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The study investigated the ACGME milestone 1.0 for the entire population of U.S. anesthesiology residents from 2015 to 2019. Descriptive analysis and longitudinal analysis were adopted to examine the residents’ training outcomes and learning trajectories at both population and individual levels. Findings reveal that a third of anesthesiology residents did not reach Level 4 for at least one of the 25 sub-competencies upon graduation, which is higher compared to other subspecialties. SLS in Anesthesiology milestone evaluations was more prevalent than in Anesthesiology compared to other subspecialty such as Emergency medicine. The three-level mixed-effect model suggests that the programs themselves explained the majority of between-resident variabilities in the baseline milestone performances (68-84%) and the growth rate (60-92%).