Abstract
The Accreditation Council for Graduate Medical Education (ACGME), the American Osteopathic Association (AOA), and the American Association of Colleges of Osteopathic Medicine (AACOM) disturbed the gravitational forces of medical education when they entered into a historic agreement in August 2014. This agreement resulted in a 6-year journey to a single accreditation pathway for all residency programs and nearly all fellowship programs in the United States. It brought together the 2 traditions of medicine in the country for the first time in more than 100 years, unifying a critical phase of medical education for all physicians in the United States. In this commentary, the authors briefly describe the Single Accreditation System and relate their perspective on the factors leading to this profoundly important event and its impact on the ACGME, AOA, and medical education.