Career flexibility after internship?

[eudaimonism]

Hello All!

I am a bit more than half way done with my internship interviews and am starting to have questions regarding the flexibility of changing career settings following internship. I have/had interviews at VA hospitals, prisons, and state hospitals, as my main interests are severe mental illness and trauma. I have really enjoyed that majority of the sites I have visited, but was kind of surprised to feel a bit more excited about the VA hospitals (which I have no experience in). So, my question is, is internship placement restricting with regard to the future? If I match to a VA, would it be difficult to transition to a prison or state hospital if I don't like it? Or would it perhaps be more difficult to transition to a VA after being mostly trained in a state hospital or prison? For any of you that may already be at a VA, I am also curious how much I will be able to work with those with severe and persistent mental illness, although I would imagine it depends on the VA. I guess I'm also curious about how feelings of success and reward may differ across sites, which I think may be a component of VA hospitals that seems appealing, although just an assumption.

Thank you for any input you may have!

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[smalltownpsych]

I did my internship at a state hospital. Since then I have worked in community mental health (post-doc and one year licensed), private for-profit residential treatment, and currently at a private non-profit medical hospital. One of my cohort from internship at state hospital, did post-doc there, then worked there, and now is at a VA. There are many options and career paths in this field and it has not been my experience that the internship placement will limit you so long as it is an APA internship. That being said, experience in one setting leads to improved opportunity to keep working in that area.

 

[WisNeuro]

People jump around all the time. I will say that if you are already in the VA, you have a leg up on non-VA people. They like to keep people within the system. But I have colleagues who have easily jumped to non-VA positions for whatever reason.

 

[SmithPsy24]

Also, can you take a look at their APPIC pages and see what recent interns are doing? It's tough because they don't all provide that information, but sometimes that can give you information about what their interns do next.. (I remember a prison site in Phase III pointing out that their graduates worked in VA and state hospitals in addition to those who stayed in the prison system.)

 

[eudaimonism]

Great, thank you very much for your replies!

 

[Existenz]

It's almost always going to be easier going from a VA internship to a state hospital than vice-versa. This is because most good VA programs have some sort of University Affiliation; also VAs tend to keep it in the family. It's easier to get a job at a State hospital, having come from VA background, without any state hospital experience than moving from a state hospital to VA without any VA experience.

 

[psychrat]

I think it is easier, but not impossible. I know one person who is currently at a hospital and has about five VA postdoc interviews. I also know of someone who did their internship at a college counseling center and then did their postdoc at a VA and currently works in the VA.

 

[Therapist4Chnge]

A person can secure employment at a VA w/o prior experience…it just really helps to have trained in the system. The most competitive applicants have solid training in substance abuse, SMI/chronic mental illness, assessment, and training in EBTs like Prolonged Exposure Therapy, CPT, etc. The VA is big into EBTs and most have a strong need for fellowship trained specialists (e..g Primary Care, Neuropsych, Gero, etc).

 

[AcronymAllergy]

A person can secure employment at a VA w/o prior experience…it just really helps to have trained in the system. The most competitive applicants have solid training in substance abuse, SMI/chronic mental illness, assessment, and training in EBTs like Prolonged Exposure Therapy, CPT, etc. The VA is big into EBTs and most have a strong need for fellowship trained specialists (e..g Primary Care, Neuropsych, Gero, etc).

Agreed. Also, I think it's important to note that at least in my experience, it's actually a bit easier (relatively speaking) to land a postdoc than a job. This is probably true in just about every setting, VA included. There's just typically more competition for each available spot.

 

[jgg323]

Great, thank you very much for your replies!

I am applying to internship as well and what I am seeing/hearing from other professionals is that if you want to specialize (e.g. ABPP) then it really matters. It is also important to note that what you do during your internship year really sets you up for postdoc oppurtunities. However, I think there is flexibility in moving around; particularly if you want to work at a state hospital. In my experience, it's hard to find good people who want to work at a state hospital and so that oppurtunity will likely always be on the table for you regardless of where you end up for internship.

 

[Fan_of_Meehl]

Hello All!

I am a bit more than half way done with my internship interviews and am starting to have questions regarding the flexibility of changing career settings following internship. I have/had interviews at VA hospitals, prisons, and state hospitals, as my main interests are severe mental illness and trauma. I have really enjoyed that majority of the sites I have visited, but was kind of surprised to feel a bit more excited about the VA hospitals (which I have no experience in). So, my question is, is internship placement restricting with regard to the future? If I match to a VA, would it be difficult to transition to a prison or state hospital if I don't like it? Or would it perhaps be more difficult to transition to a VA after being mostly trained in a state hospital or prison? For any of you that may already be at a VA, I am also curious how much I will be able to work with those with severe and persistent mental illness, although I would imagine it depends on the VA. I guess I'm also curious about how feelings of success and reward may differ across sites, which I think may be a component of VA hospitals that seems appealing, although just an assumption.

Thank you for any input you may have!

Wherever you end up I would recommend continually increasing your knowledge base, seeking out diverse clinical experiences, learning from others who have experience with a certain technique/school/diagnosis, and trying to build your vita as you go along. These things you can always take with you to your next position and you will never lose these experiences due to having to go to a different position at a different site. What you WILL lose is any political 'credit' you try to build up by sucking up to local politicians/administrators...so don't go that route. When a corrupt environment implodes, so do its 'leaders.' Build strong relationships with quality colleagues and invest in yourself as a professional and, in the long run, I think that will serve you best. And don't forget to have fun Best of luck to you for a stellar career!

 

[psychrat]

I am applying to internship as well and what I am seeing/hearing from other professionals is that if you want to specialize (e.g. ABPP) then it really matters. It is also important to note that what you do during your internship year really sets you up for postdoc oppurtunities. However, I think there is flexibility in moving around; particularly if you want to work at a state hospital. In my experience, it's hard to find good people who want to work at a state hospital and so that oppurtunity will likely always be on the table for you regardless of where you end up for internship.

what do you mean by good people? That just seems like a loaded thing to say. Also, in many states state hospital jobs are pretty competitive and not "always" on the table. I do not know of any position in this field that is always on the table, especially as the market it becoming more saturated. Just my opinion.

 

[jgg323]

Maybe it varies by state. I love hospital work and I know others who are passionate about it but it seems like most psychologists/students are more interested in other areas such as health psych or private practice. At the hospital I work at its very hard to recruit psychologist and the pay is very competitive. Again, just my experience talking. It may be very different in other areas or states. I can't back myself up with research or anything.

 

[Existenz]

what do you mean by good people? That just seems like a loaded thing to say. Also, in many states state hospital jobs are pretty competitive and not "always" on the table. I do not know of any position in this field that is always on the table, especially as the market it becoming more saturated. Just my opinion.

There are way more state hospital positions than VA positions.

 

[weeblewobble]

There are way more state hospital positions than VA positions.

Right, and my understanding from my mentor and older lab mates is that because fewer people want to go the state hospital route, state hospital spots have far less applicants and so can't be as choosy as VAs.

 

[psychrat]

Definitely varies by state. Yes VAs probably get more applicants, but I know of a local state hospital that just received over 200 applicants for one entry level position.