Problems with getting Neuro Prac sites/Will I be competitive for a NP Internship?

[neuroflail]

Hi all, first time poster here.

I have been struggling mightily trying to get neuro prac sites, and I am not sure why. I have had faculty review my application materials and done play by play reviews of interviews but I typically get 1-2 interviews from 15-20 applications and almost never get an offer by sites that see diverse neuro cases. I have been able to get sites through clearing house or through direct referrals by former supervisors/faculty, but the problem is that these sites do neuro testing almost exclusively on psych related cases, i.e. anxiety, or ADHD cases. I will be applying for internship in the fall, and I have 430 hours of F2F assessment (from Diagnostic and Advanced, I put off applying for a year to get more hours) - Will I be remotely competitive for internship? If not, is there anything I can do to help? A list of things I have tried includes: Joining more professional organizations, taking CEUs to add as additional education of my CV, I will be attending a brain dissection lab this summer, taking on supplementary practicum hours at different sites, attempting to get research assistant or psychometrist positions (like practica, I cannot seem to get interviews/offers). Any feedback or ideas would be greatly appreciated.

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[WisNeuro]

At some sites, this will hurt. They will look at where you accrued this experience. It will also impact you in that it will difficult to get letters of rec from boarded neuropsychs, which will be important for more neuro focused internship slots. Some of the peripherals will help (brain dissection lab). It's a bit concerning, many of the stronger applicants are coming from programs that have very good relationships with practicum sites for their students' placement. Best thing you can do is try and secure a practicum site through something like an academic medical center or VA hospital neuro department, as that is the biggest deficit from the information provided.

 

[bcliff]

Not to hijack the thread, but for students not yet on external prac, what recommendations do people have for being competitive for neuro- externships?

 

[neuroflail]

At some sites, this will hurt. They will look at where you accrued this experience. It will also impact you in that it will difficult to get letters of rec from boarded neuropsychs, which will be important for more neuro focused internship slots. Some of the peripherals will help (brain dissection lab). It's a bit concerning, many of the stronger applicants are coming from programs that have very good relationships with practicum sites for their students' placement. Best thing you can do is try and secure a practicum site through something like an academic medical center or VA hospital neuro department, as that is the biggest deficit from the information provided.

I have tried time and again to place at a medical center or VA to no avail, which is especially discouraging as I am a veteran and strongly desire to work in the VA system or get back into the military as a neuropsychologist. I have even delayed internship by a year to have another opportunity to place at such sites, but was rejected every one of the sites I am allowed to apply to. To be perfectly honest, I am getting desperate, and have begun considering abandoning neuro - though that will also prove challenging as all my elective coursework and practica experiences have been aimed at neuro assessment.

 

[erg923]

I have tried time and again to place at a medical center or VA to no avail, which is especially discouraging as I am a veteran and strongly desire to work in the VA system or get back into the military as a neuropsychologist. I have even delayed internship by a year to have another opportunity to place at such sites, but was rejected every one of the sites I am allowed to apply to. To be perfectly honest, I am getting desperate, and have begun considering abandoning neuro - though that will also prove challenging as all my elective coursework and practica experiences have been aimed at neuro assessment.

Your program does not sound set up to train those interested in a career in neuropsychology (lack of resources and opportunity). Can I ask why you chose this particular program?

 

[neuroflail]

Not to hijack the thread, but for students not yet on external prac, what recommendations do people have for being competitive for neuro- externships?

Not a problem, this question is pertinent to the thread IMO

 

[erg923]

Not a problem, this question is pertinent to the thread IMO

Not to hijack the thread, but for students not yet on external prac, what recommendations do people have for being competitive for neuro- externships?

I thinks some demonstrable interest in neuropsychology, but I think your program bears the burden of providing appropriate and rigorous training in assessment and foundational skills that will be needed for neuropsych practica

 

[neuroflail]

Your program does not sound set up to train those interested in a career in neuropsychology (lack of resources and opportunity). Can I ask why you chose this particular program?

I honestly had limited options due to horrible GRE quantitative scores...I looked at several Psy.D. programs in my state, and the school I chose seemed to have a well established neuro concentration - it was the only program I looked at that offered more than one elective in neuropsychology. I had a job I needed to maintain during graduate school to afford expenses and I was still contractually commited to the National Guard, and so I had a limited search area. In retrospect, there should have been many more considerations, but I was not aware of these at the time.

 

[WisNeuro]

I have tried time and again to place at a medical center or VA to no avail, which is especially discouraging as I am a veteran and strongly desire to work in the VA system or get back into the military as a neuropsychologist. I have even delayed internship by a year to have another opportunity to place at such sites, but was rejected every one of the sites I am allowed to apply to. To be perfectly honest, I am getting desperate, and have begun considering abandoning neuro - though that will also prove challenging as all my elective coursework and practica experiences have been aimed at neuro assessment.

without knowing particulars, it's hard to tell why you're having problems getting pracs in neuro. Many prac places will simply not take students from certain programs, or certain types of programs. It's possible that this is the limiting factor. If so, it won't only be a limiting factor in prac sites, it will be limiting in intern applications and postdoc fellowships.

 

[neuroflail]

without knowing particulars, it's hard to tell why you're having problems getting pracs in neuro. Many prac places will simply not take students from certain programs, or certain types of programs. It's possible that this is the limiting factor. If so, it won't only be a limiting factor in prac sites, it will be limiting in intern applications and postdoc fellowships.

I know at least some past students have placed at these types of sites (but no one I am currently in contact with or know personally) which lends me to believe that my placement problems are somehow related to me or how I present. I know that I am not a particularly good interviewer, though I have been working to develop that with the aid of a professional coach.

 

[Ollie123]

Have you spoken to your DCT and advisor and made your desire for neuro clear? Perhaps there is something more than they can do.

I agree, this may be an institution problem - particularly if you are at a freestanding school. Given neuro is already more competitive than some specialties (and arguably places greater emphasis on research training) - if you are a PsyD student coming from a freestanding school it is possible you just aren't going to be able to compete for those spots. The divide in training rigor can be pretty enormous between institutions and that is one reason we often try to steer people away from the sort of school it sounds like you might be attending. I'm guessing you are also in a major city so these sorts of things can constantly be in flux based on what other schools in the area are doing.

I'd think about what you are willing/able to do and how important neuro is to you as a specialty. Certainly some people do "away" rotations on occasion and that may be worth considering if you really need the experience and cannot get it there.

 

[Applicant786]

Does neuro-imaging training in research help with practica/internship placement?

Have you spoken to your DCT and advisor and made your desire for neuro clear? Perhaps there is something more than they can do.

I agree, this may be an institution problem - particularly if you are at a freestanding school. Given neuro is already more competitive than some specialties (and arguably places greater emphasis on research training) - if you are a PsyD student coming from a freestanding school it is possible you just aren't going to be able to compete for those spots. The divide in training rigor can be pretty enormous between institutions and that is one reason we often try to steer people away from the sort of school it sounds like you might be attending. I'm guessing you are also in a major city so these sorts of things can constantly be in flux based on what other schools in the area are doing.

I'd think about what you are willing/able to do and how important neuro is to you as a specialty. Certainly some people do "away" rotations on occasion and that may be worth considering if you really need the experience and cannot get it there.

 

[WisNeuro]

Does neuro-imaging training in research help with practica/internship placement?

To an extent, yes. More so at the practica level than internship. If it's combined with good practicum placements, it will be a boon for internship apps. It's not the neuroimaging as much as the notion that these students tend to have some better knowledge of neuroanatomy that helps. But, if it's not backed up by solid clinical experience, it doesn't mean much later on.

 

[erg923]

and the school I chose seemed to have a well established neuro concentration .

So...are your saying others in your program are getting neuropsych training experiences, but you are not? What do you think this is about?

 

[Ollie123]

Does neuro-imaging training in research help with practica/internship placement?

Could help somewhat, dependent on the nature of it. Significant research experience of some variety is going to be helpful though. I'm admittedly not a neuropsychologist, but the clinical neuropsychs I know are a far cry from imaging experts - but they are experts in assessment, neurological disease and its interaction with mental illness, psychometrics, etc. Doesn't mean you need a dozen publications to even be considered for a practicum, but someone with no publications or even posters is not going to be viewed as well as someone with several. Generally speaking, the more competitive the specialty the more this will be. I only mentioned it because there are plenty of PsyD programs out there (and some PhD programs for that matter) where students will be applying for internship without so much as a first-authored conference poster. If aiming for competitive slots (VAs, AMCs) or competitive specialties (neuro) that can make it harder to make a case that you are on par with other applicants. Not to say its impossible, just that it can negatively impact an application. If that is lacking and you are struggling, it is certainly an area to take a look and see if you can build up.

A neuro "concentration" unfortunately means little - many programs offer this as a sort of marketing tool, but don't actually have great neuro training. Its often about coursework, which is really quite secondary to what makes a good grad program - are there established neuropsychologists with solid national reputations among the core faculty? Are they publishing? What proportion of students go on to neuropsychology careers and where?

 

[neuroflail]

So...are your saying others in your program are getting neuropsych training experiences, but you are not? What do you think this is about?

I should clarify that students in the past have. However, I don't think any students in recent cohorts have. To my knowledge, the students who placed at the medical center/VA sites did so at least several years ago and since then I do not know if anyone from my program has. Other Psy.D. programs within the area seem to routinely place students at these sites, though my knowledge of this is admittedly hearsay. So it's hard to say. Perhaps the answer is both my presentation and program-related factors are contributory.

 

[neuroflail]

without knowing particulars, it's hard to tell why you're having problems getting pracs in neuro. Many prac places will simply not take students from certain programs, or certain types of programs. It's possible that this is the limiting factor. If so, it won't only be a limiting factor in prac sites, it will be limiting in intern applications and postdoc fellowships.

This has been a consideration as well. I know many sites outright do not accept Psy.D.s, so I have been carefully scouting to only apply to sites that have a history of making offers to at least some Psy.D. students. There are also several other Psy.D. programs in the area, and I have heard that these programs seem to regularly place students at these types of sites, though I cannot verify this. In terms of internships, I am doing careful research to ensure that continue the trend of only applying to sites that are likely to accept Psy.D.s. For example, I check on APPIC to see if a site has accepted a Psy.D. student within the past few years.

 

[WisNeuro]

This has been a consideration as well. I know many sites outright do not accept Psy.D.s, so I have been carefully scouting to only apply to sites that have a history of making offers to at least some Psy.D. students. There are also several other Psy.D. programs in the area, and I have heard that these programs seem to regularly place students at these types of sites, though I cannot verify this. In terms of internships, I am doing careful research to ensure that continue the trend of only applying to sites that are likely to accept Psy.D.s. For example, I check on APPIC to see if a site has accepted a Psy.D. student within the past few years.

Well, it's not necessarily whether or not they accept PsyD students, most will. But, they will tend to not accept PsyDs from certain places. For example, I've never seen a Fielding application make it through the first cut. Also, keep in mind, if you want to keep the VA open in terms of a possible workplace, you will need an APA accredited internship.

 

[neuroflail]

Well, it's not necessarily whether or not they accept PsyD students, most will. But, they will tend to not accept PsyDs from certain places. For example, I've never seen a Fielding application make it through the first cut. Also, keep in mind, if you want to keep the VA open in terms of a possible workplace, you will need an APA accredited internship.

Noted, thanks. I am also planning on focusing my efforts on more remote areas or states, such as rural VA's. I have been advised that this may help increase my chances, but what is your feedback on this idea?

 

[WisNeuro]

Noted, thanks. I am also planning on focusing my efforts on more remote areas or states, such as rural VA's. I have been advised that this may help increase my chances, but what is your feedback on this idea?

Those VA's will have less competition for spots, but, there are far fewer of those VA's that have training programs, much less neuro-specific training. Those are things you will need to get a solid postdoc, which is necessary for board certification, which is becoming more and more of a necessity these days.

 

[neuroflail]

Could help somewhat, dependent on the nature of it. Significant research experience of some variety is going to be helpful though. I'm admittedly not a neuropsychologist, but the clinical neuropsychs I know are a far cry from imaging experts - but they are experts in assessment, neurological disease and its interaction with mental illness, psychometrics, etc. Doesn't mean you need a dozen publications to even be considered for a practicum, but someone with no publications or even posters is not going to be viewed as well as someone with several. Generally speaking, the more competitive the specialty the more this will be. I only mentioned it because there are plenty of PsyD programs out there (and some PhD programs for that matter) where students will be applying for internship without so much as a first-authored conference poster. If aiming for competitive slots (VAs, AMCs) or competitive specialties (neuro) that can make it harder to make a case that you are on par with other applicants. Not to say its impossible, just that it can negatively impact an application. If that is lacking and you are struggling, it is certainly an area to take a look and see if you can build up.

A neuro "concentration" unfortunately means little - many programs offer this as a sort of marketing tool, but don't actually have great neuro training. Its often about coursework, which is really quite secondary to what makes a good grad program - are there established neuropsychologists with solid national reputations among the core faculty? Are they publishing? What proportion of students go on to neuropsychology careers and where?

What is your opinion on the idea of transferring to another program with a better placement rate? I know it sounds rather extreme as I would basically have to restart grad school from year one or two, as most credits do not transfer, and my already enormous student debt would probably almost double.

 

[neuroflail]

My final question...would you recommend trying to apply for internship this fall, or would you recommend delaying internship yet another year and trying for yet another round of practicum applications?

 

[WisNeuro]

My final question...would you recommend trying to apply for internship this fall, or would you recommend delaying internship yet another year and trying for yet another round of practicum applications?

Depends, really. If you have a solid shot at securing additional neuro training that is reputable and may net you a letter from a boarded neuropsychologist, may be a good idea. If it's still looking like slim pickings, may not help. It's much harder to make moves to shore up application weaknesses this late in the game, than it is earlier in the ballgame.

 

[smalltownpsych]

The good sites in a competitive area select the students from the programs with the better reps. Our students always got spots at the preferred local practicums such as the VAs and major university medical centers and I had good relationships with several of the training directors who stated very explicitly that they preferred our students. Even so, these same training directors know that some good students can come from the non-preferred programs so they are usually willing to look at a few students from there. I wonder if something about your interview or even your app is reinforcing a preconceived negative about your program. You can't do much about the programs rep, but you can improve your own outcome and identifying your interview deficits and remedying those will help.

For example, my interview skills were weakened for the same reason that I develop rapport with patients so easily. I now address that directly during the interview as both a strength and a weakness. In my last four interviews, I got the job which is a much better track record than interview experiences in my prior history where I was continually frustrated by being underestimated or underrated.

 

[AcronymAllergy]

Agree with WisNeuro--if the odds seem decent that you'll be able to shore up your neuro training with an additional placement over the intervening year, then putting off internship could be worthwhile. If not, applying for the fall would probably be your best bet, while also still looking for training opportunities in the event you don't match. One thing working in your favor is the balance between applicants and internship spots, which was basically even this go-round. Mind you, not all the spots were APA-accredited, but there were a good number of fairly prestigious internships that didn't fill one or more positions and went on to Phase II.

Also, non-accredited VA internships (e.g., new sites working toward accreditation that are in good standing with the VA) still meet criteria for VA post-doc/employment. It may not help you for fellowships outside the VA, and even some postdocs within the VA may still prefer folks coming from accredited internships, but you'd at least be eligible to apply.

I would hold off on considering the transfer option until all other opportunities were exhausted. And if I were going to transfer, if at all possible, I'd look to get into a funded program to avoid having to double your student loan debt. If your only transfer option(s) are other unfunded/underfunded programs, I personally would probably abandon neuro before I'd go that route.

 

[cara susanna]

Disclaimer: I am not a neuro person.

However, I do want to say that I found that I was more competitive for internship applications than for practicum applications. By that statement I mean that the same types of sites that didn't even consider me for practicum gave me internship interviews. You could try applying to sites that are more generalist and have neuro rotations.

 

[everythingbutcurling]

My final question...would you recommend trying to apply for internship this fall, or would you recommend delaying internship yet another year and trying for yet another round of practicum applications?

For what it's worth, I did not think I would be very competitive for neuro internships this year (no experience in an academic medical center or VA, and most of my evaluations were neuropsychiatric in nature) and I ended up at a VERY nice and competitive neuro track for internship at an AMC. I got a handful of interviews at other really competitive sites, too! Albeit there may be some differences in our training experiences - for example, I've had a fair amount of research experience in neuro topics, and I don't know if you've had that - I think you should go ahead and apply for internship next year! The imbalance between applicants and sites has been trending down, and you may wind up realizing (like I did) that you are far more competitive than you think.

 

[neuroflail]

Disclaimer: I am not a neuro person.

However, I do want to say that I found that I was more competitive for internship applications than for practicum applications. By that statement I mean that the same types of sites that didn't even consider me for practicum gave me internship interviews.

Why do you think that is? That seems opposite from what one would think would normally happen. What factors would make someone noncompetitive fro a prac but competitive for an internship at the same site?

 

[neuroflail]

For what it's worth, I did not think I would be very competitive for neuro internships this year (no experience in an academic medical center or VA, and most of my evaluations were neuropsychiatric in nature) and I ended up at a VERY nice and competitive neuro track for internship at an AMC. I got a handful of interviews at other really competitive sites, too! Albeit there may be some differences in our training experiences - for example, I've had a fair amount of research experience in neuro topics, and I don't know if you've had that - I think you should go ahead and apply for internship next year! The imbalance between applicants and sites has been trending down, and you may wind up realizing (like I did) that you are far more competitive than you think.

I think your research experience probably helped a great deal, but I do not have any research experience whatsoever. I have tried to get some, but I do not have access to any clinical populations or archival databases.

 

[neuroflail]

Agree with WisNeuro--if the odds seem decent that you'll be able to shore up your neuro training with an additional placement over the intervening year, then putting off internship could be worthwhile. If not, applying for the fall would probably be your best bet, while also still looking for training opportunities in the event you don't match. One thing working in your favor is the balance between applicants and internship spots, which was basically even this go-round. Mind you, not all the spots were APA-accredited, but there were a good number of fairly prestigious internships that didn't fill one or more positions and went on to Phase II.

Also, non-accredited VA internships (e.g., new sites working toward accreditation that are in good standing with the VA) still meet criteria for VA post-doc/employment. It may not help you for fellowships outside the VA, and even some postdocs within the VA may still prefer folks coming from accredited internships, but you'd at least be eligible to apply.

I would hold off on considering the transfer option until all other opportunities were exhausted. And if I were going to transfer, if at all possible, I'd look to get into a funded program to avoid having to double your student loan debt. If your only transfer option(s) are other unfunded/underfunded programs, I personally would probably abandon neuro before I'd go that route.

To clarify: I can apply for internships AND prac sites in the same year, so that if I do not place I at least have a shot at a prac? Also, by funded programs, you mean Ph.D. programs?

 

[cara susanna]

Why do you think that is? That seems opposite from what one would think would normally happen. What factors would make someone noncompetitive fro a prac but competitive for an internship at the same site?

My theory is that there are so many more internship sites so you're bound to find some that are a good fit.

 

[AcronymAllergy]

To clarify: I can apply for internships AND prac sites in the same year, so that if I do not place I at least have a shot at a prac? Also, by funded programs, you mean Ph.D. programs?

Not necessarily Ph.D., just funded. Ph.D. programs are more likely to offer funding, but I'd suggest applying to funded Psy.D. programs as well, if you identify any that would meet your training goals and that have solid outcomes (same goes for the Ph.D. programs).

And then I would consider applying to internship this year regardless. Just understand that it can be an expensive process, especially once you start factoring in the costs of interviews. My knee-jerk take: if you have a good shot at landing a solid neuro prac, forego internship and get more neuro training. If not, apply for both.