Furthermore, all of that is happening as the bedrock of residency training, the federal graduate medical education funding that pays our salaries, is under threat. Tracking outcomes through the Milestones will help our institutions make the case for continued funding. Still, if the cuts happen, we may need to rethink psychiatric residency itself. If we can track residents’ competency, does everyone need to spend four years in training? For that matter, since the PGY-4 year is mainly electives, should we have it at all? There is no formal proposal on the table, but it has been studied and argued, and it might be again.