As with CME, academic medicine looks to outside sources to support GME programs. For the last half century, funding for GME has largely come from federal sources and institutions are paid to train the physicians of tomorrow. To receive federal funding, a training program must be accredited by the Accreditation Council for Graduate Medical Education. The total number of funded slots is capped by a system designed and implemented decades ago. However, the number of accredited programs has grown as new specialties at both the resident and fellow levels of training have proliferated. Because federal funding is frozen, some GME programs now receive direct funding from industry28; this is particularly the case in dermatology. In ophthalmology, pharmaceutical company–sponsored programs29support institutions for fellowships; these fellowships are limited to cornea, retina, and glaucoma at certain institutions that perform research in pharmaceutical advances. A more common practice is industry sponsorship of brief programs for senior residents and fellows. Many of these seminars focus on subjects not traditionally emphasized in residency programs, such as practice management. Industry sponsorship of departmental conferences, journal clubs, and wet laboratories is common, including gifts of lunches, textbooks, and even equipment. There are for-profit third-party MECCs with an emphasis on GME rather than CME. All of these interactions with industry can lead to influence and bias, whether apparent or not.