Henry J. Schultz, MD, MACP, GME Physician Leader
Current position(s) and title(s)
Professor of Medicine and Consultant in Primary Care Internal Medicine, College of Medicine, Mayo Clinic
Director, Office of Program Accreditation Support, Mayo School of Graduate Medical Education (MSGME)
BS, Bowling Green State University, 1972; MD, Ohio State University College of Medicine, 1975; Residency and general medicine fellowship, Mayo School of Graduate Medical Education, 1975-1979
Special area(s) of clinical/research/educational interest
Served as program director of the Mayo internal medicine residency program, 1987-2002; over 1,200 residents completed training during this tenure.
GME organizational service
Past Chair, Residency Review Committee for Internal Medicine (RRC-IM)
Past President, National Resident Matching Program (NRMP)
Past President, Association of Program Directors in Internal Medicine (APDIM)
Past Chair and co-founder, Organization of Program Director Associations (OPDA)
Parker J. Palmer Courage to Teach Award, Accreditation Council for Graduate Medical Education (ACGME)
Distinguished Educator, Mayo School of Graduate Medical Education
Master, American College of Physicians
Why are you a program director/DIO/leader in GME?
Working as an associate program director in the early 1980s revealed educational scholarship and graduate medical education administration as a legitimate career path in academic medicine. Through work as program director, service on national GME organizations, and educational scholarship (presentations and publications about GME), I was promoted to professor of medicine.
National leadership roles were never coveted, but were accepted as an opportunity to make a difference in resident education. As presidents of APDIM, Drs. Tom Nasca, Tom Cooney, and I spent a great deal of time trying to influence GME accreditation by the ACGME and the RRC-IM. As a result of that effort, each of us subsequently was appointed to the RRC-IM, and each served as chair or vice chair since 2001. During that time, we have been able to accomplish at least three important objectives:
The program requirements for core internal medicine and the 17 internal medicine subspecialties accredited by the RRC-IM have been extensively revised and rewritten in collaboration with the program directors and specialty societies. The protection and enhancement of the educational milieu is central theme in these requirements.
The RRC-IM has successfully made the interpretation and application of these requirements more transparent through a series of program director workshops and FAQs published on the RRC-IM Web site.
The formerly contentious relationship between programs and accreditors—program directors and their societies (APDIM, ASP, and the subspecialty program director societies) versus the RRC-IM—has evolved to a much more collaborative process designed to improve GME.
What are the most important issues today in GME?
Service-education balance. Teaching hospitals have developed an unhealthy dependence on the service provided by residents and fellows. Accreditation bodies like the ACGME exist to ensure that residents are not exploited and that their curriculum is driven by educational imperatives. The on-the-ground application of this principle falls to key faculty, program directors and administrators, and DIOs supported by program requirements that delegate appropriate authority for the educational program.
Competency-based education and outcomes-based evaluation. One of the legacies of former ACGME Executive Director David Leach, MD, is the transformation of our thinking about how our adult learners—residents and fellows—should be trained and evaluated. We are seeing that transformation of the educational paradigm carried out in GME programs nationally. But while the ACGME can provide tools and examples, “All solutions are local.” Implementation requires the efforts of innovative program directors and faculty using the resources available at their institution. And successful innovations must be shared with the greater community so that they may be field tested, improved, and adapted by other programs. Medical education scholarship—studying what we do and publishing those results—has never been more critical than it is now.
If you only had a minute, what advice would you give to a physician in training?
Read every day. The very best residents and clinicians develop that competence through experience that is informed by a consistent program of reading. Patients will assume that you are knowledgeable and competent because of your degree and training. Honor that trust by staying as current as possible with medical practice through reading, conference attendance, and "just-in-time" patient-centered reading using Web-based resources for patient care.
What advice do you have for aspiring GME leaders?
In the past 20 years, I have watched a generation of program directors choose a career in GME administration. Further advancement of GME will occur only through the efforts of program directors and educational administrators who dedicate their careers to the science of medical education.
AMA member since . . .
I joined the AMA in 2000, prior to my appointment to the RRC-IM. Only after joining did I realize what a major player the AMA was in GME—through activities like FREIDA Online, the Graduate Medical Education Directory, GME Track, the JAMA medical education issue, the AMA Council on Medical Education, and more.
Personal (family, hobbies)
Wife Chris and I have three daughters: Melissa (forester, Zumbrota, MN), Katie (mother of two, Madison, WI), and Julie (pediatric nurse, Madison WI) and four grandchildren. We live on a 20-acre hobby farm north of Rochester, MN, where we enjoy Bible study, country life, and our English springer spaniel Sparkle.