100 reasons not to go to grad school...

[ResearchGirlie]

Heck, think of chiropracty--they've got their own share of issues, but they seem to be doing ok. Even if shut out of some insurance reimbursement setups, they still bring people in the door who're quite willing to pay their rates. Why? I would imagine because, in part, they've done a good job convincing the public that what they do helps, rather than simply assuming people will spontaneously recognize the values of their services (which is what I feel psychology had done in the past).

I bet a number of chiropractors spend a great deal of time defending their importance versus an MD. Similarly, psychiatrists and general practitioners likely spend their time trying to defend their status against the more esteemed MD positions such as surgeons. On this forum we tend to get locked into a battle of us vs. them and the doom and gloom of our field but my hunch is that every field has this issue in some way.

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[AcronymAllergy]

I bet a number of chiropractors spend a great deal of time defending their importance versus an MD. Similarly, psychiatrists and general practitioners likely spend their time trying to defend their status against the more esteemed MD positions such as surgeons. On this forum we tend to get locked into a battle of us vs. them and the doom and gloom of our field but my hunch is that every field has this issue in some way.

Oh, I have no doubts about that, particularly the chiropractors bit. I was just saying that they've done an admirable job of garnering public support of/demand for their services (which I would say is arguably more important, at least economically, than defending themselves against MDs/DOs), which is something psychology should start doing as well.

 

[cara susanna]

I wouldn't feel guilty! It seems like a reasonable way to get through a strenuous program. Best wishes!

It just seemed funny to hear that you had more time than undergrad - I just look back and think about those UG days and think "wow, that was carefree!" a lot now!

I guess that was a little misleading to say. In undergrad, I was really busy but I was super focused on trying to get into a clinical PhD program. However, I am definitely busier in grad school. My social life is better because 1) I've had an easier time making friends here, in addition to meeting my now-fiance and 2) I've realized that you have to make breaks for yourself in grad school because there is always something that you could be doing. I just said that to indicate that, yes, I do have time for a good social life in grad school. But honestly, my fiance helps a lot--his work schedule is crazy so on the rare days that he's home, I am very motivated to put aside what I can of my work and spend time with him.

There is a ton of HYSTERIA in the media about the economy. The unemployment rate is only 4% for people with college degrees. I have yet to meet someone with a college or graduate degree (aside from an MFT, social worker, or early career psychologists) who is struggling. The median salary for lawyers in 2011 was 120K and the unemployment rate overall is 1-2%. Keep in mind that many people who graduate from college cannot even write properly and have no study skills or life skills (those of you who were TA's in college classes at average schools understand this). One of my friends works in a managerial role for a marketing company, they are dying to hire people with solid quantitative skills but can only find 1 or 2 promising applicants out of 100. I hear such horror stories about applicants they interview, including how poor most people are at selling themselves during an interview. There are many opportunities outside of mental health and counseling. We live in a society that does not value providing services to low income people or ill people so anyone working at a social service agency or in our field is getting an abnormally low salary given level of education.

If it makes you feel better to believe that everyone in every field is suffering, go ahead and believe this. There are many opportunities outside of mental health for people who are educated and smart.

One word: aviation. Their field has suffered ever since 9/11 and the cost of training is extremely high. My friends who just recently graduated and work for regional airlines don't even make enough to pay back their student loans. 20k is the average salary and usually they have to live in larger cities with higher costs of living because that's where the airport hubs are.

It's also funny that you mention lawyers, given all of the blogs, lawsuits, and news articles about lower-tier law grads working as waiters and strippers.

 

[Doctor Eliza]

I think this is the essence of my concern as well.
Also, "misery loves company," when you're happy with your job, feel like your work has paid off, and is overall satisfied with life, you're much less likely to sit at a computer, read random people write about random things, and complain about your profession.
As I mentioned, of the ONE neuropsych I spoke to, she said that of the people she knows who graduated from Clin Psych programs (many are PsyD in clinical practice), no one has had a hard time finding a job.

If you go into MSW or masters in couseling job forums, most of what you'll see is "opportunities are limited without a PhD." I googled counseling masters and one of the first hit was titled " a masters in counseling is not enough". So while PhDs are saying masters are encroaching to their territory, masters are saying PhDs are taking all the jobs.

I find that really surprising. Have they ever looked at job postings? Granted, I have not looked across the country, but I have looked extensively in my area and the postings are at least 10 master's to 1 doctorate. I found it very disheartening when a new psych hospital opened nearby and there were 0 positions for psychologists and a good number for MSWs and psychiatrists. I did have a PhD friend convince an agency to hire him for a position that was advertising for a master's person, but of course he was compensated as if he only had a master's.

I'm not completely bitter. I do like my day to day work. I just get frustrated with the lack of opportunities and how difficult it is to pay my bills. I also went to an uncommonly cruel program which left a very bad taste in my mouth.

Best,
Dr. E

 

[PHD12]

The people on this forum who seem satisfied with their jobs and are earning good pay, do not have clinical careers. They all seem to be in research, administrative or faculty positions. I have constantly specified that the clinical field is the one that is very hard hit. And yes, people who want clinical positions and went to good programs cannot find work in their geographic region (this happens to many people).

Why don't people search for clinical psychologist (non-academic) positions in one location, and see what they come up with. There are currently only 7 positions posted for clinical psychologists in a very big city nearby (we have over 20,000 psychologists here). Out of those 7 positions, what are the chances that they will even be within your specialty area?

On another note, there is only one way to get out of this. I am always seeing MD's and lawyers publishing articles in many prominent newspapers about the debt levels in their fields, the need for increased funding, and the value their profession offers. I have yet to see a licensed psychologist write about the value of our field, the importance of mental health funding to hire psychologists, and the challenges of our field (internship crisis, very hire median debts, hospitals hiring people who are not trained vs.psychologists). As others have mentioned, we do not do a good job of promoting ourselves. I also think that being in denial about the state of affairs in our field is likely to lead to further complacency. If people are not outraged about our current challenges (and even worse act like they don't exist), how are we ever going to advocate for ourselves?

Lawyers from 4th tier law schools are also suing their programs because they are unable to find positions. I am not advocating that law suits are the only approach, but we haven't done anything effective as a field to address our challenges and to raise awareness on a national level to these challenges.

 

[erg923]

I am in a faculty position, am pretty happy, make "decent" money for the time being...but I am NOT really happy with the amount.

 

[Pragma]

The people on this forum who seem satisfied with their jobs and are earning good pay, do not have clinical careers. They all seem to be in research, administrative or faculty positions. I have constantly specified that the clinical field is the one that is very hard hit. And yes, people who want clinical positions and went to good programs cannot find work in their geographic region (this happens to many people).

Why don't people search for clinical psychologist (non-academic) positions in one location, and see what they come up with. There are currently only 5 positions posted for clinical psychologists in the big city that I'm closest to (we have over 20,000 psychologists here at least).

I know that T4C has a mostly clinical position as well and seems quite happy with compensation. Also keep in mind that a clinical faculty position at an AMC is probably better in most cases than other clinical positions (in terms of salary and prestige). I think of clinical jobs as fitting into two tiers.

Tier 1: Solid AMC or other hospital positions, Private practice owners or non-owners with a really good split, VA or BoP jobs

Tier 2: Just about everything else (CMHC, Private clinics, most private practices, contract work, etc)

Most people I know of in Tier 1 are fairly happy (maybe not with their hours outside of the VA, but like their work and compensation). Most people I know in Tier 2 are either not satisfied, or make it work because a) they are able to supplement their income by piecing together other part-time clinical positions or b) They only work part time and are happy with that (e.g., save money on daycare for kids). At least from what I've seen, there are a fair amount of part-time opportunities out there. Hospitals and other places can save some money by just giving you a part time contract.

When i was on the market last year (major metro area), I looked at everything (clinical positions were the last resort, but I payed attention). I saw more ads for the Tier 2 positions. There WERE some Tier 1 positions, but more commonly I saw the Tier 2 stuff. The Tier 2 ads usually were the MSW/MA/MA/Psy.D./Ph.D. combo searches. One other trend I noticed was that many openings were looking for pediatric specialists.

On the academic side, I'll just say that there were fewer local openings compared to what I saw for clinical. It would have been much easier to get a clinical job, although it may not have been a Tier I job. There were very few tenure-track positions. An interesting thing I noticed was a fair amount of openings at Psy.D. programs. I did not apply to any of these (was advised it would taint my credentials). Most of the hires they were making seemed to be for a niche (e.g., hiring for forensic track) or they wanted a DCT, presumably because placing their students is a stressful job.

 

[AcronymAllergy]

The people on this forum who seem satisfied with their jobs and are earning good pay, do not have clinical careers. They all seem to be in research, administrative or faculty positions. I have constantly specified that the clinical field is the one that is very hard hit. And yes, people who want clinical positions and went to good programs cannot find work in their geographic region (this happens to many people).

Why don't people search for clinical psychologist (non-academic) positions in one location, and see what they come up with. There are currently only 7 positions posted for clinical psychologists in a very big city nearby (we have over 20,000 psychologists here). Out of those 7 positions, what are the chances that they will even be within your specialty area?

On another note, there is only one way to get out of this. I am always seeing MD's and lawyers publishing articles in many prominent newspapers about the debt levels in their fields, the need for increased funding, and the value their profession offers. I have yet to see a licensed psychologist write about the value of our field, the importance of mental health funding to hire psychologists, and the challenges of our field (internship crisis, very hire median debts, hospitals hiring people who are not trained vs.psychologists). As others have mentioned, we do not do a good job of promoting ourselves. I also think that being in denial about the state of affairs in our field is likely to lead to further complacency. If people are not outraged about our current challenges (and even worse act like they don't exist), how are we ever going to advocate for ourselves?

Lawyers from 4th tier law schools are also suing their programs because they are unable to find positions. I am not advocating that law suits are the only approach, but we haven't done anything effective as a field to address our challenges and to raise awareness on a national level to these challenges.

I completely agree. The only way things are going to improve is if we begin taking action on our own behalf. In part, that's going to require that we as a field begin financially supporting organizations that advocate (politically and publicly) on our behalf. It's also going to concurrently require that we shift away from the idea that such self-advocacy is a negative thing. It can occur at the micro level when we as professionals continually advocate and educate within our own organizations (e.g., make our presence and the benefits of our services known at meetings, to administrators, etc.).

My current post-doc, for example, is such a great setup because those who established it weren't afraid to rock the boat a little (or a lot) as was necessary.

 

[weeblewobble]

I agree as well, that advocacy and promotion is the way to go. It seems like it's a two-step approach: 1) advocate for better training/compensation/reimbursement/regulation for us by systems like the government (and subsets like Medicaid) and the APA, and 2) promote what we do including therapy and assessment as a needed service to both the general public and to other medical providers and administrators. Ideally all of this would be done by the APA, but I'm starting to wonder whether they'll ever to any of it. Maybe APS will step up or some frustrated and creative early career psychologist will get the ball rolling (one of my undergrad profs had a quote about pushing a boulder a little, and then it would roll on its own. In this case, we may need to keep pushing for quite a bit to get momentum.)


As an aside- it is definitely true that well-fitting, satisfyingly compensated clinical jobs in ideal locales are few and far between. But I do think that the way early career psychs I know have gotten these jobs (and I do know them! They exist! ) is usually or always through their own connections or via mentor/supervisor connections. In these cases, school brand doesn't matter so much as reputation and connections of recommenders.

 

[ResearchGirlie]

In these cases, school brand doesn't matter so much as reputation and connections of recommenders.

But school brand often goes with those who are well respected in the field and therefore opens doors. Just starting out, grad school reputation seems to open a lot of doors both because of the name and because of the people attached to that name. This isn't an absolute rule, and school name likely shouldn't get as much credit as it sometimes does, but I don't think grad school rep is unimportant by any stretch.

 

[weeblewobble]

But school brand often goes with those who are well respected in the field and therefore opens doors. Just starting out, grad school reputation seems to open a lot of doors both because of the name and because of the people attached to that name. This isn't an absolute rule, and school name likely shouldn't get as much credit as it sometimes does, but I don't think grad school rep is unimportant by any stretch.

Absolutely school rep is important, and faculty and supervisors with better reps are more likely to be affiliated with schools (and internships and postdocs) with better reps, as you said. The point I was making was that faculty and supervisors can be an active part of the hiring process, while grad school rep is a line on your CV. It seems to me (anecdotally) that it's the faculty and supervisors making the calls and recs to their colleagues that fast-tracks early career psychologists into the coveted positions we're talking about.

 

[AcronymAllergy]

Absolutely school rep is important, and faculty and supervisors with better reps are more likely to be affiliated with schools (and internships and postdocs) with better reps, as you said. The point I was making was that faculty and supervisors can be an active part of the hiring process, while grad school rep is a line on your CV. It seems to me (anecdotally) that it's the faculty and supervisors making the calls and recs to their colleagues that fast-tracks early career psychologists into the coveted positions we're talking about.

And this is why it's very, very important not to "burn any bridges" in psychology. I completely agree that many jobs are had primarily via networking, and I would imagine that nearly as many are lost due to a former supervisor or advisor's lackluster endorsement.

 

[ishiguro78]

I am in a faculty position, am pretty happy, make "decent" money for the time being...but I am NOT really happy with the amount.

erg923, would you be wiling to say a little more about your faculty position? e.g., type of institution, and, if you're comfortable, the general breakdown of your income?

 

[Edward3nigm4]

I guarantee you have never actually "worked" 80 hours in one week. However, it must feel super cool to say you did! Props, mate!

 

[AcronymAllergy]

In the case of many members here, I wouldn't be surprised to hear that they'd indeed worked 80+ hours in a week. Although as was previously mentioned, it also depends on how you define "work." Which in all actuality, also applies to full-time positions in the "real world;" after all, during the year I worked prior to grad school, there were very few days during which I was actually actively engaged in some type of productive, work-related task for 7 or 8 straight hours. Conversely, while on postdoc, I'm consistently busy for a much greater proportion of the day (other than the breaks I take to post on here, of course...)

 

[paramour]

I've been pulling double 12-hour shifts for multiple days at one job in addition to my other positions. It's actually not that difficult to WORK 80 hours. . . NOT including all that pesky school stuff.

But it must be super cool to presume that you know what everyone else does.

 

[Sanman]

In the case of many members here, I wouldn't be surprised to hear that they'd indeed worked 80+ hours in a week. Although as was previously mentioned, it also depends on how you define "work." Which in all actuality, also applies to full-time positions in the "real world;" after all, during the year I worked prior to grad school, there were very few days during which I was actually actively engaged in some type of productive, work-related task for 7 or 8 straight hours. Conversely, while on postdoc, I'm consistently busy for a much greater proportion of the day (other than the breaks I take to post on here, of course...)

This is indeed true and I have to say that in most jobs the mindlessness means that you really are not working all of those hours. I used to work 10 hr shifts at times while ABD to make extra money, but I was not actually doing work many of those hours and occasionally even edited my dissertation at work on quiet days (because most people at lower paid office jobs are so unproductive I could actually get more work done than most and still have time to slack off and edit my diss). Conversely, I usually do not spend more than 9 hrs at work on a single day, but that includes seeing 8 pts/day, paper work, calls to schedule appointments or follow up about something, billing, approval to see pts, etc. I rarely get more than 30 minutes to myself per day without having to extend my work day. Often times, lunch still involves writing notes. I am much more exhausted at the end of those days than 10 hrs of little cognitive effort.

 

[Sanman]

I know that T4C has a mostly clinical position as well and seems quite happy with compensation. Also keep in mind that a clinical faculty position at an AMC is probably better in most cases than other clinical positions (in terms of salary and prestige). I think of clinical jobs as fitting into two tiers.

Tier 1: Solid AMC or other hospital positions, Private practice owners or non-owners with a really good split, VA or BoP jobs

Tier 2: Just about everything else (CMHC, Private clinics, most private practices, contract work, etc)

Most people I know of in Tier 1 are fairly happy (maybe not with their hours outside of the VA, but like their work and compensation). Most people I know in Tier 2 are either not satisfied, or make it work because a) they are able to supplement their income by piecing together other part-time clinical positions or b) They only work part time and are happy with that (e.g., save money on daycare for kids). At least from what I've seen, there are a fair amount of part-time opportunities out there. Hospitals and other places can save some money by just giving you a part time contract.

When i was on the market last year (major metro area), I looked at everything (clinical positions were the last resort, but I payed attention). I saw more ads for the Tier 2 positions. There WERE some Tier 1 positions, but more commonly I saw the Tier 2 stuff. The Tier 2 ads usually were the MSW/MA/MA/Psy.D./Ph.D. combo searches. One other trend I noticed was that many openings were looking for pediatric specialists.

On the academic side, I'll just say that there were fewer local openings compared to what I saw for clinical. It would have been much easier to get a clinical job, although it may not have been a Tier I job. There were very few tenure-track positions. An interesting thing I noticed was a fair amount of openings at Psy.D. programs. I did not apply to any of these (was advised it would taint my credentials). Most of the hires they were making seemed to be for a niche (e.g., hiring for forensic track) or they wanted a DCT, presumably because placing their students is a stressful job.

I would have to say that this is a fairly accurate assessment of how I find the market as well. The difference between tier 1 and tier 2 (at least to me) seems to be that at Tier 1 you get money (lets say $70-90k starting) and nice benefits (office, 401k, etc). With tier 2, you often have to make a choice between money or benefits (CMHC or college Counseling center may offer the nice benefits with a $40-$60k annual salary vs a contract position that pays $70-$90k with no perks and often means long days and way too many pts)

 

[PHD12]

I would have to say that this is a fairly accurate assessment of how I find the market as well. The difference between tier 1 and tier 2 (at least to me) seems to be that at Tier 1 you get money (lets say $70-90k starting) and nice benefits (office, 401k, etc). With tier 2, you often have to make a choice between money or benefits (CMHC or college Counseling center may offer the nice benefits with a $40-$60k annual salary vs a contract position that pays $70-$90k with no perks and often means long days and way too many pts)

I agree with the 2 tiers, but don't see enough tier 1 positions. Problem is that psychiatric hospitals, VA's, medical centers also have insane caseloads. You can go to a counseling center and earn 50K and have a decent quality of life vs. a psychiatric hospital where you are incredibly stressed all the time. I've interviewed and worked at VA's and hospitals and you cannot practice as a psychologist in many of these settings anymore. For example, at many VA's and outpatient hospitals you will have 200+ cases so you are doing a ton of case management and crisis intervention. You are not any different than a case manager. I think some VA hospitals may still be spared, but they will probably change with time as well.

I don't think earning 90K at a hospital after 20 years of experience is that great, given the enormous sacrifices you have to make as a psychologist. If you want to do clinical work, it doesn't seem like there are good options out there. Either you take a 50K job in a decent setting or have a 200+ caseload where you see your patients monthly or less.

 

[Sanman]

I agree with the 2 tiers, but don't see enough tier 1 positions. Problem is that psychiatric hospitals, VA's, medical centers also have insane caseloads. You can go to a counseling center and earn 50K and have a decent quality of life vs. a psychiatric hospital where you are incredibly stressed all the time. I've interviewed and worked at VA's and hospitals and you cannot practice as a psychologist in many of these settings anymore. For example, at many VA's and outpatient hospitals you will have 200+ cases so you are doing a ton of case management and crisis intervention. You are not any different than a case manager. I think some VA hospitals may still be spared, but they will probably change with time as well.

I don't think earning 90K at a hospital after 20 years of experience is that great, given the enormous sacrifices you have to make as a psychologist. If you want to do clinical work, it doesn't seem like there are good options out there. Either you take a 50K job in a decent setting or have a 200+ caseload where you see your patients monthly or less.

While you are busy at a VA or academic medical center, I have not seen anyone with 200+ individual cases. That might include monthly clinic check-ins and groups, but not everyone needs the weekly follow-up. At the VA centers I worked at, you still would not see more than 6-8 pts a day. With 20 yrs at the VA or an academic medical center, you are looking at more like $110-130k. I never met anyone at a VA with anywhere close to 20 yrs and less than six figures. Same goes for the academic medical ctrs I worked at as well.

 

[AcronymAllergy]

While you are busy at a VA or academic medical center, I have not seen anyone with 200+ individual cases. That might include monthly clinic check-ins and groups, but not everyone needs the weekly follow-up. At the VA centers I worked at, you still would not see more than 6-8 pts a day. With 20 yrs at the VA or an academic medical center, you are looking at more like $110-130k. I never met anyone at a VA with anywhere close to 20 yrs and less than six figures. Same goes for the academic medical ctrs I worked at as well.

That fits with my experience as well, having worked at both moderately-sized and very large VAs and AMCs. Perhaps it depends on how you define caseload, though? I know some psychologists who, if you included their wait-list and scheduled intake/assessment visits, might've topped 200 people (or easily so if you also included members of psychotherapy groups).

 

[Pragma]

I don't think earning 90K at a hospital after 20 years of experience is that great, given the enormous sacrifices you have to make as a psychologist. If you want to do clinical work, it doesn't seem like there are good options out there. Either you take a 50K job in a decent setting or have a 200+ caseload where you see your patients monthly or less.

While I don't doubt that this happens (although where is the 200 number from, that's nuts?), I think you are exaggerating a little bit. For example, my friend just started at 90K directly off of postdoc at an AMC in a completely clinical position. Another friend started at 65K at a different AMC. So while those places are busy (but more like 40 cases per week and charting at night), it didn't necessarily take 20 years to get to 90K.

I don't want to be too argumentative, but you might be seeing 30-50K jobs out there at CMHCs and such, and really those may put a lot of QOL pressure on you too given all of the case management and funding issues involved.

But I definitely agree that there aren't enough Tier 1 positions. Really, that was what I got frustrated about during my job search, although I limited myself to one city. Even though I didn't end up needing to go for a clinical job, that was my backup and it wasn't a sure thing at all.

 

[MBellows]

Why don't people search for clinical psychologist (non-academic) positions in one location, and see what they come up with. There are currently only 7 positions posted for clinical psychologists in a very big city nearby (we have over 20,000 psychologists here). Out of those 7 positions, what are the chances that they will even be within your specialty area?

One thing you will have to learn as a professional, especially as a professional in the medical or business fields, jobs aren't limited to job postings. People need to learn how to find out about agencies/businesses in the area, find out what they do, and find out how to sell yourself to them. Perhaps this should be a survey class in Ph.D. programs. If I can go into a business and find previously non-existent jobs for someone with an I.Q. of 58 and significant physical impairments, it shouldn't be that hard to find a job where you are qualified to actually produce things (psychological reports) or provide a billable service (therapy).

Another tricky thing about job postings, often they exist as a formality for jobs that are already spoken for. Most hiring is done based off of networking and who you know may matter much more than what your credentials are.

 

[Pragma]

Another tricky thing about job postings, often they exist as a formality for jobs that are already spoken for. Most hiring is done based off of networking and who you know may matter much more than what your credentials are.

Absolutely. Actually, one of the advantage of geographic restrictions is your ability to network, if you are restricting yourself to where you have a professional network. Networking was directly responsible for me obtaining solid internship and postdocs where I live.

Half of the online postings aren't viable, I'd say, except for maybe the ones you see on the APA website or through organizations through your specialty.

 

[AcronymAllergy]

Absolutely. Actually, one of the advantage of geographic restrictions is your ability to network, if you are restricting yourself to where you have a professional network. Networking was directly responsible for me obtaining solid internship and postdocs where I live.

Half of the online postings aren't viable, I'd say, except for maybe the ones you see on the APA website or through organizations through your specialty.

+1 to this and MBellows's post. I've never really felt that online job postings accurately reflect the state of employment affairs in psychology, other than perhaps in the VA to some degree. But even there, the majority of people I know heard about their current jobs via word-of-mouth, networking, and/or being directly recruited by a person who wanted them there. Academic/tenure positions are one exception, and online postings on listserves are another.

 

[PHD12]

While I don't doubt that this happens (although where is the 200 number from, that's nuts?), I think you are exaggerating a little bit. For example, my friend just started at 90K directly off of postdoc at an AMC in a completely clinical position. Another friend started at 65K at a different AMC. So while those places are busy (but more like 40 cases per week and charting at night), it didn't necessarily take 20 years to get to 90K.

Kaiser is the largest employer of psychologists in many west coast cities and all the kaiser's i've interviewed at have caseloads of 200 per psychologist, and 4-5 new intakes per week (no matter how large the caseload). I've worked at several VA hospitals and know for a fact that psychologists have 150-200 people on their caseloads in some geographic regions (this is not at every VA and depends on the specialty). They see most of their patients once every 6-12 weeks, and then see a handful of patients maybe weekly. Most of the patients are placed into groups. This was standard practice unless you were in PTSD.

Just to be clear, they are not working more than 60 hours per week despite enormous case loads because most patients are seen once every 6-8 weeks and funneled through a group. At VA's they don't see more than 6-8 patients per day but the caseloads are enormous and there are frequent emergencies when you have this many cases floating around so you end up doing a lot of case management. I am bringing up the fact that many psychologists do not want to practice this way.

 

[PHD12]

One thing you will have to learn as a professional, especially as a professional in the medical or business fields, jobs aren't limited to job postings. People need to learn how to find out about agencies/businesses in the area, find out what they do, and find out how to sell yourself to them. Perhaps this should be a survey class in Ph.D. programs. If I can go into a business and find previously non-existent jobs for someone with an I.Q. of 58 and significant physical impairments, it shouldn't be that hard to find a job where you are qualified to actually produce things (psychological reports) or provide a billable service (therapy).

Another tricky thing about job postings, often they exist as a formality for jobs that are already spoken for. Most hiring is done based off of networking and who you know may matter much more than what your credentials are.

I agree with this. I think there are HUGE opportunities to market your skills in the private sector but in the form of employment testing, organizational consultation, survey design change management, and coaching. There are less opportunities for therapy. I think many psychologists who wanted to do clinical work are finding out that the only way they can make it in the private sector is to include some sort of business consulting. That's what I'm seeing with those that stay in business in private practice. They are not doing what they originally intended to do.

 

[Pragma]

Kaiser is the largest employer of psychologists in many west coast cities and all the kaiser's i've interviewed at have caseloads of 200 per psychologist, and 4-5 new intakes per week (no matter how large the caseload). I've worked at several VA hospitals and know for a fact that psychologists have 150-200 people on their caseloads in some geographic regions (this is not at every VA and depends on the specialty). They see most of their patients once every 6-12 weeks, and then see a handful of patients maybe weekly. Most of the patients are placed into groups. This was standard practice unless you were in PTSD.

Just to be clear, they are not working more than 60 hours per week despite enormous case loads because most patients are seen once every 6-8 weeks and funneled through a group. At VA's they don't see more than 6-8 patients per day but the caseloads are enormous and there are frequent emergencies when you have this many cases floating around so you end up doing a lot of case management. I am bringing up the fact that many psychologists do not want to practice this way.

Wow, I have never heard of that or encountered such a business model. The VAs in my area are not at all like that, and there is definitely no shortage of psychologists to the point that consumers would even tolerate waiting that long. I don't think you can do effective work for most issues seeing a patient only every 6-12 weeks. What you are talking about sounds more like a psychiatrist med check.

I suppose it is another reason to hate on California

 

[PHD12]

Wow, I have never heard of that or encountered such a business model. The VAs in my area are not at all like that, and there is definitely no shortage of psychologists to the point that consumers would even tolerate waiting that long. I don't think you can do effective work for most issues seeing a patient only every 6-12 weeks. What you are talking about sounds more like a psychiatrist med check.

I suppose it is another reason to hate on California

The psychiatrists have 600-700 patients...imagine that.

 

[Sanman]

Kaiser is the largest employer of psychologists in many west coast cities and all the kaiser's i've interviewed at have caseloads of 200 per psychologist, and 4-5 new intakes per week (no matter how large the caseload). I've worked at several VA hospitals and know for a fact that psychologists have 150-200 people on their caseloads in some geographic regions (this is not at every VA and depends on the specialty). They see most of their patients once every 6-12 weeks, and then see a handful of patients maybe weekly. Most of the patients are placed into groups. This was standard practice unless you were in PTSD.

Just to be clear, they are not working more than 60 hours per week despite enormous case loads because most patients are seen once every 6-8 weeks and funneled through a group. At VA's they don't see more than 6-8 patients per day but the caseloads are enormous and there are frequent emergencies when you have this many cases floating around so you end up doing a lot of case management. I am bringing up the fact that many psychologists do not want to practice this way.

That, I can definitely see. With the VA's that I trained at, there were usually three types of pts. Clinic pts (seen every 4-6 wks in conjunction with medical appt usually), group pts (usually those that were either not that severe or on long term maintenance), and individual pts (usually newer acute cases). A lot of the crisis management was handles by social work and psychiatry. If there was housing or benefits issue, I had them contact their social worker/case manager. Emergent psych issues, I usually walked down to the ER and handed off the psychiatrist on duty. Most crises that I did manage were related to the phone rather than in person. Manage to not pick up your phone late in the day (particularly since voicemail has a nice message regarding what to do in emergencies) and you can usually avoid most of the annoying 'emergencies' that are not real emergencies.

I've heard that the medical doctors in the nursing home I am in keep 500-900 pt load depending on specialty.