In preparation for the ACGME Next Accreditation System (NAS), specialty groups have developed outcomes-based milestones for resident performance within the six domains of clinical competence. The milestones are competency-based developmental outcome expectations that can be demonstrated progressively by residents and fellows from the beginning of their education through graduation to the unsupervised practice of their specialty. The Milestones Working Groups were co-convened by the Accreditation Council for Graduate Medical Education (ACGME), the American Board of Internal Medicine (ABIM) and the Alliance for Academic Internal Medicine (AAIM) and was composed of ABIM staff, program director association members, specialty society members, ACGME Review Committee members, and others. Residents' and fellows' performance on milestones will become a source of specialty-specific normative data for the specialty Review Committees to use in assessing the quality of residency and fellowship programs and facilitating improvements to program curriculum and resident and fellow performance if and when needed. The milestones will also be used by the ACGME to demonstrate accountability of the effectiveness of graduate medical education within ACGME-accredited programs in meeting the needs of the public.
The members of the Internal Medicine Education Redesign Advisory Board, with representation from the Alliance for Academic Internal Medicine, ABIM, the ACGME, the American College of Physicians, the American Medical Association, the Association of Specialty Professors, the Society of General Internal Medicine, and the Society of Hospital Medicine, have endorsed the Internal Medicine Milestones (pdf) for use in the ACGME NAS.