The Four Horsemen and the American Board of Psychiatry and Neurology (ABPN)

Abstract

ABSTRACTAfter the gradual introduction of specialties in medicine in the United States during the late-nineteenth and early-twentieth centuries, the American Board of Psychiatry and Neurology (ABPN) was founded in 1934 to provide specialty regulation (training oversight, examination, and certification). The name reflects the combined practice of psychiatry and neurology that was still present at the time. Directors were nominated by the founding organizations: American Psychiatry Association (APA), American Neurological Association (ANA), and the Section of Nervous and Mental Diseases of the American Medical Association (AMA). Many of the early physicians who were certified by the ABPN did so for psychiatry as well as neurology. Neurologist Walter Freeman and psychiatrist Adolph Meyer played important roles in the ABPN during the early days. Following the founding of the AAN in 1948, neurological practitioners believed the AAN would better represent them in the ABPN. At first the ANA appointed AAN members to the ANA Council; but after 1972, the AAN could directly nominate directors for the ABPN. Despite this situation, the AAN had an important influence in the ABPN from its start, as is shown by the fact that all of the key organizational leaders responsible for founding the AAN—the “Four Horsemen” (Abraham B. Baker, Russell N. DeJong, Francis M. Forster, and Adolph L. Sahs—served as directors of the ABPN in the period 1951–1967. The Horsemen were able to change both examination practices that became more searching and expansive, and the basic disciplines that needed to be studied in detail.