How do I keep up with changing medical approval rules?

You have gotten good at this, and still the ground moves. Approvals grow more complex and the rules shift under you, and it can feel like the moment you master the path, someone redraws it. That is not you falling behind. That is the nature of a field built to keep pace with risk. Because the rules change, the skill that matters is not knowing them all frozen in place, but staying close to where they move. The people who get caught least are the ones who watch the guidance, not just the regulation, and who ask early instead of guessing late. Set up one steady habit: a monthly hour to read what changed and note how it touches your work. Small and regular beats a frantic scramble when the next update lands. You cannot stop the ground from moving, but you can keep your footing on it.