Under the presidency of His All-Holiness the Ecumenical Patriarch Bartholomew, the Holy and Sacred Synod of the Ecumenical Patriarchate met at its regular session from 9 until 11 May 2019. During this meeting, several reports were reviewed and appropriate decisions were taken among which the election of the new archbishops of Australia and of America. Among other things, the appeal submitted by the Church actually in schism in North Macedonia was studied.

On 9 May 2019, the Holy and Sacred Synod proceeded to the election of Bishop Makarios of Christopolis as the new Archbishop of Australia, following the death of Archbishop Stylianos on 25 March 2019.

On 11 May 2019, the Holy and Sacred Synod proceeded to fill the vacated seat of the Archdiocese of America following the voluntary resignation of its shepherd, His Eminence Senior Archbishop Demetrios of America. Following the suggestion, permission and exhortation of His-All Holiness the Ecumenical Patriarch Bartholomew, the Holy Synod unanimously elected as Archbishop of America His Eminence Metropolitan Elpidophoros of Bursa, Abbot of the Holy Monastery of the Holy Trinity in Halki and Professor of the Theological Faculty of the Aristotle University of Thessaloniki.