Engaging physicians in quality improvement (QI) and patient safety (PS) efforts has become increasingly central to creating efficient delivery systems and improving patient care. Fellowship training in gastroenterology offers a unique opportunity to develop these skills in preparation for practice. For example, learning how to analyze a problem and identify interventions to reduce harm, improve one’s adenoma detection rate, or enhance vaccination adherence is crucial to advancing patient care. Additionally, new payment and delivery reform efforts within gastroenterology require physicians to take on more accountability for quality metrics.