title: Implementation of nephrology subspecialty curricular milestones.
abstract: Beginning in the 2014-2015 training year, the US Accreditation Council for Graduate Medical Education (ACGME) required that nephrology Clinical Competency Committees assess fellows' progress toward 23 subcompetency "context nonspecific" internal medicine subspecialty milestones. Fellows' advancement toward the "ready for unsupervised practice" target milestone now is tracked in each of the 6 competencies: Patient Care, Medical Knowledge, Professionalism, Interpersonal Communication Skills, Practice-Based Learning and Improvement, and Systems-Based Practice. Nephrology program directors and subspecialty societies must define nephrology-specific "curricular milestones," mapped to the nonspecific ACGME milestones. Although the ACGME goal is to produce data that can discriminate between successful and underperforming training programs, the approach is at risk to produce biased, inaccurate, and unhelpful information. We map the ACGME internal medicine subspecialty milestones to our previously published nephrology-specific milestone schema and describe entrustable professional activities and other objective assessment tools that inform milestone decisions. Mapping our schema onto the ACGME subspecialty milestone reporting form allows comparison with the ACGME subspecialty milestones and the curricular milestones developed by the American Society of Nephrology Program Directors. Clinical Competency Committees may easily adapt and directly translate milestone decisions reached using our schema onto the ACGME internal medicine subspecialty competency milestone-reporting format.
authors.affiliation: Nephrology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD. Electronic address: christina.m.yuan.civ@mail.mil.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Yuan
authors.affiliation: Nephrology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Prince
authors.affiliation: Nephrology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: James D
authors.initials: JD
authors.lastname: Oliver
authors.affiliation: Nephrology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Abbott
authors.affiliation: Nephrology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: Robert
authors.initials: R
authors.lastname: Nee
mesh_terms: D000068:Accreditation / Q000592:standards*; D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement; D005257:Fellowships and Scholarships; D006040:Goals; D006772:Hospitals, Military; D006801:Humans; D009398:Nephrology / Q000145:classification / Q000193:education* / Q000592:standards; D014481:United States
keywords: ACGME; Nephrology; competencies; curricular milestones; fellowship; graduate medical education; medical trainee; subspecialty milestones; training programs