The Accreditation Council for Graduate Medical Education (ACGME) recently released new expectations for residency training programs entitled Pathways to Excellence. These expectations are part of the ongoing Clinical Learning Environment Review (CLER) program as a part of the ACGME’s Next Accreditation System. The CLER program is designed to provide US teaching hospitals, medical centers, health systems and other clinical setting affiliated with ACGME-accredited institutions with periodic feedback that addresses six areas: patient safety; health care quality; care transitions; supervision; duty hours and fatigue management and mitigation; and professionalism. The feedback from the CLER program will be used to improve how clinical sites engage resident and fellow physicians in learning to provide safe, high quality patient care.  For more information on the new expectations and the CLER program, see the ACGME website.