The Relationship between ACGME Milestone Evaluations and ABMS Board Certification Passage: An Empirical Study

For the last three decades, the Accreditation Council for Graduate Medical Education (ACGME) has driven changes in graduate medical education (GME) curriculum and evaluation techniques. Most recently, the ACGME has shifted from focusing on six broad competencies, common to all medical specialties, to a much more structured benchmarking model customized for each medical specialty. In 2013, the ACGME unveiled the Next Accreditation System (NAS) as a way to restructure the accreditation process for medical residency and fellowship programs. The ACGME implemented several changes to the accreditation process, including the creation and semi-annual assessment of the competency based developmental outcomes known as Milestones. The Milestones were designed as a means to report trainee progress longitudinally through the training program. Milestones marked a significant shift in the way programs evaluate trainees and determine the successful completion of the training program.;This study sought to statistically analyze whether an association existed between Milestone evaluation scores at the end of residency and board certification examination passage. The study sample included all residents (n=70) completing Internal Medicine and Pediatrics residency training programs at Saint Louis University between 2014 and 2015 who sat for their ABMS boards for the first time before December 2015. The study found that achieving a score of at least Level 4 (of 5 Levels) on the Milestone evaluation rubric and passing the appropriate ABMS exam was only statistically significant for the Medical Knowledge competency score. No other competency (Patient Care, Systems-based Practice, Practice-based Learning and Improvement, Professionalism, and Interpersonal and Communication Skills) score demonstrated a statistically significant relationship to ABMS exam passage. Future studies are needed to further explore the association between Milestone evaluation scores and physician readiness for independent practice.