Rheumatology Milestones 2.0: A Roadmap for Competency-Based Medical Training of Rheumatology Fellows in the 21st Century.

OBJECTIVE Since 2014, rheumatology fellows have been assessed not only based on their ability to provide patient care and possess medical knowledge but also on their skill in serving as patient advocates, navigators of health systems, and members of a health care team. Such assessments have been carried out through the use of competency-based "milestones" from the Accreditation Council of Graduate Medical Education (ACGME). However, a needs assessment demonstrated interest in more context validity and subspecialty-relevance since the development of the ACGME Internal Medicine (IM) Subspecialty Reporting Milestones. The ACGME thus charged a working group to develop Rheumatology Milestones 2.0, as well as a Supplemental Guide to assist with implementation. METHODS The Working Group, consisting of seven rheumatology program directors, two division directors, a community practice rheumatologist, a rheumatology fellow-in-training, and a public member who is a rheumatology patient, was overseen by the ACGME Vice President for Milestones Development and met through three 12-hour in-person meetings to compose the Rheumatology Specialty Milestones and Supplemental Guide within the ACGME Milestones 2.0 Project. RESULTS Informed by the needs assessment data and stakeholders, the Working Group revised and adapted the ACGME IM Subspecialty Reporting Milestones to create a rheumatology-specific set of milestones and a Supplemental Guide for their implementation. CONCLUSION The Rheumatology Milestones 2.0 provide a specialty-specific, competency-based evaluation tool that can be used by program directors, Clinical Competency Committees (CCC), and others to assess the competencies of rheumatology fellows during training and help measure readiness for independent practice.