**2. Focus on outcomes: safety and quality as cornerstones of modern graduate medical education**

The above-mentioned challenges are clearly evident when examining contemporary healthcare practices and outcomes, especially when compared to quality, reliability, and safety across other major industries, such as air transportation and finance [16, 17]. Progress is being made, with ongoing focus on quality and value creation beginning to result in measurable improvements. For example, the overall mortality has declined in high-income countries over the past ten years due to better prevention, early detection, and improved treatments [18–20]. This was accompanied by increases in life expectancy and a shift in chronic comorbidity patterns [21, 22], creating unique socioeconomic challenges [23]. Note that although the average annual per-capita growth in health expenditures has declined during the past decade, the US health-care system still holds the highest per-capita cost among high-income countries (approximately \$11,000) [24, 25]. The coronavirus disease 2019 (COVID-19) pandemic exposed several critical vulnerabilities among global healthcare systems. Among the most urgent systemic shortcomings,, behavioral health needs, which were among the top five conditions driving overall healthcare costs, have become a major challenge [26, 27].
