We are a deeply divided organization. Although we are past the vote on the “local option” bylaw amendment and have learned the recommendations of the Task Force on Reorganization (TFoR), we remain unsettled. The proposed bylaw allowing institutes the option of opting out of the certification requirement for training and/or supervising analyst (T/SA) appointments and preventing the Board on Professional Standards (BOPS) from using certification as a requirement for T/SA appointments was not adopted. Yet a significant majority of our members supported the change. The divisions in our organization remain and will not go away easily. So, where do we go from here? Where can we go from here?
The efforts by the Certification Research and Development Advisory Committee (CARD) to assess and improve our certification procedure are known widely and are well underway. Still, the efforts of BOPS in this regard are unlikely to satisfy critics of certification. The affect associated with the criticism goes beyond arguments about reliability and validity. The fact is that many have felt injured by our certification procedure, by other decisions of BOPS, and/or by decisions within an institute regulated by BOPS. Such injuries can lead to the conviction that our educational system is deeply flawed. Regardless, BOPS, as obligated by our bylaws, does its best to do a creditable job with its public interest tasks (standard setting, accreditation, and certification) in a difficult political environment. We can and should do better. We can start by asking, is our system fundamentally flawed? What would be best for our Association and, more importantly, for the public and for our profession? Should all educational public interest regulation procedures of our component institutes and graduate members take place within our Association? Many on all sides of our Association's political spectrum believe they should be conducted by a body or bodies external to our organization.
The tradition of the Association has been to delegate educational public interest regulatory functions to BOPS. The resentment of the authority granted to BOPS through our bylaws has contributed to the chasms in our Association. Unfortunately, injustices have occurred in our Association at least in part due to decisions of BOPS. No one likes injustice and those performing regulatory tasks in the public's good are obligated to try to prevent injustice of any kind. Although BOPS has continually tried to meet its obligations in a thoughtful, deliberative, and scientifically sound and fair way, it has become a political target. Things are unlikely to improve for the Association, BOPS, and the public interest functions unless significant changes are made.
The psychoanalytic world is larger than our Association, and our Association is larger than those who identify with our institutes. Tensions inevitably arise. Standard setting, accrediting, and certifying bodies require functional independence to work effectively in the public's interest. This is what our current bylaws intended to accomplish. Although our current bylaws have checks and balances and a separation of powers to manage inevitable organizational tension, reorganization is necessary because our bylaws are out of compliance with New York State law. Change is also necessary because our members want it. If the public interest functions of BOPS are to continue, we need to ask whether the public and the profession are best served by having these functions within our organization.
Things are unlikely to improve for the Association, BOPS, and the public interest functions unless significant changes are made.
For our Association, this is a basic issue. We need to give serious thought to our structure, mission, and the proper place for the public interest functions. The Task Force on Reorganization has recommended that we form a successor to BOPS, a Council of Institutes that would be structured as a subsidiary corporation. The subsidiary corporation for education will only be feasible if the membership supports its formation. Many on the TFoR, in the membership, and on the Executive Council do not. The idea of a subsidiary corporation is anathema to many for a variety of reasons. In 2003, the Ad Hoc Committee to Study Certification recommended, among other things, the complete externalization of certification. The TFoR's recommendation for a subsidiary corporation is a compromise that would keep these functions within the organization while also preserving some autonomy in the setting of educational standards, for the accreditation of institutes, and for the certification of graduates.
In the Fall/Winter 2004 issue of TAP, I urged the membership to accept a subsidiary corporation for the educational regulatory functions of BOPS as an evolutionary step (TAP Vol. 38, No.4, p. 5). As events have unfolded I have developed concerns that the subsidiary model may be flawed for two reasons: It may institutionalize one of the many splits in our Association, membership functions versus educational functions, and it does not accomplish what is needed—real independence for the public interest functions.
The time for change has arrived; we cannot have it both ways.
Standard setting, accrediting, and certifying bodies must be autonomous to have integrity.
Eric J. Nuetzel, M.D., is chair of the Board on Professional Standards.
As I think we all know, their decisions may not be popular. As attached as many of our members are to the public interest functions of BOPS, these functions should be outside the Association. Whether and how this can be accomplished is another matter. What is clear is that we cannot continue with a system designed over 50 years ago for a vastly different psychoanalytic landscape. Clearly, the psychoanalytic world is changing, and the Association needs to change with it. Institute representation and supportive educational functions of BOPS should continue to reside within the Association in some way, shape, or form. Education is our membership's number one priority. The public interest functions of educational standard setting, institute accreditation, and graduate certification need to reside elsewhere, outside of the Association. It is time to recognize that the public interest and the good of the profession demand change. So does the educational atmosphere within our own institutes. BOPS will safeguard its public interest functions as we work out a way to assure their survival in an external form. Meanwhile, BOPS cannot remain static.
One of the most unfortunate aspects of the conflicts and tensions within our Association is the polarization and resultant rigidity on all sides. This creates an environment in which creative thinking about improving education, including the public interest functions of BOPS, is in short supply. The atmosphere in our Association is not helping us improve the education of our candidates. As we move through this transition, I urge us to remember that safeguarding and improving candidate education is the fundamental concern of BOPS.