Clinical PhD career advice: AMC vs hospitals vs community mental health services vs others

[Neurox31]

Hello,
I have realized that I really don't know much about different settings clinical psychologists work at, I would appreciate if someone can share their experiences and insights. A little bit background here, I am currently a clinical PhD student with a concentration in neuropsych. I have some publication/posters but my advisor has crushed my last bit of interest in research, and I therefore focus more on clinical work. Recently, I started to think about future career, things really matter to me are stable income, work-life balance, and non-toxic, supportive culture/working environment. I have this ultimate goal of running my own private practice, and ideally I would like my early career to be a platform for me to accumulate experiences, reputation, interdisciplinary connections, etc. I have shared my goal with some mentors, and they all recommended pursuing internship/fellowship/early career at academic medial centers. (Of course they could be biased because they all work at AMCs.) But I am also feeling hopeless about pursuing a career at AMCs because my current lab is absolutely terrible with zero productivity. I would love to hear other people's opinions; what is it like to have a career in non-research heavy medical centers/ public or private hospitals/community mental health services/etc? Pros and cons? Is AMC really the only career path that can get me where I want to be, as I have been told? (I doubt). Thank you in advance!

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[Ollie123]

I do think some experience in AMCs can open doors, but it isn't necessary. If you have some pubs/posters, don't rule them out. Most AMCs have plenty of clinical faculty who rarely/never publish anything. Its wildly different from being traditional psychology dept faculty. A few solids pubs/posters as a grad student can get you into the clinical side of AMCs without issue, you just need more if you are on the tenure-track NIH-funding path.

VAs could fit almost all your criteria so if they aren't on your radar they should be, though toxicity and supportiveness will vary based on individual site and your tolerance for bureaucracy. I think its a nice situation for more clinically-oriented folks who want a hand in the academic world but with less stress. Research expectations are usually pretty low. Pay isn't fantastic, but its also not bad for ECPs and certainly stable. Neuro is one of the areas they excel. I know many who started at a VA and went into PP afterwards so that is a well-worn path. Smaller hospitals are fair game too. For post-doc, I would just make sure wherever you go will qualify you for boarding, which might be an issue in smaller settings. Neuro and forensics are probably the only two areas where it actually matters and not being ABPP eligible would close doors you probably want to remain open if you made it that far. Nothing wrong with doing it in other areas, but in my experience no one expects it or cares one way or another. When I asked at my last AMC, leadership was genuinely unaware that non-neuro faculty even could get board certification.

 

[summerbabe]

crushed my last bit of interest in research, and I therefore focus more on clinical work

That support group meets every Thursday (I never had this goal but know a handful who had similar experiences).

Recently, I started to think about future career, things really matter to me are stable income, work-life balance, and non-toxic, supportive culture/working environment.

ideally I would like my early career to be a platform for me to accumulate experiences, reputation, interdisciplinary connections, etc

I’m an early career psychologist working in the VA following VA internship and postdoc. One piece of great realistic advice I got was you probably won’t get everything in a job, especially a first job so make a prioritized list and figure out what is absolutely necessary and what isn’t. And where you’d like to live should be as high as it needs to be.

So if push comes to shove, do you want work-life balance more or be more achievement/reputation oriented? Me personally, as a non-academic clinician, I care about relationships with my colleagues but don’t care one bit about my own reputation in the field or anybody else’s but you might be different so I’d encourage you to honestly reflect on what your needs are in that area (and others).

what is it like to have a career in non-research heavy medical centers/ public or private hospitals/community mental health services/etc?

I’ve never been in an AMC so I don’t have that reference point.

CMH is probably furthest from your goals (overloaded with work, poor pay, crisis response duties, possible toxic work environments since people are pushed to their limits, wouldn’t do anything for your rep unless you want to manage that agency).

VA can provide good work-life balance especially in a specialty clinic or if your facility is not short on staff. You’ll get solid to great training as a trainee but as a staff member, there’s definitely a risk of becoming just a number since the first priority is always patient care so research or getting involved in other ways can be challenging. And toxicity in work environments will vary greatly, even clinic by clinic within the same facility.