Graduate medical education (GME) occurs during and is a crucial step of the transition between medical school and clinical practice. Residency program graduates' abilities to provide optimal patient care, act as role models, and demonstrate excellence, compassion, professionalism, and scholarship are key elements and outcomes of successful GME programs. In order to create and maintain the training environment that leads to such outcomes, programs must continually review and revise their patient care and educational activities. Currently, compliance with accreditation standards as determined by individual specialties such as family medicine serves as a common and significant marker for program quality. Compliance with these requirements is necessary but not sufficient if faculty and residents want to achieve the goal of residency training in terms continually improving and optimizing the care they provide to their patients and communities. For overall program improvement to truly occur, the patient care, scholarship, and community activities of current residents and graduates must be assessed and used in program improvement activities. Appropriately applied to programs and using these assessments, quality improvement principles and tools have the potential to improve outcomes of patient care in residents' current and future practice and improve programs in educating residents.