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This is my last column as editor of the Residents' Forum. In this piece, I reflect on the experience of being the member-in-training trustee from a personal perspective. Writing these essays and editing those of my colleagues has been an opportunity and pleasure.
At the end of APA's 1997 annual meeting this month, Alisa Busch, M.D., a third-year resident at Johns Hopkins, will take over as member-in-training trustee. I have really enjoyed working with Dr. Busch this last year. She is energetic, thoughtful, very smart, and very kind. She will be a wonderful trustee and resident leader. Diana Dell, M.D., a second-year resident at the University of North Carolina, joins Dr. Busch as the Member-in-Training trustee-elect. As past president of the American Medical Women's Association, Dr. Dell brings tremendous experience to this position. I also have the privilege of knowing Dr. Dell, since she was an ob/gyn attending at Duke before deciding to train in psychiatry. I cannot think of two better people to serve on the Board.
Helen Egger, M.D.
By Helen Egger, M.D.
Member-in-Training Trustee
For the last two years I have served as the member-in-training trustee-elect and then trustee on APA's Board of Trustees. The experience has been a tremendous privilege and opportunity. I arrived at my first Board meeting inexperienced, somewhat intimidated, and eight-and-a-half-months pregnant. As a young woman still in training, new to the APA organization, and without a background in the workings of a board or of the political process, I wondered whether I could make a meaningful contribution. Through my tenure, I have learned that I and other young and "minority" APA members can and must play an active role in APA's leadership. Now, as my son nears his second birthday and I approach my final Board meeting, I wanted to share a few of my thoughts about the experience. 1. People matter. From the outside, APA can seem like a monolith. Its strength is the individuals who are involved. I have met many dedicated and thoughtful people in the last two years, but I have room to mention only a few. I will always be grateful to Jack McIntyre, who sat with me on a bus ride at my first meeting in Washington, D.C., and made me feel welcome. Mary Jane England, Carol Bernstein, Michelle Riba, Nada Stotland, Leah Dickstein, Carol Nadelson, and Deborah Zarin have guided me and explained how things worked. Fred Gottlieb, who really seemed interested in pictures of my children, was always willing to discuss issues in depth, with honesty.
I admire these and many other Board members and staff. I listened carefully to their words, using them as a beacon during times when I was struggling to figure out the context, subtext, and sub-sub-context of the Board meetings. While it may sound like a cliche, the people whom I have met will always remain the most important part of this experience.
2. It is hard to be a trustee and the mother of young children. As the mother of two young children, as well as a resident, I have found the time commitment of serving on the Board very challenging. Each person who becomes involved in the organization volunteers a significant amount of time and must make choices about priorities. I am in awe of the many and various hats that all of the Board members and staff wear, with a grace and success that I still have not mastered.
Some APA leaders have made efforts to acknowledge the needs of women who have young children and are serving on the Board. Since Mary Kay Smith, who preceded me as trustee, and I were both nursing mothers when we served on the Board, Mary Jane England arranged for APA to buy a breast pump for the central APA office: a small but important recognition of the logistics of our lives. We have talked about providing day care but have not yet been able to organize and fund it. Drs. England and Eist both warmly welcomed my children to social events after Board meetings.
I chose to bring my son to meetings with my husband or nanny when my son was still nursing or when the meeting lasted for more than three days. While doing so has been my choice, it has meant a significant extra expense for my family. And while it was awkward to bring my son with me, it also reflected the reality of my life: that while the meeting is going on, my children are waiting for me in a hotel room or at home, and that when the meeting is over, my energy needs to be devoted to them.
We all attempt to solve the problems created by the competing demands of work and family in different ways. For me, serving on the Board has been a privilege and a choice. It is important that those of us with family commitments, particularly women--who often assume a large part of providing care for their children--be present on the Board, in the Assembly, and on components. Our perspectives and experiences mirror those of many current APA members, particularly young members. They must feel that APA is reflective of and responsive to their professional and personal lives if they are going to continue to choose to be APA members.
I am grateful to all the women leaders who generously mentored me, but I must note that there are too few of them. Women on the Board, in the Assembly, and in other important areas of the organization remain a minority--a particularly unacceptable condition given their proportion of the total membership. I hope that the women who are active in APA will continue their involvement and that APA will continue to recruit, welcome, and value women leaders.
3. Streamlining the organization is essential. As a relative "outsider" to APA's workings, I feel that I have been able to observe the various committees, task forces, and other components without allegiance to the current structure. Specifically, I believe that the resident representation needs to be reviewed, unified, and rationalized. The resident representation is now diffusely spread through the three fellowship groups, the Committee of Residents and Fellows (CORF), the Assembly, and the member-in-training trustee and trustee-elect. There is no centralized staffing for these groups, nor is there a cohesive organizational structure for initiation and implementation of ideas. APA has welcomed the members-in-training (MIT's) into the organization, and having an MIT as a full voting member of the Board of Trustees is a concrete recognition of the importance of our views and leadership.
It is now our responsibility to contribute our ideas and actions and energy in the most effective, professional, and informed way that we can. Designating the MIT's and perhaps the early career psychiatrists as a separate component, with each of the resident groups as parts of the component, would help to focus and unite APA's resident representation. This would reduce "turf wars," foster collaboration, and clarify the relationship and responsibilities of the residents within APA. The Residents' Summit planned for the annual meeting in San Diego is a first and important step in this process (see page 13). Members of each of the MIT groups have worked to bring all residents together so that we can reevaluate our role in APA. We hope that the summit will begin the process of defining the central issues for residents and fellows and proposing ways to restructure the representation so that we can be as effective as possible.
4. The process matters. The voted decisions that come out of Board meetings are concrete, specific, and necessary for the organization to function. Choices are made and actions taken that affect the lives of our patients and our work. The progress of parity legislation is one example of APA's significant role in the national arena.
Just as important, I believe, is the process that leads to these results. Openness, collegiality, intellectual rigor, and empathy are core values to which APA needs to commit on both organizational and personal levels. In these difficult and divisive times, having that commitment is the best way that we can serve our patients and profession and reflect the needs and desires of the members of the organization. Judge William Bryant, a federal judge for more than 30 years and a wise mentor to my husband, says, "In the end, there are very few things that matter that much." Yet, without them, we are lost.
(Psychiatric News, May 16, 1997)