“…3 Milestones have been used and studied as a measure of trainee performance for education research, programmatic assessment, and learning analytics. [4][5][6][7][8] Prior studies of milestones have demonstrated a general upward trend in milestone scores as learners progress through training, [9][10][11][12] but this trend is often less pronounced and less consistent during subspecialty fellowship training. 13,14 Other studies have found that milestone scores vary among different specialties within a single institution, as well as among identical specialties across different institutions.…”