To bolster public trust that our graduating trainees have the knowledge, skills, and attitudes required for independent practice in their respective fields, the Accreditation Council for Graduate Medical Education (ACGME) initiated the process of standardizing the Subspecialty Reporting Milestones in 2012. This concept had been advancing in graduate medical education since the development of the 6 core competencies in 1999: Patient Care (PC), Medical Knowledge (MK), Interpersonal and Communication Skills (ICS), Professionalism (PROF), Systems-Based Practice (SBP), and Practice-Based Learning and Improvement (PBLI).