• Aimee K Gardner, Daniel J Scott, Michael A Choti, and John C Mansour.
• Department of Surgery, UT Southwestern Medical Center, Dallas, Texas. Electronic address: aimee.gardner@utsouthwestern.edu.
• J Surg Educ. 2015 Jul 1; 72 (4): 618-24.

ObjectivesIn an effort to move training programs toward competency-based education, the Accreditation Council for Graduate Medical Education (ACGME) introduced the Next Accreditation System (NAS), which organizes specific milestones regarding resident skills, knowledge, and abilities along a continuum. In order to foster innovation and creativity, the ACGME has provided programs with minimal guidelines regarding the optimal way to approach these milestones.MethodsThe education team at UT Southwestern embraced the milestones and developed a process in which performance assessment methods were critically evaluated, mapped onto an extrapolated performance list corresponding to the areas required by the ACGME milestones, and filled gaps in the previous system by modifying evaluation tools and creating new program components.ResultsAlthough the authors are early in the evolution of applying the new milestones system, this approach has thus far allowed them to comprehensively evaluate the residents and the program in an efficient and effective fashion, with notable improvements compared to the prior approach.ConclusionsThe authors hope that these experiences can inform others embarking upon similar journeys with the milestones.Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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