The Committee on Certification, despite several years of genuine effort, has failed to increase the quality of applications; today the approval rate for certification application still does not approach board certification rates in other medical specialties (see TAP 27/1). The approval rate for first-time applicants in December 1993 was 36% (8 of 22) in comparison to 45% in May 1993, 43% in December 1992, 61% in May 1992, and 62% in December 1991. That fourteen first-time applicants were deferred last December suggests a substantial risk that they and others like them will become disaffected from The American, from local psychoanalytic organizations, and from psychoanalysis itself.
While standards for certification are generally regarded as necessary and important, the havoc wreaked among developing analysts seems unacceptable; it certainly damages our profession. The fact that in December 64% of the graduates of our institutes who mobilized themselves to apply could not demonstrate analytic competence in written case reports suggests a need to reassess both our conception of analytic competence and our procedures for assessing it, as in each instance a local assessment had found the candidate qualified to graduate.
The best way to create a fresh look is by providing new faces on the Certification Committee. I repeat my earlier suggestion that representatives to the committee be elected by institutes. This democratic process would allow a more faithful representation of the current diversity of psychoanalytic viewpoints than does our current method, whereby committee members are appointed by the chairs of the Board on Professional Standards and the Certification Committee.
A new look at the problems, by analysts diverse in orientation and unencumbered by commitment to prior conceptions and methods, should yield novel and effective approaches that might allow the committee, in the words of J. C. Jacobson, to “perform its functions humanely, fairly, and with optimal balance, … providing authoritative assurance of a level of competence in certified analysts, but without constricting or stultifying the creative clinical and theoretical ferment we enjoy among the diverse points of view we currently include in psychoanalysis.”
Joseph Schachter, M.D.
Chair, Committee on Certification Pittsburgh