To Be Seen and Heard: The Invisible Backbone of Graduate Medical Education
We often talk about residents, fellows, and faculty as the drivers of graduate medical education. But there’s another group that keeps the entire system running, quietly, diligently, and often invisibly: GME administrators.
They manage up, down, and across.
They initiate major projects in departments where they hold no official authority.
They’re brought in simply because they touch everything- residents, fellows, medical students, faculty, hospitals, and schools.
And yet, despite this critical work, GME administrators are often overlooked:
They are told they are the backbone of the department, but rarely offered advancement.
They are expected to lead initiatives but seldom given leadership titles.
They hold master’s degrees, doctorates, and years of institutional knowledge, yet are passed over for roles like Associate Dean of GME because they don’t have “MD” behind their name.
The Paradox of the Essential but Invisible
GME administrators sit at a unique intersection: they understand compliance, systems, and accreditation as deeply as they understand people, wellness, and culture. Their work is woven through every department, every rotation, every academic partnership.
But too often, they are pegged into fix roles, “coordinator”, “administrator”, “manager”, as though their value begins and ends with paperwork. In reality, they are strategists, educators, and leaders in every sense of the word.
A Call to Leaders
To the leaders of medical education: if you want to build strong, resilient systems, you cannot afford to overlook the very people who hold them together.
Mentor administrators. Offer structured pathways for growth.
Create new roles. Not just “coordinator” or “assistant”, but positions that reflect their expertise: Director of Education, Clinical Educator, Associate Dean.
Recognize value. Not just in words (“you’re the backbone”) but in promotions, pay equity, and visible leadership opportunities.
To GME Administrators: You are Seen
If you are reading this and you are an administrator, know this: you are not invisible. Your work matters. The system cannot function without you. And while titles may not yet reflect your impact, the future of medical education will need leaders like you. Leaders who already know how to manage the invisible threads that connect people, systems and mission.
Closing Reflection
Graduate medical education is often described as a team sport. If that is true, then administrators are not just on the sidelines. They are calling plays, holding the field together, and making sure the game goes on.
It’s time we stop overlooking the invisible backbone and start seeing, hearing, and elevating the administrators who make education possible.