Commentary: developmental stages of forensic psychiatry fellowship training--from theoretical underpinnings to assessment outcomes.

Dr. Pinals' paper provides an excellent foundation for studying the developmental process of forensic psychiatry fellows during their training year. She proposes three stages: (1) transformation, (2) growth of confidence and adaptation, and (3) identification and realization. This commentary compares Dr. Pinals' proposed developmental stages to Margaret Mahler's theory of infant development and to Dr. Lev Vygotsky's social learning theory. Assessment methods to evaluate core competencies suggested by the American Council on Graduate Medical Education (ACGME) and American Board of Medical Specialties (ABMS) are reviewed. A potential survey of forensic psychiatry fellowship program directors to validate Dr. Pinals' proposed developmental model is described.