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Previous Residents' Forums have focused on important challenges and issues many residents face today. A recurrent theme has been advocacy for our patients and profession and the diverse ways that APA can help MIT's nurture our professional identity as psychiatrists. Although this month's Residents' Forum focuses on APA organizational politics, its message of utilizing APA to identify ourselves as part of a larger whole and deepen our professional development is applicable to all MIT's-regardless of how politically active they chose to be within the organization.
This is my last Residents' Forum as your Member-in-Training Trustee (MITT). It has been an honor for me to represent and serve you in APA; thank you for allowing me that opportunity. Diana Dell, M.D., the current member-in-training trustee-elect, will be replacing me at the annual meeting in Toronto and will take over editorship of the Residents' Forum. It has been my pleasure to work with Dr. Dell over the past year. I am confident that her intelligence, tenacity, and wit will serve MIT's and APA extremely well.
By Alisa Busch, M.D.
Member-in-Training Trustee
MIT's are pretty special, aren't we? We've got some special needs and have come up with several reasons why the rest of APA should listen to us: (1) we are the most educationally and financially vulnerable; (2) we represent a sizable chunk of the membership; and/or (3) we're the future. . .period.
Sounds pretty entitled, doesn't it? I'm not disagreeing with the above reasons (in fact I've used all of them, and others, while advocating for MIT's during my tenure on the Board of Trustees.) Nor do I mean to imply that the concerns of MIT's are not valid. We've worked hard to advocate for our special needs, as we should-that's what special-interest groups do. But I would like to spend a few moments deconstructing this MIT image because it will offer a complementary view of how we should position ourselves in the future.
First, let's start with the issue of special vulnerability.
True, we currently earn less and have a lower income potential than more senior psychiatrists did when they completed residency. However, declining income is a concern for many, if not all, psychiatrists.
Educational vulnerability: Are we any more educationally challenged than our more senior colleagues? Their challenge has been to go beyond the borders of their residency to learn about neurobiological and pharmacological advances; ours perhaps will be to seek more in-depth psychodynamic training. Either way, each educational era has its challenges and requires continued study beyond residency.
Well-being issues? Well, we're not cornering the market on that problem either-just reading the APA list serve, M2M, will clue you in to the general members' struggles with demoralization, decreasing autonomy, and increasing stress.
What about the fact that we're 20 percent of the dues-paying membership? Add early career psychiatrists-our nearby relations-and the total jumps to 42 percent. Don't our sheer numbers alone justify special treatment? But you can slice up the APA membership pie in many different ways to get impressive numbers: what about women psychiatrists? international medical graduates? minorities? How about white men who graduate from American medical schools-don't they, too, have special needs? (I'm not being entirely facetious here.) Sitting on the Board of Trustees, I've heard a lot of good ideas about how the Association should spend its money to address really important issues that affect large constituencies. It doesn't diminish MIT needs, but brings them into perspective.
Ahh. . .but let's not forget the most indisputable reason: We are the future of psychiatry. Can't argue with that. But again, it's not the whole story. The truth is, psychiatry's future rests as solidly on the shoulders of our more senior colleagues as it does on ours. We need them to continue to blaze trails for us, fight battles we don't yet have the resources for, and guide us so we benefit from their experiences instead of repeating their mistakes.
While MIT's have special needs and interests, we also have considerable common interests with many other psychiatrists and APA members who are not MIT's-and also competing interests (at least for financial resources) with other APA groups. As a group we are very articulate about how we are different from the rest, but less adroit in seeing our similarities. As we continue to advocate for our issues, as indeed we must do, we also need to step back and look at the forest instead of us trees.
This issue is particularly relevant to APA now, as it struggles with how best to represent its members through reorganizing its services and governance structure. All members, rightly so, want to see more value for fewer membership dollars (and less dependence on pharmaceutical company support). APA has some serious belt-tightening to do. Our greatest challenge as MIT's (indeed, all APA special-interest groups) will be in seeing ourselves as part of the whole. The truth is, it just doesn't pay for us to view the world only through our needs; MIT is just a developmental stage, not a final resting place.
I began my tenure as the member-in-training trustee speaking to you about the equal importance of our responsibilities to APA and noting that we are wrong to just clamor for our rights as MIT's. I encouraged you to get involved, even if only to tell your MIT representatives what you want out of APA. That advice still holds. The trick now is also to set your sights on what lies ahead, understanding that your destiny is tied more to the whole APA than it is to the part.