Table1.

Categorization of ACGME milestones included in the EMIG Milestones Elective a indicates level 1 milestone not included in the elective

Competency	Sub-competency	Level 1 Milestone
1: Patient Care	PC1: Emergency stabilization	Recognizes abnormal vital signs.
	PC2: Performance of focused H&P	Performs and communicates a reliable, comprehensive history and physical exam.
	PC3: Diagnostic studies	Determines the necessity of diagnostic studies.
	PC4: Diagnosis	Constructs a list of potential diagnoses based on chief complaint and initial assessment.
	PC5: Pharmacotherapy	Knows the different classifications of pharmacologic agents and their mechanism of action. Consistently asks patients for drug allergies.
	PC6: Observation and reassessment	Recognizes the need for patient re-evaluation.
	PC7: Disposition	Describes basic resources available for care of the emergency department patient.
	PC8: Multi-tasking	Manages a single patient amidst distractionsa
	PC9: General approach to procedures	Identifies pertinent anatomy and physiology for a specific procedure.
		Uses appropriate Universal Precautions.
	PC10: Airway management	Describes upper airway anatomy.
		Performs basic airway maneuvers or adjuncts (jaw thrust/chin lift/oral airway/nasopharyngeal airway) and ventilates/oxygenates patient using BVM.
	PC11: Anesthesia and acute pain management	Discusses with the patient indications, contraindications and possible complications of local anesthesia.
		Performs local anesthesia using appropriate doses of local anesthetic and appropriate technique to provide skin to sub-dermal anesthesia for procedures.
	PC12: Other diagnostic and therapeutic procedures: Goal-directed Focused Ultrasound	Describes the indications for emergency ultrasound.
	PC13: Other diagnostics and therapeutic procedures: Wound management	Prepares a simple wound for suturing (identify appropriate suture material, anesthetize wound and irrigate).
		Demonstrates sterile technique Places a simple interrupted suture.
	PC14: Other diagnostics and therapeutic procedures: Vascular access	Performs a venipuncture.
		Places a peripheral intravenous line Performs an arterial puncture.
2: Medical Knowledge	MK: Medical knowledge	Passes initial national licensing examinations (e.g., USMLE Step 1 and Step 2 or COMLEX Level 1 and Level 2).
3: System Based Practice	SBP1: Patient safety	Adheres to standards for maintenance of a safe working environment Describes medical errors and adverse eventsa.
	SBP2: Systems based management	Describes members of ED team (e.g., nurses, technicians, and security).
	SBP3: Technology	Uses the Electronic Health Record (EHR) to order tests, medications and document notes, and respond to alerts Reviews medications for patientsa.
4: Practice Based Learning and Improvement	PBLI: Practice-based performance improvement	Describes basic principles of evidence-based medicine.
5: Professionalism	PROF1: Professional values	Demonstrates behavior that conveys caring, honesty, genuine interest and tolerance when interacting with a diverse population of patients and families.
	PROF2: Accountability	Demonstrates basic professional responsibilities such as timely reporting for duty, appropriate dress/grooming, rested and ready to work, delivery of patient care as a functional physician.
		Maintains patient confidentially.
		Uses social media ethically and responsibly Adheres to professional responsibilities, such as conference attendance, timely chart completion, duty hour reporting, and procedure reportinga.
6: Interpersonal and Communication Skills	ICS1: Patient centered communication	Establishes rapport with and demonstrate empathy toward patients and their families.
		Listens effectively to patients and their families.
	ICS2: Team management	Participates as a member of a patient care team.

EMIG: Emergency Medicine Interest Group; ACGME: Accreditation Council for Graduate Medical Education