This program will describe the new Accreditation Council for Graduate Medical Education (ACGME) requirements under the next accreditation system (NAS), an outcomes-based system that transfusion medicine specialists working with residents must become familiar with. The proposed pathology milestones, by which residents will be evaluated and assigned progressive responsibility, will be discussed along with examples of how transfusion medicine activities can be used to fulfill these milestones and how residents can be evaluated for completing the milestones. Finally, the implementation and use of hemovigilance in one pathology training program as a means to improve patient safety and the quality of care while enhancing resident education and assessment of the residents in the pathology milestones will be discussed.