Does it matter where you go on internship?!!!?

[QClinician]

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Hi All,

I am wondering if where you go on internship and the type of facility matters for my career trajectory.

I earned 4 interviews for internship. 3 at hospitals, one extremely reputable one, and 1 at a University Counseling Center. Quality of life at the most reputable hospital is horrific. The hours are long ( 60+, some rotations 7am-7pm) and often time interns have to take testings home with them.

The University Counseling Center emphasizes "self-care" and is a mere 43 hours a week. The interns there are so happy as opposed to the interns at hospitals who are bedraggled.

I dont have any hospital experience and am not sure if i have any desire to work in a hopsital in the future. They seem to stress diagnosis and assessment but I really would prefer to focus on therapy, which is the focus of the college counseling center. I am concerned though that not going to a hospital will make me less marketable in the future if i decide i want to do different things in my career. Any advice or opinions!?

 

[docma]

Be grateful you have the interviews and use the opportunity to learn more about each setting. Where you do internship inevitably makes a difference because it is a step in your professional trajectory--but it does not inevitably rule out other options. It may, however, make it much easier to get a college counseling job if you have a college counseling internship and vice versa. There are too many variables in the process at this stage to allow for a simple equation. See the sites, rank where you want to be for the next year and then see where the Match leads you. It is way more important at this stage in your career to be defining where YOU want to spend time and energy and where you will be an effective psychologist. There is no guaranteed way to "beat" the system; it is time to start sorting out where and how you want to swim in it as it is.

 

[PsyDr]

hospital practice is VERY different than most practices. if you do not get training in a hospital it would be very hard to pick the general rules up on your own. i have always been told that if you don't get training in a hospital, you will never practice in one. it has also been my experience that in most hospitals, therapy is done by social workers.

 

[QClinician]

hospital practice is VERY different than most practices. if you do not get training in a hospital it would be very hard to pick the general rules up on your own. i have always been told that if you don't get training in a hospital, you will never practice in one. it has also been my experience that in most hospitals, therapy is done by social workers.

Thanks for your responses. I agree with the idea that working in a hospital is very unique and if there is a slight chance i may want to do that in the future i should try to get a placement there.

The reality is I am very lucky to have interviews so I would be pleased going anywhere. Thanks!!

 

[Therapist4Chnge]

You'll probably have a better idea about each site after your interviews. On the one hand it can shape where you go next, but it isn't the end all and be all. As long as all are APA-acred, I'd say go with which one "feels" right.

 

[manko7]

In my experience the most important factor is the networking aspect. Competitive sites offer networking opportunities that may tremendously expedite your future goals and ultimately, career success. I've seen the most creative projects get little notice because a) one benefits from editors and reviewers to allow work to get published and the attainment of editor position is often political (see networking) b) one benefits from well-known research/practitioners to push your work and nominate you for awards.


This is no different from life in any other profession. I have heard however that the playing field levels out after post-doc and that who you trained under does not matter as much. But then again, I have always thought that once you have momentum it's easier to keep ahead in the long-run. So, I guess what i'm saying is that inequities may continue as a result of training milestones, but as long as you can find happiness in YOUR work and the training site provides you with the means to reach YOUR goals, then that is the only metric of worth that matters in selecting a site.

Oh, and like Therapist4chnge implies, APA accred makes life easier all-around!

 

[erg923]

Although I agree with all the previous posters about the value of inpatient hospital experience, I would say that you should weigh if its worth it to you. The hospital you described sounds like it not only overworks its interns (giving that they are probably making 25k), but it also sounds like the interns are not happy. Are they not happy simply because they work so much, or are there other factors contributing to their bedragglement? I bet there is something else they are unhappy about too, no? Some people will argue that you will actually get better training and supervision in site that works you 45 hrs/week. This is because the site that works you 60+ hours a week is more likley to view you as simply "free labor" that needs some additional trianing vs an actual "psychologist in-training."

Do you really need the inpatient experience? You said yourself that one of your goals is to get more advanced trainign in therapy. Consider your future, but you should ultimately go with what you want and where you will be most happy. My personal opnion is...I did not go to medical school/I am not a medical doctor and i would refuse to work 60-70 weeks for 25k/year. I am not simply cheap labor. I am a profesional in training that provides your organization with clinical services in exchange for high quality training, teaching, and supervision.

 

[docma]

I'd echo the fact that if you want to do longer term therapy, inpatient settings do not actually give you much credible experience in that, as patients are too acute for much more than crisis intervention/case management and some short term problem-solving work. Some give you a combination of inpatient and outpatient so that is different--but ask the interns you meet on interview how many clients they have seen for more than 12-15 sessions. Inpatient work will up your assessment credibility and you will definitely gain experience with SMI, which too few trainees actually get in practicum. But again, overall, you are looking with fit with you and your disposition and learning needs.

 

[Therapist4Chnge]

Manko7 brings up a good point about networking. Since we still need hours to get licensed, it really helps to land in a place that can build on our training and/or put us in a position for a solid job afterwards.

At every internship interview I asked about where their interns go for post-doc, how much assistance there is for securing positions, etc. It can be very helpful to be at a site where they take an active role in your post-doc application experience. Some sites are more active than others.

I am lucky that my supervisors have been really involved, as it has helped pick sites that fit my training. A phone call here or an e-mail there can really help make connections. It is still up to the applicant to get the job, a warm introduction can at least get you in the door.

 

[psychmama]

My personal opnion is...I did not go to medical school/I am not a medical doctor and i would refuse to work 60-70 weeks for 25k/year. I am not simply cheap labor. I am a profesional in training that provides your organization with clinical services in exchange for high quality training, teaching, and supervision.

Well said! 🙂

 

[Annakei]

Although I agree with all the previous posters about the value of inpatient hospital experience, I would say that you should weigh if its worth it to you. The hospital you described sounds like it not only overworks its interns (giving that they are probably making 25k), but it also sounds like the interns are not happy. Are they not happy simply because they work so much, or are there other factors contributing to their bedragglement? I bet there is something else they are unhappy about too, no? Some people will argue that you will actually get better training and supervision in site that works you 45 hrs/week. This is because the site that works you 60+ hours a week is more likley to view you as simply "free labor" that needs some additional trianing vs an actual "psychologist in-training."

Do you really need the inpatient experience? You said yourself that one of your goals is to get more advanced trainign in therapy. Consider your future, but you should ultimately go with what you want and where you will be most happy. My personal opnion is...I did not go to medical school/I am not a medical doctor and i would refuse to work 60-70 weeks for 25k/year. I am not simply cheap labor. I am a profesional in training that provides your organization with clinical services in exchange for high quality training, teaching, and supervision.

Check the bolded. I am glad someone said it. Hospital option sounds more like slave labor to me and the hospital would get more out of the experience than you would. It doesnt sound like what you really want except just having hospital experience on your CV when you dont really want to work at one in the first place.

 

[QClinician]

Check the bolded. I am glad someone said it. Hospital option sounds more like slave labor to me and the hospital would get more out of the experience than you would. It doesnt sound like what you really want except just having hospital experience on your CV when you dont really want to work at one in the first place.

Here is the thing, although i don't think i want to work in a hospital right now, one of my supervisors said to me that the reason to work in a hospital is to learn what a variety of severe diagnosis look like in person. That way, if you have a private practice, and someone comes in exhibiting odd behavior, work on an inpatient unit will enable you to better assess what could be going on...

and yes, hospitals seem to be save labor to me. BUT a friend of mine who went to the prestigious, 60+ hour a week internship said it would be more helpful to think of it like this: they are paying you 25K to train you....

 

[erg923]

Good point I suppose, but where does it end exactly? And did you not see any SMI in your practicum experiences? If not, it would indeed be good to fill in that gap in your training, but again, I would weigh the risks (being unhappy in the environment and with the internship) with the benefits of what it might offer.

 

[QClinician]

Good point I suppose, but where does it end exactly? And did you not see any SMI in your practicum experiences? If not, it would indeed be good to fill in that gap in your training, but again, I would weigh the risks (being unhappy in the environment and with the internship) with the benefits of what it might offer.

erg923, i am afraid it will never end!!! In the end, i am just deciding how to rank. Really, its left up to the sites to make the final decision. At this point, it looks like i may be choosing to not be happy for the year (ranking college counseling last) because of some bizarre belief that if i don't suffer on internship i may not become a "real" psychologist 😱 I don't know. I have until February to decide.

Yes, I have seen some SMI but not all that much. Not like, inpatient stuff.

 

[erg923]

I would argue that for the point you described (getting experience with them, recognizing symptoms, and then assessing them) it doesnt really matter where you saw them. Technically, the only inpatient stuff ive done was a handful of brief inpatient neuropsych consults. A couple of them were psych folks, but the majority were neuro, cardio, and oncology pts. However, I have done about 50 SCIDs for my research lab, all of who were severe major depression (for TMS studies), schizophrenia, or schizoaffective. So in my mind, ive gottem my fill of SMI, but not realy in the inpatient setting.

 

[RayneeDeigh]

Hmm I definitely vote for environment.

Unless you're really worried that the institution you're getting your degree from is less than reputable, I think the internship experience is likely grueling enough on its own - why would you want to add a crappy work environment to that? You can network at conferences and other such events. There are other ways to advance your career.

(I do think getting SMI experience is really important though... so maybe that's something to keep in mind to cheer yourself up if you end up matched to the hospital site)

 

[QClinician]

Thanks all!!