Before exploring the projected future of Sponsoring Institutions (SIs), it is important to understand their origins and development. Graduate medical education (GME) has relied on diverse learning communities to educate residents for unsupervised practice. As 1 such learning community, the SI has contributed to the education of residents and fellows by ensuring the provision of support systems, resources, and administrative structures. Through their oversight of GME, SIs have fostered clinical learning and working environments in which residents and fellows achieve educational milestones that indicate their ability to provide high-quality, safe patient care upon completion of their programs and throughout their