Forensic Psychiatry Milestones: Experience After 1 Year

• Published in: Academic psychiatry Vol. 41; no. 6; pp. 789 - 792
• Main Authors: Stolar, Andrea, Candilis, Philip J., Frierson, Richard L., Edgar, Laura
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-12-2017; Springer Nature B.V
• Subjects: Accreditation; Accreditation - organization & administration; Accreditation - standards; Clinical Competence - standards; Core curriculum; Curriculum - standards; Directors; Education, Medical, Graduate - standards; Fellowships; Fellowships and Scholarships; Forensic psychiatry; Forensic Psychiatry - education; Graduate Medical Education; Humans; In Brief Report; Internship and Residency; Medical Education; Medicine; Medicine & Public Health; Outcomes of Education; Psychiatry; Questionnaires; Scholarships & fellowships; Surveys and Questionnaires; Training; United States; Evaluation; Subspecialty; Forensic Psychiatry; Residents
• ISSN: 1042-9670; 1545-7230
• DOI: 10.1007/s40596-017-0739-8

Objective
In 1999, the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties identified six core competencies for medical practice. In 2013, the milestones were introduced to demonstrate these educational outcomes across each specialty. This study represents the first examination of the sub-specialty Forensic Psychiatry Milestones.
Methods
Members of the Association of Directors of Forensic Psychiatry Fellowships were surveyed. Areas of inquiry included whether milestones assisted in identifying areas of deficiency in fellows or programs, whether the graduation milestones matched the goals of training, and what changes were planned, or had been made, based on their implementation.
Results
Twenty-six of 35 programs responded, for a response rate of 74%. The majority found the milestones somewhat or very useful, half found the graduation-level milestones matched the program’s graduation goals, and a significant majority reported that the milestones assisted in identifying improvements, change, or intended change. In choosing terms to describe the milestones, however respondents chose a variety of negative or neutral terms, rather than positive ones.
Conclusions
The milestones provided a standard mechanism for identifying areas for improvement and a common language to standardize practice. However, due to the variability across fellowship programs and the limitations of educational resources and time, implementation of the new ACGME requirement was characterized in largely negative terms. Recommendations for improvement included modification of the milestones themselves, flexibility in their implementation, and evidentiary support for their use.