The second day of the 2024 ACGME Annual Educational Conference opened with a warm welcome from ACGME Chief of Staff and Chief Education Officer Timothy P. Brigham, MDiv, MS, PhD. Acknowledging that the organization is on the threshold of change, Dr. Brigham reinforced the ACGME’s commitment to embracing inclusion and celebrating the diversity of the more than 4,300 graduate medical education (GME) professionals in attendance. On this International Women’s Day, ACGME Board of Directors Chair Claudia Wyatt-Johnson presented the ACGME’s John C. Gienapp Award to Linda R. Archer, PhD of Eastern Virginia Medical School, recognizing her career-long commitment to improving GME. Ms. Wyatt-Johnson then introduced Thomas J. Nasca, MD, MACP for his last President’s Plenary as ACGME President and Chief Executive Officer.
Dr. Nasca began his plenary by recognizing and thanking his family for their support of his career, and then, acknowledging it was International Women’s Day, he noted the need to continue advocating for equity and equality for women, as well as for their health and safety.
In a presentation that summarized his own path in medicine and his priorities at the ACGME, he addressed several important topics, including the growth of GME, the US opioid crisis, climate change, well-being post-COVID-19, and the “evolutionary eras of the ACGME.” He reflected honestly on the effect of the ACGME’s role in these areas in the context of its Mission. He then congratulated the community on its work of producing qualified physicians. “You’re doing a good job. We always want to make it better, but we [also] want to celebrate.”
As he wrapped up his talk, the emotional impact of the moment was palpable. He told the story of a patient he treated when he was a nephrology fellow and the lessons he learned from that experience that shaped his approach to the rest of his career. Then he said goodbye.
“Thank you for giving me the opportunity to share that story with you,” he said, noting that “it has been the motivation to continuing to explore professionalism and how we can make education better tomorrow than it was yesterday.”
Following the President’s Plenary, attendees chose from four Featured Plenaries:
What Everyone Needs to Know about GME Finances
A lively panel of speakers provided a comprehensive overview of the GME funding basis, a review of common funding sources, the CMS “cap” on GME funding, and various CMS funding streams. ACGME Chief Financial and Administrative Officer and Executive Vice President, ACGME Global Services John Ogunkeye, MS introduced the panel and session. Speakers included Bethany Figg, DEdT, MLIS, MBA, C-TAGME, director of Graduate Medical Education from Central Michigan University College of Medicine-CMU Medical Education Partners; Douglas McGee, DO, FACEP, vice dean for Graduate Medical Education at Thomas Jefferson University; and Mary Jo Wagner, MD, DIO/CAO at Central Michigan University College of Medicine. An engaging question-and-answer format helped attendees gain a better understanding of the financial implications for the resources required to support accreditation requirements and GME in clinical learning environments.
Closing the Gaps in the Care of the Disabled: The Role of Graduate Medical Education
In a panel featuring experts with lived experience, this Featured Plenary, moderated by ACGME Chief of Communications and Public Policy John R. Combes, MD, discussed the gap in education and training of physicians to address their implicit bias in meeting the needs of the disabled population, as well as the ACGME’s commitment to closing that gap.
The perception physicians have of disabled patients is a barrier to improved care, said Michael Stillman, MD, an internist and clinical associate professor at Sidney Kimmel Medical College. His program offers an elective that builds learners’ skill and comfort in working with people with disabilities. He noted that only 40 percent of physicians feel comfortable caring for patients with disabilities, and more than 80 percent believe people with disabilities have a poorer quality of life.
“I invite you to imagine the type of biases that introduces into the care of people with disabilities,” Dr. Stillman said.
“I have an immensely rich quality of life,” said Council of Disability Member Emily Voorde, MEd, MPP. Ms. Voorde identifies as disabled and uses a wheelchair. She encouraged attendees to reframe the conversation about incorporating care for disabled patients into the curriculum. “Inclusion in education is a competitive advantage. It’s not only the right thing to do, but it allows you to stand out.”
Oluwaferanmi Okanlami, MD, MS is the director of student accessibility and accommodation services at the University of Michigan. He said he has felt frustrated at the lack of movement in educating physicians to care for disabled patients, especially since one in four Americans will be disabled in their lifetime. But he is also encouraged momentum is growing.
“There is going to be more at the ACGME that all of us can do to make sure that next year’s session isn’t about what we could do, but we’re talking about what we have done,” he said.
The ACGME will host a symposium on disabilities and GME in the spring of 2025.
The Generative AI Revolution: Innovations and Opportunities in Medical Education
This Featured Plenary tackled one of the fastest-moving areas in technology today – artificial intelligence (AI).
Robert Wachter, MD, professor and chair of the Department of Medicine at the University of California, San Francisco (UCSF), gave two live demonstrations of ChatGPT, stunning the audience with both its accuracy and relevancy when presented with complex medical education requests. Arguing that the health care and education sectors are areas that have seen minimal disruptors from technology, Dr. Wachter laid out the history of AI, from initial missteps to the stunningly fast evolution of open-access generative AI.
Jesse Burk-Rafel, MD MRes, assistant director of Precision & Translational MedEd Lab and assistant professor of internal medicine at NYU Grossman School of Medicine, continued the discussion around the opportunities AI presents, calling it a “great leveler” in medical education. Eva Aagaard, MD, FACP, professor and vice chancellor of medical education and senior associate dean at Washington University School of Medicine, noted that learners are already using generative AI like ChatGPT, making it important for educators to incorporate it into GME, stressing the importance of keeping an eye on ethics and how this technological revolution will affect professional identity. Eric Holmboe, MD, CEO of Intealth, echoed Dr. Aargaard, noting that current faculty members are not trained on AI and reminding the audience that exams are still written by humans.
The panel agreed that many inevitable and rapid changes will result from the advent of AI. They encouraged the audience to recognize the opportunity, but cautioned that human vigilance is vital.
Graduate Medical Education following the SCOTUS Affirmative Action Decision
The 2023 US Supreme Court decision regarding the constitutionality of affirmative action in higher education was a pivotal event. Panelists in this Featured Plenary shed light on how the decision relates to recruitment, admissions, and selection strategies and discussed legal issues; closings of diversity, equity, and inclusion (DEI) programs; and state-specific strategies that have already eliminated race from admissions decisions.
The session was introduced by ACGME Chief DEI Officer William A. McDade, MD, PhD, who set the stage for the discussion by posing the question, “Why does health care worker diversity matter?” and briefly detailed the ACGME’s commitment to diversity and inclusion. Next, Heather Alarcon, JD of the Association of American Medical Colleges summarized and translated the legal language, as well as concerns about and practical applications of their impact. She offered tips and guidance to help navigate the law and addressed the need for strategic and careful, deliberate consideration of DEI in recruitment and selection of medical students and residents/fellows in the aftermath of the Court’s decision.
Patrick N. Olomu, MD, FRCA, professor of anesthesiology and pain management, currently at the University of Texas Southwestern Medical Center, spoke about the impact of Texas Senate Bill 17, what he dubbed “the anti-DEI law,” which was proposed soon after the Supreme Court affirmative action decision. With obvious sadness, he shared how the institution responded by changing titles and disbanding committees. “DEI died,” he said, “and we don’t feel like we belong…anymore.”
Gloria Richard-Davis, MD, MBA, NCMP, FACOR, executive director of the Division of DEI and professor of reproductive endocrinology at the University of Arkansas Medical Sciences, and J. Renee Navarro, MD, PharmD, vice chancellor for Diversity and Outreach and professor of anesthesia and perioperative care at UCSF, rounded out the panel. Dr. Navarro shared her institution’s efforts and practices and stressed to the audience that there are indeed race- and gender-neutral strategies they can use to advance inclusion of underrepresented groups in medical education, underscoring the need for advocacy and support from leadership.
Punctuating the thoughtful and significant discussion, Dr. Richard-Davis quoted Supreme Court Justice Ketanji Brown Jackson’s dissent against the ruling: “deeming race irrelevant in law does not make it so in life.”
Meaning in Medicine
The conference theme was woven throughout the educational sessions that filled out the day’s agenda. Topics included ACGME accreditation and initiatives; DEI; professional and faculty development; well-being; crisis management; and more. Attendees connected during breaks, explored the Exhibit Hall, and continued sharing insights and experiences. Networking opportunities were enhanced by the Mentor/Mentee Morning meet-up in the Career Resources area of the Exhibit Hall, and additional events, including pickleball and other wellness activities, helped attendees balance out packed schedules.
Tomorrow #ACGME2024 will round out with more learning, sharing, and connecting. This third and final day of the conference also features two additional powerful presentations, the Marvin R. Dunn Keynote Address and the Closing Plenary, Conversations with the CEO. Come back for the recap here on the ACGME Blog!