In recent months, the American has renewed its focus on the relationship between certification and membership. There has been a growing discussion of those aspects of the de-linkage compromise of the early 1990s that grant to certified members the rights of voting on by-law amendments, serving on the Executive Council, serving as officers elected by the general membership, and serving as a Fellow or officer of the Board on Professional Standards (BOPS).
From the perspective that the American Psychoanalytic Association is a membership organization, it is appropriate that all individuals who qualify for membership have full membership rights. The present situation of restricted membership rights for non-certified members leads to feelings of second-class status among some members, and the organization fails to benefit from some of their talents. This situation needs to be addressed.
The American is a professional and educational organization. It charges BOPS with the responsibility of establishing and monitoring standards for the profession and for its educational programs. From this perspective, it is problematic if all members automatically qualify for all membership rights. The membership rights in question are those that relate to the governance of the Association's educational and professional functions. These rights should be limited to members who have met the appropriate educational and professional requirements established by BOPS. The difficulty in resolving the issue of the relationship between membership and certification exemplifies the long-standing challenge of coordinating the aims of a hybrid membership, professional, and educational organization.
In order to fulfill our Association's professional and educational commitment, BOPS must have legitimacy for us and for the outside world. Such legitimacy requires that the Board's integrity be protected both in reality and in perception. BOPS must function in a way that minimizes conflicts of interest and maximizes academic freedom. As is the case with an educational board in any profession, qualifications must be established that specify which members of the profession are qualified to participate in and govern that board. Certification is quite possibly the best qualification that we currently possess.
How might changes in the linkage of certification and membership rights affect the governance of BOPS? Clearly, those who vote on by-laws have a governance relationship with BOPS. In our current organizational structure, those who are Executive Councilors or officers of the APsaA elected by our general membership also have a governance relationship with BOPS. For example, the budget of BOPS is determined by the Executive Council, with much input from the Executive Committee. This budgetary process demonstrates how a general membership function influences BOPS' autonomous functioning and academic freedom, since the power of the purse potentially overrides — at the very least indirectly influences — BOPS policy.
The complexity of the governance situation is such that changes in the relationship between certification and membership must be integrated with modifications in our internal governance. It may be necessary to modify the relationship between members, Executive Council, Executive Committee, and BOPS. This task also offers us an opportunity to address a number of existing structural problems. This can only improve the general functioning of our Association.
As we look for ways to protect and preserve the integrity of our BOPS, we should not lose sight of the value of maintaining BOPS “within” the membership organization. Board and Council would be enormously impoverished without the mutual input and influence derived from our form of co-existence. I addressed this issue in a recent TAP interview: “Because of our interrelationship, we cannot ever lose sight of our educational needs: The organization stays anchored in what it believes, as transmitted by what it teaches. Also, having an integrated organization is valuable for BOPS. BOPS's evolution into a responsive and flexible body with more questions than answers has been profoundly influenced by the Association's membership dimension.”
The issue of certification and membership must be approached in a broad and sophisticated way for other reasons as well. For example, suggested changes that appear to achieve egalitarian membership status in some ways may actually create a two-tiered system in other, perhaps more problematic, ways. One option currently being considered is eliminating the requirement that Executive Councilors and officers be certified but retaining that requirement for serving as a BOPS Fellow. Could such a situation undo the progress that has been made in equalizing the two bodies' sense of pride? Perceived inequality leads to politicization and divisiveness.
I, like many others, am uncomfortable with the inequities of the current “de-linkage compromise.” I believe that we need to find a better solution than our current one. However, it would be a grievous error to approach this issue on the basis of a simplistic egalitarianism that did not take into account the complexity of our missions and our obligations.
I have appointed a new ad hoc BOPS Committee on Structure and Function, chaired by Mort Reiser, to study and present a substantial preliminary report in December 1999 and a final report in May 2000. The committee will particularly study the modifications that may be necessary to preserve and enhance BOPS's ability to fulfill the charge that the organization has given to it. We will work closely with Council and its committees to achieve a balanced solution.
Certification in any professional field is a difficult enterprise. The objections about the relevance of our certification to “actual” competency are undoubtedly raised in other fields: law, internal medicine, psychiatry. Yet, despite the difficulty in demonstrating a clear relationship between certification and career-long competency, certification is a generally accepted procedure for a profession to establish. All professions assume that their certification measures something meaningful, however inexactly or imperfectly. I believe that our certification, which examines data closer to actual practice than do many other professions, can comfortably assume as much.
Some members do not see the relevance of certification for their professional careers.
It is up to all of us, starting at the leadership level, to advocate the necessity and value of certification and find ways to make it more relevant to our members and to our patients. Some members feel that certification is too difficult or hurtful. This position affects levels of affiliation with the national organization. It is up to us to continue to develop the certification process so as to provide a collegial experience for our members.
However important it is to do what we can to protect the feelings of our members, and to grow in numbers while developing our members' organizational involvement, we have a more basic obligation to provide for the public a good-faith verification of the competency of practitioners who are members of the American Psychoanalytic Association.
Of course, there are real questions about certification that need to be studied; for example, reliability. If legitimate concerns about possible limitations in the certification process are misconstrued or rationalized and become a cause for challenging the very existence of a certification process, we will, I fear, have distinguished ourselves among the professions only to the extent of our self-servingness. We will have transformed ourselves into little more than a guild, relinquishing our tradition of serving the public by maintaining educational and professional standards and by making scientific advances.
I am confident that despite the economic and cultural pressures on us, we will not support such a short-sighted approach. I believe that as in the past, we will rise to the best within us. It is our obligation to the public — our patients — to provide certification for analysts in our Association. We will continue with our task of figuring out the most accurate and fair certification procedure because it is the right, although not the easiest, path to follow.