Emily Hinchcliff
1 
, Kaitlyn James
2,3 , Kristina Dzara
2,4,5* , Lori R. Berkowitz
2,4 1 Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
2 Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Boston, MA
3 Deborah Kelly Center for Outcomes Research, Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Boston MA
4 Harvard Medical School, Boston MA
5 Brigham Education Institute, Brigham and Women’s Hospital, Boston, MA
*Corresponding Author: Brigham Education Institute, Brigham and Women’s Hospital, Boston, MA Email KDZARA@mgh.harvard.edu
Abstract
Background: Little evidence exists regarding Accreditation Council for Graduate Medical
Education (ACGME) milestone discriminatory ability. This short report describes variability in
milestone scores by category to determine their utility in discerning high and low performers in
a single Obstetrics and Gynecology residency.
Methods: A Clinical Competency Committee (CCC) design was implemented with four
subcommittees, each responsible for a predetermined milestones subset: Obstetrics,
Gynecology, Ambulatory Practice, and Professional Activities. Milestone scores for 44 residents
per year over four biannual evaluation cycles (2014-2016) were evaluated, for a total of 176
independent evaluations.
Results: Findings indicate that discriminatory ability, assessed by variability between resident
scores, differed by subcommittee. Subcommittees that were primarily tasked with evaluating
clinical- and procedural-based milestones demonstrated lower discriminatory ability among
trainees.
Conclusion: Greater Professional Activity milestone variability indicates better differentiation;
future research should determine correlation of these findings with other professionalism
performance metrics and novel intervention strategies.