The Accreditation Council for Graduate Medical Education (ACGME) advanced Competency-Based Medical Education (CBME) in 1999 by developing six core competencies that all graduate medical trainees in the United States must demonstrate for graduation to autonomous practice. Milestones for anesthesiology were published in 2014 to help guide progress through competencies, but programs often find these challenging to implement. In response, a set of core case-based entrustable professional activities (EPAs) and procedural assessments was developed. However, the EPAs didn't cover all ACGME Milestones. The aim of this study was to develop a set of additional ad-hoc assessments that, when combined with the 20 core EPAs and procedural assessments previously described, resulted in programmatic assessment that informs the majority of anesthesiology milestones and grants entrustment to trainees in all sub-competencies.