Trainee and residency program performances can be evaluated by employing multiple tools including Accreditation Council for Graduate Medical Education (ACGME) standardized milestones. However, the objective validation of these tools in predicting written board passages is yet to be explained clearly.A recent retrospective study gathered data on 45 Wayne State University Obstetrics and Gynecology program graduates over the five years till July 2018. The study utilized- United States Medical Licensing Examination (USMLE) scores, Council on Resident Education in Obstetrics and Gynecology (CREOG) in-training scores and ACGME milestones to forecast the success of the American Board of Obstetrics and Gynecology (ABOG) board passage on the first attempt. The following results were obtained-Written board passages were found to be associated with average CREOGs and milestones except for USMLE1.USMLE1 <217 (with Positive predictive value (PPV) = 96%), CREOGs <197 (with PPV = 100%) and milestones <3.25 (with PPV = 100%), especially practice-based learning and systems-based practice milestones particularly lead to board failure.  A combination of these two milestones has the potential to correctly predict board passage using this model (PPV = 86%).This pioneering study validated the utility of milestones in a surgical speciality by displaying their ability to predict board passage. Residents with CREOGs or milestones below thresholds have the risk of board failure and thus deserve early intervention.SOURCE- Ottum S, Chao C, Tamakuwala S, et al. Can ACGME Milestones predict surgical specialty board passage: an example in Obstetrics and Gynecology. Clin Exp Obstet Gynecol. 2021;48(5):1048-1055. doi:10.31083/j.ceog4805168