Will the New Milestone Requirements Improve Residency Training?

Abstract not available. Introduction provided instead.

Education in orthopedic surgery is evolving. Recently, the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Orthopaedic Surgery (ABOS) have implemented a set of clinical “milestones” by which training programs will use as progressive benchmarks to evaluate each resident’s acquisition of medical knowledge and patient care skills. The milestones are a step toward standardizing resident education based on a progression model, which is already being used by European and Asian countries. The evaluations are disease-specific and graded from Level I (incoming resident) to Level V (career specialist). Contrary to many residents’ first impressions, the milestone levels do not correspond to post-graduate year; the recommended target for graduates is actually Level IV. Although these milestones are not intended to supersede the program’s decision to graduate an individual, program directors are now encouraged to complete these evaluations, with co-faculty, at the semi-annual review in order to identify possible weaknesses in either the resident or in the institution’s teaching methods. Several pros and cons have been identified with the current paradigm shift in orthopedic education, and the following article will discuss those controversies from one resident’s perspective.