Ophthalmology Milestones (Presentation) Author Pratap Challa, Jillian Chong, Susan Culican

Ophthalmology Milestones
The Accreditation Council for Graduate Medical Education
Second Revision: January 2020

First Revision: December 2015
©2020 Accreditation Council for Graduate Medical Education (ACGME)

All rights reserved except the copyright owners grant third parties the right to use the Ophthalmology Milestones on a non-exclusive basis for educational purposes.
Version 2 Ophthalmology, ACGME Report Worksheet
The Milestones are designed only for use in evaluation of resident’s in the context of their participation in
ACGME-accredited residency programs. The Milestones provide a framework for the assessment of the
development of the resident in key dimensions of the elements of physician competency in a specialty or
subspecialty. They neither represent the entirety of the dimensions of the six domains of physician competency,
nor are they designed to be relevant in any other context.

ii
Work Group
Pratap Challa, MD, MS Mark Juzych, MD, MHSA
Jillian Chong, MD Shahzad Mian, MD
Susan Culican, MD, PhD Nicholas Sala, DO
Laura Edgar, EdD, CAE Bhavna Sheth, MD
Matthew Fitzgerald, DrPH Misha Syed, MD
Douglas Fredrick, MD
The ACGME would like to thank the following organizations for their continued support in the
development of the Milestones:
American Board of Ophthalmology
ACGME Review Committee for Ophthalmology

iii
Understanding Milestone Levels and Reporting
This document presents the Milestones, which programs use in a semi-annual review of resident performance, and then report to
the ACGME. Milestones are knowledge, skills, attitudes, and other attributes for each of the ACGME Competencies organized in a
developmental framework. The narrative descriptions are targets for resident performance throughout their educational program.
Milestones are arranged into levels. Tracking from Level 1 to Level 5 is synonymous with moving from novice to expert resident in
the specialty or subspecialty. For each reporting period, the Clinical Competency Committee will review the completed evaluations
to select the milestone levels that best describe each learner’s current performance, abilities, and attributes for each
subcompetency.
These levels do not correspond with post-graduate year of education. Depending on previous experience, a junior resident may
achieve higher levels early in his/her educational program just as a senior resident may be at a lower level later in his/her
educational program. There is no predetermined timing for a resident to attain any particular level. Residents may also regress in
achievement of their milestones. This may happen for many reasons, such as over scoring in a previous review, a disjointed
experience in a particular procedure, or a significant act by the resident.
Selection of a level implies the resident substantially demonstrates the milestones in that level, as well as those in lower levels
(see the diagram on page vi).

iv
Additional Notes
Level 4 is designed as a graduation goal but does not represent a graduation requirement. Making decisions about readiness for
graduation and unsupervised practice is the purview of the program director. Level 5 is designed to represent an expert resident
whose achievements in a subcompetency are greater than the expectation. Milestones are primarily designed for formative,
developmental purposes to support continuous quality improvement for individual learners, education programs, and the specialty.
The ACGME and its partners will continue to evaluate and perform research on the Milestones to assess their impact and value.
Examples are provided for some milestones within this document. Please note: the examples are not the required element or
outcome; they are provided as a way to share the intent of the element.
Some milestone descriptions include statements about performing independently. These activities must occur in conformity to
ACGME supervision guidelines as described in the Program Requirements, as well as to institutional and program policies. For
example, a resident who performs a procedure independently must, at a minimum, be supervised through oversight.
A Supplemental Guide is also available to provide the intent of each subcompetency, examples for each level, assessment
methods or tools, and other available resources. The Supplemental Guide, like examples contained within the Milestones, is
designed only to assist the program director and Clinical Competency Committee, and is not meant to demonstrate any required
element or outcome.
Additional resources are available in the Milestones section of the ACGME website. Follow the links under “What We Do” at
www.acgme.org.

v
The diagram below presents an example set of milestones for one sub-competency in the same format as the ACGME
Report Worksheet. For each reporting period, a resident’s performance on the milestones for each sub-competency will be
indicated by selecting the level of milestones that best describes that resident’s performance in relation to those milestones.
Selecting a response box in the Selecting a response box on the line in

middle of a level implies that between levels indicates that milestones
milestones in that level and in lower in lower levels have been substantially
levels have been substantially demonstrated as well as some
demonstrated. milestones in the higher level(s).

vi
Patient Care 1: Data Acquisition – Basic Ophthalmology Exam and Testing
Level 1 Level 2 Level 3 Level 4 Level 5

Acquires relevant Performs problem- Identifies subtle or Orders and interprets Demonstrates expertise in
problem-focused history, focused exam with uncommon examination advanced diagnostic advanced diagnostic tests
including outside medical appropriate techniques findings of common tests and imaging and imaging
records (e.g., gonioscopy and disorders and procedures according to
scleral depression), typical or common evidence-based
consistently identifies findings of rarer medicine (i.e., when
common abnormalities on disorders and when not to order
examination; may identify testing)
subtle findings
Performs and documents Orders, performs, and Interprets unusual

a comprehensive interprets basic testing findings on routine
ophthalmic examination; (e.g., visual field testing, testing, identifies artifacts;
distinguishes between Optical Coherence recognizes indications for
normal and abnormal Tomography, B-scan) advanced diagnostic tests
findings and imaging procedures
(e.g., specular
microscopy,
electroretinography)
Comments:
Not Yet Completed Level 1
Not Yet Assessable

1
Patient Care 2: Hospital-Based Consultation

Acquires relevant Triages consult requests Manages consultations Manages consultations Oversees the consultation
problem-focused history, (including coordination of (including coordination process and manages
including outside medical care) requiring surgical of care) requiring interdisciplinary systems
records intervention, including surgical intervention, issues affecting patient
procedural options and including procedural care
Performs inpatient Performs a complete timing; requests options and timing;
consultation, with direct examination ophthalmic subspecialty requests ophthalmic
supervision advice, with indirect subspecialty input, with
supervision oversight
Recognizes ophthalmic Manages ophthalmic Manages ophthalmic

emergencies and initiates emergencies with non- emergencies with non-
non-surgical treatment surgical and surgical surgical and surgical
plan, with indirect treatment, with indirect treatment, with
supervision supervision oversight
Comments:
Not Yet Assessable

2
Patient Care 3: Office-Based Procedures

Describes essential Administers anesthesia Administers anesthesia Administers Incorporates recent
components of care and performs and performs anesthesia and advancements in
related to office-based procedure, with direct procedure, with indirect performs procedure, technologies or
procedures (e.g., supervision supervision with oversight techniques
informed consent,
indications and Recognizes and Manages intra- and post- Manages intra- and
contraindications, manages intra- and operative complications, post-operative
anesthesia, sterile post-operative with indirect supervision complications, with
procedure prep) complications, with oversight
direct supervision
Comments:
Not Yet Assessable

3
Patient Care 4: Cataract Surgery – Technical Skill

Identifies visually Assesses patients for Assesses patients for Assesses patients who Assesses patients for
significant cataract routine cataract surgery complex cataract surgery are candidates for intraocular lenses
refractive intraocular complications requiring a
lenses to correct more complex
astigmatism and/or intervention
provide near correction
Demonstrates ability to Performs elements of Performs routine cataract Performs cataract Performs lens surgery for
scrub, prep and drape cataract surgery in the surgery in the OR surgery requiring patients with
patient for surgery; hands-on surgical skills complex technical complications requiring a
performs basic suturing laboratory and in the maneuvers (e.g., pupil more complex
skills operating room (OR) expander, capsular intervention (e.g., sutured
tension ring) intraocular lenses)
Manages common post- Manages common intra- Manages complex intra- Manages rare and
operative complications and post-operative and post-operative complex intra- and post-
(e.g., post-op pain, high complications (e.g., complications (e.g., operative complications
intraocular pressure) posterior capsule rupture, endophthalmitis) (e.g., aqueous
wound leak) misdirection,
suprachoroidal
hemorrhage)
Comments:
Not Yet Assessable

4
Patient Care 5: Extraocular Surgery (Plastics, Strabismus)

Identifies patients for Develops a pre-operative Develops a pre- Assess patients and
routine extraocular plan for routine operative plan for develops a pre-operative
surgery extraocular surgery complex extraocular plan for complex/
surgery multidisciplinary
extraocular surgery (e.g.,
nerve sheath
decompression, vessel
sparing strabismus)
Demonstrates ability to Performs simple Performs routine Performs complex Performs complex
scrub, prep and drape extraocular surgery (e.g., extraocular surgery (e.g., extraocular surgery extraocular surgery
patient for surgery; simple lid laceration complex lid laceration (e.g., vertical
performs basic suturing repair, nasolacrimal duct repair, horizontal strabismus), with
skills probing) strabismus, ptosis) assistance
Identifies common post- Manages common post- Manages intra- and post- Manages complex intra-
operative complications operative complications operative complications and post-operative
(e.g., post-op pain, (e.g., bleeding, complications (e.g.,
bleeding) perforation) infection, retrobulbar
hemorrhage)
Comments:
Not Yet Assessable

5
Patient Care 6: Intraocular Surgery (Cornea, Retina, Glaucoma)

Assesses patients for Assesses patients for Assesses patients for Assess patients requiring
routine intraocular surgery complex intraocular multispecialty surgery from multiple
surgery intraocular surgeries disciplines (e.g., plastic
surgery, facial trauma)
Demonstrates ability to Performs routine Assists in subspecialty Performs routine Performs complex
scrub, prep and drape intraocular surgery in the intraocular surgery intraocular surgery intraocular surgery
patient for surgery; hands-on surgical skills
performs basic suturing laboratory
skills
Manages common post- Manages common intra- Manages complex intra- Manages rare and
operative complications operative complications and post-operative complex intra- and post-
(e.g., post-op pain, high (e.g., flat chamber, wound complications (e.g., re- operative complications
intraocular pressure) leak, hyphema) bubble graft, blebitis) (e.g., tube erosion,
proliferative
vitreoretinopathy)
Comments:
Not Yet Assessable

6
Medical Knowledge 1: Pathophysiology

Articulates knowledge of Demonstrates basic Demonstrates advanced Demonstrates Contributes new
pathophysiology and knowledge of knowledge of advanced knowledge of knowledge for
clinical findings for pathophysiology and pathophysiology and pathophysiology and pathophysiology and
ophthalmic conditions clinical findings for clinical findings for clinical findings for clinical findings for
routinely managed by common ophthalmic commonly encountered uncommon ophthalmic ophthalmic conditions
non-ophthalmologists conditions routinely ophthalmic conditions; conditions (e.g., publication,
managed by demonstrates basic curriculum development)
ophthalmologists knowledge of
pathophysiology and
clinical findings for
uncommon conditions
Comments:
Not Yet Assessable

7
Medical Knowledge 2: Differential Diagnosis

Identifies resources to Generates Generates refined Generates probabilistic Recognizes, self-reflects,
generate a focused comprehensive differential based on differential diagnosis in and shares experiences
differential differential diagnosis patient symptoms, history patients with multiple to educate others on
based on patient and examination findings, ocular and medical factors that contributed to
symptoms and history; distinguishing between comorbidities; modifies missed diagnosis or faulty
documents and presents common and uncommon likely differential with clinical reasoning (e.g.,
differential in oral conditions new information from publication, curriculum
presentation clearly and additional testing development)
concisely
Generates a basic Describes diagnostic tests Selects additional Articulates the rationale
differential diagnosis to aid in the differential diagnostic testing to for ordering diagnostic
based on patient diagnosis distinguish between testing in hierarchical
symptoms and history conditions on the fashion based upon
differential probabilistic differential
Comments:
Not Yet Assessable

8
Medical Knowledge 3: Therapeutic Interventions

Describes basic Explains relevant Identifies and describes Describes and Participates in the
concepts of ophthalmic pathophysiology and lists side effects of medical articulates the rationale development and
pathophysiology and indications and therapies and ways to for using emerging dissemination of novel
pharmacology contraindications for minimize potential alternative medical therapies or interventions
planned medical therapy complications therapies
Describes basic Explains indications, Identifies and describes Describes and

ophthalmic anatomy and contraindications, and causes of complications articulates the rationale
categories of procedural relevant steps required for and alternatives for for using novel
interventions procedural intervention routine procedural alternative procedural
(e.g., anesthesia, interventions interventions
technique, instruments)
Comments:
Not Yet Assessable

9
Systems-Based Practice 1: Patient Safety and Quality Improvement

Demonstrates Identifies system factors Participates in analysis of Conducts analysis of Actively engages teams
knowledge of common that lead to patient safety patient safety events patient safety events and processes to modify
patient safety events events (simulated or actual) and offers error systems to prevent
prevention strategies patient safety events
(simulated or actual)
Demonstrates Reports patient safety Participates in disclosure Discloses patient safety Role models or mentors
knowledge of how to events through of patient safety events to events to patients and others in the disclosure of
report patient safety institutional reporting patients and families families (simulated or patient safety events
events systems (simulated or (simulated or actual) actual)
actual)
Demonstrates Describes local quality Participates in local Demonstrates the skills Creates, implements, and
knowledge of basic improvement initiatives quality improvement required to identify, assesses quality
quality improvement (e.g., eye protection for initiatives develop, implement, improvement initiatives at
methodologies and high risk activities, and analyze a quality the institutional or
metrics diabetic eye screening) improvement project community level
Comments:

10
Systems-based Practice 2: System Navigation for Patient-Centered Care

Demonstrates Coordinates care of Coordinates care of Teaches effective Analyzes the process of
knowledge of care patients in routine clinical patients in complex coordination of patient- care coordination and
coordination situations effectively using clinical situations centered care among leads in the design and
the roles of the effectively using the roles different disciplines and implementation of
interprofessional teams of their interprofessional specialties to junior improvements
teams members of the team
Identifies key elements Performs safe and Performs safe and Advocates for safe and Improves quality of
for safe and effective effective transitions of effective transitions of effective transitions of transitions of care within
transitions of care and care/hand-offs in routine care/hand-offs in complex care/hand-offs within and across health care
hand-offs clinical situations clinical situations and across health care delivery systems to
delivery systems optimize patient outcomes
Demonstrates Demonstrates knowledge Identifies specific local Uses local resources Participates in changing
knowledge of the role of of local population and health needs and effectively to meet the and adapting practice to
the physician in community health needs disparities related to needs of a patient provide for the needs of
addressing community and disparities ophthalmic care population and specific populations
health needs and community
disparities
Comments:

11
Systems-Based Practice 3: Physician Role in Health Care Systems

Describes basic health Describes how different Optimizes patient care Advocates for patient Participates in health
care systems and system types require the given available resources care needs beyond policy advocacy activities
access models (e.g., physician to deliver care patients’ available
government, private, effectively with available resources (e.g.,
public, uninsured care) resources community resources,
patient assistance
resources, telehealth)
Demonstrates use of Identifies the Describes knowledge Demonstrates Analyzes individual

electronic medical record documentation required domains for effective administrative practice patterns and
for billing and coding transition to practice (e.g., knowledge needed for professional requirements
compliance information technology, transition to practice in preparation for practice
legal, billing and coding) (e.g., contract
negotiations,
malpractice insurance,
government regulation,
compliance)
Comments:

12
Practice-Based Learning and Improvement 1: Evidence-Based and Informed Practice

Demonstrates how to Articulates clinical Locates and applies the Critically appraises and Coaches others to
access and use available questions and elicits best available evidence, applies evidence even critically appraise and
evidence, and patient preferences and integrated with patient in the face of apply evidence for
incorporate patient values in order to guide preference, to the care of uncertainty and complex patients; and/or
preferences and values evidence-based care complex patients conflicting evidence to participates in the
in order to take care of a guide care, tailored to development of patient
routine patient the individual patient care guidelines
Comments:

13
Practice-Based Learning and Improvement 2: Reflective Practice and Commitment to Personal Growth

Accepts responsibility for Demonstrates openness Seeks performance data Uses performance data Facilitates the design and
personal and to performance data and accepts it with to measure the implementing learning
professional (feedback and other responsibility and effectiveness of the plans for others
development by input) in order to inform equipoise; demonstrates learning plan and when
establishing goals; goals; designs and implementation of a necessary, improves it
actively seeks implements a learning learning plan
opportunities to improve plan, with guidance
Identifies the factors Analyzes and reflects on Analyzes, reflects on, and Challenges Coaches others on
which contribute to the factors which institutes behavioral assumptions and reflective practice
gap(s) between contribute to gap(s) change(s) to narrow the considers alternatives in
expectations and actual between expectations and gap(s) between narrowing the gap(s)
performance actual performance expectations and actual between expectations
performance and actual performance
Comments:

14
Professionalism 1: Professional Behavior and Ethical Principles

Identifies and describes Demonstrates insight into Demonstrates Recognizes situations Coaches others when
potential triggers for professional behavior in professional behavior in that may trigger their behavior fails to
professionalism lapses routine situations complex or stressful professionalism lapses meet professional
situations and intervenes to expectations
prevent lapses in self
and others
Describes when and how Takes responsibility for Recognizes need to seek Recognizes and uses Identifies and seeks to
to appropriately report own professionalism help in managing and appropriate resources address system-level
professionalism lapses, lapses resolving complex ethical for managing and factors that induce or
including strategies for situations resolving ethical exacerbate ethical
addressing common dilemmas as needed problems or impede their
barriers (e.g., ethics resolution
consultations, literature
Demonstrates Analyzes straightforward Analyzes complex review, risk
knowledge of the ethical situations using ethical situations using ethical management/legal
principles underlying principles principles consultation)
informed consent,
surrogate decision
making, advance
directives, confidentiality,
error disclosure,
stewardship of limited
resources, and related
topics
Comments:

15
Professionalism 2: Accountability/Conscientiousness

Takes responsibility for Performs tasks and Performs tasks and Recognizes situations Takes ownership of
failure to complete tasks responsibilities in a timely responsibilities in a timely that may impact others’ system outcomes,
and responsibilities, manner with attention to manner with attention to ability to complete tasks attempts to implement
identifies potential detail in routine situations detail in complex or and responsibilities in a changes at a systems
contributing factors, and stressful situations timely manner level in order to advance
describes strategies for the goals of professional
ensuring timely task accountability
completion in the future
Responds promptly to Recognizes situations Recognizes detrimental Proactively implements

requests or reminders to that may impact own consequences when strategies to ensure that
complete tasks and ability to complete tasks tasks and responsibilities the needs of patients,
responsibilities and responsibilities in a are not completed in a teams, and systems are
timely manner timely manner (e.g., team met
members, compliance)
Comments:

16
Professionalism 3: Self-Awareness and Help-Seeking

Recognizes status of Independently recognizes With assistance, Independently develops
personal and status of personal and proposes a plan to a plan to optimize
professional well-being, professional well-being optimize personal and personal and Coaches others when
with assistance professional well-being professional well-being emotional responses or
limitations in
Recognizes limits in the Independently recognizes With assistance, Independently develops knowledge/skills do not
knowledge/skills of self limits in the knowledge/ proposes a plan to a plan to improve the meet professional
and/or team, with skills of self and/or team; improve knowledge/skills knowledge/skills of self expectations
assistance demonstrates appropriate of self and/or team and/or team
help-seeking behaviors
for self or others
Comments:

17
Interpersonal and Communication Skills 1: Patient and Family-Centered Communication

Uses language and Establishes a therapeutic Establishes a therapeutic Easily establishes Mentors others in
nonverbal behavior to relationship in relationship therapeutic situational awareness and
demonstrate respect and straightforward in challenging patient relationships, with critical self-reflection to
establish rapport encounters using active encounters (e.g., breaking attention to consistently develop
listening and clear bad news) patient/family concerns positive therapeutic
language and context, regardless relationships
of complexity
Identifies barriers to Addresses barriers to When prompted, reflects Role models self-
effective communication effective communication on personal biases while awareness to minimize
(e.g., health literacy, attempting to minimize communication barriers
language, disability, communication barriers
cultural) while accurately
communicating own role
within the health care
system
Comments:

18
Interpersonal and Communication Skills 2: Interprofessional and Team Communication

Uses language that Communicates Communicates concerns Role models flexible
values all members of information effectively to the team and learners communication
the health care team and uses active listening strategies that value
with all health care team input from all health
members care team members,
resolving conflict when
needed
Accepts feedback on Solicits feedback on Provides feedback and Provides feedback and Facilitates regular health
performance from all performance as a constructive criticism to constructive criticism to care team-based
members of the health member of the health peers and learners superiors feedback in complex
care team (e.g., nurses, care team situations
staff members, peers)
Comments:

19
Interpersonal and Communication Skills 3: Communication within Health Care Systems

Accurately records Demonstrates organized Communicates clearly Provides feedback to
information in the diagnostic and and concisely, including improve others’ written
medical record therapeutic reasoning anticipatory guidance, in communication
through notes in the the medical record
medical record
Aware of the role of Appropriately selects Avoids creating or Provides feedback and Facilitates dialogue
communication in patient forms of communication propagating errors in the constructive criticism regarding systems issues
safety and privacy; (e.g., telephone versus medical record through regarding compliance among larger community
safeguards patient text) to promote patient accurate use of with patient privacy and stakeholders (institution,
personal health safety and privacy documentation tools safety health care system, field)
information
Aware of responsibility to Identifies appropriate Uses appropriate Offers clear and Guides departmental or
report system channels to communicate channels to communicate constructive institutional
deficiencies system deficiencies system deficiencies suggestions to address communication around
system deficiencies policies and procedures
Comments:

20

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Ophthalmology Milestones

The Accreditation Council for Graduate Medical Education

Second Revision: January 2020

©2020 Accreditation Council for Graduate Medical Education (ACGME)

©2020 Accreditation Council for Graduate Medical Education (ACGME)

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Understanding Milestone Levels and Reporting

©2020 Accreditation Council for Graduate Medical Education (ACGME)

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Selecting a response box in the Selecting a response box on the line in

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Patient Care 1: Data Acquisition – Basic Ophthalmology Exam and Testing

Level 1 Level 2 Level 3 Level 4 Level 5

Performs and documents Orders, performs, and Interprets unusual

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Patient Care 2: Hospital-Based Consultation

Level 1 Level 2 Level 3 Level 4 Level 5

Recognizes ophthalmic Manages ophthalmic Manages ophthalmic

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Patient Care 3: Office-Based Procedures

Level 1 Level 2 Level 3 Level 4 Level 5

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Patient Care 4: Cataract Surgery – Technical Skill

Level 1 Level 2 Level 3 Level 4 Level 5

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Patient Care 5: Extraocular Surgery (Plastics, Strabismus)

Level 1 Level 2 Level 3 Level 4 Level 5

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Patient Care 6: Intraocular Surgery (Cornea, Retina, Glaucoma)

Level 1 Level 2 Level 3 Level 4 Level 5

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Medical Knowledge 1: Pathophysiology

Level 1 Level 2 Level 3 Level 4 Level 5

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Medical Knowledge 2: Differential Diagnosis

Level 1 Level 2 Level 3 Level 4 Level 5

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Medical Knowledge 3: Therapeutic Interventions

Level 1 Level 2 Level 3 Level 4 Level 5

Describes basic Explains indications, Identifies and describes Describes and

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Systems-Based Practice 1: Patient Safety and Quality Improvement

Level 1 Level 2 Level 3 Level 4 Level 5

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Systems-based Practice 2: System Navigation for Patient-Centered Care

Level 1 Level 2 Level 3 Level 4 Level 5

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Systems-Based Practice 3: Physician Role in Health Care Systems

Level 1 Level 2 Level 3 Level 4 Level 5

Demonstrates use of Identifies the Describes knowledge Demonstrates Analyzes individual

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Practice-Based Learning and Improvement 1: Evidence-Based and Informed Practice

Level 1 Level 2 Level 3 Level 4 Level 5

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Level 1 Level 2 Level 3 Level 4 Level 5

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Professionalism 1: Professional Behavior and Ethical Principles

Level 1 Level 2 Level 3 Level 4 Level 5

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Level 1 Level 2 Level 3 Level 4 Level 5

Responds promptly to Recognizes situations Recognizes detrimental Proactively implements

©2020 Accreditation Council for Graduate Medical Education (ACGME)

Professionalism 3: Self-Awareness and Help-Seeking

Level 1 Level 2 Level 3 Level 4 Level 5