Pediatrics Milestones - The Accreditation Council for Graduate Medical Education - ACGME
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Pediatrics Milestones
The Accreditation Council for Graduate Medical Education
Implementation Date: July 1, 2021
Second Revision: March 2021
First Revision: December 2012
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.Pediatrics Milestones
The Milestones are designed only for use in evaluation of residents 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 competence 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.
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
IPediatrics Milestones
Work Group
Marsha Anderson, MD Mel Heyman, MD, MPH
Courtney Brantley, MD Oriaku Kas-Osoka, MD, MEd
April Buchanan, MD Kristin Koehn, MD, MACM
Ann Burke, MD Emily Machogu, MD
Carol Carraccio, MD Brian May, MD, MEd
Jennifer Chen, MD Judy-April Oparaji, MD, RD
Abhay Dandekar, MD Kris Rooney, MD
Stephanie Dewar, MD Johannah Scheurer, MD
Jennifer Di Rocco, DO, MEd Daniel Schumacher, MD
Maya Eady, MD Judith S. Shaw, EdD, MPH, RN
Laura Edgar, EdD, CAE David Turner, MD
John Frohna, MD, MPH Anne Warwick, MD, MPH
Bahareh Gordon, MD, MS Kimberly Wolf, DO
Mary Fran Hazinski, RN, MSN, FAAN, FAHA
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
IIThe ACGME would like to thank the following organizations for their continued support in the
development of the Milestones:
American Board of Pediatrics
Association of American Medical Colleges
Association of Osteopathic Directors and Medical Educators
Association of Pediatric Program Directors
Council of Pediatric Subspecialties
Review Committee for Pediatrics
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
iiiUnderstanding 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).
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
ivAdditional 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. Furthermore, Milestones 2.0 include revisions and
changes that preclude using Milestones as a sole assessment in high-stakes decisions (i.e., determination of eligibility for
certification or credentialing). 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.
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.
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
vThe 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).
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
viVersion 2 Pediatrics, ACGME Report Worksheet
Patient Care 1: History
Level 1 Level 2 Level 3 Level 4 Level 5
Gathers information Adapts template to filter Filters, prioritizes, and Filters, prioritizes, and Recognizes and probes
strictly following a and prioritize pertinent synthesizes the history to synthesizes the history subtle clues from patients
template positives and negatives develop a differential to develop a differential and families;
based on broad diagnosis in real-time for diagnosis in real time distinguishes nuances
diagnostic categories or uncomplicated or typical for complicated or among diagnoses to
possible diagnoses presentations atypical presentations efficiently drive further
information gathering
Comments:
Not Yet Completed Level 1
Not Yet Assessable
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
1Version 2 Pediatrics, ACGME Report Worksheet
Patient Care 2: Physical Exam
Level 1 Level 2 Level 3 Level 4 Level 5
Performs fundamental Performs complete Performs complete or Performs complete or Detects, pursues, and
physical examination physical examination and focused physical focused physical integrates key physical
identifies variants and examination, as indicated, examination, as examination findings to
abnormal findings and interprets normal indicated, and selects distinguish nuances
variants and abnormal advanced maneuvers to among competing, often
findings distinguish between similar diagnoses
diagnoses
Performs a rote physical Performs a physical Performs a physical Performs a physical Performs a physical
examination using a examination considering examination with examination using examination that
strict head-to-toe appropriate adaptation for consistent use of a strategies to maximize consistently and positively
approach age and development developmentally patient cooperation and engages the patient
appropriate approach comfort
Comments:
Not Yet Completed Level 1
Not Yet Assessable
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
2Version 2 Pediatrics, ACGME Report Worksheet
Patient Care 3: Organize and Prioritize Patient Care
Level 1 Level 2 Level 3 Level 4 Level 5
Completes tasks for an Organizes patient care Organizes and prioritizes Organizes, prioritizes, Serves as a role model
individual patient, when responsibilities by the simultaneous care of and delegates patient and coach for patient care
prompted focusing on individual patients with efficiency care responsibilities responsibilities
(rather than multiple) even when patient
patients volume approaches the
capacity of the
individual or facility;
anticipates and triages
urgent and emergent
issues
Comments:
Not Yet Completed Level 1
Not Yet Assessable
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
3Version 2 Pediatrics, ACGME Report Worksheet
Patient Care 4: Clinical Reasoning
Level 1 Level 2 Level 3 Level 4 Level 5
Presents clinical facts Generates an unfocused Organizes clinical facts to Integrates clinical facts Role models and coaches
(e.g., history, exam, differential diagnosis compare and contrast into a unifying the organization of clinical
tests, consultations) in based on the clinical facts diagnoses being diagnosis(es); facts to develop a
the order they were considered, resulting in a reappraises in real time prioritized differential
elicited prioritized differential to avoid diagnostic error diagnosis, including life
diagnosis threatening diagnoses,
atypical presentations,
and complex clinical
presentations
Comments:
Not Yet Completed Level 1
Not Yet Assessable
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
4Version 2 Pediatrics, ACGME Report Worksheet
Patient Care 5: Patient Management
Level 1 Level 2 Level 3 Level 4 Level 5
Reports management Participates in the Develops an Develops and Serves as a role model
plans developed by creation of management interdisciplinary implements informed and coach for
others plans management plan for management plans for development of
common and typical complicated and management plans for
diagnoses atypical diagnoses, with complicated and atypical
the ability to modify diagnoses, with the ability
plans as necessary to modify plans as
necessary
Comments:
Not Yet Completed Level 1
Not Yet Assessable
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
5Version 2 Pediatrics, ACGME Report Worksheet
Medical Knowledge 1: Clinical Knowledge
Level 1 Level 2 Level 3 Level 4 Level 5
Demonstrates basic Links basic medical Applies medical Integrates a breadth of Teaches at multiple
medical knowledge knowledge to clinical knowledge to common medical knowledge that levels, drawing from a
scenarios and typical scenarios to includes complicated breadth of medical
guide patient care and atypical conditions knowledge that spans the
to guide patient care continuum of simple to
complex problems
Comments:
Not Yet Completed Level 1
Not Yet Assessable
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
6Version 2 Pediatrics, ACGME Report Worksheet
Medical Knowledge 2: Diagnostic Evaluation
Level 1 Level 2 Level 3 Level 4 Level 5
Lists basic evaluation Recommends broad Recommends focused Prioritizes and Educates others about
(e.g., diagnostic testing evaluation based on an evaluation based on a optimizes evaluation risks, benefits,
and consultation) for unfocused differential prioritized differential based on risks, benefits, indications, and
common diagnoses, with diagnosis diagnosis indications, and alternatives to guide
prompting alternatives to clarify the diagnostic decision
diagnosis(es) making
Reports results of Identifies clinically Interprets clinical Interprets clinical Teaches others to
diagnostic studies significant diagnostic significance of diagnostic significance of interpret clinically
study results, with study results diagnostic study results significant results and
guidance while considering study consider study limitations
limitations
Comments:
Not Yet Completed Level 1
Not Yet Assessable
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
7Version 2 Pediatrics, ACGME Report Worksheet
Systems-Based Practice 1: Patient Safety
Level 1 Level 2 Level 3 Level 4 Level 5
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)
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
8Version 2 Pediatrics, ACGME Report Worksheet
Systems-Based Practice 2: Quality Improvement
Level 1 Level 2 Level 3 Level 4 Level 5
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., community initiatives develop, implement, improvement initiatives at
methodologies and vaccination rate, infection and analyze a quality the institutional or
metrics rate, smoking cessation) improvement project community level
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
9Version 2 Pediatrics, ACGME Report Worksheet
Systems-Based Practice 3: System Navigation for Patient Centered Care – Coordination of Care
Level 1 Level 2 Level 3 Level 4 Level 5
Lists the various Coordinates care of Coordinates care of Coordinates Coaches others in
interprofessional patients in routine clinical patients in complex interprofessional, interprofessional, patient-
individuals involved in situations, incorporating clinical situations, patient-centered care centered care
the patient’s care interprofessional teams effectively utilizing the among different coordination
coordination with consideration of roles of interprofessional disciplines and
patient and family needs teams, and incorporating specialties, actively
patient and family needs assisting families in
and goals navigating the health-
care system
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
10Version 2 Pediatrics, ACGME Report Worksheet
Systems-Based Practice 4: System Navigation for Patient-Centered Care – Transitions in Care
Level 1 Level 2 Level 3 Level 4 Level 5
Uses a standard Adapts a standard Performs safe and Performs and Coaches others in
template for transitions template, recognizing key effective transitions of advocates for safe and improving transitions of
of care/hand-offs elements for safe and care/hand-offs in complex effective transitions of care within and across
effective transitions of clinical situations, and care/hand-offs within health care delivery
care/hand-offs in routine ensures closed-loop and across health care systems to optimize
clinical situations communication delivery systems, patient outcomes
including transitions to
adult care
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
11Version 2 Pediatrics, ACGME Report Worksheet
Systems-Based Practice 5: Population and Community Health
Level 1 Level 2 Level 3 Level 4 Level 5
Demonstrates Identifies specific Uses local resources Adapts practice to Advocates at the local,
awareness of population population and effectively to meet the provide for the needs of regional, or national level
and community health community health needs needs and reduce health and reduce health for populations and
needs and disparities and disparities; identifies disparities of a patient disparities of a specific communities with health
local resources population and population care disparities
community
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
12Version 2 Pediatrics, ACGME Report Worksheet
Systems-Based Practice 6: Physician Role in Health Care Systems
Level 1 Level 2 Level 3 Level 4 Level 5
Engages with patients Identifies the relationships Discusses the need for Advocates for the Coaches others to
and other providers in between the delivery changes in clinical promotion of safe, promote safe, quality, and
discussions about cost- system and cost- approaches based on quality, and high-value high-value care across
conscious care and key conscious care and the evidence, outcomes, and care health care systems
components of the impact on the patient care cost-effectiveness to
health care delivery improve care for patients
system and families
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
13Version 2 Pediatrics, ACGME Report Worksheet
Practice-Based Learning and Improvement 1: Evidence-Based and Informed Practice
Level 1 Level 2 Level 3 Level 4 Level 5
Develops an answerable Independently articulates Locates and applies the Critically appraises and Coaches others to
clinical question and clinical question and evidence, integrated with applies evidence, even critically appraise and
demonstrates how to accesses available patient preference, to the in the face of apply evidence for
access available evidence care of patients uncertainty and complex patients
evidence, with guidance conflicting evidence to
guide care tailored to
the individual patient
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
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14Version 2 Pediatrics, ACGME Report Worksheet
Practice-Based Learning and Improvement 2: Reflective Practice and Commitment to Personal Growth
Level 1 Level 2 Level 3 Level 4 Level 5
Participates in feedback Demonstrates openness Seeks and incorporates Seeks and incorporates Role models and coaches
sessions to feedback and feedback and feedback and others in seeking and
performance data performance data performance data incorporating feedback
episodically consistently and performance data
Develops personal and Designs a learning plan Designs and implements Adapts a learning plan Demonstrates continuous
professional goals, with based on established a learning plan by using long-term self-reflection and
assistance goals, feedback, and analyzing and reflecting professional goals, self- coaching of others on
performance data, with on the factors which reflection, and reflective practice
assistance contribute to gap(s) performance data to
between performance measure its
expectations and actual effectiveness
performance
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
15Version 2 Pediatrics, ACGME Report Worksheet
Professionalism 1: Professional Behavior
Level 1 Level 2 Level 3 Level 4 Level 5
Identifies expected Demonstrates Maintains professional Recognizes situations Models professional
professional behaviors professional behavior with behavior in increasingly that may trigger behavior and coaches
and potential triggers for occasional lapses complex or stressful professionalism lapses others when their
lapses situations and intervenes to behavior fails to meet
prevent lapses in self professional expectations
and others
Identifies the value and Demonstrates Fully engages in patient Exhibits a sense of duty Extends the role of the
role of pediatrics as a accountability for patient care and holds oneself to patient care and pediatrician beyond the
vocation/career care as a pediatrician, accountable professional care of patients by
with guidance responsibilities engaging with the
community, specialty, and
medical profession as a
whole
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
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16Version 2 Pediatrics, ACGME Report Worksheet
Professionalism 2: Ethical Principles
Level 1 Level 2 Level 3 Level 4 Level 5
Demonstrates Applies ethical principles Analyzes complex Manages and seeks to Called upon by others to
knowledge of the ethical in common situations situations using ethical resolve ethical consult in cases of
principles underlying principles to address dilemmas using complex ethical
informed consent, conflict/controversy; appropriate resources dilemmas; identifies and
surrogate decision seeks help when needed (e.g., ethics seeks to address system-
making, advance to manage and resolve consultations, literature level factors that induce
directives, confidentiality, complex ethical situations review, risk or exacerbate
error disclosure, management/legal
stewardship of limited consultation)
resources, and related
topics
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
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17Version 2 Pediatrics, ACGME Report Worksheet
Professionalism 3: Accountability/Conscientiousness
Level 1 Level 2 Level 3 Level 4 Level 5
Performs tasks and Performs tasks and Performs tasks and Coaches others to Creates strategies to
responsibilities, with responsibilities in a timely responsibilities in a ensure tasks and enhance others’ ability to
prompting manner in routine thorough and timely responsibilities are efficiently complete tasks
situations manner in complex or completed in a thorough and responsibilities
stressful situations and timely manner in
complex or stressful
situations
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
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18Version 2 Pediatrics, ACGME Report Worksheet
Professionalism 4: Well-Being
Level 1 Level 2 Level 3 Level 4 Level 5
Recognizes the Describes institutional Recognizes institutional Describes interactions Coaches and supports
importance of resources that are meant and personal factors that between institutional colleagues to optimize
addressing personal and to promote well-being impact well-being and personal factors well-being at the team,
professional well-being that impact well-being program, or institutional
level
Comments:
Not Yet Completed Level 1
This subcompetency is not intended to evaluate a resident’s well-being, but to ensure each resident has the fundamental knowledge of factors that impact well-
being, the mechanisms by which those factors impact well-being, and available resources and tools to improve well-being.
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
19Version 2 Pediatrics, ACGME Report Worksheet
Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication
Level 1 Level 2 Level 3 Level 4 Level 5
Demonstrates respect Establishes a therapeutic Establishes a culturally Establishes a Mentors others to develop
and attempts to establish relationship in competent and therapeutic relationship positive therapeutic
rapport straightforward therapeutic relationship in in straightforward and relationships
encounters most encounters complex encounters,
including those with
ambiguity and/or conflict
Attempts to adjust Adjusts communication Communicates with Uses shared decision Models and coaches
communication strategies as needed to sensitivity and making with others in patient- and
strategies based upon mitigate barriers and meet compassion, elicits patient/family to make a family-centered
patient/family patient/family patient/family values, and personalized care plan communication
expectations expectations acknowledges uncertainty
and conflict
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
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20Version 2 Pediatrics, ACGME Report Worksheet
Interpersonal and Communication Skills 2: Interprofessional and Team Communication
Level 1 Level 2 Level 3 Level 4 Level 5
Respectfully requests a Clearly and concisely Formulates a specific Coordinates consultant Maintains a collaborative
consultation, with requests consultation by question for consultation recommendations to relationship with referring
guidance communicating patient and tailors communication optimize patient care providers that maximizes
information strategy adherence to practice
recommendations
Identifies the members Participates within the Uses bi-directional Facilitates Coaches others in
of the interprofessional interprofessional team communication within the interprofessional team effective communication
team interprofessional team communication within the
interprofessional team
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
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21Version 2 Pediatrics, ACGME Report Worksheet
Interpersonal and Communication Skills 3: Communication within Health Care Systems
Level 1 Level 2 Level 3 Level 4 Level 5
Records accurate Records accurate and Concisely documents Documents diagnostic Models and coaches
information in the patient timely information in the updated, prioritized, and therapeutic others in documenting
record patient record diagnostic and reasoning, including diagnostic and
therapeutic reasoning in anticipatory guidance therapeutic reasoning
the patient record
Identifies the importance Selects appropriate Aligns type of Demonstrates Coaches others in written
of and responds to method of communication with exemplary written and and verbal
multiple forms of communication, with message to be delivered verbal communication communication
communication (e.g., in- prompting (e.g., direct and indirect)
person, electronic health based on urgency and
record (EHR), telephone, complexity
email)
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Pediatrics Milestones on a non-exclusive basis for educational purposes.
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