A Milestone in the Milestones Movement: the JGME Milestones Supplement

Abstract

The definition of the current competencies as well as their optimal assessment has remained controversial.,14,15 The purpose of competency assessment will need to be clarified, beyond formative vs. summative. Multiple agendas derived from different stakeholders may need to give way to the few that directly impact the goal of producing high caliber, independent practitioners.16 Streamlining the various purposes for assessment will be an important issue for the embryonic milestones as well. The reality for most training programs is that the supply of time and money is decreasing. No matter how laudable the goals of valid, reliable, and national educational outcomes, their implementation must be feasible within this reality. Therefore cost-effectiveness will need to be considered in future assessment studies. We must ensure the competent performance of graduate physicians, in the right balance of specialties, at a reduced cost to the nation; the milestones project may well be measured by how well it contributes to these aims. Will milestones advance the field of assessment and mark a turning point in GME? We urge readers to continue to the national conversation that seeks answers to these questions.