Courage to Care: Leadership, Legacy, and the Heart of Graduate Medical Education
The 2026 ACGME Annual Educational Conference concluded with the Thomas J. Nasca Lecture, delivered by former ACGME Chief Education Officer and Chief of Staff Timothy P. Brigham, MDiv, MS, PhD. Introduced by former ACGME President and Chief Executive Officer Thomas J. Nasca, MD, MACP, Dr. Brigham’s remarks served as both a closing reflection on the conference and a capstone to nearly two decades of leadership in graduate medical education (GME).
“It’s the end of the conference,” he told attendees. “And it’s the end of my time working with you.”
Throughout his career, Dr. Brigham became a steady presence in the GME community, known for leading with empathy, compassion, and dignity. Reflecting on the conference’s growth from fewer than 1,000 participants to now around 5,000, he pointed to this evolution as a testament to the strength and shared purpose of the GME community.
Drawing on stories and recorded testimonials from residents, Dr. Brigham emphasized that GME is rooted not only in scientific knowledge and technical skill, but also in the art of caring for human beings.
“I see you,” he said to the room full of educators. “You teach knowledge and skills, but you do so much more. You teach how to be with suffering. You teach how to fail without failing.” Dr. Brigham reminded attendees that they are preparing physicians to care for patients as if they were their own loved ones, alone, vulnerable, and afraid.
Throughout the lecture, Dr. Brigham returned to the idea of purpose and direction, describing educators and physicians as guided by a “North Star”—a steadfast commitment to patients and learners, even in difficult times.
“No matter how dark the sky or how rough the seas,” he said, “You are the North Star of GME.”
He noted that much of GME’s most meaningful work happens quietly, in moments unseen by others. Small acts of care, he explained, can set long trajectories of impact that extend far beyond what any individual may ever witness.
At the heart of the lecture was the concept of the courage to care, or the willingness to remain present with patients and learners even when the work is challenging, exhausting, or emotionally taxing. That courage, said Dr. Brigham, also includes caring for oneself and offering grace instead of unrealistic expectations. Drawing on the Japanese concept of wabi-sabi, he reflected on the beauty of imperfection and how brokenness and repair can cultivate strength.
Dr. Brigham reminded attendees that GME is not simply a profession, but a calling. Whether that call is quiet or unmistakable, the work is transformational rather than transactional, and it requires courage, even in moments of deep fatigue. Quoting a Japanese proverb, he encouraged perseverance: “Fall down seven times, get up eight.”
Dr. Brigham also distinguished between happiness and joy, describing happiness as fleeting and joy as something deeper, rooted in meaning, connection, and purpose. He urged attendees to remain open to awe—the sense of wonder that can emerge in moments of care and human connection.
As the lecture drew to a close, Dr. Brigham reflected on the far-reaching impact of GME. Each graduating physician may touch tens of thousands of lives over the course of a career. Every act of care, he noted, shapes lives in ways that may never be fully visible. Courage, care, and presence are the enduring gifts physicians and educators leave the world.
With humor and a slight variation on the quotation, Dr. Brigham concluded with a reference to the cartoon “Pinky and the Brain,” in every episode of which Pinky always asked The Brain:
“What are we going to do tonight?”
And The Brain would answer (slightly adjusted for the conference’s audience):
“Try to change the world.”
Dr. Brigham’s final charge to attendees was similarly powerful and simple:
“Do what you have always done,” he said. “Change the world.”
Immediately following the lecture, the ACGME announced the establishment of a new scholarship named in Dr. Brigham’s honor. The Timothy P. Brigham Resident Scholarship, named to recognize Dr. Brigham's caring leadership and dedication to resident education, will provide funding for recipients to attend the ACGME Annual Educational Conference or another ACGME learning activity. Details are still being finalized and will be announced on the ACGME website and communications channels soon.