PhD/PsyD Geropsychology

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NeuroLady

Gero Neuro Nerd
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Can anyone tell me about geropsychology internship rotations or tracks at VA's? Someone mentioned to me that these positions are somewhat less competitive but any information you could provide would be helpful.

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IMO I would not consider geropsych rotations less competitive, if you consider that our Vietnam era veterans are all exceeding 65-yo (perhaps less desirable, but there are still a lot of folks who are thinking about the longevity of their training, especially in the VA). During my VA internship, we were able to chose between the inpatient nursing home rotation and other rotations, but we were all required to do 6-months in outpatient geropsych. I enjoy working with older Veteran patients (Korean War and Vietnam War era). It was challenging, don't get me wrong...but the challenges they faced, the therapy required, and I met were all welcomed in my training. The caseload was not overburdening. There was some palliative care required for inpatient cases. I was not on the neuropsych track, but most of outpatient cases had neuropsych testing to evaluate the extent of disorder.

There are also specialized 12-month gerospych postdocs at VAs...those were very competitive, and I feel like were basically given to individuals who focused on some aspect of geropsych in their individual research (i.e., dissertations) or were shoo-ins from having done internships at the same VA (seems like one site filled their 1 or 2-spots consistently from their pool of interns for the past few years - I applied to one geropsych postdoc but eventually found a much better postdoc opportunity at a MIRECC).

Do you have more specific questions?
 
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It depends on what you're comparing it to. My sense is that it is less competitive than neuro because there are less people interested in it but there is a very big need, as mentioned above. You can do a lot of neuropsych in gero, so this can become a viable internship option for folks primarily interested in geriatric neuro. However, geropsych proper does involve a lot of intervention work, so it would be ill-suited for anyone just wanting to do assessments with old people.

You might want to read through manuals of some VA programs with gero tracks to get a sense of the expectations. Most involve work in community living centers and geriatric psychiatry:
Boston
Denver (new position this year, I believe)
West LA
Palo Alto
Buffalo
... others, I'm sure.

Also check out GRECC sites: http://www.va.gov/GRECC/GRECC_Demographics_and_Profiles.asp
 
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Thank you both! I'm actually doing a geropsych prac right now and I'm truly loving it. It has also been a nice way to combine my interests. I guess I am just curious about how it might be different at a VA and what kind of qualifications one should have before applying for geropsych rotations in internship- I'm applying now. I haven't been in it long but I suspect my other prac experiences would make for a nice fit. So far I really like the sound of GRECC sites.
 
I guess I am just curious about how it might be different at a VA and what kind of qualifications one should have before applying for geropsych rotations in internship- I'm applying now.

One thing to understand and look into, most VA internships offer different sub-rotations during your 12-months. My VA split them over 6-months. We ranked our choices and our internship director matched us to our rotations selections as best as possible.

At my VA (and I believe most VA internship training modules are pretty similar), you could do the General Psych track or Neuropsych track. From there, we were all required to do the following sub-rotations: PTSD clinic, Supportive Recovery (Substance Use/Outpatient), Mental Health Outpatient clinic, Inpatient psychiatric ward, and Geropsych Outpatient. Then we could further choose between the Spinal Cord Injury Unit, Primary Care clinic, Geropsych-Inpatient (Community Living Center), Neuropsych, or DBT.

I did the General Track with DBT, and also requested Geropsych Inpatient. We were not asked to commit, but asked what our choices were during an interview with the Internship Director. After we matched, during the summer before internship, we then formally selected our choices and were scheduled accordingly.

I believe that Geropsych externship placement will help, especially if you add something about wanting to continue the work in your internship essays (I emphasized my desire to work with older Veterans in one or two lines in one of the internship essays).

Also, no worries about doing a rotation that you’re not crazy about (like I was not so stoked about the substance use rotation, as it was never an emphasis for me), but BOY, the VA knows how to train clinicians because it has become one of the most useful and practical rotations in my training because substance use is often a co-morbidity in the Veteran population. Now, I will not shy away from substance use treatment if it is something my patient needs (not that I would have before, but I am much more confident about assessment of symptoms and recurrent behaviors, especially as it relates to trauma).

Search the internet for internship brochures from various VAs. The entire brochure explains the selection choice and what these rotations entail. It will also help you tailor your essays to illustrate how good of a match you may be to some of their sites (like I was very excited at PTSD clinic prospect, and appreciated during the open house that were told we would all be on that particular rotation). Oh, and I recommend going to the open houses during the internship interview times. You meet faculty, can leave a good impression, show your genuine interests, and have most of your questions answered to make an informed decision about how to rank.

One more thing: At our VA, the GRECC does not have internship placements (it is more the function of the psychology training program). They may have postdoctoral fellowships, so I believe you would be generally looking for internships that have geropsych rotations, and if you find ones that only focus on geropsych for 12-months, great! If not, you can always subspecialize during postdoc.

Good luck! :luck:

Edit: Oh, and what qualifications do you need to be competitive? Well, it will be across the board for any VA, I suppose: Demonstrate your intellect, your ability to understand theory as it relates to practice; have great letters of rec that emphasis your ability to form effective alliances with your patients; be prepared to be asked what evidence-based treatments you are familiar with (but no worries if you are fully-fledged in some of the EBTs...they will train you for the ones approved by the VA). Basically, know what you know and know it well. Be confident, and know how to talk about your cases in a sophisticated way. The VA wants smart, flexible clinicians who will work well on multidisciplinary teams, and one thing I've learned, VAs want to train you to stay at the VA, so if you love it...let them know. I plan on staying in the VA system until I develop some sort of post-retirement plan. I truly enjoy the work and my Veterans can tell I am honored to be there....no BS b/c they can usually see thru the BS.
 
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The GRECC takes on different forms across VAs with respect to internship training. At Denver, for example, it sponsors a formal internship track. At some other sites (e.g., the Tennessee Valley VA system [Vanderbilt Consortium]) the funding for internship slots is spread out across all interns to ensure everyone receives some training in geriatrics. As mentioned above, you can get significant gero training within either of these structures, but if you know you are set on gero, it might be good to create a list of the gero-specific sites that appeal to you first and supplement with more general training programs that have gero components.

Re competitiveness, the VA wants generalists who have fairly strong backgrounds in both assessment and intervention, regardless of track. Your practicum experience will be key for gero, and I think for the sites that do have a gero track, you will want to speak at some length in your cover letter about your interest in working with the elderly. If you can demonstrate some understanding of the issues facing older folks (and specifically aging veterans) and why you want work to address these, that will be compelling. You already said that gero was a nice way to combine your interests, so do go into more detail about that in your letter and connect it to each site's training.
 
Thank you both! I'm actually doing a geropsych prac right now and I'm truly loving it. It has also been a nice way to combine my interests. I guess I am just curious about how it might be different at a VA and what kind of qualifications one should have before applying for geropsych rotations in internship- I'm applying now. I haven't been in it long but I suspect my other prac experiences would make for a nice fit. So far I really like the sound of GRECC sites.

I'm a super gero person currently on post doc and am happy to hear how much you are loving gero practicum! I am very passionate about the gero field and am happy to talk more about it via PM if you are interested 🙂 I applied to both gero-tracks and general tracks (that offered gero experience) for internship. I came into internship with a lot of applied gero experience, so I ended up really benefiting from a general internship that offered my about ~60% gero experience and ~40% non-gero specific training. Remember you can (and should?) do a gero post doc if you want to pursue geropsychology which will be very specialized so I would suggest getting some other experiences on internship in addition to gero. In terms of good gero experience on internship, GRECC rotations are great, as are HBPC, CLC and maybe some neuro rotations as well. Good luck!
 
Thank you, thank you, thank you! I'm not 100% sure what I want to do yet but I appreciate the offer for the PM and will take you up on that offer if I think of something. 🙂
 
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