activities prior to July 1. However, due to COVID-19, some fellowships are now instructing residents to arrive two weeks prior to orientation so that they may quarantine in their new location. This additional requirement would place unwarranted pressure on programs and trainees alike.

The Alliance encourages fellowship programs to consider what aspects of the onboarding process can be conducted virtually. Critical orientation activities scheduled prior to July 1 can be pre-recorded or executed using virtual platforms, provided that they are administered independent of resident required duty hours at their current institution. AAIM developed a letter template to notify fellowship program directors about the repercussions; programs should enhance this correspondence by articulating the pandemic’s impact on their particular institution and learners as well as support the use of virtual platforms instead of in-person orientation.

The Alliance continues to educate members  and encourage alignment with recommendations. If you have any questions or comments about this email, please contact the Education and Research team at or (703) 341-4540.

Are your residents being asked to arrive prior to July 1 for fellowship or orientation activities?

Fellowship PD letter template