Clin Psych in UK: What do i need to do if i want to work in states or canda

[PsychUK]

Hey guys, was wondering if you could help me. I am a first timer here. I am still at uni doing my PsychD in the UK. When I qualify I want to work in either the states or Canada. Could anyone tell me how easy this would be or if there is a way of converting my qualifications or if they are recognised in both these countries. An what should i expect to earn in my first job? in the uk a Clin Psych will earn about £35 000; $63 431CAN; $52 876US. Please help.

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[PsyDr]

you would most likely have to complete a year long internship (which places you wherever they want as opposed to you selecting it) and a year long post doc in order to obtain a license. most states have a minimum of 2 yrs supervised experience, one of which may be a pre doctoral internship.

you will also have to pass a standardized test, and perhaps have to take a few other tests and maybe even an oral exam depending on the state in which you want to practice. fingerprinting may also be something you have to do.

oh, and i am going to bet that you would have to take an ethics course or two as well given that the american psychological association's ethics code is the standard around here.

this is because of the huge difference in education:


a psychd = 3 yrs with approx 500 client contact hours.

in comparison a phd or psyd in the states = 5-7 yrs + 1 yr post doc (total=6-8 years) with an estimated very very very minimum of 2000 client contact hrs. i would think that really we are talking 4000+ client contact hours by the time one obtains his/her license.

money: psychologists make an average of $71k in institutional settings. self employed psychologists are not counted in the federal data. sweet's report on neuropsychologists in the states report an average of something like $103K per year. but neuro is a separate 2 year post doc in the states.

in your internship you would earn something ridiculous like $25k. in your post doc you would earn something like $30-40k. after that it depends on where you work, what kind of work you do, how much time and effort you are willing to put into your business, your charisma, your locale, business acumen, how much of your life you are willing to sell, how many days a week you want to work, if you are ever going to take vacation, overhead, etc.

 

[PsychUK]

Thanks a lot for your reply PsyDr. I am not sure whether to this is a realistic endeavour? I was under the impression that your psyD courses only lasted 3yrs! Also, why do the internship if you get your work experience and supervision whilst doing the psyD? What is the post doc? Is that after licensing? Do all (inc. American trainees) people have to do internship and standardised exams? If so I genuinely feel for you guys, the internship pay does not sound like enough to live on (excuse my ignorance if it’s the opposite) especially considering you have a loan to payback after your doctorate. In the UK we are paid to do the doctorate, so have no debt when qualified. Is there competition to apply for internship and how do they determine who to employ? (Supposing all psyD graduates have to apply)

I am aware, I have asked a lot of questions but a response to any of these would be appreciated. As you can imagine i have no clue how the US psych system works. It is still something I want to do, just to get the experience of working in another country.

 

[KillerDiller]

The statistic you are probably running into is that most Ph.D/Psy.D programs in the U.S. (and Canada too from what I understand) require 3 years of coursework to complete the degree. This is only a fraction of the puzzle, however. While doing coursework, clinical students complete practicums, externships, etc. to gain clinical experience. Ph.D programs also require an empirical thesis and a dissertation and some Psy.D programs do as well (although this aspect may be more of a summary of their clinical work or a review of existing literature instead of an original study, depending on the program). In addition to this, all clinical students complete one year of internship before they are awarded a degree. Then, after the degree is granted, but before a clinician is eligible for licensure, we complete another year of clinical work which is called the post-doc. Every clinician who seeks licensure, regardless of where they were educated must pass the standardized liscensing exam as well as meet whatever other requirements their state liscensing board has.

Yeah, the internship and post-doc aren't very well paid, and many of us would like to see those figures raised (especially for post-doc), but it is nevertheless possible to live comfortably on this for that time period. I don't even anticipate having a problem living off that in the more expensive areas of the country, but then again, I'm used to eliminating luxeries from my life. Many programs in the U.S. and Canada, like those in the UK, are fully funded and we are paid a stipend while we are in school. Loan repayment is only an issue for those who attend poorly funded programs or those who have to take out loans for other reasons. Also, federal loans do not come due until after the degree is granted, which is after the first internship year.

Hope this helps to clarify. Best of luck in making your decision!

 

[PsyDr]

i will try to answer all of your questions. I apologize in adavne for my spelling, i am on a different computer with tiny keys:

psyds last between 5-7 years. in general it is 4 years of course work, with one year of internship, followed by graduation. there was an article in the APA student journal the other month that had an "under a decade club", referring to time to completion of a doctorate.

also important: in america you cannot call yourself a psychologist without a doctorate, except if you have a masters in school psychology.

1) internship is a requirement for the degree. you cannot complete a phd or psyd without the internship. as such, state laws have internship requirements. so i guess the answer is that you would have to do an internship to create an equivalent degree and meet state licensure law requirements.

2) for a general post doc: it is after graduation but before licensure. in the states, once you graduate you do not have a license to practice independently. state laws require one year of supervision of supervision after graduation from the program. these laws typically also have internship hours requirements as well. moreover, we have a third party payor system here (i.e., insurance pays for the services, not the individual). most insurance panels will not let you into their system until you have been licensed for 3-5 years after you obtain a license. so having a post doc as a means to obtaining patients is pretty important.


3) yes, all americans have to complete the internship and standardized exam. the one exception is that california has a different standardized exam than the others.

4) yes, internship pay is highway robbery. then again, they cannot bill for your services.

5) internsip is HIGHLY competitive. the worst sites have a minimum of say, 20:1 applicants to acceptance. at the best sites you are talking about somethign like 500 applicants for 1-2 positions.

6) internship is a formalized process. the process basically works thus: you complete all coursework, you get several letters of rec, you complete a 30 page application, you prepare your cv, you then pay a company somethign like $90 to join their service, you search a database and find internships you want to apply to, you send your matierals to them along with any special things they want (cd roms, etc), you are then notified of who wants to interview you, they call and schdule the interviews at their faciliy at their convenience, you then fly out to whereever they are, interview, after several interviews you tell the service how you rank the internships in terms of preference, they secretly do the same, a computer system matches you or not. you are then notified if you matched. a weekend later you are told where. if you do not match you have to wait a year and do it all over again. they determne who they employ based upon the letters of rec, how many hours of client contact you have had (phds average around 2000hrs, with psyds supposedly lower although mine was higher than the ph average)., what kind of patients you have seen (this can get VERY specific including as they require you to describe the deongraphics of everyone you have ever seen on race, ethicnicity, sexual preference, SES, learning diasbaility, etc. ), how many tests of what variety you have given, etc.



i understand your interest in working in another country. a while back i looked at a job in the NHS. however, our systems are incredibly different. being aware of some key differences is a great idea.

 

[psychmama]

Wow! When I read PsyDr's reply (quite accurate and comprehensive) it makes me think I must be nuts to put myself through this! Since I'm in the process of the internship applications, this post really hit home.

I guess we aspiring professional psychologists are all just gluttons for punishment! Oh well, that's the system and process we all signed on for.

 

[KillerDiller]

they determne who they employ based upon the letters of rec, how many hours of client contact you have had (phds average around 2000hrs, with psyds supposedly lower although mine was higher than the ph average).

I was always under the impression that Psy.D candidates amassed a greater number of clinical hours because those in a Ph.D program split their time between research and clinical work.

 

[PsyDr]

a lot of the numbers game has to do with what what you can count as client contact hours. the appi has a slot for everything, except for how much time you have spent studying or in class. if memory serves you can count some research activities as client contact hours, hence phd students have higher numbers.

imo, phd students are also simply better instructed in how to complete the appi.

when i went through internship, i sat down and read every last word and took notes. as a result i had well over 2000 hrs, and i am thinking it was more like 3000hrs+. when i would mention certain areas to psyd classmates, they usually expressed surprise that X activity could be counted.


ps. so psychmama, you're not really a post-doc then?

 

[psychmama]

No - I'm not a post-doc, and I'm not sure how that ended up on my profile. I tried to change it, but could not determine how. Although I'm old enough to be a post-doc 10 times over ...

 

[PsychUK]

Wow! Thanks again PsyDr, but that does seem a very strenous process! The NHS does not put us through anything as challenging ae that. It is incredibly competitive to get onto a doctorate programme but once you are on there and manage to successifully complete you are free to practice independently or for the NHS.

This leaves me wondering about the Clinical Psychologists who have been qualified and have many years experience here in the UK. Surely if they chose to migrate they wouldn't have to go through internship!? That would seem patronising to the masses of experience they have acquired? Wouldn't it? Are you guys offered supervision and client contact in your PhD/PsyD courses? Without intending to question the system too much, it is hard to understand why you should work for a year under supervision if this was part of your training?

What a sacrifice you guys take, you really have to be dedicated to see this through, there certainly are no guarantees! I am wondering how competitive I would be with the high calibre indigenous applicants? WE do not record specific data about our client contact (i.e. demographics etc) just the hours (in some cases) and the diagnosis/problem.

What if you have a small family and you are offered an internship in a different state, is it a matter of whatever comes you have to take? Also, what is the average time people have waited to find an internship?

PsyDr, I think you'd be well suited to work in the NHS and probably have to take a few tests that's all. Have any of you come across foreign psychologists (who have qualified elsewhere)? They must be rear! I am still going to try and do this though it would be difficult to attend interviews if i am all the way out here?


I think there should be some student exchange programme amongst doctoral trainees in USA and UK, that way we can learn from each other's systems (i am sure there is a benefit in that somewhere?


Another question so i could get an idea (as much as that is possible) about cost of living. What is the average pay in the states? And would someone on that pay be able to afford a 2 bed flat (mortgage), car payments and have change at the end? Here in the UK for example an average wage of £28 000 could only get you anything in the most rural of places , probably won't be able to get a mortgage even in those places.


After ALL that sacrifice, aren't we the lowest paid profession in this SDN??? Which begs the question, amongst other professionals how do Clinical psychologists fair in terms of pay?

Sorry for all the questions guys, but if you have any about the UK I would be most happy to oblige.

 

[PsyDr]

everyone has to go through internship: it is a requirement for degree completion. you cannot graduate a clinical psychology doctorate in the states without it.

we do have supervision and client contact hours as part of our degree. in general, we have 2-3 year long practica (one for assessment, one for therapy, one for whatever). this is done with coursework, and the student receives a minimum of 3 hrs of supervision per week. then there is internship.

if you do continue on this path, i would suggest you attempt to think back and get the most accurate demongraphics for each patient you have had.

as for the family thing: the system is BRUTAL. if you have a family and match out of town, then you are still expected to go. no excuses.

there is no average wait time for internship. there is a set day on which you are notified if you match or not. usually applications are due for sites around dec 15. you match sometime in march. you then start at the beginning of summer. if you don't match, then you wait a year.

cost of living is highly dependent on locale. urban areas obviously cost significantly more. on the average salary for a psychologist, i believe that most individuals could afford a 2 bedroom flat and car payment, depending on which car and flat. however, if you want to live in new york city, in manhattan, being middle class starts in the mid 6 figures. if you want to live in a rural area, then you could live a great life on the average 71k salary, but you would have limited entertainment options.

of course, the US is a free market economy. one can make significantly more money than average if he/she has some business knowledge, a special skill, the ability to effectively market said skill, and is willing to work hard. however, in my opinion, many individuals in this profession are more attracted to this job for a lax work life and as such, make less money.

work ethic in the US is also fairly ridiculous. 2 weeks of vacation is average. going to the dentist? that time comes out of your vacation. it's pretty easy to see how you can end up with no vacation at all.

i agree our systems are very different. even our medical doctors have a different and more strenuous training than their UK counterparts.

i have never met a psychologist trained abroad.

we are the lowest paid group because we have done a TERRIBLE job marketing ourselves. as a profession we don't demand to be called Dr. , we defer to all sorts of idiots, etc.

 

[psychmama]

PSYDR - you've really made the career path of clinical psychologist in the US sound so appealing! Unfortunately, it's a fairly accurate depiction.

SO why did we all sign on to this anyway?

 

[PsyDr]

yeah, i am not a therapist or a hand holder.

when you look the effort and the payoff, it makes you wonder why this job is so popular among relatively intelligent people... unless non-monetary reinforcers are at play.

as for money: you can make money in this profession. however, ours is a service profession wherein X hours worked= Y amount paid. you want Y to go up, you have to increase X.

 

[psychmama]

yeah, i am not a therapist or a hand holder.

when you look the effort and the payoff, it makes you wonder why this job is so popular among relatively intelligent people... unless non-monetary reinforcers are at play.

as for money: you can make money in this profession. however, ours is a service profession wherein X hours worked= Y amount paid. you want Y to go up, you have to increase X.

In terms of a profession with more potential for $$, perhaps I was wrong to get out of the law field?... NAH!! No amount of money was worth being a lawyer.

 

[PsychUK]

You have really hit it home, especially regarding how pathetic we are at marketing our own profession. We suffer the same ailment in the UK and risk obliterating our own professions because we ‘market' our job skills as common sense, no suppose why the financiers can't justify allocating money to psychologists to do commonsensical jobs when they can pay a nurse, social worker or OT much cheaper to do what they think is the same thing! Don't get me wrong, there are loads of jobs for Psychs available in the UK, it's just that the government is now ceasing this new boost in CBT and psychometric testing and training lower paid people (at a very large scale) to do it. Seems like the beginning of extinction (and I am not catastrophising). We don't (in the UK) expect to be called Dr either, yet it would be an abominable sin to refer to our psychiatric colleagues just by name! I read on here once, someone's ingenious idea that all applied psychologists should have the same generic training and then after their doctorate, choose to branch out to their specialist areas of interest e.g. clinical, counselling, neuropsych , education etc. I feel this would unify our respective professional bodies, APA; BPS, to have a single identity and encourage a more cohesive approach to practice or bureaucratic challenges. Here counselling and clinical psychs don't share the same identity so while one profession is willing to settle for just about anything and the other is asking for a little bit more, the employers hire the less demanding one, which in many ways undermines the ‘other' group.

I really do prefer your ‘non hand holding style'. Our leave is quite good here you can have up to 41 days leave a year, 35 days on appointment and increased gradually every 5 years work for the NHS. In terms of dentist visits, we are given 3 days leave self appointment (meaning you don't need the GPs letter or dentist etc), we work flexible hours and generally allowed 6 days per year carers leave of you have a child under 16 years (no questions asked). These days are inclusive of bank holidays of which we only have 8. I understand in the US you have 12 days bank holiday allowance so i guess it could add up to our equivalent (assuming your two weeks leave excludes bank holidays).

I appreciate some of you don't really care how we do things, so ignore the comparison; I guess I am just thinking ‘out loud'. On the bright side, your cost of living is so much cheaper than us. And there is the attraction!

 

[PsyDr]

No worries PsychUK, i find this fascinating.


i had seen the UK had started a significant computer based CBT program. is this still going on? could you tell us more about the death of psychologists?

i believe that the US and Uk are opposite sides of the same coin. The UK traded a significant amount of upward mobility for security, whereas the US traded any sort of security for exceptional prospects of upward mobility.