Board Moves to Redefine Fellowship Criteria

The APA Board of Trustees voted last month to redefine in principle the categories and criteria for APA fellowship status in an effort to extend fellowship designations to more and to younger members.

The new two-tiered fellowship plan, if the Trustees approve an amendment to the APA Bylaws at a meeting later this year, would have categories for members to become fellows and distinguished fellows. These changes are expected to take effect in January 2002.

Under the proposal, all current fellows would be shifted to the distinguished fellow category. The existing category of distinguished fellow, which is reserved primarily for nonpsychiatrists and psychiatrists who are not APA members, would be renamed honorary fellow.

The criteria to become a fellow would be five consecutive years as an APA member; certification by the American Board of Psychiatry and Neurology, Canada’s Royal College of Physicians and Surgeons, or the American Osteopathic Association; three letters of recommendation from APA fellows; and a 90-day period in which district branches can comment on the fellowship candidates.

Candidates for the category of distinguished fellow would have to meet the more comprehensive criteria, including significant achievement in several areas of psychiatry, that APA currently requires for fellowship designation. In the future, candidates seeking distinguished fellow status would not need to be APA fellows first.

An amendment to accomplish this change in fellowship standards and categories appeared on the 1999 APA election ballot. Since it would have mandated a change to the APA Constitution, passage required that one-third of eligible voters cast ballots on the amendment and that two-thirds of those voters cast a favorable vote. While the first criterion was met, the number of members voting in favor of the amendment fell short of the two-thirds required for passage by only a few votes. APA’s new bylaws, which went into effect this past January when the members transferred into a 501(c)(6) organization now known as APA, allow the Board to amend the bylaws, provided two-thirds of the voting members of the Board present at a meeting at which a quorum is present vote in favor of the change. APA’s voting members may repeal bylaws changes approved by the Board by submitting a petition signed by 200 voting members. The amendment would then go on the next annual ballot. Through the petition process, voting members may also propose additional bylaws, as they did under the old bylaws.

The Trustees also took these actions at their March meeting:

• Established the Committee on the Prevention of Mental Disorders and the Promotion of Mental Health. Included in the committee’s charge is a review of scientific literature and government-sponsored reports on prevention, assessment of the status of prevention research, and “identifying and encouraging” prevention-related activities.

• Renewed the contract of Nancy Andreasen, M.D., for another five-year term as editor of the American Journal of Psychiatry.

• Approved a position statement on the care of pregnant and newly delivered women addicts, which updates a 1991 position statement on this topic. The statement addresses the need for treatment for the multiple problems that these women and their offspring may suffer as a result of substance abuse and condemns the trend toward jailing instead of treating substance-abusing pregnant and postpartum women.

• Approved a position statement that says APA does not “discriminate against physicians based on their country of medical education. . .[and] strongly encourages all [APA] medical journals, electronic media, and Web sites not to accept advertising that discriminates against IMGs based solely on the country of their medical education.”

• Endorsed a document titled “Precepts of Palliative Care” developed by an organization called Last Acts. This document addresses the need to manage the “physical, psychological, social, spiritual, and existential needs of patients. . .with incurable, progressive illnesses.” The goal is to help patients maintain the best possible quality of life their illness will allow.

• Endorsed several statements and actions contained in a position statement from the organization Doctors Against Handgun Injury. Among these are that “consistent requirements” should be applied to the purchase of handguns by “persons at risk of harming themselves or others,” there should be more extensive background checks before handgun purchases can go through, and there should be support for “aggressive enforcement” of existing handgun laws.

• Changed the name of the APA Committee on Electroconvulsive Therapy to the Committee on Electroconvulsive and Other Electromagnetic Therapies. The change was to acknowledge that there are several treatments emerging that are based on electrical stimulation such as vagal nerve stimulation and transcranial magnetic stimulation.

• Approved in principle the formation of an APA political action committee (PAC), which is permitted under APA’s new 501(c)(6) tax status. In the past psychiatrists were able to contribute money to political candidates through the PAC of the independent Corporation for the Advancement of Psychiatry.

• Appropriated $5,000 to support an amicus curiae brief by the California Psychiatric Association in the case Joseph v. Rademan.This case involves issues of psychotherapist-patient privilege that arose during a state medical board investigation of psychiatrist Alan Rademan, M.D. Citing the need for patient consent, Rademan and two of his patients have refused to comply with a subpoena to turn over their treatment records to investigators looking into charges of excessive prescribing of controlled medication for the two patients.

The Board also heard reports from consultant Barbara Marx, who is working on a complete redesign of the APA Web site, and from Kathy Stein, finance director of American Psychiatric Publishing Inc., who indicated that APPI expects to take in about $22 million in gross revenues for 2001, almost equally divided between journals and books. ▪