Accreditation Council for Graduate Medical Education Milestones for Emergency Medicine Residency Training Incorporated into Firstand Second-Year Medical Student Elective

Introduction: as part of its next accreditation system, the accreditation council for graduate medical education and the american board of emergency medicine describe 6 competencies containing 23 sub-competencies graded by milestones ranging from level 1 (expected of an incoming intern) to level 5 (demonstrates abilities of an attending) that are used to track resident training progression. to the best of our knowledge, there have been no studies introducing a milestones-based curriculum to medical students prior to their introduction to the wards, so we sought to determine the effects that a pre-clinical emergency medicine interest group (emig) milestones elective would have on preparing the students interested in emergency medicine (em) as a specialty to meet the level 1 milestones prior to their intern year. methods: the elective hosted 15 events throughout the academic year, and pre- and post-curriculum surveys were administered. thirteen first- and second-year medical students at our institution who completed the elective self-reported their perception of preparedness for each level 1 milestone in the 19 sub-competencies. a repeated measures design was used through identical pre- and post-curriculum surveys to determine any changes in self-reported preparedness for meeting level 1 milestones after completing the elective using wilcoxon signed ranks test. results: there was a significant increase in the median scoring from 1 to 2 (p=0.027) in overall self-reported preparedness for meeting the level 1 milestones included in the elective, as well as significant increases in subcategories across competencies 1-4 outlined by the acgme. there was no significant increase in preparedness for professionalism or interpersonal communication competencies. there was no significant increase in interest in em as a result of the elective. conclusion: implementing a milestones-based curriculum during the pre-clinical years shows improved self-reported preparedness of students interested in pursuing em for meeting level 1 milestones prior to residency. additionally, a specialty-based elective such as this one offered through emig may further increase interest in the field during pre-clinical years.