Over the past 2 decades, there has been a growing body of literature detailing disparities in health and health care, especially in rural areas. As population health care needs increase, the health care workforce shortage continues to be a focal point of discussion among stakeholders in policy, education, and residency training. In addition, the need for increased diversity of health care teams provides another area of concern. Osteopathic medical schools and osteopathic educators have been tasked to explore innovative approaches to increase student body diversity and address interest in rural and underserved areas. This educational discussion has targeted a continued need for increased diversity in rural medicine and an increase in the number of primary care providers to address health disparities. The discussion has also expanded the concept of collaborative practice from interprofessional education in the classroom setting to include students at all levels in the clinical learning environment.^1-3 Interprofessional education and collaborative practice has been cited throughout medical education and health professions literature for more than half a century.⁴ In its conceptual framework, interprofessional education provides a mechanism to facilitate collaborative teamwork and future collaborative practice for health care teams. Throughout this progression, medical educators have grappled with the introduction and application of competencies, milestones, and, more recently, entrustable professional activities to teaching and learning in the clinical environment.⁵ Educators have been challenged to identify methods of assessment while establishing and ensuring continuous skill development and entrustment that translates to the clinical learning environment. 

In fall 2017, the National Collaborative for Improving the Clinical Learning Environment (NCICLE) held its first multiday symposium to engage active interprofessional discussions.⁶ The symposium provided a forum to articulate ideas among key stakeholders from across the country and across health professions. This national discussion embraces a shared learning environment inclusive of patients, learners, hospitals, health systems, and academic centers. As NCICLE evolves this conversation, its goals are to continue investigating the development of key milestones. For example, NCICLE milestones will look to best define and measure skills that drive an effective optimal clinical learning environment as we address sustainable approaches to achieve change in a shared clinical environment in which lifelong learning focuses on patient safety.⁶ 

This annual medical education theme issue of The Journal of the American Osteopathic Association highlights efforts to increase diversity in medical school. The issue also explores factors that influence residency program decision making, assesses student perceptions of collaborative practice in the clinical environment, provides an update on the single accreditation system for graduate medical education, and assesses faculty and residents' value of osteopathic recognition.