From Chrysalis to Taking Flight, the Metamorphosis of the ACGME During Dr Thomas Nasca’s Tenure as CEO

Thomas J. Nasca, MD, MACP, served as the President and Chief Executive Officer (CEO) of the Accreditation Council for Graduate Medical Education (ACGME) for 17 years, with his tenure ending December 2024. During this time he led and supported significant changes in accreditation and medical education. This article will examine the changes during this period through the lens of key themes, including the redesign of the graduate medical education (GME) accreditation model and new and expanded roles that the ACGME assumed during 3 phases between 2007 and 2024: (1) the development years leading to the Next Accreditation System (NAS), (2) implementation of the NAS, and (3) the COVID-19 pandemic. Launched in 2012, the NAS redesigned accreditation as a balanced combination of assurance- and improvement-focused policies and activities. The NAS served as the foundation for harmonizing GME training through the creation of the single accreditation system. The ACGME also took on new roles within the professional self-regulatory system by tackling difficult issues such as wellness and physician suicide, as well as diversity, equity, and inclusion in medical education. In addition, the ACGME substantially expanded its role as facilitator and educator via the introduction of multiple resources to support GME. However, the medical education landscape remains complex and faces continued uncertainty, especially as it emerges from the effects of the COVID-19 pandemic. The next ACGME President and CEO faces critical issues in GME.