discriminatory ability of milestones: an analysis of milestone variability by obstetrics and gynecology subspecialty

Background: little evidence exists regarding accreditation council for graduate medicaleducation (acgme) milestone discriminatory ability. this short report describes variability inmilestone scores by category to determine their utility in discerning high and low performers ina single obstetrics and gynecology residency.methods: a clinical competency committee (ccc) design was implemented with foursubcommittees, each responsible for a predetermined milestones subset: obstetrics,gynecology, ambulatory practice, and professional activities. milestone scores for 44 residentsper year over four biannual evaluation cycles (2014-2016) were evaluated, for a total of 176independent evaluations.results: findings indicate that discriminatory ability, assessed by variability between residentscores, differed by subcommittee. subcommittees that were primarily tasked with evaluatingclinical- and procedural-based milestones demonstrated lower discriminatory ability amongtrainees.conclusion: greater professional activity milestone variability indicates better differentiation;future research should determine correlation of these findings with other professionalismperformance metrics and novel intervention strategies.