Anesthesiology Milestones 1.0: Residents’ Learning Trajectories and Training Outcomes
Authors' conclusion
We found a high prevalence of straight-lining in Anesthesiology Milestones 1.0 ratings.
Study context
- Population
- Anesthesiology residents in all US Accreditation Council for Graduate Medical Education (ACGME) anesthesiology residency programs, July 2015 to June 2019153 training programs
- Participants
- 11,691 residents
- Outcome
- Prevalence of straight-lining, progression trajectories (baseline, growth rate) and graduation outcomes (≥1 Level 4 rating; not reaching Level 4 for ≥1 subcompetency) across 25 Milestones subcompetencies
Methodological detailsnational ACGME Milestones data, 3-level linear mixed-effect models
- National ACGME Milestones data
- 3-level linear mixed-effect models
Main finding
As reported in the abstract
- Clinical anesthesia year 3 residents (n = 6696) with ≥1 Level 4 or above rating on graduation
- 98.3%
- Graduating cohort not reaching Level 4 for ≥1 subcompetency among the 6 core competencies
- 28.8% to 36.8%
- Programs with straight-lining for ≥1 reporting period
- 136 (88.9% of 153)
- Between-resident variability in baseline ratings accounted for by residency programs
- 63% to 84%
- Between-resident variability in growth rates accounted for by residency programs
- 60% to 92%
Observational data: associations, not effects.
Original publication
Anesthesiology Milestones 1.0: Residents’ Learning Trajectories and Training Outcomes. Anesth Analg. Published 15 August 2025. doi:10.
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