The ACGME Milestone Project in ophthalmology.

The ACGME is moving towards the next generation of accreditation in the USA called the Next Accreditation System (NAS). The NAS is anticipated to reduce the burden on programs to comply with accreditation requirements; to produce meaningful, innovative, and continuous benchmark outcomes data; to use ongoing individual and programmatic milestones to judge performance; and ultimately to produce better trained residents, to improve the quality of care, to reduce health care costs and health care disparities, and to provide objective evidence to the public and other external stakeholders of the quality of graduate medical education across the specialties of medicine. We describe the ACGME milestone development process for ophthalmology. If successful, the NAS will benefit all programs by reducing the programmatic burden and paperwork; increasing accreditation cycle length; and improving all programs through formative and summative feedback.

Lee AG ，Arnold AC 《-》

The Next Accreditation System in ophthalmology.

The accreditation of graduate medical education through the evaluation of residency programs and the teaching hospitals that offer them in the United States is the primary mission of the Accreditation Council for Graduate Medical Education (ACGME). In 1999, the ACGME formulated the six ACGME competencies and, ten years later, developed a multi-year plan to restructure the accreditation process in order to assess educational outcomes. The result of these evolving efforts has been termed the Next Accreditation System (NAS). The stated goals of the NAS are 1) to enhance the ability of the peer-review system to prepare physicians for practice in the 21st century; 2) to accelerate the ACGME's movement toward accreditation on the basis of educational outcomes; and 3) to reduce the burden associated with the current structure and process-based approach. The NAS is an interesting and novel approach to re-engineer the GME accreditation process to become more equitable, fair, and transparent and less costly and burdensome, and to improve resident education and ultimately patient care. The new process will rely upon measurable and meaningful outcomes rather than simply structure and process assessments. Instead of the episodic program biopsies with site visitor reports, detailed program information forms, and formal residency review committee evaluations that characterized the old accreditation system, the NAS will be based upon annual reports of specific quantitative, trended, performance benchmarks; the ACGME milestones; and an institutional clinical competency committee. In addition, a separate but related specialty-specific Clinical Environment Learning Review (CLER) will be a more detailed examination of the learning environment and infrastructure. The CLER, however, will not have a direct role in the accreditation decision-making process of the NAS.

Lee AG ，Arnold AC 《-》

The development of the emergency medicine milestones.

The Accreditation Council for Graduate Medical Education (ACGME) has outlined its "Next Accreditation System" (NAS) that will focus on resident and residency outcome measurements. Emergency medicine (EM) is one of seven specialties that will implement the NAS beginning July 2013. All other specialties will follow in July 2014. A key component of the NAS is the development of assessable milestones, which are explicit accomplishments or behaviors that occur during the process of residency education. Milestones describe competencies more specifically and identify specialty-specific knowledge, skills, attitudes, and behaviors (KSABs) that can be used as outcome measures within the general competencies. The ACGME and the American Board of Emergency Medicine (ABEM) convened an EM milestone working group to develop the EM milestones. This article describes the development, use within the NAS, and challenges of the EM milestones.

Beeson MS ，Carter WA ，Christopher TA ，Heidt JW ，Jones JH ，Meyer LE ，Promes SB ，Rodgers KG ，Shayne PH ，Swing SR ，Wagner MJ ... -  《-》

Specialty milestones and the next accreditation system: an opportunity for the simulation community.

Beeson MS ，Vozenilek JA 《-》

Resident surgical practice patterns for vitreoretinal surgery in ophthalmic training programs in the United States.

Shah VA ，Reddy AK ，Bonham AJ ，Sabates NR ，Lee AG ... -  《-》