title: The pathology milestones and the next accreditation system.
abstract: BACKGROUND
  In the late 1990s, the Accreditation Council for Graduate Medical Education developed the Outcomes Project and the 6 general competencies with the intent to improve the outcome of graduate medical education in the United States. The competencies were used as the basis for developing learning goals and objectives and tools to evaluate residents' performance. By the mid-2000s the stakeholders in resident education and the general public felt that the Outcomes Project had fallen short of expectations.
  
  
  OBJECTIVE
  To develop a new evaluation method to track trainee progress throughout residency using benchmarks called milestones. A change in leadership at the Accreditation Council for Graduate Medical Education brought a new vision for the accreditation of training programs and a radically different approach to the evaluation of residents.
  
  
  METHODS
  The Pathology Milestones Working Group reviewed examples of developing milestones in other specialties, the literature, and the Accreditation Council for Graduate Medical Education program requirements for pathology to develop pathology milestones. The pathology milestones are a set of objective descriptors for measuring progress in the development of competency in patient care, procedural skill sets, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice.
  
  
  CONCLUSIONS
  The milestones provide a national standard for evaluation that will be used for the assessment of all residents in Accreditation Council for Graduate Medical Education-accredited pathology training programs.
authors.affiliation: From the Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles (Dr Naritoku); the Department of Pathology, University of Alabama Birmingham (Dr Alexander); the American Board of Pathology, Tampa, Florida (Dr Bennett and Johnson); the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston (Dr Black-Schaffer); the Hematopathology Division, Joint Pathology Center, Silver Springs, Maryland, and Washington, DC (Dr Brissette); the Department of Pathology, Virginia Commonwealth University Medical Center, Richmond (Dr Grimes); the Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Hoffman); the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock (Dr Hunt); the Department of Pathology, University of Virginia Health System, Charlottesville (Dr Iezzoni); the Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha (Dr Kozel); the Department of Pathology, East Carolina University, Greenville, North Carolina (Dr Mendoza); the Department of Pathology, University of Colorado School of Medicine, Aurora (Dr Post); the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas (Dr Powell); the Department of Molecular Pathology, Cleveland Clinic Foundation, The Pathology and Laboratory Medicine Institute, Cleveland, Ohio (Dr Procop); the Department of Pathology, Albert Einstein College of Medicine, Bronx, New York (Dr Steinberg); and the Accreditation Council for Graduate Medical Education, Chicago, Illinois (Ms Thorsen and Dr Nestler).
authors.forename: Wesley Y
authors.initials: WY
authors.lastname: Naritoku
authors.forename: C Bruce
authors.initials: CB
authors.lastname: Alexander
authors.forename: Betsy D
authors.initials: BD
authors.lastname: Bennett
authors.forename: W Stephen
authors.initials: WS
authors.lastname: Black-Schaffer
authors.forename: Mark D
authors.initials: MD
authors.lastname: Brissette
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Grimes
authors.forename: Robert D
authors.initials: RD
authors.lastname: Hoffman
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Hunt
authors.forename: Julia C
authors.initials: JC
authors.lastname: Iezzoni
authors.forename: Rebecca
authors.initials: R
authors.lastname: Johnson
authors.forename: Jessica
authors.initials: J
authors.lastname: Kozel
authors.forename: Ricardo M
authors.initials: RM
authors.lastname: Mendoza
authors.forename: Miriam D
authors.initials: MD
authors.lastname: Post
authors.forename: Suzanne Z
authors.initials: SZ
authors.lastname: Powell
authors.forename: Gary W
authors.initials: GW
authors.lastname: Procop
authors.forename: Jacob J
authors.initials: JJ
authors.lastname: Steinberg
authors.forename: Linda M
authors.initials: LM
authors.lastname: Thorsen
authors.forename: Steven P
authors.initials: SP
authors.lastname: Nestler
mesh_terms: D000068:Accreditation / Q000592:standards*; D002983:Clinical Competence / Q000592:standards*; D004503:Education, Medical, Graduate / Q000592:standards*; D006801:Humans; D010336:Pathology / Q000193:education*; D014481:United States