{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T22:16:55Z","timestamp":1785795415551,"version":"3.56.0"},"reference-count":21,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi251011-4\"><jats:title>Importance<\/jats:title><jats:p>Milestones ratings have been used to assess resident physicians for more than a decade, but little is known as to whether there are posttraining implications of ratings for patient experiences.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi251011-5\"><jats:title>Objective<\/jats:title><jats:p>To investigate the association of residents\u2019 Milestones ratings of professionalism and interpersonal and communication skills (ICS) with patient experience survey results in the first year of unsupervised practice.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi251011-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective cohort study included physicians who completed residency training at Accreditation Council for Graduate Medical Education\u2013accredited programs between July 1, 2015, and June 30, 2019, and subsequently worked at facilities that collected Clinician &amp;amp;amp; Group-Consumer Assessments of Healthcare Providers and Systems Surveys (CG-CAHPS). Milestones ratings from adult primary care training programs (internal medicine, family medicine, and obstetrics and gynecology) and patient survey data were linked for physicians who had more than 30 CG-CAHPS results in their first year of unsupervised practice. Physician characteristics (sex and specialty), CG-CAHPS patient respondent demographics (sex, race, and language spoken at home), and a CG-CAHPS question about a facility-related experience were collected for multivariable linear regression analyses. Data were analyzed from February 1, 2024 to April 10, 2025.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi251011-7\"><jats:title>Exposures<\/jats:title><jats:p>Mean professionalism and ICS scores in Milestones evaluations collected 6 months before the end of training. Physicians were categorized into those with higher (\u22653.5) or lower (&amp;amp;lt;3.5) mean scores.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi251011-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>CG-CAHPS Top Box scores for 6 questions pertaining to physician behaviors and the overall clinician rating. (Top Box scores denote the percentage of patients who selected the most favorable response option.)<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi251011-9\"><jats:title>Results<\/jats:title><jats:p>A total of 1349 physicians (753 [55.8%] aged 26-30 years; 804 [59.6%] female) were included in the analysis. Higher mean professionalism or ICS Milestones ratings were associated with higher Top Box scores across all CG-CAHPS questions pertaining to physician-related experiences (eg, adjusted mean difference in physician\u2019s knowledge of the patient\u2019s medical history: professionalism, 2.9 [95% CI, 1.4-4.5] percentage points; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001; ICS, 3.2 [95% CI, 1.5-4.9] percentage points; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) as well as overall physician ratings (adjusted mean difference: professionalism, 2.9 [95% CI, 1.4-4.3] percentage points; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001; ICS, 3.5 [95% CI, 2-5.1] percentage points; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) in multivariable linear regression models.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi251011-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study of physicians who completed residency in adult primary care specialties, those with higher mean professionalism and ICS Milestones ratings in training received better patient experience survey ratings in their first year of unsupervised practice. These findings suggest that trainees with lower ratings may benefit from intervention.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.36380","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T15:00:26Z","timestamp":1759935626000},"page":"e2536380","source":"Crossref","is-referenced-by-count":1,"title":["Trainee-Physician Milestones Ratings and Patient Experience Surveys in Early Unsupervised Practice"],"prefix":"10.1001","volume":"8","author":[{"given":"Jenny X.","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deirdre","family":"Mylod","sequence":"additional","affiliation":[{"name":"Press Ganey Associates, Inc., South Bend, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuezhou","family":"Jing","sequence":"additional","affiliation":[{"name":"James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Kerschner","sequence":"additional","affiliation":[{"name":"Press Ganey Associates, Inc., South Bend, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Trock","sequence":"additional","affiliation":[{"name":"James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Meth","sequence":"additional","affiliation":[{"name":"Johns Hopkins Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Accreditation Council for Graduate Medical Education, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean O.","family":"Hogan","sequence":"additional","affiliation":[{"name":"Accreditation Council for Graduate Medical Education, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misop","family":"Han","sequence":"additional","affiliation":[{"name":"James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"issue":"11","key":"zoi251011r1","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1056\/NEJMsr1200117","article-title":"The next GME accreditation 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competence.","volume":"94","author":"Hamstra","year":"2019","journal-title":"Acad Med"},{"issue":"6","key":"zoi251011r19","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.1016\/j.surg.2020.12.006","article-title":"Effects of surgeon sociodemographics on patient-reported satisfaction.","volume":"169","author":"Nuyen","year":"2021","journal-title":"Surgery"},{"issue":"11","key":"zoi251011r20","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.24583","article-title":"Association of racial\/ethnic and gender concordance between patients and physicians with patient experience ratings.","volume":"3","author":"Takeshita","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"9","key":"zoi251011r21","doi-asserted-by":"publisher","first-page":"1618","DOI":"10.1016\/j.ajem.2018.11.025","article-title":"The effect of practice settings on individual Doctor Press Ganey scores: a retrospective cohort 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CAHPS Clinician & Group Adult Survey 3.1. Accessed September 5, 2025. https:\/\/www.ahrq.gov\/sites\/default\/files\/wysiwyg\/cahps\/surveys-guidance\/cg\/adult-english-cg-3-1-2351a.pdf"},{"key":"zoi251011r7","unstructured":"Edgar? L, Hatlak? K, Haynes? IL, . The Milestones guidebook. Accessed July 31, 2024. https:\/\/www.acgme.org\/globalassets\/milestonesguidebook.pdf"},{"key":"zoi251011r8","unstructured":"Correa? R, Curran? M, Eno? C, . Milestones guidebook for residents and fellows. Accessed September 4, 2025. https:\/\/www.acgme.org\/globalassets\/pdfs\/milestones\/milestonesguidebookforresidentsfellows.pdf"},{"key":"zoi251011r9","unstructured":"Accreditation Council for Graduate Medical Education. Milestones by specialty. 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