At the end of October 2025 and after nearly 18 years of leadership and impactful service, Chief Education Officer and Special Advisor to the President and Chief Executive Officer (CEO) Timothy P. Brigham, MDiv, MS, PhD retired from the ACGME. As head of the Department of Education, his responsibilities included oversight of the ACGME Annual Educational Conference, which grew under his vision to one of the largest gatherings of graduate medical education (GME) professionals in the world. He also spearheaded development of new educational programs for the ACGME and the GME community, launched the ACGME’s digital learning programming, cultivated faculty and chief resident training and development programs, and served as the heart and driver of the organization’s well-being initiatives. He is also the ACGME’s former Chief of Staff, a role in which he served—whether he realized it at the time or not—as a mentor and champion for dozens, if not hundreds of ACGME staff members.
Before he signed off and packed up his office to transition to the next chapter, ACGME Director, Communications Maayan Schwab, MA—one of his mentees—sat down for a conversation with Dr. Brigham to look back and reflect on his contributions and legacy, and forward to what might come next. The conversation took place over two days, and is marked by Dr. Brigham’s warmth, sincerity, thoughtful insights, and quotable stories, as well as a dash of his signature self-deprecating humor.
Part 1: Looking Back
Ms. Schwab: Ok, let’s start with maybe the easiest one… What would you say first brought you to the ACGME, and then what convinced you to stay for 18 years?
Dr. Brigham: Well, it was [former ACGME President and CEO] Tom Nasca. It took him a year to convince me that it was a sensible thing to work in one city and live in another. He did it by sharing his vision, which centered in the Mission to serve the health care needs of the American public through the education of residents and fellows, and through accreditation of their programs. It was a compelling vision, and so I came to the ACGME, and I have never experienced a more meaningful and worthwhile job.
Now, what convinced me to stay? Those years went by in a blur. I didn’t count the years or think about how long I would stay. It was the work, and the Mission, and more truthfully, the amazing people I got to work with. It was the enormously worthwhile things we were doing—that was what drew me to continue working. In some ways it's sad that I’m departing at this point. But it’s time. There are unbelievably creative and intelligent people here, and having a little piece of being able to unleash that talent into the world of graduate medical education is just simply soul-satisfying. I mean, even in the roughest of times, I just loved the work and loved the people.
Ms. Schwab: What are you most proud of accomplishing as Chief Education Officer?
Dr. Brigham: I wouldn’t own any accomplishment on my own – it’s always been a collaboration. But I’m proud to say we did some astoundingly good stuff.
Of course, there is the Annual Educational Conference, which grew from about 800 attendees to close to 6,000. And it wasn’t just the growth in numbers, but the community we built. We widened it far beyond “how to pass your next site visit,” and it became a home of sorts for the world’s GME community to gather, celebrate, and figure out how to move forward together.
The chief resident workshops [Leadership Skills Training Programs for Chief Residents] are another piece. The team that now puts those together has turned it into a launch pad for the future leaders of GME – the DIOs [designated institutional officials] and program directors and deans of tomorrow!
The introduction of our Digital Learning services was a dream for a long time, and it has become a resource I never could have imagined. Our instructional designers create incredible learning opportunities that match the needs of the community and use the technology in profound ways.
The Milestones, of course, are now a mechanism that allows our health care education system to say with some confidence that a physician in Portland, Oregon has the same level of competence as a peer in Portland, Maine, and everywhere in between.
And how can I not mention the well-being work? Again, this is not just my accomplishment. But I’m so proud that the ACGME launched the effort that became a nationwide phenomenon and continues to this day. And it was all based on finding a way to bring the entire community together after the horrible tragedy of a fellow dying by suicide.
That’s just some of what happened in the Department of Education. But there was so much more. There were so many collaborations with all of my incredible colleagues across the organization, and I’m proud of every one of those accomplishments.
Part 2: Leadership and Legacy
Ms. Schwab: What leadership lessons have guided your career?
Dr. Brigham: I’ll rephrase the question: what leadership lessons have I learned that have guided me? A lot of it is about finding really good people, setting up the environment so they can thrive, blocking and tackling when they come up against barriers, and watching them fly. I can’t say I succeeded all the time, but it really is about people. It’s also about me understanding it’s not about me, outside of my getting out of their way and helping them thrive. I believe strongly in authentic relationships. I’ve fallen, I’ve picked myself up, and I’ve tried to do it better the next time. And I’m incredibly proud of the people I work with.
Ms. Schwab: What do you hope will be your legacy at the ACGME?
Dr. Brigham: Truthfully, I just don’t think in these terms. But perhaps the legacy is, does the work go on? Can I hand the baton off to someone who will continue the work and not only take the next leg, but do it better, and then hand the baton off again. The legacy is in the work, and whether we can look back and see we changed things for the better. Maybe that’s how I really want to be remembered. I hope the world is a slightly better place for my having traveled through it. But that’s not for me to decide.
Ms. Schwab: Can you share a moment or story that encapsulates your ACGME experience?
Dr. Brigham: My goodness, there were so many moments. There are small ones and big ones, some are funny, some are sad. I’ll talk about one that was just very significant, both personally and in the bigger picture, and that was when a fellow’s parents came to talk with us about the tragic death by suicide of their son. That tragedy catalyzed a movement that says this is not acceptable any longer, and that ultimately has, I really believe, changed the dynamics of GME. Interestingly, that moment led to some other very specific, very important moments. We continued working with that family, and a few years after that first meeting, there were two resident deaths very close together. Several of us from the ACGME went to see what we could learn, so we could conceive of systematic changes that could prevent future tragedies. When we returned from that trip, it was a Board meeting weekend, and I met with the residents in the Council of Review Committee Residents (CRCR) and talked with them about what we had heard and learned. Well, the Chair of the CRCR at that time happened to have been roommates in medical school with the resident whose parents came to speak with us years before. So what came next, I think was really the moment. The CRCR Chair came to talk to the Board, and it turned that meeting into an incredibly moving and emotional one, with every member of the Board speaking about their connection to someone who died by suicide, or to their own thoughts and experiences. At the end, the Board said, “no more.” We launched a task force, which led to a summit, which resulted in our partnership with the National Academy of Medicine and the Association of American Medical Colleges. And the residents continued on this track, too, and found that for most residents, real meaning comes from deep, powerful connections with their patients. And that’s what led to the Back to Bedside initiative.
So that fellow whose parents came to me was not a moment, he was a person. And because of this series of profoundly important moments, I find that he continues to sit on my shoulder and reminds me not to forget.
Part 3: Reflections and Looking Ahead
Ms. Schwab: What advice would you give to the next generation of medical educators and leaders?
Dr. Brigham: Well, I would say this: you can really have a lousy day, week, month, year, and still wake up every day with joy, because you know you’re connected to something that’s crucially important. Education is more than metrics or minimums. I believe it is sacred work. Everybody is writing their own story or novel of their life—they’re holding the pen. The only time they turn the pen over to another person is when they don’t know what to do at a startling intersection: life and death; wellness and illness; injury and healing. That’s when someone comes to a physician and asks for help with a word or sentence or paragraph or chapter, or even the end of the book. So my advice is this: If you’re doing it right, you’re going to create technical wizards, sure. But it’s your presence, your integrity, the ability you have to establish a connection – that’s what leaves an imprint. Residents and fellows are shaped by what you teach, but they also learn from your presence, your care, and the example you set every day in your practice, technique, and expertise, and in your treatment of others, your ability to listen and watch. This will stay with them for life. It will help them become the most excellent version of themselves, as physicians and as humans. Remember this, and lead with it every day, and your legacy will live on in every life they touch.
Ms. Schwab: What advice would you give to your colleagues at the ACGME?
Dr. Brigham: My advice is simple: Stay focused on the Mission and ask yourself if you can come to work every day and see that you are doing something with significant purpose. And if you have meaning and connection, you can do anything. When your ship is blown off course, keep focused on that North Star, keep tacking toward it. Keep the Mission in your heart, and follow it. Stay connected to each other. Believe and trust.
Ms. Schwab: What’s next for you?
Dr. Brigham: Well, nothing about my previous life or my education predicted that I’d end up here, but here I am. What I’ve learned from that is to stay open. And I am. I’m open to discovery and to adventure, and I’m going to recommit myself to being with my family. It’s time to reconnect.
I do want to give myself a little bit of time to settle into this and see what this new phase of my life feels like. But I’ll be working a little bit on the conference, and I’ll see what comes after that.
Ms. Schwab: If you could go back and give your younger self one piece of advice, what would it be?
Dr. Brigham: You know, we always look back and say, “Those were the good old days,” but when we’re going through them, we rarely say, “These are good days.” And what I would have said to myself is, “Enjoy the ride and the extraordinary things you will experience with the extraordinary people you will meet. Let it sink in as it’s happening. As you’re going through it, treat it as if these really are the good old days. Because it goes by so fast.”
The other important piece of advice is about connections. Friendships and connections are really important. So stay connected, Tim.
Oh, and one more: Learn to type faster.
Ms. Schwab: Anything we haven’t talked about that you want to add?
Dr. Brigham: Well… yes. The support and the love that I got to start this adventure was so deeply instrumental in each moment of my career and none of this would have ever happened or been possible without my wife, Bettie Ann. I could not have done any of it without her. Her willingness to keep renewing this pact with me each year allowed me to have the opportunities that I did, and simultaneously maintain our love and support and connection and joy. It was a big price for her to pay—for us to pay. But we did make it work, and we did it with joy, and wonder, and awe. She is a huge source of awe to me. You should all be so lucky.
We thank Dr. Brigham for his decades of service, not just to the ACGME and GME, but to the world around him, and for making time for this important and meaningful conversation as he took the last pictures off his office walls.
This is not the last time the GME community or Dr. Brigham’s many friends and colleagues at the ACGME will see or hear from him. Dr. Brigham has just been announced as the Thomas J. Nasca Lecturer at the 2026 ACGME Annual Educational Conference, taking place next February in San Diego, California. His talk will close out the conference, and should not be missed, so if you haven’t already, click here to be notified when registration opens soon!