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“Milestones” has been a part of the ACGME vocabulary for nearly 17 years now. In the final session of the 2018 Annual Educational Conference, Eric Holmboe, MD, MACP, FRCP, senior vice president, Milestone Development and Evaluation, kicked off a discussion about the Milestones today and the Milestones to come.

In one of the final sessions at the 2018 Annual Educational Conference on Sunday, March 4, a panel of ACGME executives, deans, a patient safety expert, and a resident spoke to the crowd about how medicine is changing and graduate medical education may need to evolve to serve patients well into the 21^st century.

With overdose as the leading cause of death for Americans under 50, it is imperative that the nation—including the entire medical community—take responsibility for its role in creating this epidemic and identify and enact strategies that can address it. This is Dr. Leana Wen’s position. The former Baltimore Health Commissioner and current president of Planned Parenthood spoke about the steps she and the City of Baltimore took to address opioid addiction in the community, and what role she sees physicians playing in solving this problem that is devastating the nation.

Associate Program Director Kimberly Collins, MD of Johns Hopkins All Children's Hospital in Saint Petersburg, Florida set out to see how simulating conversations about social determinants of health (as opposed to in-class learning or immersion-based training) affected a resident’s or fellow’s ability to broach and explore these complex, often sensitive, subjects with patients and their parents. Her results are recorded in her poster: Improving Resident Comfort with Discussing Social Determinants of Health through Simulation.

Jamie Arsenyevictz, MPH, led a team at Geisinger Health System to develop a GME analysis tool, leading to the development of shared language and knowledge surrounding GME finance and value between the GME Office and Geisinger leadership.

ACGME President and CEO Dr. Nasca kicked off his Saturday morning session at the Annual Educational Conference with some “non-rhetorical” questions: Can anyone predict what the health care system will look like in 2035? Can anyone predict how long your residents will practice? 40 years?

After stumping the room, he went on to explain that it is our job is to prepare residents to practice in the future—not to arm them with practices, skills, and knowledge of the present. We want our residents to be prepared not just for 2018 but for 2035—and beyond.