Abstract Introduction All specialties in medicine will be transitioning to a new accreditation system in 2013. This new system will replace one that utilized six core competencies, which included professionalism, medical knowledge, practice-based learning, systems-based practice, interpersonal and communication skills, and patient care. This new system of milestones is predicated on “observable developmental steps moving from beginning resident to the expected level of proficiency at graduation from residency, ultimately, the level of expert/master.” This system, in theory, is more objective than the old system, and thus presents academic faculty with the difficulty of how to assess the resident in terms of these milestones. The ACGME has provided suggestions for this, ranging from standardized direct observation tools (SDOTS), to simulation sessions, to checklists. However, there is no literature describing the best methodology for assessment, and thus programs are left to determine the means that would work for that specific program. Methods Within emergency medicine, the first category in the new Emergency Medicine milestone system is “Emergency Stabilization.” Due to the substantive nature of this milestone (basically taking the just-graduated medical student and making them an “expert/master”) this module focuses on the first level of this milestone: recognition of abnormal vital signs. This is done through a self-guided slide presentation, yet can be easily modified for a small group setting. This level encompasses how the learner assesses a critically ill or injured patient and how they recognize abnormal vital signs. Given the fact that this level is clearly focused on the beginner in perhaps the most difficult aspect of the specialty, this module was developed to satisfy the needs of the beginner, an early medical student (first- and second-year), or students on clinical rotations. It may also serve as a refresher for interns. Results This module has been successfully used with third- and fourth-year medical students and emergency medicine residents. Evidence of the modules effectiveness include the fact that this module is required reading for all new residents to our department, and soon will be required for all medical students. Plans for expansion include coverage of treatment for temperature-related disorders. This module is also the first in a series of vital sign modules. Discussion This module successfully prepares beginner medical students, and medical students on clinical rotations, to be able to assesses a critically ill or injured patient and recognize abnormal vital signs, thus achieving the first level of the first milestone in the Emergency Medicine Milestone Project, “Emergency Stabilization.”