The economics of medicine have drastically changed during the past quarter century. Institutions may be faced with difficult decisions concerning graduate medical education (GME), particularly as it relates to the growth of existing programs and the creation of new programs. The authors describe a tool that they developed that can consistently measure the value of individual training programs while aligning with an institution's strategic priorities. This tool, the assessment metric scorecard, permits the annual prioritization of GME programs by the leadership of Mayo Clinic, Jacksonville, Florida. The scorecard also provides valuable data regarding the strengths and weaknesses of individual programs. The metric seeks to evaluate GME programs on the basis of four broad areas: Research, Teaching, Patient Service, and a General category. The assessment metric scorecard has been used since 2004; this article reports on its use for the academic years 2004–2005 and 2005–2006. The scorecard has proved to be a helpful tool for the yearly evaluation and prioritization of GME programs at the authors' institution. The overall mean score of the GME programs increased, which suggests a positive trend. This scorecard is flexible; modifications of the relative weights of the metrics can be made to align it with the strategic priorities of other institutions. The resources necessary to implement the scorecard are minimal.