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Dr. Paniagua has served as a course director, clerkship director and internal medicine residency program director at various points during his career in academic medicine prior to joining the staff of the National Board of Medical Examiners (NBME), where he served as Associate Vice President, Assessment Operations & Medical Education. After eight years at NBME Miguel assumed the role of Vice President of Medical Education at the American College of Physicians (ACP). Miguel received his undergraduate degree from Saint Louis University before earning his MD at the University of Illinois College of Medicine, Chicago. Dr. Paniagua completed his internal medicine residency and gerontology & geriatric medicine fellowship at the University of Washington, Seattle. Dr. Paniagua practices consultative Hospice and Palliative Medicine at the Hospital of the University of Pennsylvania and is Adjunct Professor of Medicine in the faculty of the Perelman School of Medicine at the University of Pennsylvania.  He is the co-editor of the fifth & sixth edition of "Constructing Written Test Questions for the Basic and Clinical Sciences," The chapter on “Writing High-Quality Constructed-Response and Selected-Response Items” in Assessment in Health Professions Education (2nd ed.), and the fifth edition of “Essential Practices” (UNIPAC) palliative medicine book series.