ABA Research Highlights Resident Progress Patterns and Variability in Anesthesiology Milestones

Raleigh, N.C. (Nov. 3, 2025) – A recently published study by the American Board of Anesthesiology (ABA) analyzing the Accreditation Council for Graduate Medical Education (ACGME) framework for the assessment of residents’ progression in the field of anesthesiology reveals that while anesthesiology residents show steady year-over-year advancement in core competencies, significant variability persists across programs.

“These findings represent another important step in the ABA’s on-going research work to help the graduate medical education community better understand how assessments are being done in programs across the country,” said Chief Assessment Officer Ann Harman, Ph.D.

ACGME began implementing the Anesthesiology Milestones 1.0 evaluations in the 2014–2015 academic year and continued through 2019. The overall aim of integrating Milestones into residency training was to provide residency training programs with another assessment tool to help them share feedback with their trainees, facilitating their growth toward independent practice with an emphasis on competency rather than duration of training.

While residents overall demonstrated steady progress, the study reveals that Milestones 1.0 ratings often reflect differences in how programs apply evaluations rather than purely individual performance. This variability underscores the need to refine early training assessment methods, enabling learners to more accurately track their progress and pinpoint areas for improvement.

Further analysis highlights two key issues:

• Straight-Line Scoring (SLS): Nearly 89% of programs exhibited at least one instance of SLS, assigning the same rating across all competencies, suggesting potential over-simplification in resident evaluations. This confirms ACGME findings that there has been significant SLS within and across residency training programs.
• Program-Level Variability: Residency programs accounted for 60% to 92% of the variation in both resident competency levels and growth trajectories, pointing to inconsistencies in evaluation standards across institutions.

View the full publication for more details here.

Senior Psychometrician Tianpeng Ye, Ph.D.; former ABA Director of Psychometrics and Research Huaping Sun, Ph.D., MBA; ABA Chief Assessment Officer Ann Harman, Ph.D.; ABA Board Director Stacie G. Deiner, M.D., M.S.; former ABA Physician Research Consultant John D. Mitchell, M.D.; and ABA Board Director Alex Macario, M.D., MBA; authored this research, titled “Anesthesiology Milestones 1.0: Residents’ Learning Trajectories and Training Outcomes.” The study is published in the Aug. 14, 2025, issue of Anesthesia & Analgesia.

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ABA Media Contact
Mike Charbonneau
Chief Communications Officer
(919) 745-2233
mike.charbonneau@theaba.org

About the American Board of Anesthesiology
Our mission is to advance the highest standards of the practice of anesthesiology. As the certifying body for anesthesiologists since 1938, we work with physicians to elevate practice standards and foster exceptional patient care. We administer initial and subspecialty certification exams as well as the continuing certification in anesthesiology program known as MOCA, which is designed to promote lifelong learning, a commitment to quality clinical outcomes and patient safety. Based in Raleigh, NC, we are a nonprofit organization and a Member Board of the American Board of Medical Specialties (ABMS).