This interview is one in a series of interviews with recipients of the 2020 ACGME Awards. The awardees join an outstanding group of previous honorees whose work and contributions to graduate medical education (GME) represent the best in the field. They will be honored at the upcoming ACGME Annual Educational Conference, taking place February 27-29 in San Diego, California.
John C. Gienapp Award Awardee Debra F. Weinstein, MD is the vice president for GME at Mass General Brigham (Partners HealthCare). She is a gastroenterologist and internist.
ACGME: Your biography notes you were a music major as an undergraduate student. How did you become involved in medicine, and in academic medicine and medical education specifically?
Weinstein: I wanted to be a doctor as far back as I can remember, but majored in music because liberal arts is an amazing gift: it allowed me to indulge my love of music even though I was heading in another direction professionally. With no doctors and, fortunately, no major illness in my family, my early perceptions about medicine were shaped by idealized TV docs. I was drawn to the prospect of solving problems to help people—and I also recall being irritated that all of the fictional (and most of the actual) physicians were men.
Serving as chief resident in internal medicine at MGH [Mass General Brigham] got me hooked on medical education. Just after that I had the opportunity to become the program director. I found that helping to shape the program, influence the educational environment, and mentor residents felt like the ideal path for me, alongside patient care. Subsequently, I’ve gravitated toward opportunities to do those same things on a larger scale, hoping to impact GME more broadly.
ACGME: How do you feel about receiving the Gienapp Award?
Weinstein: Wonderful, of course! It feels rather indulgent to be recognized for doing what I love. It’s also a bit over-the-top to receive this award after the Courage to Lead Award back in 2007. Actually, the ACGME Awards program inspired me to start a Med Ed Awards program at Partners HealthCare in 2010, which—like ACGME’s program—helps to elevate the importance of the education mission.
ACGME: What do you think is one of your greatest contributions to GME?
Weinstein: That’s a hard question to answer. At the institutional level, I’m glad to have initiated a bunch of cross-specialty activities for learners and program leaders (back in the '90s)—an intern core curriculum retreat, chief resident course, a series of program director workshops, and coordinator activities, all of which helped to break down specialty-based silos in our institutions.
In the broader GME context, I try to catalyze change by shining a light on an area of GME that needs improvement in order to create a coalition of champions to effect change on a larger scale. Recent examples would be supporting learner-parents and addressing challenges of trainees in the DACA program and/or with economic challenges. I’ve also been trying to lay the groundwork for a national GME database that facilitates educational quality improvement and research, with the hope that GME will become increasingly evidence-based. If this takes hold, it would likely be the most impactful contribution.
ACGME: What roles have you had with the ACGME? Why did you decide to participate in and collaborate with our organization?
Weinstein: I’ve been an ACGME “constituent” since 1991, initially as an internal medicine program director and then as a GME leader (14 years as a designated institutional official). These roles gave me a sense of ACGME’s enormous responsibility and impact related to physician education.
Serving on ACGME’s Board was a great learning opportunity, a chance to work with amazingly dedicated colleagues, and enormously gratifying. Chairing the Journal Oversight Committee as we launched JGME [Journal of Graduate Medical Education] (with huge kudos to Ingrid Philibert) was a privilege. I was sorry to leave the Board early to join the Institute of Medicine (IOM) Committee for Governance and Financing of GME, for which the Board role was seen as a conflict of interest.
Mostly recently, I was part of the Sponsoring Institutions 2025 Task Force and participated in an inspiring workshop co-sponsored by ACGME and ABMS [American Board of Medical Specialties] focused on parental and family leave.
ACGME: What do you see as a major challenge to the ACGME, and how is the organization doing in tackling it?
Weinstein: Preparing physicians for tomorrow’s challenges, not just yesterday’s, is the key challenge. Doing this in a way that cultivates a learning environment that supports well-being, improves diversity and inclusion, and helps individuals achieve their own highest aspirations is difficult. Doing this across such varied Sponsoring Institutions and specialties brings additional complexity. And the time course involved in developing and implementing new standards, and then evaluating their impact, is another layer of challenge.
I think ACGME does a great job of taking stock, seeking broad input, and shifting priorities as needed. I appreciate that the organization is willing to effect bold changes, but at a reasonable pace that won’t cause whiplash. I also applaud ACGME for affording increasing flexibility to facilitate research. Going forward, reevaluating foundational processes and signature efforts over time isn’t easy, but is critical.