Lessons from the Launch: Program Directors Reflect on Implementing the Child and Adolescent Psychiatry Milestones

Prior to the formal July 2014 implementation, there were publications describing the purpose and intent of the Psychiatry Milestones Project, the development process, potential evaluation tools and techniques to assess milestone acquisition, and a resident perspective on the potential utility of milestones [3–5]. Since implementation of the milestones, some educators have raised concerns about whether the shift to milestone-based assessments was premature. Though some fellowship program directors (PDs) may have initially consulted with their core general psychiatry PDs in the initial milestones implementation, the usefulness of this collaboration may have been limited due to the distinct nature and shorter duration of psychiatric sub-specialty training. [...]it is especially useful for CAP PDs to gain insight on milestone implementation from other fellowships of shorter duration. The entire P5 membership reconvened in person during the 2015 American Association of Directors of Psychiatric Residency Training (AADPRT) Annual Meeting to discuss the subgroup’s progress. Programs that provided less formal training on the CAP milestones reported that faculty were more often frustrated with the length of the assessment forms and confused about the rationale for change in the evaluation process and appropriate ratings on milestone-based assessment forms, and more likely to assess fellows higher than expected based on the milestone descriptions. Conduct training with faculty about milestone-based evaluations during regularly scheduled institutional events (e.g., faculty retreats, division meetings, faculty development trainings, or annual program evaluation meetings) to maximize attendance.