Perspective The Milestones for Psychosomatic Medicine Subspecialty Training Robert J. Boland, M.D., Madeleine Becker, M.D., James L. Levenson, M.D., Mark Servis, M.D., Catherine C. Crone, M.D., Laura Edgar, Ed.D., C.A.E., Christopher R. Thomas, M.D. Background: The Accreditation Council of Graduate Medical Education Milestones project is a key element in the Next Accreditation System for graduate medical education. On completing the general psychiatry mile- stones in 2013, the Accreditation Council of Graduate Medical Education began the process of creating milestones for the accredited psychiatric subspecialties. Methods: With consultation from the Academy of Psychosomatic Medicine, the Accreditation Council of Graduate Medical Education appointed a working group to create the psychosomatic medicine milestones, using the general psychiatry milestones as a starting point. Results: This article represents a record of the work of this committee. It describes the history and rationale behind the milestones, the development process used by the working group, and the implications of these milestones on psychosomatic medicine fellow- ship training. Conclusions: The milestones, as presented in this article, will have an important influence on psychosomatic medicine training programs. The implications of these include changes in how fellowship programs will be reviewed and accredited by the Accreditation Council of Graduate Medical Education and changes in the process of assessment and feedback for fellows. (Psychosomatics 2015; 56:153 –167) INTRODUCTION The Accreditation Council of Graduate Medical Education (ACGME) milestones project is a key element in the Next Accreditation System for graduate medical education. 1 The ACGME completed the general psychiatry milestones in 2013, which were implemented in July 2014. The ACGME then turned its attention to creating milestones for the accredited subspecialties. This article describes the history and rationale behind the milestones, the development process for the psychosomatic medicine (PM) mile- stones, and their implications on fellowship training. HISTORY AND RATIONALE FOR THE NEXT ACCREDITATION SYSTEM The Next Accreditation System was part of the Out- comes Project for graduate medical education, 2 begun in 1997, which was developed to address concerns raised by the Institute of Medicine and other organ- izations regarding the quality of graduate medical education in the United States, particularly how training outcomes were measured. 3 The intention of the project was to improve how programs evaluate residents, how curricula are developed and, ultimately, Received October 12, 2014; revised November 6, 2014; accepted November 6, 2014. From Department of Psychiatry, Brigham and Women’ s Hospital and Harvard Medical School, Boston, MA (RJB); Thomas Jefferson University, Philadelphia, PA (MB); Virginia Com- monwealth University, Richmond, VA (JLL); University of California, Davis, Davis, CA (MS); George Washington University, Washington, DC (CCC); Accreditation Council for Graduate Medical Education, Chicago, IL (LE); University of Texas Medical Branch at Galveston, Galveston, TX (CRT). Send correspondence and reprint requests to Robert J. Boland, M.D., Department of Psychiatry, Brigham and Women’ s Hospital, 75 Francis Street, Boston, MA 02115; e-mail: rjboland@partners.org & 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved. Psychosomatics 2015:56:153–167 & 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved. Psychosomatics 56:2, March/April 2015 www.psychosomaticsjournal.org 153