Gerald Leventhal

Partnerships with Psychiatry and Other Clinical Disciplines: A Key to Psychology's Success in U.S. Medical Schools

This paper describes the growth of psychology in medical schools and the distribution of psychologists across medical school departments. The Association of American Medical Colleges (AAMC) and American Psychological Association (APA) use different data collection approaches that reflect their different missions. AAMC focuses solely on medical school faculty, whereas APA tries to reach all psychologists working in academic health centers (AHCs). The number of psychologists in medical school settings has increased, largely due to their research expertise; but psychologists also contribute through teaching and clinical service. Psychologists hold appointments in wide variety of medical school departments, which has been a key factor in their success. Through partnership and interdisciplinary collaboration with a wide range of academic physicians, psychologists have gained increased support, become valued members of the AHC and medical school communities, and can rise to leadership positions in medical schools.

History of the Association of Medical School Psychologists (AMSP), 1982–2005

This paper presents a brief history of the Association of Medical School Psychologists (AMSP) from the Association’s beginning in 1982 to the present day. Prior to 1982, there had been several unsuccessful efforts to form an association that would represent psychologists in academic medical centers. Attempts by psychiatry to limit the growing number and influence of psychologists in medical schools created a sense of threat among psychologists that catalyzed the formation of the Association. Membership was initially restricted to one senior psychologist from each medical school, a restriction that limited AMSP’s development, but AMSP later opened its doors to all academic medical center psychologists. The Association was rebuffed in initial efforts to join the Association of American Medical Colleges, and at a later date, to become a Division of the American Psychological Association (APA). In time, however, AMSP did establish formal ties to both of those organizations, and it has collaborated with APA in important surveys of academic medical center psychologists. Following a period in the late 1990’s when AMSP seemed likely to lose its way, the Association rebounded. AMSP now has an Administrative Director, a stable home base, and revised bylaws that assure greater stability and continuity of leadership. These developments, in conjunction with a strong working relationship with the Journal of Clinical Psychology in Medical Settings, have positioned AMSP to grow and more effectively serve the community of psychologists who work in academic medical centers.

Psychology’s Adaptation to Medical Schools, Teaching Hospitals, and Academic Medical Centers: The Role of Academic Medicine Organizations

Psychologists in medical schools, teaching hospitals, and academic medical centers are comparatively small in number, and are often undervalued and denied full practice privileges. As a profession, psychologists must therefore adapt to the realities of a physician-driven, physician-controlled environment. Psychologists’ adaptation to academic medical settings has been considered from several vantage points. An overlooked aspect of adaptation is psychologists’ knowledge of and participation in academic medicine organizations that regulate medical education and specialization. These organizations significantly influence teaching hospital and medical school environments and the psychologists and academic physicians who work in those environments. This paper focuses primarily on three academic medicine organizations, the Liaison Committee on Medical Education (LCME), the Accreditation Council for Graduate Medical Education (ACGME), and the American Board of Medical Specialties (ABMS), which together shape and regulate medical education across all levels and specialties. Knowledge of the evolution and workings of these organizations is useful information for psychologists, but beyond that, such information is a framework that provides benchmarks for understanding psychology’s evolving system of education and specialization.

Federal Funds to Train Clinical Psychologists for Work with Underserved Populations: The Bureau of Health Professions Graduate Psychology Education Grants Program

This paper describes the Bureau of Health Professions (BHPr) Graduate Psychology Education program (GPE), which supports projects that train health service psychologists for work with underserved populations. BHPr history and funding criteria are discussed, as are those of BHPrs parent organization, the Health Resources Service Administration. BHPr objectives and methods for support of clinical psychology training parallel those that BHPr has used to support training in other heath professions. The paper also describes three psychology internship training programs in academic medical settings that competed successfully for BHPr GPE funding in 2002. The three training projects differ significantly in training rotation sites, target populations with which trainees work, and the other health care professions that partner with psychology in interdisciplinary training—but they are similar in that each project provides an example of a program that effectively satisfied BHPr criteria for expanding psychologys scope of practice with underserved populations.

The Association of American Medical Colleges and the Association of Medical School Psychologists: Finding Psychology’s Place in Academic Medicine

This paper highlights the role of the Association of Medical School Psychologists (AMSP) as a bridge between academic medicine and psychology. AMSP’s affiliation with Division 12 of the American Psychological Association is discussed, but the primary focus is AMSP’s affiliation with the Association of American Medical Colleges (AAMC) and the AAMC’s Council of Academic Societies (CAS). The history, structure, activities, and goals of AAMC and CAS are examined. AMSP’s affiliation with AAMC is important for psychologists in medical schools and academic medical centers, and for psychology in general, because AAMC is the major voice of academic medicine in the US. AAMC activities affect medical education at all levels, as well as research and health services at academic medical centers, and health care policy at the national level. AMSP’s dual affiliation with AAMC’s CAS and APA’s Society of Clinical Psychology will increase psychology’s visibility and influence in academic medical centers and enhance the two-way flow of ideas and information between academic medicine and psychology.

The 2003 Survey of Academic Medical Center Psychologists: Implications and Outlook

This paper offers commentaries on Pate and Kohout’s (2005) report of data from the 1997 and 2003 surveys of psychologists in medical school settings. The commentaries reflect upon the significance of the survey findings and implications for psychology’s role in medical school and academic health science settings. Though the response rate to the survey was disappointing, the data indicate that psychologists are moving up in academic rank, and have made substantial gains in salary. The data also indicate that among psychologists who are medical staff members, who constitute half the 2003 sample, an increasing proportion are functioning autonomously as reflected in gains in the percentage having admitting privileges, staff voting privileges, and authority to write orders. Research continues to be a major focus for psychologists in academic medical centers. Overall, the findings indicate that psychologists can have productive, satisfying careers in medical school/academic health center settings—though there is one troubling sign, a sizeable drop in the number of positions being created for younger, more recently trained psychologists. Methodological enhancements are described that could improve the quality, scope, and usefulness of data from future studies, both for understanding long-term trends and for conducting salary negotiations. High quality data provide a solid foundation for advocating for psychologists’ full participation in the life of medical schools and academic health centers.

Introduction to the Special Issue: Psychology in Academic Health Centers

Articles in this special issue of the Journal of Clinical Psychology in Medical Settings (JCPMS) are adapted from invited papers and symposia presentations organized by the Association of Medical School Psychologists (AMSP) and presented at the 2003 American Psychological Association Convention in Toronto. The Journal enjoys a longstanding special relationship with AMSP. Members of AMSP receive a subscription to JCPMS as a benefit of AMSP membership, and the Journal has published articles in the past that were based on presentations at AMSP meetings. For example, the JCPMS special issue that was published in June 1999 (Vol. 6, No. 2) contained papers from an AMSP conference and dealt with employment trends and salaries of medical school psychologists, the future of psychology in academic health centers (AHCs), as well as administration and governance in AHCs. The articles in this special issue of JCPMS are an expression of the ongoing collaboration between the Journal and AMSP. The issue contents reflect the mission of AMSP, which is to promote psychology in AHCs and medical school settings, and to foster leadership roles for psychologists in all facets of training, clinical practice, research, and administration in those settings. AMSP strives to articulate the priorities of psychologists in AHCs, facilitate networking, and advocate for psychology and psychologists in AHC and medical school settings. AMSP was first established in 1983. The

Psychology’s Adaptation to Academic Medical Settings

This introduction provides an overview of the papers that follow. Each paper contributes to the central theme of the issue, psychologists’ adaptation to the realities of academic medical settings. The specific approach of each paper to the shared theme of “adaptation” is described in some detail so the busy reader can go directly to the papers of greatest interest.

Celebrating Change, Renewal, and Continuity

This note offers news of celebrations at the 2013 Nashville TN Conference of APAHC, the Association of Psychologists in Academic Health Centers. Approximately 100 conference-goers and a host of distinguished speakers attended, including Dr. Norman Anderson, CEO of the American Psychological Association, and Dr. Suzanne Bennett Johnson, 2012 APA President. A January 31st evening reception honored the 30th anniversary of the founding of APAHC, the voice of psychologists in academic health centers. A lunchtime celebration the next day honored the 20th anniversary of the founding of this Journal, the Journal of Clinical Psychology in Medical Settings (JCPMS), first published in 1994 under the guidance of founding Editor Dr. Ronald Rozensky, and which now is the official journal of APAHC. For the luncheon celebration, Janice Stern, Senior Editor for Health and Behavior, represented JCPMS publisher Springer Science?Business Media. A notable ceremonial event was the cutting-of-the-cake, a blue on white beauty in JCPMS colors (see Fig. 1) provided by Ms. Stern. Executing the cake cutting with consummate skill was a trinity of JCPMS Chief Editors, Dr. Rozensky, Dr. Barbara Cubic, JCPMS second Chief Editor who is stepping down after 6 years of exemplary service to the Journal and is now in her second year as APAHC President, and finally myself, the new and third Editor-in-Chief of JCPMS. The three Chief Editors all have been members of APAHC’s Board of Directors, which reflects the close tie between the Journal and the Association. Our celebrations commemorated change. My father used to say: ‘‘The only thing that never changes is change.’’ However, sources informed by a higher Father tell a different story, namely, ‘‘there is no new thing under the sun’’ (Ecclesiastes). Perhaps ‘‘change with renewal and continuity’’ is the expression that best reconciles these two views of change. Consider the history of JCPMS, in fact, consider the universe of all the journals that we psychologists, as well as other scientists and professionals, read and publish our research and insights. When JCPMS first came on the scene in 1994, authors submitted hardcopy manuscripts that came to the Editor’s desk via U.S. mail, and in turn, the Editor sent hardcopies to Associate Editors via U.S. mail, who in turn sent hardcopies to reviewers, and so forth. At the end of the publication chain, readers received a hardcopy issue of the Journal delivered by U.S. mail. From then to now, much has changed, but much else has stayed the same. Today, manuscripts for editors, reviewers, and readers are delivered directly to offices and homes by our amazing computerized Internet communication system—a change that is real and far-reaching, and qualitatively different from anything that has come before in human history. Yet, many things stay the same, the professionals involved, the tasks they do, the layout of articles, and so forth. Thus, true change is coupled with true continuity; and both deserve celebration. Although three Chief Editors can cut a cake, it takes more than a trio of Editors-in-Chief to make a successful scientific/ professional journal. The interest and efforts of many others are essential: readers and authors; reviewers and Associate Editors; Editorial Board members and Senior Advisory Board members; and just as important, though perhaps less visible, the worldwide human and technical resources of a publishing house like Springer. These stakeholders make Gerald Leventhal (&) University of Medicine & Dentistry of New Jersey, Newark, NJ, USA e-mail: Jerryumdnj@aol.com