D.B. Dispatches

Two Views of Fellowship

By Craig W. Maumus, M.D.

APA will soon be sending the district branches the names of members who have been elevated to fellowship status. The process begins in the spring and ends in the late fall. It is APA’s way of singling out members who have made significant contributions to their profession and their Association.

According to APA guidelines, excellence, not mere competence, is the hallmark of a fellow. This is determined by a member scoring high in at least five of nine specified areas. In addition, the prospective fellow must have been a general member for at least eight years and must be proposed by at least three current fellows.

Recently two district branch newsletters featured articles on APA’s fellowship process, one favorable and one critical.

We begin with the critical article, which was titled "APA Fellowship Criteria are Exclusionary." It was written by Jack Dang, M.D., president of the Northern Chapter of the New Jersey Psychiatric Association, as a guest editorial in the summer issue of New Jersey Psychiatric News (Daniel M. Greenwald, M.D., editor; William M. Greenberg, M.D., acting editor).

"I continue to have a major problem with the way APA awards fellowships and restricts the district branches in their promoting members to become fellows," he writes. "I submit that if the APA guidelines were followed strictly, almost nobody would be eligible for APA fellowship. How can anybody be exceptionally superb in five or more- categories? Sigmund Freud, Nathan Kline, Marcus Welby, Superman, and many other high achievers would be excluded automatically. It would be easier to acquire sainthood than fellowship; you need to be the best in only one attribute to be a saint."

Comparing the criteria for APA fellowship with those of other specialty organizations, Dr. Dang points out, "After board certification, their qualifications are very simple and inclusionary. APA is different! Superior!" He believes that this difference is one reason other specialist physicians view psychiatrists as a breed apart rather than equals.

"The whole idea that you need three fellows to write concerning their personal and professional contacts with a potential nominee smacks of favoritism and nepotism," he insists. Dr. Dang suggests that this policy can be used as a way to exclude minorities and other ethnic groups from fellowship. He also takes exception to the requirement that prospective fellows must have demonstrated significant involvement in their district branch, believing this can be used as another exclusionary tactic. "An exceptional practitioner has no chance of becoming a fellow as he will probably not have time to get involved in the politics of APA."

To support his contention, Dr. Dang cites as examples a psychiatrist congressman and a research scientist, both of whom might be so wrapped up in their work that they would not qualify for fellowship, yet one might craft major health legislation, the other win the Nobel Prize. He maintains that being involved in community service and attending organization meetings are very time consuming and take valuable time away from earning a living.

Dr. Dang thinks there is a chance that the status quo will change in the future, but "rules have to be changed to keep membership; inclusion rather than exclusion has to become the norm rather than an exception."

A far more benevolent view of fellowship comes from Simon Epstein, M.D., editor of Connecticut Psychiatrist. He feels that APA has already made significant positive changes in its fellowship process. Writing in his editor’s column in the summer 1997 issue of that publication, Dr. Epstein notes, "It was not always this way. In the early 1980’s we had mammoth battles with APA, which chose to reject most applications from all district branches. They seemed to judge applications on a whim and paid little attention to our concerns. At one point we almost joined with the Westchester DB to revolt and issue our own recognition awards. Gradually APA began to see the light and developed reasonably clear standards." He notes that his district branch now has a good working relationship with APA on the fellowship process.

"Fellowship is an important recognition award for those of us who are active in the society," Epstein explains. Disagreeing with Dr. Dang on the role of district branch participation in achieving fellowship, he notes, "The key element in a successful application is activity at the DB or national level in a well-rounded individual who is active not only in psychiatry, but also in the community. However, outstanding activity in the society is the necessary keystone, without which there can be no fellowship."

Dr. Epstein, himself a fellow, believes that "[f]ellowship is a very positive reward for ongoing contribution to our profession and our Association. The Fellowship Committee and executive director [of the district branch] work with the applicant to help produce the strongest application possible. For many years, no applicant approved at the district branch level has been rejected by APA. I’ve enjoyed the ritual and the recognition, and I urge others who are active to consider applying."