Curricula designed to engage trainees in quality and safety education continue to expand in professional schools and their affiliated hospitals nationally. Academic medical centers pose unique challenges in improving quality and safety, including the responsibility of training future providers. This qualitative study conducted structured interviews with residents and key educational and quality leaders to determine the impact of high-performing hospitals on residents' knowledge of quality and safety. Investigators found no relationship between a hospital's quality status and its residents' curriculum or understanding of quality and safety. While a few programs had formal curricula, the majority of residents learned about quality and safety through an informal curriculum such as through ongoing hospital initiatives. The authors conclude that teaching hospitals provide an important vehicle to support and promote quality and safety education for trainees, with opportunities to leverage initiatives into resident learning.