PhD/PsyD EPPP Step 2

[Shooter]

Reflections of a Modern Psychologist:

"Today, I was privileged to have come across an unusual case. From the second we met, my intuition started telling me something serious was bothering this young man. Once we sat down at the office, his self-reports and behavioral observations, started to sound like out of a Anatomy and Pathophysiology textbook... and like a Health Psychology class from grad school. I was not convinced.. until he endorsed family history of Huntington's Chorea. Consultation with Neurology confirmed that he was at the beginning stages of this Major Neuro-Cognitive Disorder.

While it is fascinating to have come across such an unusual case (from the clinical standpoint), helping him understand what's ahead of him and his prognosis, was a process for the both of us. Today, I cannot help but Reflect on what is like to be a Psychologist:

The things that make up a Psychologist ARE NOT affiliations, accreditations, status, state rules, over-priced exams, or money spent on certifications. The things that make up a Psychologist ARE FORMED by the Psychologist's Experiences...the People.

What I'm Saying Is... Psychologists can create definitions for the "practice psychology" all they want... but much more importantly, our experiences with people is what really create us as Psychologists.

What If...We Stopped Depriving Thousands of People the Opportunity to Make Us Better Psychologists?

What If...We Stopped Creating Unnecessary Hurdles for a Handful of Organizations to Profit Financially by the Millions $$$?

What If... We Could DO This Right Now??

WITH the APA Licensure Model (2010) Alone..
AND
WITHOUT the ASPPB Compensating Psychologists in Public Office (perhaps promoting a self-serving rule-making process)..

There Would Be NO License Portability Issues For Psychologists in this Country.

It Is Time The Field of Psychology Opens Its Eyes.

If We Cannot Think Differently There Will Be No Progress.

Non-Leaders Need Not Apply

#NoEPPP2

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Members don't see this ad.

 

[WisNeuro]

What if ....we appropriately used the rules of capitalization?

 

[Shooter]

While We Are The Toughest Critic on These Type of Organizations, We Must Admit That... We Agree With Most of the Points Made Here By APAGS Chair, Dr. Christine Jehu.: “Thoughts On The EPPP-2":

“You may have heard that the Association of State and Provincial Psychology Boards (ASPPB) is currently developing a second examination (EPPP Step 2) for psychology licensure to assess clinical competency. This exam would follow the Examination for Professional Practice in Psychology (EPPP).

This exam may feel like a massive surprise to students and Early Career Psychologists. Unbeknownst to many of us, our field has been moving toward competency assessment since the Competencies Conference in 2002 and subsequent publications highlighting the importance and value in competency assessments (e.g. Rodolfa, Bent, Eisman, Nelson, Rehm, & Ritchie, 2005). During the 2013 updates to the APA Commission on Accreditation’s Guidelines and Principles, the APAGS Committee provided a comment that supported the development of competencies based assessment, but had concerns about cost, the process of assessing competencies, and the fair implementation of a new exam to psychology license applicants.

Given that ASPPB has started development of a clinical competencies exam, the APAGS Committee has discussed this issue at length. A number of concerns and issues arose that we would like to highlight:


Cost – The cost of the current EPPP is $687 in most jurisdictions. This is substantial to graduates who may owe a median debt of up to $200,000 (Doran et al., 2016). Students have reported that finances are the #2 stressor they face in graduate school (El-Ghoroury et al., 2012). To be fair to the next generation of psychologists, APAGS believes the cost of the EPPP Step 2 needs to be as low as possible, with serious consideration given to cutting costs in other areas as well (e.g., current EPPP).

Sequence of Examinations and Training –

1. The EPPP typically is administered after the doctorate degree has been awarded and all requirements for licensure have been completed, including postdoctoral requirements in over 35 US jurisdictions. The ASPPB proposes the EPPP Step 2 be administered after the first exam. APAGS is concerned that this would add substantially to the time it takes to get licensed, and psychologists already have the longest time to licensure when compared to other health professionals (Olvey, Hogg, & Counts, 2002).
2. APAGS strongly recommends that applicants have the option to take the EPPP Step 1 (the knowledge based exam) as soon as possible after completing coursework, and ideally before internship. This would put the EPPP in line with the United States Medical Licensing Examination (USMLE) Step 1 knowledge based exam, and would place the exam substantially closer to when coursework had been completed. Given that length of time from graduation is positively associated with a higher fail rate (Schaffer et al, 2012), moving the EPPP Step 1 before internship should substantially increase the first time
3. Finally, with a clinical competency exam such as the EPPP Step 2, APAGS would encourage ASPPB and jurisdictions to adopt the APA policy on sequence of training, recommending the doctorate as the entry level into the profession. Functionally, this would mean that training prior to the internship could be counted towards hours required by jurisdictions for licensure, and would eliminate the need for a full year postdoctoral supervised experience. This would allow licensure to occur sooner, and have substantial positive financial implications for new graduates.

Test Development – APAGS would like to know the data on the validity of exams such as the proposed EPPP Step 2. The ASPPB website currently has references for the history of the competency movement, but does not list references for the type of exam it hopes to develop. APAGS is also concerned that the time frame for the test development is fast; and that, in an effort to reach the completion date goal, the test may not be as fully developed or as valid as it could be with more time

Test Preparation – Finally, APAGS is concerned that the EPPP Step 2 is being developed without appropriate training for students in the pipeline. It is unfair to pose a test to students without training materials and information to the education and training community. Therefore, implementing a test would need to come after materials were distributed to the training community so that rising psychologists would be aware of the exam and have experience with components of the exam. Distributing these materials widely also provides accurate informed consent to students entering the psychology pipeline.

An additional exam, and the associated costs that come with it, without other changes in the process, are not ideal for students who are in the process of becoming a psychologist. However, if this exam could allow for the EPPP Step 1 (the knowledge based exam) to be moved before the internship, and if jurisdictions adopted the APA policy on sequence of training to allow psychologists to get licensed earlier, there would be substantial advantages for future psychologists. An earlier EPPP Step 1 would result in more applicants passing the exam on the first attempt (which is a better outcome). Earlier licensure could have substantial positive financial implications for psychology graduates, such as being eligible for the National Health Service Corps Loan Repayment Program a year earlier, or having a better paying position with possession of a license. Such changes to the licensure processes would make the addition of the EPPP Step 2 much more bearable and also put psychology’s licensure process in line with that of many comparable professions.”


P.S. Now watch @WisNeuro try to fit in.. again n switch stances LMAO

1. Still #NoEPPP2 #NoBackBone

 

[erg923]

Cost – The cost of the current EPPP is $687 in most jurisdictions. This is substantial to graduates who may owe a median debt of up to $200,000 (Doran et al., 2016). Students have reported that finances are the #2 stressor they face in graduate school (El-Ghoroury et al., 2012). To be fair to the next generation of psychologists, APAGS believes the cost of the EPPP Step 2 needs to be as low as possible, with serious consideration given to cutting costs in other areas as well (e.g., current EPPP).

I think you really need to recognize that this is choice, a rather dumb one, that students make. There is zero reason to take on such insane debt for a ph.d or psyd.

The majority of programs continue to provide tuition remission and stipends such that any loans taken out by the student need not rise to such insane levels in comparison to the expected income.

 

[erg923]

The things that make up a Psychologist ARE NOT affiliations, accreditations, status, state rules, over-priced exams, or money spent on certifications. The things that make up a Psychologist ARE FORMED by the Psychologist's Experiences...the People.

What I'm Saying Is... Psychologists can create definitions for the "practice psychology" all they want... but much more importantly, our experiences with people is what really create us as Psychologists.

What If...We Stopped Depriving Thousands of People the Opportunity to Make Us Better Psychologists?

What If...We Stopped Creating Unnecessary Hurdles for a Handful of Organizations to Profit Financially by the Millions $$$?

What If... We Could DO This Right Now??

WITH the APA Licensure Model (2010) Alone..
AND
WITHOUT the ASPPB Compensating Psychologists in Public Office (perhaps promoting a self-serving rule-making process)..

There Would Be NO License Portability Issues For Psychologists in this Country.

It Is Time The Field of Psychology Opens Its Eyes.

If We Cannot Think Differently There Will Be No Progress.

Non-Leaders Need Not Apply

#NoEPPP2

This looks/sounds.... paranoid.

Some of your valid points are going to be lost on your potential audience due to how you are presenting your material. You have been told this time and time again but arent listening.

 

[Justanothergrad]

This is substantial to graduates who may owe a median debt of up to $200,000 (Doran et al., 2016).

Besides the point that erg makes, you are clearly making misleading statements with that citation. No where in that article did it suggest this was a median debt (Third quartile of debt of PsyD.. but thats not the same and is much narrower). It is, in fact, NOT the median debt and not close to it. The median is 110 and thats skewed higher because of the 160 median for PsyD, particularly predatory PsyD programs.

 

[Shooter]

Besides the point that erg makes, you are clearly making misleading statements with that citation. No where in that article did it suggest this was a median debt (Third quartile of debt of PsyD.. but thats not the same and is much narrower). It is, in fact, NOT the median debt and not close to it. The median is 110 and thats skewed higher because of the 160 median for PsyD, particularly predatory PsyD programs.

that's the APAGS Chair article... "your rules don't apply here" best of luck

 

[Justanothergrad]

that's the APAGS Chair article... "your rules don't apply here" best of luck

Is there another article by Doran et al. (2016) that examines graduate debt besdies the one linked below that I referenced?

http://www.apa.org/pubs/journals/features/tep-tep0000112.pdf

 

[Shooter]

Is there another article by Doran et al. (2016) that examines graduate debt besdies the one linked below that I referenced?

http://www.apa.org/pubs/journals/features/tep-tep0000112.pdf

average numbers are 100,00o plus per APPIC stats

 

[Justanothergrad]

average numbers are 100,00o plus per APPIC stats

Yes, which is why I was confused about your use of the term "owe a median debt of up to $200,000". Although that 100k stat is largely skewed as average probably isn't the best measure since it is driven more heavily by outliers. Thus why the average is 94k per 2015 and the median is only 80k.

$0 515 19%
$1 - $9,999 130 5%
$10,000 - $19,999 123 5%
$20,000 - $29,999 109 4%
$30,000 - $39,999 97 4%
$40,000 - $49,999 88 3%
$50,000 - $59,999 87 3%
$60,000 - $69,999 93 3%
$70,000 - $79,999 84 3%
$80,000 - $89,999 119 4%
$90,000 - $99,999 52 2%
$100,000 - $149,999 428 16%
$150,000 - $199,999 297 11%
$200,000 - $249,999 240 9%
$250,000 - $299,999 104 4%
$300,000 - $349,999 64 2%
$350,000 - $399,999 15 1%
$400,000 or higher 23 1%

Even then, what is your expectation for what a reasonable level of debt is and what that range /should/ look like? What is your alternative to "no more costly testing" to become licensed? What model would serve better?

 

[WisNeuro]

@Justanothergrad , how dare you bring actual facts and logic into this discussion!

 

[Justanothergrad]

@Justanothergrad , how dare you bring actual facts and logic into this discussion!

I'll show myself out...

 

[smalltownpsych]

graduates who may owe a median debt of up to $200,000

What kind of meaningless statement that conflates individuals with a statistic used to describe a group is this? IMO Psychologists should be careful about language and especially when it comes to using statistical terms. After all, we are supposed to have expertise in this area. It's not like we are talking multiple regression analysis either, we're talking about properties of a distribution and measures of central tendency such as mean, median, and mode.

average numbers are 100,00o plus per APPIC stats

Average is not even the correct term because it lacks specificity.
It is ironic that you are arguing for less hoops to jump through or maybe not...

 

[dissonance_]

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[wandergirl]

Certainly any field where people's well-being is on the line should be regulated and that involves hoops. However, from what I can tell this idea of the EPPP Step 2 violates our own field's hard developed principles. Before you implement a plan to "fix" a problem, you need to do a thorough needs assessment. First of all, are we currently licencing an undue number of incompetent providers? If we are, is this exam, at the tail end of a 5-7 year training process, the answer? Can this exam actually ascertain someone's competence (personally I'm skeptical after taking the EPPP which to me lacks face validity, and I'm unaware of any evidence about its discriminative/construct validity). Will studying for this exam remediate incompetence?

As others have suggested, IF there is a competency problem, and IF these exams will be helpful to fixing this, the timing probably should be substantially earlier in the process for one or both of the exams.

 

[dissonance_]

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[Justanothergrad]

Sounds like an uphill battle. Re: validity, let's take it back to the first hoop-- the GRE. It can be argued that the GRE lacks validity. I remember reading a study from the (90's?) that showed the GRE was an unreliable predictor of graduate school success (for older students). I'm not sure what the mean age of incoming doctoral students is, but I'm guessing most have been out of school for several years (more than a few for me)

ETS themselves admit that the GRE accounts for only a small portion (8% iirc) of variance in first semester (only first semester) grades, but that isn't why its used. It's generally used because programs need a way to reduce down applicants because not everyone can get in- the rest is post hoc imho. A bad reason, but a reasonable one given the constraints of the application process. I don't disagree about the validity bar needing to be higher (and a strong focus) for the EPPP though, the expectation of the EPPP is not to cull out applicants in mass but to establish a bar where most people are trained too- very different from the role of the GRE.

 

[dissonance_]

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[Justanothergrad]

Point taken. I guess I'm a cynic regarding the validity of standardized testing and board exams/board committees in general. It was amusing to read @shooter's posts, mocking his peers and calling them(you) puppets. At the end of the day, we are all puppets to the big boys (e.g., insurance companies, big pharma, APA, ASPPB, ABCN, etc.). Money makes the world go round

Oh, You won't see me disagreeing on questioning the validity of testing. It's what I study lol

 

[dissonance_]

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[foreverbull]

I'm a little late to join this conversation, but while I understand the need for standardization and testing clinical skill, and the problematic issue of supervisors being invested in their own ratings, as I reflect on every single internship interview and several postdoc interviews I had, they essentially tested me clinically with their own case vignettes. Essentially everything we did in our doc program and all interviews were geared toward preparing us for clinical practice.

That being said, a second clinical test won't separate those who are intelligent enough to know what people expect from us clinically but then don't practice those skills vs. those who are solid practitioners. Is incompetent practice really a huge issue among doctoral level graduates? I am way more concerned about master's level training, because prior to my doc program, I attended a 2-year master's program in which ONE SEMESTER of practice prior to graduation was believed to be enough and qualified for readiness for practice in the field. This is a much bigger problem than doctoral level incompetence, in which there are at least 3+ years of practice before graduation.

If the ASPPB really cared about keeping costs down, they'd split the EPPP step 1 and combine it with questions from the EPPP step 2. Plain and simple. Problem solved. Instead, they're ensuring that it will be a separate test with separate practice materials, and making the test intensive enough that a lot of time and energy have to be spent to create it. That's why it feels money-driven to me. If they actually cared about the students they will be testing, they'd cut costs.