The Certification Club is pleased with the attention TAP (27/1) has given to issues of certification. The Certification Committee has made significant strides toward smoothing the certification process, and of late we hear fewer “war stories” from applicants. We appreciate the committee's immediate feedback to applicants, and find helpful its detailed document delineating the requirements for satisfactory case write-ups. The committee has also discontinued contacting applicants' institutes, thus ridding the process of possible complications.
However, this June I received The American's current application material for certification and was disheartened to find that it still includes, unmodified, the “Application for Certification in Psychoanalysis” against which we have campaigned since 1990.
Often we are asked what evidence we have that there are problems with the certification process. While we do have individuals' accounts, we cannot explore trends in a systematic way, since we lack cumulative data. One trend seems to be toward the reversal of negative decisions when the Certification Committee learns of an applicant's recent professional accomplishments. However, our strongest evidence of a problem is the committee's continuing reliance on the Application. Why include it unless it is needed? And if it is needed, the often repeated remark by the committee, “We have nothing to go on except what you tell us in your reports,” would seem significantly inaccurate.
To review this document once again: The applicant must provide the following data: institute, date of graduation, name, sex, address, place and date of birth, marital status, Social Security number, medical or other graduate school, year of graduation. The applicant must report all postdoctoral training and other professional experience (such as military), licenses, specialty boards, and the dates of affiliate and associate membership in The American. He or she must list all teaching and clinical positions held, with dates, all institutes attended, and all personal analyses, giving the analysts' names, the frequency of sessions in each year, total hours with each analyst, and indicating which of these have been credited toward training. The number of hours in course work, etc. must be tallied, along with hours of supervision. Finally the applicant is instructed, “Please describe on this page your current professional activities and affiliation. Give approximate number of weekly hours devoted to psychoanalysis (number of hours and number of patients), other therapy, teaching, research, other professional work. Include postgraduate psychoanalytic education.”
The form concludes by requiring the applicant's signature to the statement, “I hereby certify that to the best of my knowledge the information contained in this application is correct and that to my knowledge there have never been any professional ethical charges against me. (Please amplify if necessary.)” It seems implied that withholding any data is unethical. For our part, we question the propriety of requiring any of this potentially biasing material. It casts a pall over the application process, as if one were applying for membership in an exclusive club, rather than applying to have one's work simply and seriously evaluated.
The Certification Club will continue to work for improvements in the certification process. Although we were generally pleased with the report by Drs. Buie and Peltz, we found the closing statement by Arthur Rosenbaum, chair of the Certification Committee, to be troubling: “Recommendations presented for the committee's consideration include the anonymity of applications and the use of personal interviews with all applicants. The committee is not yet ready to make a recommendation regarding these suggestions, though gender anonymity would for many reasons seem an impossible goal. Interviews for all and anonymity are mutually exclusive.”
Despite the initial plausibility of this last assertion, it takes only a little reflection to dispel the appearance of their mutual exclusivity. It would be a simple matter to have someone on the Central Office staff assign an application number to each set of cases from a given applicant. Any attempt by a Certification Committee member to tamper with the anonymity process would be forbidden. Applicants could be asked whether they request an interview or wish to defer this option. For those opting for an interview at the time of the committee's decision, the staff member could designate two or three committee members from a geographic area other than the applicant's. At the interview they would ask the applicant's number rather than name. If one of them were to know the applicant, that committee member would so indicate, and a back-up member could be called in.
Ann-Louise S. Silver, M.D.
Columbia, MD