Bad supervision?

[BrainStormer]

I’m at a big name AMC for practicum. I do not have individual supervision time with licensed attendings but instead have supervision with whichever fellow is on the case. From what I’ve heard from former prac students, it seems like the fellows are the ones writing evaluations and letters of rec. Former students have also stated that they barely knew the attendings other than the interview for the site and a few interactions on-site. I have a couple of questions… Is this what tiered supervision is supposed to be like or should practicum students have some individual supervision with the attending? Is it a bad look for letters of rec to come from unlicensed fellows?

At my previous site, I was very close with the attendings and they prioritized supervision and quality training. I’m not sure if this is the exception or if my current situation is the norm. I’m interested in hearing other peoples experiences training at large AMC’s and what the model of supervision looks like. Thanks all!

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[BuckeyeLove]

So you're not getting ANY supervision by someone with an actual license?

 

[WisNeuro]

So you're not getting ANY supervision by someone with an actual license?

Ummmm, this would constitute a major problem.

 

[jdawg2017]

When I’ve worked in tiered supervision it was rare to have 1:1 supervision for a case with the attending, but I and the fellow or intern (or my prac student when I was an intern) would meet together with the attending both before and after the assessment. If you ever see your own case, then you obviously need direct 1:1 supervision.

I’ve worked in both models at an AMC but I can say I usually didn’t get 1:1 supervision if I was working with a more advanced trainee on the case, but obviously I got 1:1 if I was working by myself with the attending. I also met weekly for about 30-60 mins with the site’s practicum director to check in on my general progress. Do you have group supervision with the attending? There is no reason IMO that you shouldn’t be sitting with the fellow during supervision regarding shared cases.

IMO, there is no reason a fellow should be writing you letters or rec or completing your evaluation. They may provide the attendings with input for these, but fellows are still trainees themselves.

 

[cara susanna]

I supervised an intern as a fellow but it was vertical supervision, so my supervision was supervised by the licensed psychologist.

Edit: I should add this was a VA/AMC site

 

[R. Matey]

I always received weekly supervision from licensed psychologists during my AMC prac.

 

[AcronymAllergy]

I agree that it seems problematic to not have any direct supervision by the psychologist, even if it's meeting with them together with the fellow. I don't recall this being the situation at any AMCs where I trained, but it's been a little while since the grad school and internship days, so my memory may be a bit fuzzy.

Although ultimately, the potential problem is more on the end of the psychologist than it is anything you're doing wrong.

As for rec letters, as an application reviewer, I probably would've thought it a bit strange that someone received a letter from a fellow and not the psychologist in charge.

 

[PsyDr]

https://www.asppb.net/page/SupGuidelines

 

[AcronymAllergy]

From a liability perspective, I wouldn't want to have to answer for issues in a practicum student by saying, "well no, I never supervised them directly, but my fellows are really great, so I just relied on what they told me."