1.
Geographical/Time-Based Fellowships:
These fellowships require your physical presence for a specified period
of time at a specified location(s).
Some of these fellowships are “accredited” by being officially
recognized by the American Board of Psychiatry and Neurology (ABPN). Accredited fellowships have multiple-choice
board exams that fellows take upon completing the time commitment of the
fellowship (usually 1-2 years). As a
result of these official examinations, psychiatrists (especially academic
psychiatrists) usually respect accredited fellowships more than non-accredited
fellowships. However, patients or the
public at large might not care where a specialist gained his or her
subspecialty expertise. For example,
the ABPN accredits fellowships in addiction psychiatry, but the American
Society of Addiction Medicine (ASAM) also has a pathway to certification in
addiction medicine that involves a standardized multiple-choice test and
documented experience in addiction medicine, yet does not require being present
at a specific institution and geographical location. In general, the public does not seem too concerned with which
path a clinician takes to addiction-treatment expertise. However, academic psychiatrists tend to be
more impressed with ABPN-accredited fellowships.
Geographical/Time-Based Fellowships fellowships can
be sub-divided into two types:
A. Clinical Fellowships, which usually recruit M.D.s
or D.O.s (usually not called a “post-doctoral” fellowship even though they
occur after having earned a doctoral degree).
Currently there are five areas of sub-specialty fellowship training that
are accredited by the American Board of Psychiatry and Neurology. They are:
1. Pain
Management; 2. Forensic Psychiatry; 3.
Child and Adolescent Psychiatry;
4. Addiction Psychiatry; 5.
Geriatric Psychiatry.
B. Research Fellowships (often called “post-doctoral”
fellowships) because many Ph.D.s enter into these fellowships immediately upon
completing their Ph.D. degree programs.
However, these fellowships are also available to M.D.s and D.O.s who
have an interest in research.
2.
Honorary Fellowships: These
fellowships are awarded based on meritorious and/or demographic criteria, but
generally do not require extended stays of time at any particular
location. Instead, attendance at
certain periodic meetings might be expected.
Also, collaboration in ongoing projects involving research, writing, or
political action might also be expected.
Usually, these projects are ones that do not require being physically
present for more than a few days at any one geographical location.
3.
Combination of “1” and “2”: These
fellowships are ones which are awarded on the basis of merit and/or demographics,
but which also require work which is confined to a particular geographical area
over a specified period of time.
What are the
Benefits of Doing a Fellowship?
Fellowships can provide expertise
in a more-specific area than a general psychiatry residency allows.
Public Relations (having a
credential that communicates that you actually have expertise in a specific
area.) However, it is certainly
possible to gain the same level of expertise in any area despite not having
done a fellowship, yet persuading the public of your expertise might be more
difficult without having done a fellowship in a given area.
Doing a
fellowship often, but not always, translates into greater earning power.
Note: A potential conflict of interest exists on
the part of those who recruit for geographical/time-based fellowships. This conflict arises from the fact that
fellows often perform labor that is cheaper than would be possible if the
institution offering a fellowship had to hire someone at "faculty"
rates. Consequently, recruiters for
fellowships are at risk of exaggerating the pedagogical or economic value of a
fellowship. I am not encouraging anyone
to be paranoid or inordinately suspicious, but rather to consider potential
conflicts of interests when evaluating any fellowship.
What Clinical Fellowships are Accredited by the American Board of
Psychiatry and Neurology?
The American Board of
Psychiatry and Neurology (www.abpn.com)
accredits clinical fellowships in the following five subspecialty areas of
psychiatry:
1. Pain Management
2.
Forensic Psychiatry
3.
Child and Adolescent Psychiatry
4. Addiction Psychiatry
5. Geriatric Psychiatry
To
discover which institutions have accredited clinical fellowships, contact
specific institutions or subspecialty organizations. The subspecialty organizations corresponding to the five areas of
subspecialty training listed above are:
1. Pain
Management: There is currently no
organization containing only psychiatrists who focus on pain management. However, the American Academy of Pain
Management (www.aapainmanage.org)
welcomes physicians from all specialties who focus on pain management. For more specific information about Pain
Management fellowships accredited through ABPN, contact the ABPN at www.abpn.com.
2. Forensic
Psychiatry: The American Academy of Psychiatry and the Law (www.aapl.org)
3. Child and Adolescent Psychiatry: The American
Academy of Child and Adolescent Psychiatry
4. Addiction
Psychiatry: The American Academy of Addiction Psychiatry (www.aaap.org)
5. Geriatric
Psychiatry: The American Association for Geriatric Psychiatry (www.aagpgpa.org)
What Specific
Honorary Fellowships are Currently Available?
See http://aadprt.org/public/educators.html
Which Honorary Fellowships are Considered the Most
Prestigious, Competitive, or Selective?
For psychiatry residents, the
Fellowship of the Group for the Advancement of Psychiatry (GAP) (http://groupadpsych.org) and the Laughlin
Fellowship of the American College of Psychiatrists (ACP) (http://www.acpsych.org) are generally
considered the most prestigious, competitive, and selective honorary
fellowships available to psychiatry residents.
GAP chooses 15 fellows every two years and ACP chooses 15 fellows every
year. Thus, in terms of shear numbers, the
GAP fellowship is more selective. Also,
the Laughlin Fellowship is not entirely merit-based, as selection is influenced
by a policy of trying to choose fellows from psychiatry programs that have not
yet had Laughlin Fellows.
For any given sub-specialty
of psychiatry, a sub-specialty organization’s honorary fellowship might yield
more social currency. For example, the
Rappeport Fellowship of the American Academy of Psychiatry and the Law (AAPL)
might be more impressive than a GAP or Laughlin Fellowship to someone who was a
dedicated member of AAPL, or to someone who was attentive to credentials that,
by definition, specifically suggested expertise in a particular area, such as
Forensic Psychiatry.
Recommendations to Residency/Fellowship Training Directors Regarding
the Fair and Equitable Choice of Nominees for Honorary Fellowships and Other
Awards
1. Residency/fellowship training directors
have a fiduciary duty to educate all residents and fellows as to what
fellowships and awards are available, and as to the benefits and implications
of participating in any particular fellowship.
Please see http://aadprt.org/public/educators.html
for a compilation of currently available fellowships.
2. If a fellowship is advertised as being
“merit-based,” it is unethical and an abuse of fiduciary duty to nominate a
resident or fellow for that fellowship for any reason other than merit.
3. If a fellowship is advertised as being “merit-based”, the
decision of who to nominate for that fellowship should be an independent
decision not influenced by what previous fellowships or nominations a
resident/fellow under consideration has received. Some have argued that this policy could allow one exceptional
person to garner a substantially larger number of honorary recognitions than
their peers, resulting in jealousy and/or poor morale on the part of
peers. Yet, if this outcome is at risk
of occurring, there are more honest ways of addressing resident behavior and
morale than to dishonestly apply criteria that were intended to be merit-based.
4. The nomination of honorary fellowships
and awards should NEVER be used as “carrots” to manipulate resident behavior,
or as a means of boosting morale in residency programs by sprinkling awards
over residents who have not demonstrated merit in the area for which an award
was intended. Either of these uses of
fellowships is dishonest, unethical, and an abuse of fiduciary duty.