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The New Milestones: Do We Need to Take a Step Back to Go a Mile Forward?

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Abstract

The Milestones Project, like all previous systems and changes in graduate psychiatric education, for example, moving from 3 to 4 years of training or adopting six competency domains, has been devised without any supporting data and does not assess meaningful outcomes, such as improved patient outcomes. No evidence is presented that Milestones-based training will produce better psychiatrists. There is a path forward. First, replace unproven expert consensus with scientific and evidence-based approaches. Second, exchange endpoints that are easy to assess but uncorrelated with real world functioning (e.g., multiple-choice examinations) for outcomes that are meaningful and external to the training program (e.g., patient outcomes). Finally, to prevent possible waste, excess burden, or harm, no changes should be mandated until proven in prospective studies.

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Disclosure

Dr. Dewan has received a grant funded by the Health Resources and Services Administration (HRSA) and receives royalties from American Psychiatric Press, Inc.; John Wiley; and Taylor & Francis Group, LLC. He serves as a consultant to Streufert Consulting, LLC.

Dr. Satish has received grants funded by Syracuse University/Center of Excellence/EPA and serves as a consultant to Streufert Consulting, LLC.

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Authors and Affiliations

  1. Upstate Medical University, Syracuse, NY, USA

    Mantosh Dewan, John Manring & Usha Satish

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  1. Mantosh Dewan
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  2. John Manring
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  3. Usha Satish
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Correspondence to Mantosh Dewan.

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Dewan, M., Manring, J. & Satish, U. The New Milestones: Do We Need to Take a Step Back to Go a Mile Forward?. Acad Psychiatry 39, 147–150 (2015). https://doi.org/10.1007/s40596-014-0213-9

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  • DOI: https://doi.org/10.1007/s40596-014-0213-9

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