National Initiative V, launched in the summer of 2015 with 29 teams, will focus on navigating the disparities component of the ACGME’s Clinical Learning Environment program. Why health disparities? National Initiative IV (2013-15) focused on the ACGME’s Clinical Learning Environment Review (CLER). Our experience with that Initiative — coupled with the findings of the ACGME’s site visit teams over the past two years — has confirmed that institutions are not equipped to successfully meet the expectations for reducing health disparities as suggested by the ACGME, IOM and others. Health disparities in the United States are well documented, and despite the efforts of numerous organizations, stark inequities remain. Independent academic medical centers play a critical dual role in addressing this national problem because we train the future physician workforce and serve as key safety net providers for our local populations.