In academic internal medicine departments, clinical educators are responsible for both patient care and the training of residents. As such, they are well-positioned to implement health care improvements and the associated changes to medical education.

The teams of the 41 Academic Chronic Care Collaboratives offer five lessons about implementing health care improvements in academic settings:

1. Redesign the clinical practice before making residency curricular changes.
2. Exploit all practice staff—faculty, residents, nurses and managers—to incorporate continuous improvement change.
3. Recognize everyone is a learner, including faculty members.
4. Take advantage of Internet resources and national collaboratives to develop high levels of improvement expertise.
5. Employ rigorous methodology to implement and evaluate interventions for practice redesign.

As patient care settings and resident education are redesigned, new clinician educator leaders are emerging. Three potentially thorny issues related to these changes have promising news: 1) achieving professional satisfaction from collaborative successes despite increased workloads; 2) encouraging academic promotion by consistent criteria on par with other faculty; and 3) increasing opportunities for scholarly publication of original health care work or innovative residency curricula.

Integrating continuous health care improvement into residency training reaps benefits for many—health systems, faculty, residents, patients and society.