Background In 2022, the Accreditation Council for Graduate Medical Education (ACGME) made several changes to the common program requirements for radiation oncology, which may be difficult for some residency programs to meet in their current state. Now, programs are expected to have 1.5 clinical physician faculty members per resident. Plus, the sponsoring institution must sponsor at least one medical oncology program and sponsor or have affiliations with ACGME-accredited surgical oncology and pathology programs. We sought to investigate if radiation oncology programs would presently be able to meet these requirements. Methods We compiled a list of accredited radiation oncology residency programs from the ACGME website. We visited the webpage of each program to count the number of radiation oncology physician residents and clinical physician faculty to calculate the corresponding ratio. We included clinical faculty from main campus and select satellite sites and affiliate sites, if residents definitely or probably rotated there. We also searched the websites of each sponsoring institution for sponsored pathology, medical oncology, and surgical oncology programs. Results We identified 90 ACGME-accredited radiation oncology residency programs. At least 9 programs appear to currently have a ratio of clinical physician faculty to residents of less than 1.5:1, ranging from 0.85 to 1.38. Additionally, 1 sponsoring institution does not have its own hematology and medical oncology or medical oncology program, 61 do not have a surgical oncology fellowship, and 5 do not have a pathology residency; however, this does not include affiliated programs. Discussion Approximately 10% of radiation oncology residency programs seem to have an insufficient number of clinical faculty to accommodate their residents, per new ACGME requirements. Furthermore, almost 70% of sponsoring institutions do not sponsor a medical oncology, pathology, or surgical oncology program, though this does not include potentially affiliated programs. A primary limitation of our study is that we collected information from publicly available information, which may be inaccurate. Nevertheless, based on our findings, it is likely that the new requirements may impose challenges on several programs, and failing to achieve them can risk program accreditation. In 2022, the Accreditation Council for Graduate Medical Education (ACGME) made several changes to the common program requirements for radiation oncology, which may be difficult for some residency programs to meet in their current state. Now, programs are expected to have 1.5 clinical physician faculty members per resident. Plus, the sponsoring institution must sponsor at least one medical oncology program and sponsor or have affiliations with ACGME-accredited surgical oncology and pathology programs. We sought to investigate if radiation oncology programs would presently be able to meet these requirements. We compiled a list of accredited radiation oncology residency programs from the ACGME website. We visited the webpage of each program to count the number of radiation oncology physician residents and clinical physician faculty to calculate the corresponding ratio. We included clinical faculty from main campus and select satellite sites and affiliate sites, if residents definitely or probably rotated there. We also searched the websites of each sponsoring institution for sponsored pathology, medical oncology, and surgical oncology programs. We identified 90 ACGME-accredited radiation oncology residency programs. At least 9 programs appear to currently have a ratio of clinical physician faculty to residents of less than 1.5:1, ranging from 0.85 to 1.38. Additionally, 1 sponsoring institution does not have its own hematology and medical oncology or medical oncology program, 61 do not have a surgical oncology fellowship, and 5 do not have a pathology residency; however, this does not include affiliated programs. Approximately 10% of radiation oncology residency programs seem to have an insufficient number of clinical faculty to accommodate their residents, per new ACGME requirements. Furthermore, almost 70% of sponsoring institutions do not sponsor a medical oncology, pathology, or surgical oncology program, though this does not include potentially affiliated programs. A primary limitation of our study is that we collected information from publicly available information, which may be inaccurate. Nevertheless, based on our findings, it is likely that the new requirements may impose challenges on several programs, and failing to achieve them can risk program accreditation.