Milestones
Competency-based developmental markers that describe what residents and fellows are expected to achieve at defined stages of training.
Definition
ACGME Milestones are specialty-specific, competency-based developmental markers that describe the knowledge, skills, and behaviors expected of residents and fellows at various stages of their training. Milestones are organized across the six ACGME core competencies and use a 1-5 scale. Programs are required to assess residents on milestones semiannually and report those assessments to ACGME. The Clinical Competency Committee is responsible for making milestone determinations.
Why it matters for your program
Milestone assessment is one of the most important and most difficult aspects of GME. Faculty often struggle with the assessment process, leading to grade inflation, lack of differentiation, or milestone ratings that don't reflect actual resident performance. Poor milestone processes are a major risk factor in accreditation reviews — and a poor milestone record can affect a resident's ability to demonstrate competency for board certification.
Related terms
Annual Program Evaluation (APE)
A required yearly review of a residency or fellowship program's performance, conducted by the Program Evaluation Committee.
Clinical Competency Committee (CCC)
A required committee responsible for reviewing resident and fellow performance and making milestone determinations semiannually.
Faculty Development in GME
Structured programs and activities designed to improve the teaching, assessment, leadership, and professional skills of GME faculty.
Direct Observation
The practice of faculty directly watching a resident perform a clinical skill or procedure and providing structured feedback based on that observation.
Related Service
Faculty Development Programs
Ashley Wood, PhD helps programs navigate milestones requirements with director-level expertise from HCA Healthcare and Vanderbilt.
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