The second day of the 2025 ACGME Annual Educational Conference opened with a warm welcome from ACGME Chief of Staff and Chief Education Officer Timothy P. Brigham, MDiv, MS, PhD. Dr. Brigham celebrated the growth of the conference – not just in numbers but also in content and scope. He described the impact of the graduate medical education (GME) community in the context of the butterfly effect, noting that while we may feel we’re flapping our wings in one place, the impact can and will reach across distance and time. Following Dr. Brigham’s welcome, ACGME Board of Directors Chair George E. Thibault, MD presented the ACGME’s John C. Gienapp Award to Lawrence M. Opas, MD of USC/LA General Medical Center, recognizing his career-long commitment to improving GME. Dr. Thibault then introduced Debra F. Weinstein, MD for her first President’s Plenary as ACGME President and Chief Executive Officer.
Dr. Weinstein framed her talk around inspiration and aspiration. She reflected on her early impressions during her first seven weeks on the job, as well as on the external contexts in which the ACGME and GME operate. She shared her initial priorities, as well as her vision for GME and the path to follow to achieve it.
Dr. Weinstein acknowledged that GME is functioning in an increasingly complex and polarized world, with the structure of institutions and medicine delivery consolidating and evolving in new ways and said a full-scale assessment of the state of GME is necessary. “We need to recognize with humility that the way we’re doing things may not be the best way,” she said.
To find that best way, it is vital that the ACGME gather and analyze data to determine what’s working and what’s not, and then develop opportunities to try out new approaches. This will require trust, communication, and flexibility, she said.
“We have to think about where our organizational Mission and priorities overlap,” she said. “How can we avoid unnecessary redundancy or competition to focus our resources where they will make the most difference?”
Following the President’s Plenary, attendees chose from four Featured Plenaries:
Keep Calm and Carry On: Managing Crisis in GME
Focusing on human-related crises since those are the most likely to occur in GME, presenters Christin Hart, MEd; George Sarosi, MD; and Jarrett Weinberger, MD gave the audience steps and strategies for creating a crisis plan that stemmed from real-world examples they had faced at their own institutions, and how mistakes can lead to creating better policies for the future. The trio suggested building a crisis response team; developing relationships with local law enforcement and community service providers; and sending clear, succinct, and compassionate communications as part of the crisis response. Most importantly, they said, GME leaders handling a crisis should be compassionate with themselves. “Give yourself grace,” Dr. Weinberger said. “Servant leaders consistently putting the needs of others ahead. Give yourself time to reflect and grieve.”
Strategies to Manage the Evolution of Title IX: What GME Leaders Should Know
ACGME Vice President, Diversity, Equity, and Inclusion Pilar Ortega, MD, MGM led a panel that included presenters, Kimberly Templeton, MD, Lauren Jones McKown, JD, and Jenny Mladenvoic, MD, MBA through a discussion on the impact of Title IX on GME and the persistent challenges faculty members, residents, and fellows face. Despite progress, gender disparities and sexual harassment remain prevalent issues in the field, with one in four women and one in 31 men experiencing its impact. Certain behaviors, often dismissed as jokes, can have long-term effects and consequences on individuals’ career progression, morale, and even patient care. While Title IX does not supersede clinical requirements, it ensures protection and promotes a trauma-informed approach to addressing grievances. Encouraging a culture of accountability, transparency, and proactive support measures is key to creating a learning environment where all can thrive. The panelists shared information on the history of the legislation and how to navigate the process, and then presented four case studies for discussion.
Physician Workforce Shortage: How States Are Responding
Representatives from the ACGME, Intealth, and the Federation of State Medical Boards (FSMB), all part of the Advisory Commission on Alternate Licensing Models, discussed issues relating to alternate pathways for international medical graduates (IMGs), and gave an overview of the work of the Commission, including its recently released recommendations.
A key theme of discussion was the geographic imbalance and maldistribution of the physician workforce. Erin P. Fraher, PhD, MPP noted that population growth in the US does not correlate with physician access once broken down into geographic regions, exacerbating the physician shortage problem in rural and medically underserved areas. FSMB President and CEO Humayun Chaudhry, DO, MACP, FRCP focused on the maldistribution, the proposed pathways, and how legislators in many states have created legislative language incongruent with the medical sector, and Intealth CEO Eric Holmboe, MD, MACP, FRCP reminded the audience that the journey of an IMG to independent practice is not an easy one, and discussed issues such as assessment and visa concerns.
ACGME Chief Communications and Public Policy Officer John R. Combes, MD noted that the Commission’s recommendations have already yielded results, providing the example of recent legislative language unveiled in Kentucky that reflected a key recommendation: to collect and share data to evaluate the program’s effectiveness.
Remediation of Professionalism Issues in Residency
Presenters Kathryn Hughs, MD; Elexis McBee, DO, MPH, FACP; Biraj D. Shah, MD, FACP; and Mark Tschanz, DO, MACM, FACP adeptly shared the process of remediation for professionalism lapses from each of their role’s perspectives through three case studies.
Beginning with an historical review of professionalism in American medicine as a background and ending with the ACGME Core Competency and Milestones description of Professionalism, the presenters discussed helpful recommendations that any program could adopt, from requiring a resident to review and sign a professionalism contract on Day 1, to emphasizing the importance of documenting everything and having a robust evaluation program.
Attendees weighed in at different points in the case studies, which led the audience through the journey of identifying kinds of professionalism lapses, three stages of escalating intervention, and eventual outcomes. The aim of the process is sustained behavior change.
Meaning in Medicine
The conference theme was woven into the entire day’s agenda. Topics included ACGME accreditation and initiatives; DEI; professional and faculty development; well-being; crisis management; and more. A Sunset Session capped off the day with a powerful discussion between William A. McDade, MD, PhD of the ACGME and Georges C. Benjamin, MD, MACP from the American Public Health Association on “Ending Unequal Treatment.”
Attendees connected during breaks, explored the Exhibit Hall, and balanced out their day with a variety of well-being-enhancing activities and events.
Today, the final day of #ACGME2025, promises another full agenda of learning and networking. Two additional not-to-miss presentations, the Marvin R. Dunn Keynote Address and the Thomas J. Nasca Lecture, will bookend the day. Come back for the recap here on the ACGME Blog!