Residency training is a profoundly important time in physician development. Patterns of practice established during residency persist for decades.1,2,3 Each US graduate medical education (GME) program has a program director responsible for all aspects of the program, from establishing and delivering the educational curriculum to ensuring that patient care delivered by residents is safe and of the highest possible quality.4 Ultimately, program directors attest to specialty boards and societies that trainees are competent for independent practice.