Figure 1.

Example program-level mean milestone ratings in EM for year 1 residents, from 123 ACGME-accredited EM programs, 2013–2016 (for the full version of the figure, see Supplemental Digital Appendix 3 at http://links.lww.com/ACADMED/A694). The thick black line is the best-fit regression slope, indicating the national-level trend of program-level average ratings (thin gray lines) over time. The ordinate is scaled in terms of the 5 levels of milestone ratings. The regression line presented here does not account for variations in the number of residents per program. The results for the MK01 subcompetency are not reported here because the milestone language was modified midway through the period covered by this study. Abbreviations: EM indicates emergency medicine; ACGME, Accreditation Council for Graduate Medical Education; PC, patient care; MK, medical knowledge; SBP, systems-based practice; PBLI, practice-based learning and improvement; PROF, professionalism; ICS, interpersonal and communication skills.