Introduction : the four foundational professional development and formation (PD&F) goals and their benefits for students, faculty, staff, and administrators -- A framework for purposefulness to realize the four professional development and formation goals -- Competency-based education as another step in purposefulness : lessons learned from medical education's fifteen years of additional experience with professional development and formation goals -- Ten principles to inform curriculum development -- Going where each major stakeholder is and building bridges among them in order to realize the four professional development and formation goals -- The opportunity to lead.