Today, the ACGME announced that many fellowships will now accept the COMLEX-USA examination on equal footing with the USMLE. This change is specifically related to the "exceptionally qualified candidate" provision included in the ACGME's new Common Program Requirements that go into effect on July 1, 2016. If an individual applies to a fellowship program based on this provision and has successfully completed Levels 1, 2 and 3 of COMLEX-USA, he/she will not be required to take the USMLE. Between July 1, 2015 and June 30, 2020, a resident who completes training in an AOA-approved program with pre-accreditation status will be subject to the ACGME fellowship eligibility standards that were in effect June 30, 2013, or will be in effect July 1, 2016, whichever is less restrictive. A number of Review Committees allow programs to grant an exception to the ACGME Common Program Requirements related to eligibility for prior training. If the program director determines that the applicant’s qualifications are acceptable he/she may be appointed to the program. This applies only to graduates of programs with a status of pre-accreditation. The ACGME will be issuing guidelines to assist fellowship program directors in determining whether individual applicants are eligible for appointment. It is important to know that some subspecialties did not in 2013, and will not in 2016, accept as prerequisite training anything other than completion of an ACGME-accredited program. Eligibility criteria for every ACGME-accredited subspecialty can be reviewed on the ACGME’s website.