Stories from the field
The no that built a journal
A declined manuscript, a few honest conversations, and why GME professionals needed a place to publish their own work.
Most people in GME know the feeling of opening a journal decision letter. A few years before FULGME existed, I submitted a manuscript to the Journal of Graduate Medical Education. It came back declined.
A decline is part of scholarly work. Editors turn down far more than they accept, and good feedback makes the next version stronger. I've learned that more than once. But that particular no stayed with me, and the manuscript wasn't the reason.
The conversations afterward
When I talked it through with other GME leaders, the same theme kept coming up. So much of what program administrators and GME professionals build doesn't fit the shape of a traditional research article.
We redesign onboarding. We rebuild tracking systems. We fix a committee process that has limped along for years. We notice patterns in how programs prepare for site visits, and we quietly change them.
That work is process improvement. It's quality improvement. Sometimes it's careful qualitative inquiry. It deserves to be written down, reviewed, and shared. Yet the outlets for it were few, and most were designed around a different kind of evidence.
The problem wasn't that our work lacked value. It was that it had nowhere to go.
So we built a place
In 2023 I founded the Forum for United Leaders in Graduate Medical Education, or FULGME. It's a 501(c)(3) nonprofit, and at its center is an open-access, peer-reviewed journal driven by GME professionals. It publishes perspectives, educational innovations, brief reports, and research, including the administrative innovations that rarely find a home elsewhere.
FULGME runs on volunteers. There is no paid staff. There is a full, active board that shares the idea I kept coming back to after that decline: the people who keep GME running have expertise worth publishing.
Issue 3 came out in August 2026. Submissions for Issue 4 are open now.
What I took from it
I still submit to traditional journals, and I still get feedback that makes my work better. A no isn't a verdict on your value. Sometimes it's information. Sometimes it points to a gap someone needs to fill.
If you've built something in your program office that made the work easier for the next person, write it down and share it. There's a place for it now.