Pilot Study of Divisions of Child Psychiatry

in 32 Schools of Medicine

M eyer Sonis, M.D.

In 1960, with the action of the American Board of Psychiatry andNeurology, the profession of child psychiatry achieved the status ofan accredited subspecialty of psychiatry. As a consequence, a majorshift emerged in the base of influence on the academic functions ofchild psychiatry and the source of fiscal and professional supportfor child psychiatrists working within academic settings (Allen,1961).

Prior to 1960, the primary base of influence and source of sup­port for academic functions of child psychiatry and academic childpsychiatrists was to be found in community ch ild guidance clinicswhich were not integral to a school of medicine, and in the market­place of clinical services and interdisciplinary staffs.

Since 1960, the base of influence and source of support for thesubspecialty of child psychiatry has increasingly shifted to childpsychiatry programs integral to a school of medicine and to theacademic marketplace of medical education. With this shift, the aca­demic child psychiatrist'S need for a greater understanding of thisacademic marketplace in which the subspecialty of child psychiatryoperates, and for the collecti ve support of others engaged in simi ­lar tasks and faced with similar problems, has emerged.

The first National Conference of Division Chiefs of Child Psychi­atry, held in 1963, and the ultimate formation in 1969 of an orga­nization of Division Chiefs of Child Psychiatry, called the Society ofProfessors of Child Psychiatry, were intended to answer theseneeds. In line with these purposes, a pilot study of 32 divisions ofchild psychiatry in 32 schools of medicine was undertaken for pre­sentation to the Society of Professors of Child Psychiatry in 1970,of which this paper is a report.

Dr. Sonis is Prof essor ofChild Psychiat ry, Department of Psychiatry, University of Pittsburgh Schoolof Medicine.

Reprints may be requested from the author at 3811 O'Hara Street, Pittsburgh, Pa. 15260 .

604

Pilot Study ofDivisions of Child Psychiatry

PURPOSE OF PILOT STUDY

605

The basic aim of this pilot study of divisions of child psychiatry wasthreefold: (1) to ascertain the feasibility of securing informationand data of an operational nature on a sample of divisions of childpsychiatry; (2) to utilize this information and data as a common de­nominator for the Society of Professors of Child Psychiatry to ex­plore the administrative place of child psychiatry within a school ofmedicine; and (3) to utilize the experience of this pilot study in thedesign of a future study of all divisions of child psychiatry repre­sented in the Society of Professors of Child Psychiatry.

METHOD OF ApPROACH

A questionnaire was designed to elicit information from the divi­sions exclusively about their administrative operation. The ques­tionnaire, of 23 questions, addressed itself to the following opera­tional areas: organization of the division; category and types ofprograms operated or provided for by the division; operatingbudget of the division, including expenditures, sources of income;size, composition, and distribution of faculty within the division;salaries and benefits provided by the division for its faculty; resi­dency positions in child psychiatry offered and filled by the divi­sion, and stipends offered; affiliate relationships with other institu­tions, and the nature of programs and budgets they provide; andthe nature of participation of the division in policy decisions withinthe school of medicine. Of the questions, 21 required descriptiveanswers.

In addition, the procedures and a process for conduct of thestudy were designed in such a way as to maximize the anonymity ofthe respondents, the participation of respondents in review andcritique of the results and report of the study, and the participationof the respondents in the decision regarding wider circulation ofthe report of the study beyond themselves.

The questionnaire was submitted to the 45 division chiefs ofchild psychiatry who were then members of the Society of Profes­sors of Child Psychiatry. Within the deadline of April 1969, 32divisions replied and formed the sample for the pilot study.

The data and information available for each question and in allquestionnaires were collated and analyzed. (Additional data, ofpertinence to this study, were secured from the surveys and re­ports listed in the references.) A complete and detailed preliminaryreport of the pilot study, including 63 tables, raw material, ex pla-

606 Meyer Sonis

nations, and comments, was submitted to the 45 divisions of childpsychiatry in February 1970, with comments and critiques invited.

With the utilization of the subsequent comments and critiques,and with the agreement of the members of the Society of Profes­sors of Child Psychiatry, the preliminary report on the pilot study,including all raw material and results, was reexamined by the in­vestigator to prepare this final report.

RESULTS

General Comments

Of the 45 divisions, 32 (74%) returned completed questionnaires.The findings of this study therefore reflect characteristics of these32 divisions. The findings presented in the tables of this paper area summary compilation of the more extensive data submitted tothe members of the Society of Professors of Child Psychiatry. As asupplement to the specific data presented in this paper, commentswill be made which are based on the more extensive informationavailable .

Organization 0/32 Child Psychiatric Programs

Of the 32 programs, 22 (70%) are formally designated as Divisionsof Child Psychiatry, while 5 are called Child Psychiatry Services, 4are called Sections of Child Psychiatry, and 1 is called a Depart­ment of Child Psychiatry. Of the 32 child psychiatry programs, 28(90%) had their administrative base in a department of psychiatryalone; 1 had an administrative base in a department of psychiatryand a department of pediatrics; 1 had an administrative base in adepartment of psychiatry and a child guidance clinic; 1 had an ad­ministrative base in a pediatric hospital ; and 1 had an administra­tive base in a school of medicine.

Although the predominant pattern of organization for the 32divisions was that of an administrative unit of a department of psy­chiatry alone, wherein the chief of child psychiatry was accountableto the chairman of the department of psychiatry, there were infi­nite variations in the channels of command and authority for theoperation of the division. A few examples will suffice. In one divi­sion, the chief of child psychiatry was accountable to the chairmanof the department of psychiatry for the operation of inpatient ser­vices, but was accountable to another authority for the operation ofoutpatient services. In another division, the chief of child psychia­try was accountable to the chairman of the department of psychia-

Pilot Study ofDivisions of Child Psychiatry 607

try for some personnel in the division, while someone else was ac­countable to the chairman of the department of psychiatry forother personnel in the division.

In the remainder of this paper, for the purpose of simplicity inreporting all child psychiatry programs will be referred to as Divi­sions of Child Psychiatry.

Category of Programs Operated and Funded by the Divisionsof Child Psychiatry

Of the 32 divisions of child psychiatry, all operated some form ofclinical services; and all operated some form of educational program;30 (94%) operated some form of research program; 24 (76%)operated some form of community services; and 24 (76%) operated,in some form, all category programs listed.

On the question of whether the division itself provided funds,received by the division through any source, for partial or totalsupport of the category programs administered by the division, thefollowing information emerged. Of the 32 divisions whichoperated clinical services, 25 provided funds, 4 did not, and 3 didnot provide this information. Of the 32 divisions which operatededucational programs, 27 furnished funds, 2 did not, and 3 did notprovide this information. Of the 30 divisions which operated re­search programs, 24 provided funds, 3 did not, and 3 did not offerthis information. Of the 24 divisions which operated all categoryprograms, 7 provided funds for all programs, 11 did not, and 6did not provide information.

Types of Programs Provided by the Divisions

Clinical Services. As can be seen in Table 1, outpatient clinical ser­vices are provided by all divisions, while day care and pediatric liai­son services are the least provided. It is of interest to note that the

Table I

Number and Percerlt of Divisions by Type of Clinical Services Provided(N = 32)

Type of Provided Not Providecl UnknownClinical Service N % N % N %Outpatient 32 100 0 0 0 0Inpatient 27 85 4 12 I 3Day Care 20 64 II 33 I 3Emergency 27 85 5 15 0 0Pediatric Liaison 19 61 9 27 4 12Adolescent 26 82 2 6 4 12All of Above 9 27 17 55 6 18

608 Meyer Sonis

provision of all of these clinical services has been viewed as the"ideal" for training in child psychiatry by the National Conferenceon Training in Child Psychiatry in 1963. As Table 1 reveals, aminimum of 9 divisions, to a "possible" maximum of 15 divisions(45%), reach this "ideal."

Educational Programs. As would be surmised, Table 2 indicatesthat all divisions provide educational programs for residents ingeneral and child psychiatry, and for medical students; almost allof them provide programs for psychologists, social workers, andpediatricians. As might not be expected, Table 2 indicates that a

Table 2

Number and Percent of Divisions by Type of Educational Program(N=32)

Type ofEducational Program

Career Child PsychiatryGeneral PsychiatryMedical StudentsSocial Work StudentsPsychology StudentsNursing StudentsEducatorsChild Care WorkersPediatriciansAll of Above

ProvidedN %

32 10032 10032 10027 8530 9421 6723 7319 6126 82II 33

Not ProvidedN %o 0o 0o 05 152 69 277 21

13 393 9

18 58

UnknownN %o 0o 0o 0o 0o 02 62 6o 03 93 9

majority of the divisions are involved in educational programs fora wide spectrum of professions. Among other educational pro­grams noted in the more complete information were programs forvolunteers, social scientists, recreational and occupational thera­pists, and chaplains.

Research. As noted elsewhere, 30 (or 94%) of the divisions wereinvolved in some form of research. Table 3 indicates that clinicalresearch is the predominant form of research provided by thedivisions as an academic function. Operational research (i.e., ad-

Table 3

Number and Percent of Divisions by Type of Research Program Provided(N=32)

Type of Provided Not Provided UnknownResearch N % N % N %

Clinical Research 30 94 2 6 0 0Developmental Research 21 67 8 24 3 9Operational Research 12 38 12 38 8 24Pharmacological Research 12 38 15 47 5 15

Pilot Study ofDivisions of Child Psychiatry 609

ministrative, program evaluation) and pharmacological researchare least provided.

Community Services. Of the divisions, 24 (76%) indicated involve­ment in some form of community services, and from the more de­tailed information available, we learn that all of the divisions pro­vide consultation to social agencies as a community service, 29(91%) of the divisions are involved in community services to the laypublic in the form of giving speeches, 21 (67%) of the divisionsprovide consultation to courts, and 15 (47%) of the divisions offerconsultation to state hospitals as a community service.

Fiscal Information on Divisions of Child Psychiatry

We requested information of a fiscal nature from the divisions toutilize the detailed data on expenditures and income as a means ofascertaining relationships between these data and data on pro­grams (categories, types) provided, and on faculty (size, composi­tion, salaries). Unfortunately, these detailed data could be securedonly from 19 of the 32 divisions; these are summarized in Tables 4,5, and 6 and form the basis for the comments made regarding rela­tionships to other information. Of the remaining 13 divisions, 6 re­ported that the budget for the division could not be separatedfrom that of their departmental budget, while 7 divisions providedonly partial fiscal information.

From the fiscal information provided by 26 divisions, it wouldseem that the business of academic psychiatry could be viewed as"big business." The combined expenditures of 24 departments ofpsychiatry were about $53,000,000, ranging from those of one de­partment with a budget of $300,000, to those of one with a budgetof $7,500,000. Budgets of $1,000,000 or more were reported by 19of the 24 departments of psychiatry. The combined expendituresof 26 divisions of child psychiatry were approximately $12,000,000,ranging from a budget of $90,000 in one division to a budget of$2,500,000 in another. Of these 26 divisions, 4 reported a budgetof $1,000,000 or more. Of the 26 divisions, 12 reported affiliationswith independent organizations, which provided a combinedbudget of $4,000,000.

Tables 4, 5, and 6 are a summary compilation of detailed fiscalinformation provided by 19 divisions of child psychiatry. Of the 19divisions, 16 were divisions with an administrative base in a depart­ment of psychiatry alone, and 3 were divisions with an administra­tive base other than that of a department of psychiatry alone.Thus, the 16 divisions represented a 60% sample of the total

610 Meyer Sonis

Table 4

Combined Budget Allocation of 19 Divisions of Child Psychiatry

Budget Allocation Amount Percentage

Clinical Services $4,542,000 55Education 2,737,000 33Research 957,000 12

Total $8,236,000 100

number of divisions with an administrative base in a department ofpsychiatry alone, while the 3 divisions represented a 75% sample ofthe total number of divisions with an administrative base otherthan a department of psychiatry alone.

Of the 19 divisions, with a combined total budget of approxi­mately $8,000,000 (see Table 4), 6 had budgets ranging from$500,000 to $1,000,000, and 13 had budgets ranging from $90,000to $500,000. Of the 19 divisions with combined budgets for clinicalservices, education, and research, as shown in Table 4, 2 providedno budget for clinical services, 2 provided no budget for education,and 7 provided no budget for research.

Tables 5 and 6 give a more detailed breakdown of Table 4 intoits component parts. From an examination of these data and thedata available in regard to programs operated and funded, andfaculty size and composition, the following is suggested for thedivisions: a greater reliance on income from sources which bring

Table 5

Combined Income and Expenditures of 16 Divisions of Child Psychiatry Based in aDepartment of Psychiatry Alone

Income Amount Range Percentage

Fees $246,897 5500-66,000 4Community Chest 1,000 0-1000 >1City 1,460,000 135,000-540,000 22State 1,757,466 12,000-775,000 26Federal Training

Grant 1,332,149 9300-220,000 19Federal Research

Grant 343,700 10,000-164,000 5Mental Health

Center 658,769 24,000-500,000 9Dept. of Psychiatry 178,000 3000-75,000 3Medical School 720,841 9300-238,800 11Other 2,000 0-2000 >1

Total $6,700,822 100

Expenditures

Clinical Services $3,963,912 93,000-1,000,000 59Education 2,194,910 0-425,000 33Research 542,000 0-175,000 8

Total $6,700,822 93,000-1,130,000 100

Pilot Study ofDivisions of Child Psychiatry

Table 6

Combined Incom e and Ex pendi tures of 3 Division s of Child PsychiatryNot Based in a

Department of Psychiat ry Alone

611

In com e Amo u nt Ran ge Percentage

Fees $268,000 18,000-250,000 18Co mmu nity Ch est 18,000 0-1 8,000 ICity 50,500 0- 32,500 3Sta te 114,000 0-114,000 7Federal Training

Grant 439,500 36,000-227,5 00 29Fede ral Resea rch

Grant 262 ,500 0-227,5 00 17Mental Health

Center 0 0 0Departmental 270,000 50,000-1 30,000 18Medical School 32,500 0-32,500 2Other 80,000 0-50,000 5

Total $1,535,000 100

Expenditures

Clinical Services $5 78, 000 60,000-300,000 38Education 542,000 126,000-2 I0,000 35Research 41 5,000 0- 380 ,000 27

Tota l $ 1,535, 000 426,000-650,000 100

an obligation for delivery of clinical services ; a greater financial in­vestment in the operation of clinical and educational programsthan in research and community services; the utilization of affiliaterelationships to independent organizations for fiscal support ofclinical services; and a crossover relationship between income re­ceived for clinical services, and expenditures for the academicfunction of research. A similar situation exists for the divisions asfor departments of psychiatry in their reliance on "soft monies" forsupport of programs.

The survey by the American Association of Psychiatric Clinicsfor Children (196 8) of 45 approved training clinics indicated thatincome sources were distributed in this way: 17% from fees; 12%from Community Chests; 10% from city; 10% from state; 36%from federal grants; 3% from medical schools and departments ofpsychiatry; 12% from others (foundations) . When compared(within the limits imposed by the three-year time difference) withthe data in Tables 5 and 6, the divisions in this study reveal a dif­ferent pattern of funding.

Faculty Size, Composition, and Comparisons

Although Table 7 revea ls the wide spectrum of professions holdingfaculty rank in the division s, the professions ordinarily viewed as

612 Meyer Sonis

the "traditional team" comprise 75% of the total full-time faculty,and 90% of the total part-time faculty. Of the 31 divisions, with atotal full-time faculty of 471, 14 had a full-time faculty of between4 and 10, 16 had a full-time faculty of between 11 and 30, and 1had a full-time faculty of 71. As shown in Table 7, of the 31 divisionsproviding for a total of 302 part-time and full-time child psychia­trists, 3 divisions had no full-time child psychiatrists, 9 had no part­time child psychiatrists, and 19 had both part- and full-time childpsychiatrists. Of the 19 divisions with part- and full-time child psy­chiatrists, the majority (13) had a ratio of 1 part-time to 2 full-timechild psychiatrists.

It is of interest to note that in the A.A.P.C.C. survey (1968) of 90child guidance clinics, the distribution for the full-time staff of the

Table 7

Professions Holding Academic Rank in 31 Divisions of Child Psychiatry Accordingto Full- and Part-Time Status

Profession

Child PsychiatristPsychiatristPh.D. PsychologistM.A. PsychologistSocial Work M.S.W.Social Work (no degree)PediatricianNurseEducatorPhysicianPsychotherapist

Total Faculty

Full TimeNo. %

133 447 35

78 7213 89

110 892 675 31

68 9650 98

I 1004 100

471 66

Part TimeNo. %

169 5613 6530 28

2 1113 II

I 3311 693 41 2o 0o 0

243 34

TotalNo. %

302 10020 100

108 10015 100

123 1003 100

16 10071 10051 100I 1004 100

714 100

"traditional team" was: 18% child psychiatrists, 28% psychologists,and 54% social workers. In this study of 31 divisions, Table 7reveals the distribution to be 40% child psychiatrists, 26% psychol­ogists, and 34% social workers.

It is of further interest to note that according to the National Ad­visory Commission Report on Health Manpower (1967), 947 childpsychiatrists comprised the available pool for the country; theA.P.A. Manpower Study (Whiting, 1968) reported 1,219 child psy­chiatrists in its membership; and yet, in a period of only one ortwo years, this study reveals that almost one third or one fourthof the earlier totals are to be found in only 31 divisions of childpsychiatry.

In order to provide a gross comparison of the faculty patterns inthe divisions of child psychiatry with those of other academic facul-

Pilot Study ofDivisions of Child Psychiatry 613

Table 8

Comparison of Faculties of Divisions of Child Psychiatry, Several Departments,and All Clinical Departments in Medical Schools *

% Full-Time Faculty OnStatus Profession Federal Grant Support

% Full % Part % % Non-Time Time M.D. M.D. None 1-49% 50-99% 100%

31 Divisions of ChildPsychiatry 66 34 43 57 65 16.5 11.5 7

Department of Psychiatry 29 71 65 35 40 25 19 16Department of Pediatrics 29 71 80 20 53 18 12 19Department of Public Health 42 58 65 35 67 16 17 34All Clinical Departments 20 72 83 17 55 19 12 14

* Caution is expressed since this table is a gross approximation of data from two sources:this study and American Medical Association (1967).

ties, Table 8 is presented. Despite the caution which is expressed inthis gross comparison of data secured through two differentsources (see footnote, Table 8), the pattern of the divisions doessuggest a profile which is quite different from that found in psychi­atry or other clinical specialties; a reliance on nonmedical profes­sions for discharge of functions of the divisions; and lesser relianceof the divisions on grant support for their full-time faculty (Sonis,1970a).

Faculty Salaries and Benefits

Of the 32 divisions, 15 (47%) defined their organization as aca­demic full-time (full-time salary, no other compensation allowed);10 (32%) defined their organization as geographic full-time (full­time salary, other compensation allowed); 3 (10%) defined their or­ganization offering both (academic and geographic); and 4 (11%)of the divisions did not supply information.

Table 9 presents the distribution of these divisions according tothe range of salary for each rank. As can be seen, and as ordinarilyassumed, there is a tendency for more of the academic full-timedivisions to offer higher salary ranges than the geographic full­time divisions.

Additional comments made by the respondents in regard to sal­aries were: "Changes are anticipated in our definition of academicfull time in order to permit higher salaries and outside compensa­tion. Psychiatrists have a higher salary range than the other clinicaldepartments. Salaries augmented by a partnership corporation."

From information on 30 divisions, the following emerged inregard to the benefits provided by them for full-time faculty mem­bers. Of the 30, 13 (42%) offered tuition scholarships for faculty

614 M eyer Sonis

T ab le 9

Number (Percent) o f Division s of Child Psychiatryby Academ ic Rank and Salar y Range *

AcademicAcademic Rank and All F.T. Geo graphic

Salary Range Division s Divisions FT. Div. Mixed Unknown

Instructor$ 10-20,000 20 (80%) 7 (70%) 8 (90%) 2 (67%) 3 (100 %)$20- 30,000 5 (20%) 3 (30%) I (10%) 1 (33%)

Assista nt Pro fesso r$ 10-25,000 24 (83%) I I (79%) 8 (90%) 2 (67%) 3 (100%)$ 15-30,000 5 (17%) 3 (21%) 1 (10%) I (33%)

Associate Professo r$ 15-25,000 8 (28%) 2 (15%) 4 (46%) 1 (33%) 1 (25%)$ 15- 35,000 18 (6 1%) 9 (70%) 5 (54%) 1 (33%) 3 (75% )$25- 35,000 + 3 (11%) 2 (15%) 0 1 (33%) 0

Professor$ 15-25,0 00 3 (12%) 0 2 (22%) 1 (33%) 0$ 15-35,000 12 (46%) 6 (50%) 5 (56%) 0 1 (50%)$ 15-35,000 + II (42%) 6 (50%) 2 (22%) 2 (67%) 1 (50%)

* T he nu mber of divisio ns with no one in this rank, was del eted .

children attending college at home; 6 (20%) offered tuition schol­arships for facu lty children attending a college awa y from home;24 (80%) provided for T.I. A.A.; 8 (27%) paid th e professionaldues of facul ty members; 12 (40%) offered a part-tuition scholar­ship for wife or husband of a faculty member attending under­graduate college; 22 (73 %) provided fo r a part paid sabbaticalleave ; 1 (4%) provided for par tial or total cost of psychoanalytictraining. An examination of the benefits provided showed that ex­cept for sabbat ical leave, a higher percentage of academic fu ll-timedivisions offered th ese benefits th an did geog ra phic full-time divi­sions . Among other be nefits noted by th e respondents were hospi­talization insu rance, special mortgages, major medical insurance ,group life insurance, malpractice insurance, travel ex penses paid.

Child Psychiatry R esident Positions in the Divisions

T he 31 divisions of child psychiatry offered 208 resident positions,and filled 165 (79 %) of these positions. O f th e 31 division s, 22 of­fered between 6 and 8 resident positions eac h. T he largest numberof res ident positions offered was 14, and th at in only one d ivision.Of th e 31 divisions, 13 div isions (42%) had no residency vacancies,while 18 divisions (58%) did . It is of intere st to note that the 13divisions with no vacancies comprised 42% of all the divisions re­porting, provided for 51% of the total resident positions offered ,

Pilot Study of Divisions of Child Psychiatry 615

Div. WithVacancies

N %

7.5 2 1054 II 6231 5 28

7.5 0 0

100 18 100

0 2 1038 4 2447 10 56

7.5 2 10

7.5 0 0

100 18 100

o56

13

I74I

13

Table 10

Comparison of Divisions of Child PsychiatryWhich Do Not Have and Have Vacancies

by Stipend Level Offered

Div. WithNo VacanciesN %

Total

Second-Year ResidentPublic Health Stipend AlonePublic Health Stipend + $3,000Public Health Stipend + $5,000Public Health Stipend + Practice

Supplement

No Public Health Stipend

Total

Stipend LevelOffered

First-Year ResidentPublic Health Stipend AlonePublic Health Stipend + $3,000Public Health Stipend + $5,000No Public Health Stipend

constituted 55% of the divisions with the largest number of posi­tions offered, and had 74% of all the residents filling positions in31 divisions. It is of further interest to note that of these 13 divi­sions with no vacancy, 10 were divisions in departments of psychia­try which also had no resident vacancies in general psychiatry andoffered the largest number of resident positions of 27 departmentsof psychiatry.

Of the 31 divisions, 60% offered a Public Health stipend plus$3,000, and 29% offered a Public Health stipend plus $5,000 tofirst-year residents in child psychiatry. Of the 31 divisions, 29% of­fered a Public Health stipend plus $3,000, and 51% offered a Pub­lic Health stipend plus $5,000 to second-year residents in child psy­chiatry. As Table 10 reveals, stipend level offered does not seem tobe a major distinguishing feature between divisions with vacanciesand no vacancies. From the more total information available, dis­tinguishing features between divisions with vacancies and no vacan­cies are suggested in other factors of operational nature, such asthe size of resident positions offered and filled by the parent de­partment; approximation of the division to the "ideal" of clinicalservices provided; size of the division, in terms of number of full­time faculty, number of child psychiatrists on faculty, amount ofbudget; and the extent of involvement of the division in policydecisions of the parent department and medical school.

616 Meyer Sonis

Involvement of Divisions in Policy Decisions ofTheir Parent Department and School of Medicine

Of the 32 divisions, 30 provided definitive information regardingthe extent of their involvement in various policy decisions. Of these30 divisions, we find 28 involved in general policy matters of theirparent department; 26 involved in the planning of curriculum forresidents in general psychiatry; 26 involved in various committeesof their medical school; 24 involved in decisions regarding aca­demic promotions; 22 involved in budgetary decisions about childpsychiatry; and 21 involved in policy decisions regarding medicaleducation.

SUMMARY

This study, as reported in this paper, was born of a reality,challenge, and necessity during the process of founding the Societyof Professors of Child Psychiatry in 1969.

The reality for undertaking such a study was provided by theunparalleled opportunity available through the Society of Profes­sors of Child Psychiatry, namely, an organization whose mem­bership reflected the majority of child psychiatric programs in theUnited States which were operated by schools of medicine in 1969.

The challenge for planning such a study was provided by theagreement of 45 divisions of child psychiatry to provide a forumfor academic child psychiatry to discuss matters of scientific andoperational pertinence to planning, developing, and implementingthe function of child psychiatry within a school of medicine.

The necessity to conduct such a study emerged when it becameevident that more definitive information, of an administrative na­ture, would be required to discuss the mutual problems encoun­tered in discharge of the function of child psychiatry within aschool of medicine, if these discussions were to be more than ex­pressions of impressions, feelings, and wishes of 45 divisions ofchild psychiatry.

In light of the above reality, challenge, and necessity, this studywas conceived primarily as a feasibility study of a longer-range pos­sibility. In other words, this pilot study attempted to address itselfto the following sequential questions. Was it feasible, in 1970, to so­licit the interest of 45 divisions of child psychiatry in making orga­nizational and operational information available on each of theirprograms? Could this information be collected in some uniformmethod for purposes of rudimentary comparison with information

Pilot Study ofDivisions of Child Psychiatry 617

available elsewhere? Could such initial information provide a com­mon denominator for discussion of problems mutually encoun­tered by 45 divisions of child psychiatry? Would it be possible toutilize the experience gained in this initial exercise with 45 divi­sions of child psychiatry to evolve a more sophisticated informationsystem? Could the Society of Professors of Child Psychiatry, atsome future time, serve as both a forum and a voluntary center ofan information system for medical school child psychiatry pro­grams?

The results of this pilot study, as summarized in this report,suggest an affirmative answer to what is feasible and what might bepossible.

REFERENCES

ALLEN, F. H. (1961), Certification in child psychiatry under the American Board of Psychia­try and Neurology. Amer. j. Psychiat., 117: 1098-1101.

AMERICAN ASSOCIATION OF PSYCHIATRIC CUNICS FOR CHILDREN (1968), Children and Clinics(mimeographed). New York: A.A.P.C.C.

AMERICAN MEDICAL ASSOCIATION (1967), Medical education in the United States. j. Amer.Med. Assn., 202:725-832.

NATIONAL ADVISORY COMMISSION ON HEALTH MANPOWER (1967), Report, Volume II. Wash­ington, D.C.: U.S. Government Printing Office.

NATIONAL CONFERENCE OF 25 DIVISION CHIEFS OF CHILD PSYCHIATRY (1963), Report to Na­tional Institute of Mental Health.

SONlS, M. (l970a), The administrative place of child psychiatry within a department of psy­chiatry of a school of medicine. In: Academic Child Psychially, ed. P. L. Adams, H. H. Work,& J. B. Cramer. Gainesville, Fla.: Society of Professors of Child Psychiatry, pp. 107-125.-- (l970b), Report on survey of approved training programs in child psychiatry in

A.A.P.C.C. clinics (mimeographed). New York: A.A.P.C.C.WHITING, J. (1968), Psvchiatric Services and Manpower Utilization. Reports 2 & 3. Washington,

D.C.: American Psychiatric Association.