The Accreditation Council for Graduate Medical Education (ACGME) sets standards for medical education and training to which teaching institutions, including hospitals, must adhere to maintain their accreditation. On February 14, 1995, the ACGME voted to require every obstetrics and gynecology residency program to provide abortion training for their residents. Prior to this decision, abortion training was optional. However, because some institutions choose not to offer the training and many students choose not to undergo it, pro-abortion advocates sought to make this kind of training mandatory. As David Grimes, MD, stated in a January 19, 1995 speech, "Making abortion training a routine part of any residency...will put abortion back in the mainstream of medicine." The change in policy was motivated by ideology and not by medical need. Congress reacted by amending the Public Health Service Act (42 U.S.C. 238n) with an amendment designated "Establishment of Prohibition Against Abortion-Related Discrimination in Training and Licensing of Physicians," which was signed into law April 26, 1996 (PL 104-134).