December 4, 1998

By Barry Wall, M.D.

The furniture had been delivered, the telephone had been activated, the first month's rent had been paid. Because I had income from part-time work, I had run counter to the prevailing wind and opened a solo private practice. This was my space, my phone, my things-and I was thrilled.

The euphoria soon faded, however, as I realized that patients were booking few appointments during the first months, and the telephone certainly was not ringing off the hook. Even though I had hired a colleague to provide supervisory advice, was working part time in a hospital, and had joined a peer supervision group, I was learning how difficult and lonesome it was getting started.

The transition from the academic environment of residency training to a psychiatric practice has probably never been easy. Historically, traditional issues such as beginning solo practice or joining single-specialty groups certainly caused anxiety for many psychiatrists making the transition. In the 1990s, the advent of managed care, provider panels, employment contracts, and noncompete clauses has made this transition extremely complicated.

Fortunately, at the time that I was realizing the importance of maintaining contact with my psychiatric peers, Dr. Patricia Recupero, then president-elect of the Rhode Island Psychiatric Society, asked whether I would become involved as the early career psychiatrist (ECP) designee for our district branch. I accepted the challenge because this seemed to be a good way to stay connected with colleagues and to obtain valuable mentorship in the intricacies of starting and developing a private practice.

MITs and ECPs who have little involvement in organized medicine often underestimate or do not know how helpful APA can be as they make the transition from residency to private practice.

In my case, using the resources of APA provided me with mentorship and communication at a critical stage of my professional development, and this occurred because one person took an interest in me.

Because receiving mentorship from and maintaining communication with colleagues can be critical to getting started in practice, APA's Early Career Psychiatrist committees are working to devise new ways to provide communication with other ECPs and with more experienced colleagues on the national and district branch levels.

ECPs are working on a number of initiatives to improve communication between members and to aid individuals formally and informally as they make the transition from resident to attending.

One new forum that provides a place to discuss issues pertaining to entering practice is the EarlyCareerNet, a new ECP list serve. Similar to the residents' GRASSMITS list serve, this list serve provides a grass-roots forum where participants can discuss any ECP-related issue.

When MITs graduate and are no longer eligible to subscribe to GRASSMITS, they are encouraged to sign up for EarlyCareerNet. Unlike GRASSMITS, EarlyCareerNet is managed through APA's organizational structure.

ECPs are encouraged to subscribe to EarlyCareerNet by e-mailing larrygshire.net or Barry--W--Wall@brown.edu. In addition to submitting your e-mail address, you must provide the name of the residency training program from which you graduated and the year in which you completed training.

Another way in which ECPs are fostering communication is by creating ECP committees or designating an ECP representative in each district branch. If you are interested in forming a district branch committee or becoming involved in your district branch committee, contact your district branch office or your ECP Area representative or deputy representative. For information on how to contact any of these individuals, call Sandra Price of the APA staff at (202) 682-6145.

A third way that APA's ECP committees are working to increase communication among psychiatrists beginning their careers is by upgrading the ECP Web site, which can be accessed through the APA Web site, . Click on "Practice of Psychiatry" and then "Early Career Psychiatrists." Our Web site upgrade will enhance the ability of ECPs to gain rapid access to information crucial to them.

With the advent of the national list serve and increasing opportunities for ECPs to be involved at the local and state levels, it is easier than ever to feel connected with your ECP colleagues simply by sharing your ideas and concerns.

Your ECP Area representative and deputy representative look forward to serving you and hope you will contact us soon.

Dr. Wall, a psychiatrist in Providence, R.I., is the Area 1 ECP deputy representative to the APA Assembly and is an Assembly liaison to the Council on Psychiatry and Law.