In October 2026, Thomas J. Cummings, MD, professor of Pathology and Ophthalmology and director of Duke Pathology's Residency Program, published "Credibility: A Metric for Graduate Medical Education (GME) Evaluation," in Academic Pathology, the official open-access journal of the Association for Academic Pathology.
The article examines whether credibility, a quality central to medical practice but largely overlooked in formal trainee assessment, should play a greater role in GME. While Accreditation Council for Graduate Medical Education (ACGME) Milestones and Entrustable Professional Activities (EPAs) help educators evaluate residents' and fellows' knowledge, skills, professionalism, and trustworthiness, Cummings proposes that credibility represents a distinct attribute that also plays a part in physician success.
“Patients, colleagues, and communities place tremendous trust in physicians,” Cummings writes. “A key goal of GME is helping trainees develop the character, competence, and professionalism needed to earn and maintain that trust.”
Distinguishing Credibility from Trustworthiness
A central theme of the paper is the distinction between credibility and trustworthiness.
Trustworthiness is evaluated through objective measures, such as performance against established educational standards and clinical competencies. Credibility, by contrast, is more subjective and reflects whether patients, colleagues, mentors, and learners view an individual as reliable, competent, and worthy of confidence.
"Credibility is an attribute that others invest in you," Cummings writes, noting that while trustworthiness can be assessed through performance, credibility is earned through professional conduct and relationships over time.
A Framework for Growth and Mentorship
Drawing on literature from medicine, education, leadership, and communication studies, Cummings writes that credibility should be considered in discussions of trainee development, mentorship, and remediation.
The paper presents a framework in which character, competence, and commitment form the foundation of trustworthiness, which in turn helps establish credibility. Cummings suggests that conversations about credibility could be incorporated into mentorship meetings, Clinical Competency Committee discussions, and career planning to help trainees fully understand the qualities that contribute to long-term professional success.
He also emphasizes that credibility is not fixed. It can be strengthened through mentorship, accountability, and experience, but can also be undermined by lapses in professionalism or integrity.
Preparing Future Physician Leaders
As Residency Program director, Cummings has long been committed to developing the next generation of pathologists. In the paper, he offers ways credibility might be incorporated into residency evaluations and educational discussions, while acknowledging the challenges of assessing an inherently subjective quality.
Ultimately, he argues that educators should strive to help trainees leave residency with a stronger foundation of credibility than when they entered.
“Our goal is to mentor each trainee to a higher level of credibility by the time they graduate residency,” Cummings writes, “and allow the foundation built during residency to continue to strengthen during fellowship and post-GME practice.”