At the January 2012 meeting of the APsaA Board on Professional Standards, the fellows to the Board voted unanimously to externalize certification. This significant action is a critical first step in rectifying a long-standing problem within APsaA, one that has been at the epicenter of controversy for close to 60 years. By now we are all painfully aware of the perils of having professional regulatory functions embedded within a membership organization. Numerous recommendations have focused on rectifying this situation.
The BOPS leadership will immediately appoint a task force to recommend the most professionally and economically feasible plan to externalize the function of certifying psychoanalysts. This challenging task will be made easier by the thoughtful and carefully detailed 2008 Report on Externalization produced by a Council appointed joint task force. Since that time, the Accreditation Council for Psychoanalytic Education (ACPE) has evolved to become a recognized independent accrediting body for all psychoanalytic institutes, not just our own. To date, six of our institutes have applied for ACPE accreditation and BOPS is encouraging all our training facilities to eventually do the same. The benefits of ACPE accreditation have been outlined in previous TAP articles and will continue to be a focus for many years to come. The important point for our current task force is that now we have only to think through the many complexities of externalizing certification, a more manageable task.
A much greater challenge will be to restructure the meaning and place of certification in the mindset of our members. Some of our newer members may not know that at one time certification was a requirement for full membership in APsaA. More recently, it has been linked to training and supervising analyst appointments. In this context, some experience it as a status symbol, and others as another annoying hoop to jump through. These characterizations and experiences have to do with our relationships with each other; this kind of internal preoccupation has crippled our organization and distanced us from other professional organizations.
We believe that certification is essentially about our professional relationship to the public and to other health care professions. From this perspective we believe that virtually all our graduates can and should be certified in psychoanalysis, especially those who plan to develop a clinical practice in psychoanalysis. For other professions becoming certified is a necessary step in one's professional development and a reliable credential for the public when choosing a professional. We hope that the anticipated changes in certification will help bring us into alignment with other professions and turn our attention to the outside world and our place in it.
To this end, we have asked Harvey Schwartz, the chair of the Certification Examination Committee (CEC), to share his thoughts about certification, particularly his findings regarding our certification process compared to those of other health care professions. His comments below also include comments from recently certified APsaA members.
While some physicians may think of board certification as just another complicated hoop they have to jump through in order to practice their craft, it can also be seen as a valuable way to demonstrate your commitment to the highest quality care, and to receive recognition for the many long years of work you have put into achieving expertise.
American Board of Orthopedic Surgery
Evaluation by one's peers is an aspect of all professions. All professions involve completing an educational program and then being evaluated by a national body of colleagues. Accountants, architects, engineers, and, as the above quote indicates, orthopedic surgeons, like all medical specialties, have a board certification process. Psychoanalysts do too, though we tend to talk more about it. Being board certified in any specialty does not conflict with, compete with, or diminish one's prior educational training. It is a final capstone to one's identity as a professional. One need not be a physician, of course, to appreciate the essential professionalism of being a psychoanalyst.
Colleen L. Carney, Ph.D., is chair of the Board on Professional Standards, and Lee I. Ascherman, M.D., is secretary.
Harvey Schwartz, M.D., is chair of APsaA's Certification Examination Committee.
I felt that the interviewers' questions were thoughtful and constructive. I felt that in our ongoing discussion of the analysis of the adolescent youngster, we came to an agreed-upon understanding of what was achieved in the analysis and what was not. It was done in the spirit of collegiality. It was quite validating to have that experience.
Anonymous
post-interview comments from a recent certification applicant
Some 15 of 24 medical specialties include oral examinations as part of their board certification procedures. Many of their examinations are quite similar to our own—applicants are asked to bring in their cases and discuss them with volunteer colleagues. Like us, the applicants have been given a set of guidelines and are expected to demonstrate core competencies in their specialty. Like us, subjectivity is an aspect of the evaluation. We on the CEC now involve researchers in our examination procedures in order to minimize the idiosyncratic aspects of our subjectivity. Experienced researchers sit in on our deliberations and on the interviews themselves. Soon, their research will assist us in better focusing our evaluations on the essential psychoanalytic skill sets.
I actually enjoyed the chance to speak at length about my two cases with both of my interviewers. I was surprised that the format was very open, giving me the opportunity to highlight what I thought was important. The interviewers were really facilitators. It was surprisingly pleasant.
Respectful interactions between applicant and interviewer are essential both to honor our professionalism and collegiality and to conduct an in-depth interview. This essential requirement has not always been met in past years. The CEC is committed to monitoring and evaluating the interview process to ensure that despite being stressful these encounters reflect our regard for our colleagues.
I found both interviews to be conducted with the utmost respect. There was genuine interest in my cases and my development as an analytic thinker. Through both interviews this was a constant experience. Though I was disappointed in June, being able to return six months later and present the progression in both cases and my analytic development seemed more valuable than had I just been passed first round. Being “continued” and having been asked to think about the analyzability of my patients, provided me with an opportunity to think deeply about the import of my analytic work, to conceptualize it, and to believe in its value deeply… I would like to say that I found the process of writing up my cases, presenting and studying process notes in depth prior to the interview to be an excellent learning experience and of great value to me both times.
The pass rate of the American Psychoanalytic Association's Board Certification Examination is comparable to other specialties and professional certifying examinations; it is higher than CPAs' and lower than cardiac electrophysiologists.' The rigor with which we maintain the anonymity of our applicants during the evaluation process is something other boards can learn from us. That their boards are external to their membership organizations is something we can learn from them.