October 7, 2026 Salus Forum

So that’s just a few things around various ways of teaching and learning with learners. Let me talk a little bit about ABFM and where we might go with the core outcomes, which Jeremy asked me to talk about. And a little bit about our new CAQ in health administration, leadership and management.

As all of you may know, the core outcomes include one that is lead, manage and participate in healthcare teams that can improve care to patients. The words were important. It felt to us important  that there be not only leadership, but also followership. There were skills that we could develop over time. However, something is missing. I’m hoping that the field will develop what assessment look like. Are we giving feedback, formal feedback, written feedback when we have residents in leadership roles or when they go into the community? And I think there’ll be more attention to advocacy, both for patients and for populations, if you will. I’m hopeful that that’s where the field will go.

A second initiative concerned our advancing innovation residency education. This is coming out of the last standards. The RC suggests we need to experiment with four-year residencies. We would add additional competency to traditional residency with more time. And there’s some early data with obstetrical C-sections indicating that if you actually integrate it over four years, you get more experience than having three years in a fellowship. We have so far two residencies that are trying to develop leadership and have a focus on leadership as a part of a fourth year. One isn’t quite ready yet. The other one is designed an experience.

This is in a community hospital in Ohio. This program is designed to do a variety of things, some of them are academic. It is writing an article and so on, but it’s also participating in groups. It falls short of what the ACGME fellowships in health administration, leadership. I think their concept is that you take a resident/fellow and you put them in the room with all those in the C-suite and they pick up projects as they go forward. And that’s their clinical role. The final piece is the HALM CAQ or subspecialty. As all of you know, in family medicine, we call them CAQs. The rest of the world called them subspecialties. We started this several years ago. Emergency medicine is the administrative board for that. We are one of what’s called the co-sponsoring board.

And I’ve been delighted at the response of family medicine to this. Basically, the intent is to have a credential that will help people become C-suite leaders or health system leaders. And there’s actually a textbook for this. The ACGME requires both education and clinical experience, the clinical experience being what I’ve mentioned to you. And family medicine actually has the most applicants and the most successful takers of the exam of any specialty. So, we’re up to probably 75 participants per year, and we’ll end up at the end of the exam, probably close to 200 of these. It’s not huge, but it’s not itty bitty in terms of a subspecialty and there seems to be picking up.

It may be useful for you to understand our framework and how we decide which family docs can be a part of that. We think that people need to have experience with managing talent. Applicants need to be able to manage and run budgets, and they need to manage and improve quality. So, when we’re looking for applicants, they’ve got to have enough time devoted to leadership. We’re looking for the actual experiences in each one of those as a kind of credential for leadership.