With CMS, HRSA and others investing close to $9 billion dollars annually in graduate medical education, the day has now come for greater accountability in graduate medical education around safety and quality. Imagine what would happen if academic medical centers were ”reimbursed” for their graduate medical education the same way hospitals are now being reimbursed for patient care with penalties for lapses in safety and quality education, similar to readmission or infection rates. A reimbursement model based on Value-Based Education and HCAHPS for graduate medical education…where organizations like Consumer’s Union, Healthgrades and Leapfrog would publish annual ”grades” for GME quality and safety programs across the country. That would surely raise the stakes, get institutional leadership’s attention, and change the graduate medical education landscape. Is that type of educational “transparency” heading our way in the not-too-distant future?