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I understand why this process can feel like a roll of the dice at times, but I think labeling it a "total crapshoot" and "completely arbitrary" might be an overstatement. It is definitely a numbers game to the extent that, in order to match, you need to fall within the top x number of spots on sites' lists (and this is very difficult because of the high number of qualified students), but it is not completely arbitrary. Based on my experience of interviewing this year (12 interviews, all competitive, child-focused, APA-accredited programs), the groups of interns I had the chance to talk with at each site did not just have a random smattering of previous training experience and found themselves matched at some particular site. Nearly every intern had some unique clinical or research interest and/or extensive prior training with particular populations that the internship program offered training in (and often very extensively so). In other words, they had weaved a pretty consistent thread of interest since beginning graduate school of wanting to work with X population in X setting.
I recognize that this goes against APA's purported stance that internships should be generalist in nature, but the reality is that the seemingly single most important question internship sites are asking is this: "does this person's career interests and goals line up with what we have to offer, and do their previous experience and training line-up with those interests?" (i.e., "where do you see yourself in 5 years," "what makes you specifically interested in our training program?" "what opportunities are you particularly interested in/excited about that we offer?"...all questions I was asked at nearly every one of my interviews).
Also, I was surprised (as has been mentioned on here before) to see the overlap in the group of interviewees for many of the sites I visited. I noted two major observations about them: First, the vast majority were from large cities and reputable practicum training programs within those cities (New York, Chicago, and California were overwhelming majority). It was fairly clear to me that coming from a large hospital or children's hospital with a big name (and probably a letter of rec from a TD with some clout) would land you interviews at similar sites across the country (including smaller, lesser populated regions). Secondly, as I mentioned above, each person seemed to have very specific interests that were offered as tracks through the sites, or at least had a major emphasis. Their previous training (for better or worse) was not comprised of generalist training (e.g., VA, CC, CMHC, and then interviewing at a medical school or children's hospital w/ child/family emphasis).
All this to say that, based on my experience, I can understand why people feel so confused about "top notch" students not matching. "Top notch" can be subjectively defined when you cannot accurately compare yourself or your cohort mates to others across the country, and especially in much bigger, and unfortunately more reputable, markets. Of course, nothing is a guarantee, and even top notch students that I interviewed with from reputable programs in big cities with gobs of interviews may not have matched due to the flood of the system. However, I encourage students behind me in our program to (if they can) work on developing a consistent thread of training/interests and then be mindful about selecting sites that offer training in that area, as I think it helps boost your odds tremendously.
So, there ya go. My post-internship musings. Hopefully it helps some student out there who's already reading these boards (like I was) 2-3 years away from this ridiculous process!
