appic/apa internship - Fam Med and Sleep Med experience

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Hello All-
I hate to annouce I'm part of the 20% that didnt match for internship last year.
I hate it, but I know it'll work out for the best.
Anyways, I'm making a preliminary list of places to apply to this year. I'm looking for sites I might not know about to add to my list to investigate further, and potentially apply to.

Factors:
- Dont care about pay (that much, but I cant do it for free)
- Dont care about location (but in a perfect world, I'd be close to decent sized airport and not in the middle of nowhere, as that's been a larger burden than I ever imagined the last few years)
- Needs to be APA approved.
-Looking for experience working in Sleep Medicine/Family Medicine/Primary Care/Hospital setting. If possible, inpatient and crisis experience would be great as well.
-Orientation isnt a BIG deal, but I'm pretty much CBT/Family Systems/ACT myself. So getting a faculty that's going to push psychodynamic on me probably wont fly, at all.
-Whether or not it's a VA or some other setting doesnt really matter to me. What matters is what I'll get to do.
-I love me some reseach, but I'm not looking to do that on internship. I want to be a good practioner, quite frankly.

I'm not from a big name program. Though that's not explicitly a factor, it does make some programs MUCH harder to get into.

Thanks,
bmedclinic

Originally Posted by bmedclinic

Hello All-
I hate to annouce I'm part of the 20% that didnt match for internship last year.
I hate it, but I know it'll work out for the best.
Anyways, I'm making a preliminary list of places to apply to this year. I'm looking for sites I might not know about to add to my list to investigate further, and potentially apply to.

Factors:
- Dont care about pay (that much, but I cant do it for free)
- Dont care about location (but in a perfect world, I'd be close to decent sized airport and not in the middle of nowhere, as that's been a larger burden than I ever imagined the last few years)
- Needs to be APA approved.
-Looking for experience working in Sleep Medicine/Family Medicine/Primary Care/Hospital setting. If possible, inpatient and crisis experience would be great as well.
-Orientation isnt a BIG deal, but I'm pretty much CBT/Family Systems/ACT myself. So getting a faculty that's going to push psychodynamic on me probably wont fly, at all.
-Whether or not it's a VA or some other setting doesnt really matter to me. What matters is what I'll get to do.
-I love me some reseach, but I'm not looking to do that on internship. I want to be a good practioner, quite frankly.

I'm not from a big name program. Though that's not explicitly a factor, it does make some programs MUCH harder to get into.

Thanks,
bmedclinic

I would encourage you to blanket the VA system with apps, as with exception of sleep medicine (although you will have plenty of opps for doing CBT-I protocols), almost all VA med centers have opps for PC psych and bmed in general. I think every single one of my patients here has diabetes, so im sure you'd love it.

Originally Posted by erg923

I would encourage you to blanket the VA system with apps, as with exception of sleep medicine (although you will have plenty of opps for doing CBT-I protocols), almost all VA med centers have opps for PC psych and bmed in general. I think every single one of my patients here has diabetes, so im sure you'd love it.

Agree with erg 100%; the VA has a LOT of opportunities for PC psych, and the majority of your patients will have multiple medical problems (as erg pointed out, DM and HTN are unfortunately nearly universal, it seems).

I'd also definitely look into consortiums, as many acadmic medical centers will be able to get you some inpatient experience that might not be available through a stand-alone VA. UAB and MUSC/Charleston Consortium are two that immediately spring to mind (is my southern bias shining through...?).

Originally Posted by AcronymAllergy

UAB and MUSC/Charleston Consortium are two that immediately spring to mind (is my southern bias shining through...?).

These are both very research friendly places. You'll need some solid publications to be competitive (from what I've been told, I didn't end up applying at either). I think the VA is a great place to train for Primary Care, as they have a big focus in this area....particularly if you are a psychologist/health psychologist. You'll see plenty of comorbidity with various sleep disorders (e.g. sleep apnea, etc). Academic medicine can have similar opportunitities, but it depends on the site.

Thanks for the feedback, guys. I'd appreciate more. I have considered some VA's for sure.
Erg, there's the reason they call it dye-uh-beat-us in the south- because every southerner has it!
As far as sleep goes, I'm looking to work in a sleep clinic, get exp reading a polysomnogram-- not just doing sleep hygiene, etc.

What I didnt say, and I'm editing my post now to say is that the most important of all of the experiences I get in internship at this point is being in a sleep clinic, even if it's only for a minor rotation. Thanks again, all. I'll check out MUSC/Charleston Consort!

The VAs will probably provide you with the best overall set of opportunities given your interests, as other posters here have mentioned.

I also would suggest looking into County Hospitals. Some have BMed programs and your population will have just as many (and probably more) health comorbidities as you would find at a VA. But the training quality is likely going to vary a bit from place to place, and it may not be as rigorous as a VA.

Originally Posted by bmedclinic

Thanks for the feedback, guys. I'd appreciate more. I have considered some VA's for sure.
Erg, there's the reason they call it dye-uh-beat-us in the south- because every southerner has it!
As far as sleep goes, I'm looking to work in a sleep clinic, get exp reading a polysomnogram-- not just doing sleep hygiene, etc.

What I didnt say, and I'm editing my post now to say is that the most important of all of the experiences I get in internship at this point is being in a sleep clinic, even if it's only for a minor rotation. Thanks again, all. I'll check out MUSC/Charleston Consort!

Look into the University of Rochester. I don't know if they have openings but they are very strong on integrating psychology with family medicine, also have had a fabulous family therapy training program.

don't know if they offer a rotation in it, but i know that umass med has a psychologist that specializes in sleep and have some health psych rotations through the hospital

I saw quite a few sites with sleep rotations when making my own preliminary list... Granted, I don't have that list in front of me, and I don't remember them after going through ~458 sites. I do seem to think that most of them were at hospitals or academic medical centers.

After working as a PSG tech previously, I'd love to find a place that has a minor rotation, but I'm not sure you're going to learn everything on a "minor" rotation during internship to read a polysomnographic record (and I'm not sure if I recall any places that had more "major" rotations off the top of my head). I'm also wondering whether these sites actually teach you that aspect at all or whether it's more sleep hygiene and working with folks with various sleep disorders (most of the folks I know in the sleep arena who read the charts are psychiatrists, respiratory techs, psg techs, etc.)

G'luck!

If you want the name of an absolutely fabulous sleep medicine expert (and psychologist) who I actually learned a bit of the basics from when I was an intern (and I learned how to do some basic navigating of PSG studies from her too), PM me and I can give you her info. She may know some good places to look for training.

update:
I found a pdf put out by Florida. I know its a few years old because I remember seeing it a few years ago. Either way, it lists at all levels (undergrad/grad courses/experiences/internship/postdocs) what places are areas of sleep you can get involved at.

So far, it's the best I've got. Sadly, I think every place I saw on there I'd already found. Good news: my list was exhaustive. Bad news: there's not enough spots out there.
http://sleep.phhp.ufl.edu/about/pdf/...%208-20-10.pdf

I am specializing in behavioral sleep medicine, so I am happy to see that you are interested in sleep medicine! Here are a few of the programs that pop into my head.

Detroit VA
Ann Arbor VA
University of Rochester (someone else mentioned, Wil Pigeon is a good sleep med supervisor)
UCSD
Western Psych, though it is very research-heavy

And the one site you HAVE to check out that I bet you haven't found yet: WVU Charleston. Great behavioral med site, they have sleep medicine, solid program!

Originally Posted by irish80122

I am specializing in behavioral sleep medicine, so I am happy to see that you are interested in sleep medicine! Here are a few of the programs that pop into my head.

Detroit VA
Ann Arbor VA
University of Rochester (someone else mentioned, Wil Pigeon is a good sleep med supervisor)
UCSD
Western Psych, though it is very research-heavy

And the one site you HAVE to check out that I bet you haven't found yet: WVU Charleston. Great behavioral med site, they have sleep medicine, solid program!

They're actually on my list. So there!

Originally Posted by paramour

They're actually on my list. So there!

lol, Paramour, how long have we both been on this board? I probably told you about it back when I applied to internship .

Originally Posted by irish80122

lol, Paramour, how long have we both been on this board? I probably told you about it back when I applied to internship .

Perhaps. I kept think it sounded reeeeally familiar for some reason but couldn't quite put my finger on it.

Originally Posted by irish80122

I am specializing in behavioral sleep medicine, so I am happy to see that you are interested in sleep medicine! Here are a few of the programs that pop into my head.

Detroit VA
Ann Arbor VA
University of Rochester (someone else mentioned, Wil Pigeon is a good sleep med supervisor)
UCSD
Western Psych, though it is very research-heavy

And the one site you HAVE to check out that I bet you haven't found yet: WVU Charleston. Great behavioral med site, they have sleep medicine, solid program!

ok, so here's what I've learned. Most all of these I knew existed and were on my list (including the WVU Charleston one, and I'm sad in a totally selfish way others knew about that site).

I guess I would just think there would be more interest. I feel like I'm going to have a really hard time competing with those who have been in programs that allowed them the opportunity to do sleep med stuff, whereas I've been doing a lot of primary care/fam med stuff up to this point, but very little sleep stuff (except for my thesis- which was at a diff university where I had access to 1 sleep person and their lab).

Originally Posted by bmedclinic

ok, so here's what I've learned. Most all of these I knew existed and were on my list (including the WVU Charleston one, and I'm sad in a totally selfish way others knew about that site).

I guess I would just think there would be more interest. I feel like I'm going to have a really hard time competing with those who have been in programs that allowed them the opportunity to do sleep med stuff, whereas I've been doing a lot of primary care/fam med stuff up to this point, but very little sleep stuff (except for my thesis- which was at a diff university where I had access to 1 sleep person and their lab).

I understand your feelings about WVU Charleston, it is a wonderful site that I assume no one has heard about because it is in West Virginia, and yet everyone has heard about it. I interviewed there last year, and while I didn't match there, I have tremendous respect for their program.

As far as experience with sleep medicine, I think you are over-estimating how many applicants have sleep med experience. Heck, last time I checked there were only about 150 psychologists certified in Behavioral Sleep Medicine in the US (here is the list: http://www.absm.org/bsmspecialists.aspx). Thus, I don't think there are that many trainees whom have had the opportunity to be trained in BSM.

Another thing to consider is even if you don't get the experience during internship, there are several very strong post-docs that are focused in sleep medicine. Sadly, I am not sure that they are that popular (I have seen one very good one re-posted three times this year). I think you can be competitive for the post-docs even without much experience in sleep medicine, and they would prepare you well for the CBSM exam.

I hope that helps some, good luck!

Thanks for the reply, Irish.
In what you've seen, do the people who have more experience than I do seem to match with the sleep places? Am I on the outside looking in, or do I have a fair chance even though I've only done very little work with the sleep area?

Originally Posted by bmedclinic

Thanks for the reply, Irish.
In what you've seen, do the people who have more experience than I do seem to match with the sleep places? Am I on the outside looking in, or do I have a fair chance even though I've only done very little work with the sleep area?

From what I have seen, I think you have a good shot at the sleep places. Remember, this is internship, so the focus is (or at least should be) on training. When I applied, I already had two years of sleep med experience, so what I found was that while sites were receptive to letting me to sleep med again, since it was of interest, they encouraged me to think about other rotations that would better help me round out my experience. In other words, sometimes experience can work against you.

Like with most things, internship is at least in part about match, but it isn't always the match you think of. For instance, for where I matched, I thought I was out-classed by several other applicants. Others had more experience than me in the area that the site specializes in, and had significantly more publications in that area than me (it is a research-heavy site), etc. However, I later found out that I was ranked very highly because they wanted someone who needed trained in the areas that they were strong. Thus, being interested in an area, but not having had the opportunity to gain experience, is actually a really strong place to be IMHO. Again, it is a training year, you are not meant to be a final product yet!