"Is It a Tusk From a Woolly Mammoth, a Finnish Soap Powder, or a Software Adaptation for Windows97?" No, It’s AADPRT!" By Herbert S. Sacks, M.D. APA President

This tongue-twister, an acronym for the American Association of Directors of Psychiatric Residency Training, has contributed to keeping AADPRT’s remarkable virtues hidden from mainstream psychiatry. Creative logo writers must give a try at converting AADPRT into TEACH or an equivalent descriptive acronym. A major marketing effort is imperative to inform clinical faculty of the mission and activities of training directors. While the latter report to the chairs, the clinical faculty most often don’t relate to the directors and look to the chairs for leadership, direction, and advancement opportunities. Clinical faculty, especially those colleagues committed to psychotherapy, must take the lead in connecting with training directors in assuming more important teaching obligations. What better models are available to residents, models richly experienced, often charismatic, with a command of the literature and knowledgeable about the vicissitudes of the private sector?

AADPRT recently held its 27th annual midwinter meeting in Orlando. This exuberant meeting had 500 registrants, entertained 90 workshop submissions, and was attended by 34 coordinators, the lay executives who help administer the programs. The enthusiasm marking this conclave was enhanced by the presence of spouses and lively young children who were drawn to nearby Disney World.

Gene Berezin, AADPRT’s president, emphasized that the directors are motivated by the joy of teaching. Money and power are beyond their reach and are not implied in their job descriptions. Their espoused mission is to maintain the integrity of our field and combine our knowledge base with clinical practice. The task is daunting, given that training directors are young, are likely to be untenured, and on average work at that endeavor for two and a half years. Their goals are supported collaboratively by organizations that address undergraduate and graduate medical education, including the Residency Review Committee (RRC), the Association of Medical Student Education and Training (ADMSET), the American Board of Psychiatry and Neurology (ABPN), the chair societies in adult and child and adolescent psychiatry, the Council on Medical Education and Career Development of APA, and federal agencies.

In the course of the meeting, I spoke to the Executive Council and later the Plenary Session of AADPRT. But I was most affected by my conversations with the seven Ginsberg-AADPRT Charter Fellows. This fellowship honors the memory and contributions of a good friend, George Ginsberg of New York University, who was a former president of AADPRT and a member of the Assembly Executive Committee of APA. George, a powerful advocate of psychotherapy training, was struck down in his prime by sudden illness. The fellows I visited were a superb group of promising teachers and published investigators whose optimism and creativity reflect the strengths of so many of our residents entering training.

The fellows urged a significant expansion of psychotherapy training and sophisticated supervision in their programs. In the past five years, there have been resident surveys, including those done by the Glaxo-Wellcome Fellows, which have recommended intensifying and broadening psychotherapy education. A counterpart of these requests has been the expression of concern about providing availability of psychotherapy for psychiatric residents.

Flying north from Orlando, I attended the midyear meeting of the APA Commission on Psychotherapy by Psychiatrists (COPP) in Washington, D.C. Eva Szigethy and Zachary Solomon reported on their conversations at AADPRT on the provision of psychotherapy for residents. Their discussions captured the reflections of 40 to 50 chief residents around the country. They cited the financial burden of seeking treatment, the problem of confidentiality leaks and databank porousness, the availability of time during the work week, and the stigma attached to being in treatment. The commission discussion pointed out that seeking treatment in some programs is seen as a virtue and in fact may be antistigmatic. Many psychiatric residents are not aware of the availability of psychotherapy in their programs. And many believe that training programs should pay for a number of treatment sessions. Dr. William Sledge and Dr. Solomon of COPP have drafted an excellent paper on the subject, which will be presented by the commission after minor revisions.

Residents represent the future of psychiatry. Education is central to our commitment to advance the frontiers of our knowledge. The major groups cited earlier, dedicated to psychiatric education, are autonomous and independent, and those qualities must be preserved. However, a unified approach to educational issues will avoid duplicative efforts of effort and generate rapid and considered responses to the fresh challenges of our time.