Program leadership, 3+1 ambulatory block schedule improves clinical service, education, and personal well-being, ambulatory clinic building, ultrasound/QI/simulation medicine, pathways program for the categorical residents, residents and faculty mentorship, pulmonary plus CCM joint fellowship with CPMC, dedicated primary care immersion weeks for the primary resident program, health justice curriculum, wellness support pods, and academic 1/2 day protected teaching Q4 weeks.