Most U.S. institutions that sponsor graduate medical education (GME) programs are struggling to commit to a non-volume-based care business model while, at the same time, working to sustain or expand a fee-for-service status quo.1 The Association of Academic Health Centers and some of its member institutions contend that there is a viable business case to be made for a population-based care model that seeks to resolve environmental, social, and behavioral determinants of health. As teaching hospitals struggle with these tectonic shifts in their business models and social contracts, they are also contending with how to prepare young physicians for practice in the resulting new models of care. Here, we offer key steps that academic health centers (AHCs) can take to position their GME programs at the leading edge of change.