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J Surg Educ. 2017 Mar 23. pii: S1931-7204(16)30373-7. doi: 10.1016/j.jsurg.2017.02.012. [Epub ahead of print]

Program Director Perceptions of the General Surgery Milestones Project.

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Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address:
The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island.
Department of Pediatrics, Rhode Island Hospital, Providence, Rhode Island.



As a result of the Milestones Project, all Accreditation Council for Graduate Medical Education accredited training programs now use an evaluation framework based on outcomes in 6 core competencies. Despite their widespread use, the Milestones have not been broadly evaluated. This study sought to examine program director (PD) perceptions of the Milestones Project.


A national survey of general surgery PDs distributed between January and March of 2016.


A total of 132 surgical PDs responded to the survey (60% response rate). Positive perceptions included value for education (55%) and evaluation of resident performance (58%), as well as ability of Milestones to provide unbiased feedback (55%) and to identify areas of resident deficiency (58%). Meanwhile, time input and the ability of Milestones to discriminate underperforming programs were less likely to be rated positively (25% and 21%, respectively). Half of PDs felt that the Milestones were an improvement over their previous evaluation system (55%).


Using the Milestones as competency-based, developmental outcomes measures, surgical PDs reported perceived benefits for education and objectivity in the evaluation of resident performance. The overall response to the Milestones was generally favorable, and most PDs would not return to their previous evaluation systems. To improve future iterations of the Milestones, many PDs expressed a desire for customization of the Milestones' content and structure to allow for programmatic differences.


Interpersonal and Communication Skills; Medical Knowledge; Practice-Based Learning and Improvement, Patient Care and Procedural Skills; Professionalism; Systems-Based Practice; assessment; evaluation; graduate medical education; milestones; surgery

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