This article introduced the preliminary outcomes of three approaches adopted for CBME implementation in the field of Anesthesiology in Taiwan. First, a three-round Delphi national survey has been carried out for shaping consensus and developing a local version of Milestone indicators. Second, a simplified, cloud-based milestone has been merged to anesthetic work shift. Third, all 25 Anesthesiology subcompetencies have been deliberately covered by 6 EPAs for evaluating an anesthesiologist’s clinical competence. The aforementioned three contextually derived strategies aim at minimizing resistance to change, ensuring quality of resident training and patient safety.