This interview is one in a series of interviews with the 2025 recipients of the ACGME Awards. These awardees join an outstanding group of previous honorees whose work and contributions to graduate medical education (GME) represent the best in the field. They will be honored at the 2025 ACGME Annual Educational Conference, taking place February 20-22, 2025, in Nashville, Tennessee.
2025 Parker J. Palmer Courage to Lead Awardee A. Michelle Thompson, MD is the chief education officer, vice dean for GME, and designated institutional official (DIO) at Geisinger Health.
ACGME: How did you become involved in medicine, and in academic medicine specifically?
Dr. Thompson: I have always enjoyed science and working with people; in college, I debated between careers in medicine and education. My mother, a life-long educator, encouraged me to consider medicine, noting that I would be able to achieve both goals as a physician.
My early goals in medicine were primary care, with plans to be a physician in a small town. I matched into internal medicine-pediatrics at Geisinger to fulfill that goal and learned that while I loved learning and practicing medicine, my best days were those where I had the opportunity to teach.
After residency, I was selected as the chief resident for internal medicine. During this year, I discovered that I enjoyed the administrative side of medical education in addition to the direct teaching. The year was rewarding and challenging, as there was an unanticipated departure of the program director early in the year. While this increased my workload and responsibility during the transition, it also allowed a deeper immersion in educational leadership at the GME level. The DIO at the time recognized the work and my interest, and provided the support and encouragement I needed to consider pursuing a career in academic medicine.
Since then, I have held several different roles in educational leadership at the undergraduate medical education and GME levels, including 13 years as the internal medicine-pediatrics residency director prior to transitioning into the DIO role.
ACGME: What does this award mean to you?
Thompson: For me, the Courage to Lead Award is aptly named, as courage has been necessary both personally in saying “yes” to advancing in leadership and professionally in advancing the GME mission in a busy health system. I assumed the role of DIO in the same year our organization integrated with a medical school. While exciting, this also meant a transition in familiar structures and resources. Over my eight years, the only stability has been the constant change. I experienced three CEOs, two deans, and the COVID-19 pandemic, all while building over 20 new residency and fellowship programs in community hospitals that were new to academic medicine.
I learned early as a leader that I needed to be the advocate and expert for everything related to GME with the health system. There are many challenges in meeting the GME mission in busy health care systems, and there are not always clear answers or guidance available. It has taken courage to make hard calls in the face of uncertainty and I have learned to lead through my core values of integrity, respect, and a commitment to equity to inform decisions.
This has been helpful in the areas of well-being, professionalism, and diversity, equity, and inclusion (DEI), where resident experiences highlighted organizational needs for a level of support that acknowledges the unique role and position of a resident. For this reason, I worked toward developing a clinical learning environment team to better understand and support DEI, well-being, and professionalism in the GME space. And while we are making strides in these areas through solidifying support structures, the road has not been easy, and courage has been (and continues to be) required to advance the work. Seeing early positive results for the residents in the areas of DEI, well-being, and professionalism has provided validation and motivation to continue pressing where there are needs.
Being nominated and selected as a Courage to Lead Awardee serves as both a validation and a motivation for leadership in unknown and challenging spaces.
ACGME: What do you feel is the most important job that’s part of your role as a DIO?
Thompson: The most important part of my position as DIO is ensuring that the residents and fellows are getting what they need in their journey through education, advocacy, negotiation, and strategy. Much of what is required for this is not spelled out in the job description or accreditation requirements, nor is there an instruction manual!
I have found that this can mean many things – from ensuring the right types of food are available in the cafeteria, to ensuring safe parking, to navigating interprofessional conflict that may detract from clinical learning. This work has required active engagement in all levels of the health system to effectively partner with clinical leaders to ensure we are able to achieve the dual mission of taking care of patients and educating residents. Each new challenge creates opportunity to connect across the health system and raise awareness of who the residents and fellows are and the value they bring to the system. I have found over time that many of the needs identified by the residents and fellows have also been needs of employees and faculty members, and the efforts of GME have led to necessary enhancements for all.
ACGME: What is the most rewarding part of your job?
Thompson: The most rewarding part of my job is seeing the growth and development of those around me – residents, fellows, program directors, my staff, and team – this really resonates with my inner “educator.”
Working one on one with residents on their development was the best part of my job as a program director and I was concerned that I would not have the same experiences as the DIO. Creating the opportunities to continue supporting, mentoring, developing, and sponsoring has been an important focus for me in this role and is what fuels my passion for the work. As DIO, I now have broader opportunities to intersect with a larger group of individuals and see ideas advance to action.
This takes many forms, from providing opportunities for the high performers to advance initiatives to seeing a struggling learner find success.
Over the years, a significant part of the work that I have been credited for leading has come from the ideas and ambitions as others. As a leader, my job has been to open the door wide enough for inspired and engaged individuals to walk thorough and succeed.
Eight years into my position, I have been fortunate to have good organizational relationships and support for GME in my organization, which has allowed the ability to foster opportunities for others.
ACGME: What is the most challenging?
Thompson: Earlier in my career, I was most frustrated when I could not accomplish things quickly. I’ve had to learn patience in leadership and find ways to advance efforts that ensure the environment is ready for change. I have learned that it is more important to reach the desired outcome and that the process toward that goal may look different than I originally intended, and that is ok. I have also found that it is a better use of my time and energy to build a bridge and develop a relationship, as this will pave the way for future successes. I now see the relationship-building as the first step in any work that needs to be done, and this takes continued time and effort.
There are many challenges inherent to the position of DIO; this is the job. Now that I am more experienced in the position, I realize the challenges are truly opportunities and should be embraced.
ACGME: What advice do you have for residents or fellows who may be interested in pursuing a career in academic medicine?
Thompson: Go for it! Seriously, if you have the interest and the passion – meaning the opportunity to teach and lead learners or advance knowledge – if this is the work that gets you excited and adds value to your interactions with patients, then pursue it. The “it” can mean anything! What I have learned is you must enjoy and embrace the challenge and change. We have a saying in my office that the life of a GME leader is never boring, as there are always new leadership challenges to embrace, and these challenges push you to continue evolving and growing. If this sounds exciting to you, then you are on the right path!
ACGME: Is there anything else you would like to add?
Thompson: As a DIO, it is easy to feel that you are on an island – there is no other position like yours in the organization, and many do not truly know what a DIO is! I have learned that this is not a job that you can do alone – you need networks and communities, both internally and externally. I have had the fortune of working with a great team over the years – my “DIO Cabinet” has been essential in achieving outcomes and providing necessary support. My “home team,” my husband and two daughters, are incredibly supportive and I would not be here today without them!
Learn more about the ACGME’s Parker J. Palmer Courage to Lead Award and nominate a deserving DIO for the 2026 Award – Nominations are due by March 12, 2025.