This interview is one in a series of interviews with the 2025 recipients of the ACGME Awards. These 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 2025 ACGME Annual Educational Conference, taking place February 20-22, 2025, in Nashville, Tennessee.
2025 David C. Leach Awardee Mikael Guzman Karlsson, MD, PhD is a clinical informatics fellow specializing in neurodevelopmental disabilities at Baylor College of Medicine, Texas Children’s Hospital in Houston, Texas.
ACGME: Why did you want to become a physician?
Dr. Guzman Karlsson: I’ve always been captivated by the brain’s complexity and its role in shaping who we are. My path to medicine was fueled by a desire to combine scientific discovery with compassionate care, particularly for children with neurodevelopmental disabilities. Becoming a physician-scientist allows me to translate scientific discoveries into meaningful interventions that improve lives.
ACGME: What, so far, has been the most rewarding part of your residency/fellowship experience?
Guzman Karlsson: The most rewarding moments have been those where I’ve guided families through understanding and navigating their child’s diagnosis. Witnessing their relief and renewed sense of hope, knowing they have a clear plan, is deeply fulfilling.
On a broader scale, being part of a collaborative team that addresses real challenges in patient care has been equally meaningful. The opportunity to work alongside residents, faculty members, and professionals in other disciplines to improve systems of care has shown me the power of teamwork and innovation in creating lasting, meaningful change. It has reinforced my commitment to ensuring that children with neurodevelopmental disabilities receive timely, equitable, and compassionate care.
ACGME: What has been the most challenging?
Guzman Karlsson: The most challenging aspect has been addressing the systemic barriers to care for children with neurodevelopmental conditions. These barriers often involve navigating provider inexperience, fragmented systems, and the emotional weight families carry while waiting for answers.
Additionally, managing the complexities of interdisciplinary collaborations—ensuring that diverse priorities and expertise align—requires patience, persistence, and open communication. Despite these challenges, seeing the tangible impact of these efforts on both families and the practitioners who serve them has made every hurdle worthwhile.
ACGME: What innovation/improvement did you implement in your program?
Guzman Karlsson: One of the biggest challenges in pediatric neurology is addressing delays in autism spectrum disorder (ASD) diagnosis and management. These delays often stem from practitioner uncertainty about diagnostic criteria, limited access to validated tools, and hesitancy around post-diagnosis counseling and referrals. Such barriers can leave families waiting months—or even years—for clarity and support, during which time critical early interventions are missed.
To tackle this, our resident-led team designed and implemented a comprehensive initiative to streamline ASD diagnosis and improve care pathways. We focused on two main areas: equipping providers with accessible tools through the electronic health record (EHR) and empowering them with multimodal educational resources. This included creating custom EHR-based flowsheets, templates, and documentation tools to standardize diagnostic practices and streamline data collection.
Simultaneously, we developed a robust educational curriculum with lectures, digital and printed resources, badge cards, and regular updates to ensure providers felt confident and supported in applying these tools. The project spanned multiple levels of training and disciplines, involving neurology residents, developmental behavioral pediatricians, social workers, and IT specialists.
What makes this initiative unique is its scalability and adaptability. Beyond neurology, we are now exploring ways to expand this model to primary care pediatrics, where earlier intervention could make an even greater impact. This collaborative, systems-focused approach has not only improved care for children with ASD but has also empowered providers to embrace innovation and build confidence in managing complex conditions.
ACGME: What does it mean to you to receive this award?
Guzman Karlsson: Receiving the ACGME David C. Leach Award is an honor that reflects not just my efforts, but the collective dedication of our multidisciplinary team. It’s a recognition of what residents and fellows can achieve when we lead with innovation, collaboration, and a patient-centered focus. This award highlights the importance of addressing disparities in care for children with neurodevelopmental disabilities and inspires us to continue pushing boundaries, building on this work, and advocating for patients and families with neurodevelopmental disabilities.
ACGME: What advice would you give to other residents/fellows who are looking to either replicate your improvement or implement an original idea of their own in their own program?
Guzman Karlsson: Start with a problem you’re passionate about and think big. Building change takes time, so celebrate every small victory along the way. Engage a diverse, multidisciplinary team—social workers, IT specialists, faculty members, and peers can all bring invaluable perspectives. Emphasize change management and practitioner education, as tools like EHR integrations or diagnostic scales only work if they’re adopted effectively. And remember, learners have a unique ability to spark innovation—we’re immersed in both the day-to-day challenges and the solutions.
ACGME: Is there anything else you would like to add I haven’t asked about?
Guzman Karlsson: This initiative addressed a pressing gap in care for children with ASD, but its principles extend far beyond this specific population. Our work demonstrates how resident-led efforts, grounded in multidisciplinary collaboration and data-driven approaches, can transform health care delivery. We’re excited to continue adapting and expanding this model, particularly to support primary care pediatrics, ensuring that families across the health care spectrum have timely access to diagnosis, counseling, and resources.
Learn more about the ACGME’s David C. Leach Award, and nominate a deserving resident or fellow for the 2026 award – nominations are due by March 12, 2025.