Sylvia Botros-Brey, MD, MSCI, professor of urology, obstetrics and gynecology, and medical education at The University of Texas Health Science Center at San Antonio (UT Health San Antonio), was selected for a Catalyst Award for Transformation in Graduate Medical Education from the Josiah Macy Jr. Foundation and Accreditation Council for Graduate Medical Education.
Botros-Brey, who also is program director of the Female Pelvic Medicine and Reconstructive Surgery Fellowship program and assistant dean for faculty in the Joe R. and Teresa Lozano Long School of Medicine, was one of six selected for the award nationwide.
The Catalyst Award supports projects that improve the clinical learning environment for both residents and fellows through innovative strategies and tools that can help them succeed. Projects must also show sustainability after the funding period ends. The foundation will provide $93,166 for an 18-month period beginning April 1.
“Each of the six projects selected for support will make meaningful contributions to improving their own clinical learning environments and the experience of their residents, as well as providing important models and exemplars for other programs and other institutions,” said Macy Foundation President Holly J. Humphrey.
Botros-Brey’s project, “Exploring Professional and Ethical Dilemmas to Teach and Assess the ACGME Competencies of Professionalism, Interpersonal and Communication Skills, and Systems-Based Practice in the Clinical Learning Environment,” was chosen from a pool of 90 graduate medical education programs and academic institutions.
Her proposal uses forum theater as a tool to explore and engage in communication, ethical dilemmas and conflict resolution strategies. In forum theater, participants act out specific scenarios and invite the audience to participate in creating collective solutions.
Woodson S. Jones, MD, vice dean for Graduate Medical Education and Designated Institutional Official Professor of Pediatrics, said Botros-Brey’s work exemplifies innovation needed in medical education.
“Her use of forum theater to tackle the complexities of professionalism, ethics and effective communication in clinical training is not only novel, but transformative,” he said. “This project teaches invaluable interpersonal skills and helps cultivate a culture of collaboration and system-level problem-solving. By equipping residents and fellows with tools to navigate real-world challenges, Dr. Botros-Brey is shaping the future of graduate medical education and, ultimately, enhancing patient care.”
The Accreditation Council for Graduate Medical Education sets out six core competencies for physicians in training — patient care, medical knowledge, practice-based learning and improvement, systems-based practice, professionalism and interpersonal skills communication. Of these, Botros-Brey notes that teaching, assessing and remediating professionalism are the most challenging for residency and fellowship program directors. Another challenge is teaching and assessing interpersonal and team communication. Her program teaches learners how to deal with interpersonal, professional and ethical dilemmas that align with key milestones in each of the six competencies.
The process, she said, allows residents, fellows and faculty to develop skills to recognize, respond to and resolve common professional and ethical challenges in the clinical learning environment using communication skills and systems thinking.
As part of the project, Botros-Brey and her team will develop a modular and scalable curriculum that program directors can use or modify for their own unique needs. Example scenarios will be recorded on video for distribution and use at other institutions.
“This project transforms how medical trainees learn to handle tough ethical and team challenges they face in hospitals and clinics,” Botros-Brey said. “By using interactive theater and real-life scenarios, we’ve created a hands-on curriculum that teaches communication skills and how to spot systemic issues — like unclear roles or workplace norms — that often fuel conflicts. Instead of blaming individuals, this approach helps teams solve problems together, fostering safer, more supportive environments for both providers and patients.”
Co-investigators for the project include Jason Morrow, MD, PhD, and Emily S. Wang, MD, UT Health San Antonio, Long School of Medicine; and Gregory Nicholas Wallingford Jr., MD, MBA, and Gretchen Fuller, MD, The University of Texas at Austin, Dell Medical School. Also assisting on the project are Ross Willis, PhD, UT Health San Antonio; Nicholas Yaghmour, MPP, and Kate Hatlak, PhD, with the Accreditation Council for Graduate Medical Education.
For a full list of the 2025 Catalyst Award winners, visit: https://macyfoundation.org/our-grantees/catalyst-awards
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