Standardizing Resident Assessment and Competency —Milestones Matter

Smith et al present findings from an observational cohort study of early-career vascular surgeons and patient outcomes following endovascular aneurysm repair (EVAR), where lower mean Accreditation Council for Graduate Medical Education (ACGME) Milestone ratings were associated with major complications in early surgical practice. Milestone ratings were corrected for program effect using a deviation score from the program mean and surgeon performance was assessed controlling for patient-level and health care professional –level covariates. Of note, this association was limited to those programs with lower program-level mean Milestone ratings. For graduates with Milestone mean ratings of 3.5, the odds ratio (OR) of major complications was 0.50 (OR, 0.50; 95% CI, 0.26-0.95), which is equivalent to a 2 times increase d risk for every 1-point decrease in Milestone rating.
Source: JAMA Surgery - Category: Sports Medicine Source Type: research