Teaching the Teachers With Milestones: Using the ACGME Milestones Model for Professional Development

Physicians-in-training are educated through the paradigm of competency-based medical education (CBME), which promotes progressive development of expertise. To better support CBME, the Accreditation Council for Graduate Medical Education (ACGME) introduced the Milestones assessment framework across all ACGME-accredited graduate medical education (GME) training programs.1,2 Milestones are behavioral descriptions of the developmental trajectory of trainees in the GME environment, which provide longitudinal and trajectory-based metrics along domains of physician competency. These metrics aim to promote lifelong learning and ensure residents and fellows are “ready for autonomous practice” at graduation. Yet, such “readiness for autonomous practice” at the completion of training does not equate with the completion of professional learning, nor does it preclude the development of further levels of expertise.