Sacred or self-evident? The constitutional process and milestones 2.0.

In 1787, the founders of the United States crafted the Constitution for a fledgling democracy. In the same way, the Accreditation Council of Graduate Medical Education (ACGME) convened a group of educators to design milestones 2.0-the criteria of residency training for internal medicine in the United States. Like the constitution, these milestones are a foundational document. They define the supported, graduated path towards independent practice, incorporating competency- based educational principles such as Entrustable Professional Activities (EPAs).