Certification in ECT

Journal of ECT

Volumn 14, Issue 1, 1998, Pages 1-4

  Max Fink, ^a   Charles H Kellner, ^b  

^a NONE   (United States)

^b NONE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CERTIFICATION; CURRICULUM; EDITORIAL; EDUCATION; ELECTROCONVULSIVE THERAPY; HEALTH CARE QUALITY; HUMAN; LEGAL ASPECT; MEDICAL EDUCATION; PSYCHIATRY; UNITED STATES;

CERTIFICATION; CURRICULUM; ELECTROCONVULSIVE THERAPY; HUMANS; INTERNSHIP AND RESIDENCY; PSYCHIATRY; QUALITY ASSURANCE, HEALTH CARE; UNITED STATES;

EID: 0032015256     PISSN: 10950680     EISSN: 15334112     Source Type: Journal    
DOI: None     Document Type: Editorial

References (21)

1. Hermann RC, Dorwart RA, Ettner S, Hoover CW, Yeung E. Characteristics of psychiatrists performing ECT. Am J Psychiatry (in press). Psychiatrists performing ECT were more likely to be male, having graduated from a non-US. medical school, completed a fellowship in geriatric psychiatry, trained in the 1960s or the 1980s rather than the 1970s. They conclude: “Expanding training opportunities for ECT and making education, training, and testing more consistent nationwide could improve clinician consensus about ECT and narrow variation in its use,”
2. Pippard J, Ellam L. Electroconvulsive treatment in Great Britain, 1980. Gaskell, London, 162 pp., 1981.
3. Pippard J. Audit of electroconvulsive treatment in two national health service regions. Br J Psychiatry 1992;160:621-37.
4. A recent survey of British registrars finds training in ECT remains informal. One-half of the queried senior residents reported variable training with "… their initial experience not supervised by an experienced psychiatrist on the first occasion they administered ECT. Responses to exam-type questions revealed that 45% lacked knowledge about one or more basic issues related to effective administration of ECT,” Duffett R, Lelliott P. Junior doctors’ training in the theory and the practice of electroconvulsive therapy. Psychiatric Bulletin 1997;21:563-5.
5. Fink M. Random thoughts about ECT. Am J Psychiatry 1981;138:484-5.
6. Fink M. Training in convulsive therapy. Convulsive Ther 1986;2:227-229.
7. Fink M. New technology in convulsive therapy: A challenge in training. Am J Psychiatry 1987;144:1195-8.
8. Consensus conference. Electroconvulsive therapy. JAMA 1985;256:2103-8.
9. Following publication of the 1978 APA Task Force report, many hospitals sought to develop ECT facilities, but the cadre of trained ECT practitioners was small. By the mid-1980s, single day courses were developed in conjunction with meetings of the American Psychiatric Association and later, the Association for Convulsive Therapy. The courses were led by Richard Abrams, Max Fink, Donald Hay, Richard Jaffe, and Charles Kellner under the auspices of their academic institutions, the APA, ACT, and CME, Inc. Despite enthusiastic attendance, both the instructors and the students realize that these didactic lecture-format courses of 3 to 10 hours are limited in their ability to translate the skills needed for a technical practice that can come mainly from “hands-on” experience in treating individual patients.
10. Fellowships are available at Columbia University (Harold Sackeim), Duke University (Richard Weiner), Medical University of South Carolina (Charles Kellner, Mark Beale), and the Long Island-Jewish Hillside Medical Center (Max Fink, Samuel Bailine).
11. American Psychiatric Association. Electroconvulsive Therapy. Task Force Report 14. Washington DC: American Psychiatric Association, 1978.
12. American Psychiatric Association. Electroconvulsive Therapy: Recommendations for Treatment, Training and Privileging. Washington DC: American Psychiatric Association, 1990.
13. Page 43.
14. Most certificates attest to 3 to 10 hours of CME attendance credit. The material is didactic and classes vary in size, but range from 25 to 100 students.
15. The aversion to ECT is so strong that even the remotest alternative is of national interest “as a replacement for ECT,” Interest is now aroused by rTMS-rapid transcranial magnetic stimulation-which is espoused as a replacement for ECT. The evidence for an effect in mental illness of the severity treated by ECT is as yet too little to justify the interest that these studies have generated.
16. Convulsive Therapy [now The Journal of ECT] is the official journal of ACT. The report of the Task Force on Ambulatory ECT was endorsed by the Association and published in the journal in 1996 (12:45-55).
17. Abrams R. Electroconvulsive Therapy. 3rd Ed., New York: Oxford University Press, 1997.
18. Kellner CH, Pritchett JT, Beale MD, Coffey CE. Handbook of ECT. Washington DC: American Psychiatric Press, 1997.
19. Coffey CE. (Ed.) The Clinical Science of Electroconvulsive Therapy. Washington DC: American Psychiatric Press, 1993.
20. Herman RD, Dowart RA, Hoover CW, Brody J. Variation in ECT use in the United States. Am J Psychiatry 1995;152:869-75.
21. Thompson JW, Weiner RD, Mayers CP. Use of ECT in the United States in 1975, 1980, 1986. Am J Psychiatry 1994;151:1657-61.