Emergency Medicine Milestones

Emergency Medicine Milestones

The EM Milestones are a matrix of the knowledge, skills, abilities, attitudes, and experiences that should be acquired during specialty training in Emergency Medicine. The EM Milestones will provide a basis for six-month evaluations for EM residents.

The Milestones Project was a Joint Initiative of the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Emergency Medicine. The Milestones were designed by representatives of the following organizations:

  • The Association of Academic Chairs of Emergency Medicine (AACEM)
  • The American Academy of Emergency Medicine (AAEM)
  • The American Board of Emergency Medicine (ABEM)
  • The American College of Emergency Physicians (ACEP)
  • The Council of Emergency Medicine Residency Directors (CORD)
  • The Emergency Medicine Residents’ Association (EMRA)
  • The Resident Review Committee for Emergency Medicine (RRC-EM)
  • The Society of Academic Emergency Medicine (SAEM)

The ACGME provided oversight and instruction for this project.

The Emergency Medicine Milestone Project

Knowledge, Skills, and Abilities (KSAs)

Knowledge, Skills, and Abilities (KSAs) represent parts of EM practice and are tied to the Physician Tasks and Category 20 (Other Competencies of the Practice of Emergency Medicine), both components of the 2016 Model of the Clinical Practice of Emergency Medicine (EM Model).

The KSAs and the EM Model form the basis of examination blueprints. The 2021 KSAs were approved February 2021 and are available here: 

2021 KSAs (Word)
2021 KSAs (PDF)

Hierarchical performance scales related to each KSA were also identified. These scales provide a ranking of competence, with “A” being the highest level of competence. The level that a physician should demonstrate to become board certified is then determined based in part on the importance and frequency of the task. The level of competence (the “standard”) a physician would need to demonstrate to become board certified is indicated in bold.

Similar to the EM Model, it is important to note that only a sample of KSAs are examined on any given test (Qualifying, ConCert™, In-training, or the Oral Certification Exam)

Archived KSAs

2016 KSAs (PDF)
2016 KSAs (Word)
2014 KSAs