The American Medico-Psychological Association (AM-PA)
was founded in 1892 primarily to accommodate the increasing number of asylum
physicians who were not directors. This
organization began publishing the American Journal of Insanity in July
1844 and it was continued until May 1943 when it became the American Journal
of Psychiatry. The AM-PA
transitioned to the American Psychiatric Association in 1921. Between 1880 and 1920 there was a journal Alienist
and Neurologist that I am using as a proxy for alienists in the US. The literature at the time reflects the use
of both terms (alienist and psychiatrist) in the same literature – even though the term psychiatrist was coined by Reil in 1808.
So the questions remain.
How did this transition between asylum directors, alienists, and psychiatrists
occur? When did modern psychiatric
training start? Another indicator is the early establishment of psychiatric hospitals
and clinics. I recently added the New
York State Psychiatric Institute (NYSPI) and Johns Hopkins to the timelines
for establishing education and research program in 1895 and 1913 respectively.
Johns Hopkins is considered to have established the first residency programs in
Internal Medicine, Surgery, and Gynecology in 1889. The Phipps Clinic opened at Johns Hopkins in 1913 under the leadership of Adolph Meyer. It was described by Shorter as a German-style psychiatric clinic. I was having some difficulty
getting adequate documentation on the first residency programs in psychiatry
until today.
Today I got the first solid information on psychiatric residents
from NYSPI. In July of 1930, there was
an initial reference to 3 psychiatric “internes” being appointed. I was very grateful
to receive that information from a colleague on Twitter who was kind enough to
ask an archivist at this institution about this information. The American Board of Psychiatry and
Neurology was formed in 1934 so there were probably several residency
programs at that time.
If you are a residency director, archivist or historian for
a large medical school program and have similar information on the first
residency program at your institution – I am very interested in hearing about
it and will place your program on the timeline.
I am also very interested in the actual numbers of asylum
directors, alienists, and psychiatrists at all points in time across the span
of this timeline. I have very accurate information
for the past several decades. I am very
interested in any historical information on how the numbers of these subgroups
varied in the late 1880s to mid 1900s. I
appreciate any data that can add to this timeline.
George Dawson, MD, DFAPA
