**8. Conclusion**

The process to start successful and dynamic residency programs appeared a bit overwhelming at times, but it was a meaningful experience. The main pillars of implementation for a successful graduate medical education program encompass all "3Fs"; program faculty, facilities, and finances to build and support a cutting-edge, competency-based medical education. The advice to other programs is to embrace the experience and help encourage growth in graduate medical training positions to create succession and increase the number of physicians to help prevent reduce of physician shortage.

*Starting New Accreditation Council for Graduate Medical Education (ACGME) Residency... DOI: http://dx.doi.org/10.5772/intechopen.93617*
