The Accreditation Council for Graduate Medical Education publishes the ACGME Bulletin three to four times a year. The Bulletin is distributed free of charge to more than 12,000 individuals involved in residency education. The ACGME receives and publishes letters to the editor in the interest of furthering dialogue about accreditation, program quality and matters of general interest in residency education. Inquiries, comments or letters should be addressed to the editor.