The Accreditation Council for Graduate Medical Education (ACGME) established new duty hour recommendations for pediatric subspecialty trainees in July 2011. Short-term and long-term implications to Pediatric Hematology/Oncology (PHO) are reviewed. Other modifications have been introduced by the ACGME and the American Board of Pediatrics (ABP) in the last decade, including the introduction of the six core competencies and an expansion in the definition of scholarship for fellows. The effect of these on fellows are discussed with suggested strategies for PHO to prepare for further change likely to result from a new ABP initiative to evaluate subspecialty training and certification over the next 3 years. Pediatr Blood Cancer 2012; 59: 1168–1172. © 2012 Wiley Periodicals, Inc.