Longitudinal milestones improvement of residents received internal medicine specialty training in Taiwan

Milestone framework has been implemented in residency training to facilitate the residents' assessment worldwide. We aim to evaluate the effectiveness of longitudinal milestones developed by Taiwan Society of Internal Medicine and compare the milestone ratings between the first-year resident (R1) program and the second-year post-graduate year (PGY2) program in Taiwan.

A multicenter observational cohort study was conducted, enrolling 153 first-year residents (107 R1 and 46 PGY2) in 2020 at six medical centers. The study tracked improvements in 22 sub-competencies over three years. The correlation between final milestone ratings and medical specialty board examination scores was analyzed.

Of the 153 first-year residents recruited (107 R1 and 46 PGY2), 125 residents (100 R1 and 25 PGY2) completed three years of continuous milestone evaluations. Significant improvements in all 22 sub-competencies were found during the training of residents (all P < 0.001). Generally, there were no differences of milestone ratings in each year between R1 and PGY2 groups, except one sub-competency of practice-based learning and improvement (PBLI) had significant lower ratings in PGY2 group. A significant correlation was found between final milestone ratings and medical specialty board examination scores, particularly in the domains of Patient Care (P = 0.036), Systems-Based Practice (P = 0.024), and Professionalism (P = 0.041).

We demonstrate that milestone ratings effectively support the educational objectives of internal medicine residency in Taiwan. No major differences were found between the two residency programs. Final milestone ratings correlated with board exam performance, reinforcing the framework's validity.