The governance of graduate medical education (GME) and management of its interface with clinical care is a shared responsibility of teaching hospitals and medical educators. Significant changes in the structure and financing of medical care over the last few decades, along with a recent shift in the educational paradigm for GME, have made this collaboration all the more challenging. Calls for increased institutional accountability for GME from the Association of American Medical Colleges and the Accreditation Council on Graduate Medical Education have highlighted the need for more effective models of GME governance.With these challenges in mind, this article examines the recent experiences of The McGaw Medical Center of Northwestern University, a multiinstitutional, not-for-profitcorporation that serves as the vehicle for educational collaboration between Northwestern University Feinberg School of Medicine and the teaching hospitals/health systems that provide the clinical homes for McGaw-sponsored GME programs. The authors explore the rationale for pursuing a new model of GME governance at McGaw, and various factors important to its success. These "critical success factors" may be of use in other, similarly complex GME settings.
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