New! Review the recording of a webinar held 11 May 2023 that provides more information about Milestones 2.0, available in ACGME-I’s online learning portal, Explore. Note: The webinar will appear as a featured item in the online learning dashboard once logged into Explore. The link will redirect to the recording, which is available on-demand. An account (free) is required to access the resources in Explore.

What Are the Milestones?

In general terms, a milestone is simply a significant point in development. The ACGME-I Milestones provide narrative descriptors of the Competencies and subcompetencies along a developmental continuum. Simply stated, they describe performance levels residents and fellows are expected to demonstrate for skills, knowledge, and behaviors in the six Core Competency domains. They lay out a framework of observable behaviors and other attributes associated with a resident’s or fellow’s development as a physician. Programs should judge each resident or fellow based on the actual level of performance as described in the Milestones, not in relation to peers or others.

The Milestones are different from many other assessments in that there is an opportunity for the learner to demonstrate the attainment of aspirational levels of the subcompetency, and just as importantly allows for a shared understanding of the expectations among learners and faculty members.

It is also important to recognize what the Milestones are not. First and foremost, they do not describe or represent the totality or a complete description of a clinical discipline. They represent the important core of a discipline, meaning programs will need to use good judgment to fill in the gaps in curriculum and assessment. Second, it is essential that the Milestones are not thought of as curriculum in and of themselves, but rather that they should guide a thoughtful analysis of curriculum to identify strengths and gaps. Third, they are not tools designed to negatively affect program accreditation.

The Milestones are intended for formative purposes to help learners, programs, and the Review Committees-International improve educational, assessment, and accreditation processes. In addition, the Milestones must not be used as the only set of assessment tools. Instead, the Milestones should inform the use and development of assessment tools aligned with the program’s curricular goals and the tasks learners will undertake as part of their education in the specialty/subspecialty.

Milestones 2.0

Access the current version (2.0) of the Milestones for each specialty/subspecialty, effective 2024, on the specialty pages linked below. Note that Milestones documents on these pages—found under the “Milestones 2.0” header at the bottom of these pages—are available by specialty, subspecialty, and region, as applicable.

Contact and Support

Questions about the Milestones:

Questions about the ACGME-I Requirements and accreditation processes: