Internship experiences- worth it?

[54321]

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I saw on the APA survey about training that some people mentioned the possibility of turning internship into a post-doc experience. This led me to think about my own internship experience and whether I think it was really necessary/worth it, particularly in light of the huge burden of the whole internship match process (financially, emotionally, and in terms of months of lost graduate training)

I'm not sure I'd say that my internship year has been worth it. I've found didactics to be repetitive of graduate training and supervision has amounted largely to consultation about crises rather than anything that has helped me grow as a clinician. While I have learned during the year, the things I've learned relate to either (a) knowledge in my future area of specialization (i'm in an internship with tracks) or (b) increased confidence in my own skills due to leaving the comfort of my grad program. These are things that I think I could have easily learned with a post-doc or supervised pre- license job, while actually making a living wage. At times I feel like I am just working for a very low salary and that makes me quite frustrated.

I also know that I am really burnt out right now so that may be playing into my opinion. I'm curious to hear thoughts from those currently on internship or recently in the post-doc/ job world. What have you learned? Do you think the year added substantially to your training? Could it have been a post-doc experience instead? Anyone else feel frustrated by the whole experience?

 

[erg923]

I saw on the APA survey about training that some people mentioned the possibility of turning internship into a post-doc experience. This led me to think about my own internship experience and whether I think it was really necessary/worth it, particularly in light of the huge burden of the whole internship match process (financially, emotionally, and in terms of months of lost graduate training)

I'm not sure I'd say that my internship year has been worth it. I've found didactics to be repetitive of graduate training and supervision has amounted largely to consultation about crises rather than anything that has helped me grow as a clinician. While I have learned during the year, the things I've learned relate to either (a) knowledge in my future area of specialization (i'm in an internship with tracks) or (b) increased confidence in my own skills due to leaving the comfort of my grad program. These are things that I think I could have easily learned with a post-doc or supervised pre- license job, while actually making a living wage. At times I feel like I am just working for a very low salary and that makes me quite frustrated.

I also know that I am really burnt out right now so that may be playing into my opinion. I'm curious to hear thoughts from those currently on internship or recently in the post-doc/ job world. What have you learned? Do you think the year added substantially to your training? Could it have been a post-doc experience instead? Anyone else feel frustrated by the whole experience?

I learned alot, but its could have been post-doc easily.

 

[AcronymAllergy]

I learned alot, but its could have been post-doc easily.

I agree with this. I'd be all for awarding the degree pre-internship, assuming the internship was then required for licensure. This would also sort of roll the internship and post-doc hours situations all into one, while possibly making it easier to bill for interns' services. The name could then be changed to "residency," and current post-docs would then truly be akin to medical model-type fellowships, so if nothing else our training would potentially seem to make a bit more sense to our patients/clients and fellow healthcare/mental health providers.

 

[Mindfulpsych22]

I wonder if students are getting less and less out of internship as the internship crisis has worsened. It seems like students are getting more and more experience prior to applying to internship just to be competitive in the process. Successful applicants these days already seem to have a "specialty" that they are quite well trained in. It seems like as the pool of applicants gets more and more stellar, sites are opting to take students who already have a lot of experience that corresponds with the experience of the site. For many, it seems less and less of a year to focus on training in areas that they are weak on rather than develop even more of an expertise in their chosen area. UCCs and forensic placements especially come to mind. I wonder how much a student who spent a practicum or two in a UCC really learns during an internship at a UCC. Given this, today's average intern is probably in a very different place training-wise than the typical intern 20 years ago.

 

[Pragma]

I saw on the APA survey about training that some people mentioned the possibility of turning internship into a post-doc experience. This led me to think about my own internship experience and whether I think it was really necessary/worth it, particularly in light of the huge burden of the whole internship match process (financially, emotionally, and in terms of months of lost graduate training)

I'm not sure I'd say that my internship year has been worth it. I've found didactics to be repetitive of graduate training and supervision has amounted largely to consultation about crises rather than anything that has helped me grow as a clinician. While I have learned during the year, the things I've learned relate to either (a) knowledge in my future area of specialization (i'm in an internship with tracks) or (b) increased confidence in my own skills due to leaving the comfort of my grad program. These are things that I think I could have easily learned with a post-doc or supervised pre- license job, while actually making a living wage. At times I feel like I am just working for a very low salary and that makes me quite frustrated.

I also know that I am really burnt out right now so that may be playing into my opinion. I'm curious to hear thoughts from those currently on internship or recently in the post-doc/ job world. What have you learned? Do you think the year added substantially to your training? Could it have been a post-doc experience instead? Anyone else feel frustrated by the whole experience?

My internship was so so. I think you take from it what you put in, though. It's the first time you really get that volume of clinical work (in the capacity of a psychologist), and at least for me, the patient population was fascinating. I think sites vary a lot in terms of the quality of didactics, supervision, etc. But I viewed it as a "tryout" of sorts for a full time clinical job, and thought the experience of doing that for a year was worthwhile on its own.

I'd love it if they awarded degrees first and had it more like the medical school model. We'd see a huge surge in dissertation completion efficiency 😀

 

[cara susanna]

I was reading the comments that inspired this thread and a lot of people are saying that internship is the time you really can see if someone is cut out for clinical work, so this year is necessary because it can be a last-stage weeding out process. I dunno, don't you think they should figure it out earlier if you're not cut out to be a psychologist?

 

[Therapist4Chnge]

I found internship helpful for a few reasons:

1. It helped round out my training experience (mostly because it was a generalist site). I probably would have been fine for post-doc and licensure w/o the polish, but it was useful to make sure I was ready for more independant practice.

2. Offered time for students to finish their dissertations and not get caught in the Post-Doc Trap of ABD. I had a 5th year so this was a non-issue for me, but 5 of the other 6 interns in my cohort had to finish their dissertations while working FT.

3. It was truly "full-time", which ended up being a lot of clinical time. Day to day work is quite different when it is 40-50hrs+/wk instead of 10-20hr/wk. Could I get that same feeling in 6 months....probably, but I don't see the field abolishing internship any time soon.

 

[futureapppsy2]

I was reading the comments that inspired this thread and a lot of people are saying that internship is the time you really can see if someone is cut out for clinical work, so this year is necessary because it can be a last-stage weeding out process. I dunno, don't you think they should figure it out earlier if you're not cut out to be a psychologist?

I agree. Considering it requires hours of practicum hours to apply for internship, they really should figure out if someone is or is not psychologist material before they spend 4 or more years training to be one.

 

[Sanman]

I really like the idea that AcronymAllergy mentioned. I found internship to be a good learning experience, but I had a good amount of experience prior to that. I had 3 semesters of externship in my area of specialty and the internship gave me an extra year. I found the experience worthwhile, but have found my post-doc/unlicensed yr to be quite redundant and much more like indentured servitude. I do really think it depends on the quality of the institution one goes through and the experiences available. As accreditation levels slip, students are more likely to be used as indentured servants than as trainees. Allowing internship and post-doc to be years to be a residency and tightening accreditation so that learning actually occurs is important. Otherwise, we are just abusing the young trying to make their way.

 

[54321]

I agree with this. I'd be all for awarding the degree pre-internship, assuming the internship was then required for licensure. This would also sort of roll the internship and post-doc hours situations all into one, while possibly making it easier to bill for interns' services. The name could then be changed to "residency," and current post-docs would then truly be akin to medical model-type fellowships, so if nothing else our training would potentially seem to make a bit more sense to our patients/clients and fellow healthcare/mental health providers.

This is what I would vote for as well. People could be required to complete dissertation prior to applying. This would allow hospitials to bill more for our services, give us closer to a resident wage, and hopefully increase respect for interns. Oh, and like every other Ph.D. profession, we could actually be "Dr" after defending rather than having to wait until a year after the defense to take that title. I'd be much happier with this whole experience if it was a two year internship +post-doc committment with a post-doc level salary and I could enjoy that fact that I've already met the primary requirement for a Ph.D.

I wonder if students are getting less and less out of internship as the internship crisis has worsened. It seems like students are getting more and more experience prior to applying to internship just to be competitive in the process. Successful applicants these days already seem to have a "specialty" that they are quite well trained in. It seems like as the pool of applicants gets more and more stellar, sites are opting to take students who already have a lot of experience that corresponds with the experience of the site. For many, it seems less and less of a year to focus on training in areas that they are weak on rather than develop even more of an expertise in their chosen area. UCCs and forensic placements especially come to mind. I wonder how much a student who spent a practicum or two in a UCC really learns during an internship at a UCC. Given this, today's average intern is probably in a very different place training-wise than the typical intern 20 years ago.

I think this is a big part of it. Internship may have served an important purpose in the past but now we have so much experience coming in. What annoys me is that it seems like internship faculty don't seem to recognize this. For example, I find a bit out of touch to offer didactics on things like conducting a suicide risk assessment or basic multicultural issues that were taught early in grad school. Maybe some programs don't teach this stuff well so it is necessary for some, but for me, very little has been new information. It seems like some internship faculty have an overly inflated view of how important this training is and don't realize that we've already learned much of what they are teaching us. I'm at a well-regarded program so this isn't an issue of a bad internship site.

I was reading the comments that inspired this thread and a lot of people are saying that internship is the time you really can see if someone is cut out for clinical work, so this year is necessary because it can be a last-stage weeding out process. I dunno, don't you think they should figure it out earlier if you're not cut out to be a psychologist?

YES. If you can't figure out who is qualified in 4-5 years, the problem lies with the trainers, not the trainees. I understand the point that internship is important because it is the first full year of clinical work. I think that is more important for assessing one's own personal tolerance of 100% clinical work, not overall competence.

I really like the idea that AcronymAllergy mentioned. I found internship to be a good learning experience, but I had a good amount of experience prior to that. I had 3 semesters of externship in my area of specialty and the internship gave me an extra year. I found the experience worthwhile, but have found my post-doc/unlicensed yr to be quite redundant and much more like indentured servitude. I do really think it depends on the quality of the institution one goes through and the experiences available. As accreditation levels slip, students are more likely to be used as indentured servants than as trainees. Allowing internship and post-doc to be years to be a residency and tightening accreditation so that learning actually occurs is important. Otherwise, we are just abusing the young trying to make their way.

Agree. Indentured servitude is how it sometimes feels. Perhaps it's my site but with the exception of one rotation, I feel more like an employee than a trainee (due to lack of meaningful clinical feedback, repetitive clinical assignments, being asked to do things like cover for a supervisor that are more about them than my training). Sure there was good training for the first few weeks of each rotation, but after that it's just sort of been autopilot clinical work with little new skill-building. I don't think I'd mind internship so much if I was either paid a post-doc salary or felt like I was constantly learning.

 

[bmedclinic]

Super.
From this thread, I've learned that I'll gain nothing from internship except jumping through one more hoop.
Jump, bmed, Jump. Would also love to study and get to take the EPPP during internship year, but I get that I cant get away with that in my state.

 

[AcronymAllergy]

Super.
From this thread, I've learned that I'll gain nothing from internship except jumping through one more hoop.
Jump, bmed, Jump. Would also love to study and get to take the EPPP during internship year, but I get that I cant get away with that in my state.

I actually feel like I learned quite a bit while on internship despite having spent the prior 4-ish years working in my area of interest, so there's hope for your experience yet, bmed.

Although I agree, having the ability to sit for the EPPP while on internship would've been great.

 

[Sanman]

Super.
From this thread, I've learned that I'll gain nothing from internship except jumping through one more hoop.
Jump, bmed, Jump. Would also love to study and get to take the EPPP during internship year, but I get that I cant get away with that in my state.

Lol, lets not be so cynical. I had some great experiences on internship and some terrible ones. Much like externship, the value to you will depend on your supervisor and their willingness to teach and invest in you. Those with experience that have stopped to really teach made a great difference. Those that saw us as cheap labor made it another hoop. Everyone takes their chance with that.

 

[HomeworkHelper]

I actually feel like I learned quite a bit while on internship despite having spent the prior 4-ish years working in my area of interest, so there's hope for your experience yet, bmed.

Although I agree, having the ability to sit for the EPPP while on internship would've been great.

I also am learning quite a bit from internship. It is what you make of it, really. I chose to identify what areas I still wanted to work on and communicated those areas with my supervisors, who have been helpful in tailoring my internship year to fit my training goals and needs. If you come into internship with a bad attitude such as "this is just another hoop to jump through," I think it's less likely you will maximize the time you spend while you're there.

 

[Pragma]

Agree. Indentured servitude is how it sometimes feels. Perhaps it's my site but with the exception of one rotation, I feel more like an employee than a trainee (due to lack of meaningful clinical feedback, repetitive clinical assignments, being asked to do things like cover for a supervisor that are more about them than my training). Sure there was good training for the first few weeks of each rotation, but after that it's just sort of been autopilot clinical work with little new skill-building. I don't think I'd mind internship so much if I was either paid a post-doc salary or felt like I was constantly learning.

Get used to it, because that is what postdoc is in a lot of ways too. I did learn a ton on postdoc but mostly I just did all of the grunt work for low pay.

 

[cara susanna]

Honestly, I've also felt like that on practicum.

 

[Therapist4Chnge]

I loved my internship experience. It exposed my to practitioners from many different models. I had not been trained in an academic medical center, and the didactic opportunities were awesome, great speakers were available very often. Focusing on clinical full time for a year was an immersive experience, which greatly enhanced my clinical skills. The networking aspect of it was also helpful and it directly lead to my postdoctoral position.

All of this...but in a VA setting. For instance, 3 of my 5 days a week involved brown bag (lunch & learn) presentations by various depts. I also was able to attend case presentations in areas of interest TBI, epilepsy, stroke, etc). The best takeaway I had from internship was one on one mentorship in my speciality area, which helped get me prepared for the 'trial by fire' approach of my fellowship program. If I had only been doing therapy the year would have dragged, but instead I was able to build in a range of eval experiences I didn't get during my practica training: pain evals, transplant evals, C&P evals, capacity evals, etc.

Getting the degree prior to internship would help with being able to bill for more of the services AND help w. professional standing. Being an intern was rough at times, but overall it was a good transition year.

 

[Therapist4Chnge]

Get used to it, because that is what postdoc is in a lot of ways too. I did learn a ton on postdoc but mostly I just did all of the grunt work for low pay.

I felt like is much of the time, but now that I've had time to reflect on it....being pushed (60-70+hr wks) helped prepare me to take over an in-patient unit from day #1 of my first faculty gig. I felt like being pushed out there and forced to make everything work was far better than being sheltered. I was recruited because places knew I had been tested. It wasn't always pleasant, but looking back I respect all of my mentors and appreciate the pressure they put on me to get things done.

 

[cara susanna]

The way that I heard internship was originally conceived is to give you generalist training and then post-doc is when you specialize. I was reading that "Things I learned from internship applications" thread and it struck me how internship seems to no longer be a way to fill in gaps in your training--it seems to be expected that you'll have practicum experience in the areas you'll be applying to. Seems kind of sad that the imbalance has made people feel like they have to be experts before they even apply for internship (and honestly, that perception seems pretty accurate).

Edit: This is pretty much what Mindfulpsych and a few others' posts were getting at.

 

[Therapist4Chnge]

Seems kind of sad that the imbalance has made people feel like they have to be experts before they even apply for internship (and honestly, that perception seems pretty accurate).

FWIW...I remember talking to my former DCT about this exact point, and she had a great response. She basically said that she doesn't expect an applicant to come in as an "expert" in the core areas they cover because then they would have very little to offer the student during the training year. Instead, coming in with some known strengths and weaknesses, and then work on the weaknesses and complete the "areas of competency" outlined by the site.

 

[serotonin]

I've learned a TON during this internship year. Had to work harder than I've ever worked, but I wouldn't trade it for anything. It's been really incredible. The training has been top-notch, supervisors amazing, super high quality at every step. Well, at every neuropsych step. My program is like 80/20 neuro/general- the general stuff felt like a waste of time maybe 75% of the time. So that, what, 85% worth it overall? But seriously, I have learned SO much. I feel very well-prepared for post-doc and beyond and I owe it to this year.

 

[erg923]

I've learned a TON during this internship year. Had to work harder than I've ever worked, but I wouldn't trade it for anything. It's been really incredible. The training has been top-notch, supervisors amazing, super high quality at every step. Well, at every neuropsych step. My program is like 80/20 neuro/general- the general stuff felt like a waste of time maybe 75% of the time. So that, what, 85% worth it overall? But seriously, I have learned SO much. I feel very well-prepared for post-doc and beyond and I owe it to this year.

I didn't even know you were allowed to be that specialized on internship? I am not sure how I feel about that...

 

[serotonin]

well, on paper it is 50/50. But certainly not in practice. And I am counting cognitive rehabilitation as neuropsych in my estimate. I am very, very happy with the balance & feel it was the best match. But I can see it would not the best choice for every applicant.

 

[AcronymAllergy]

I didn't even know you were allowed to be that specialized on internship? I am not sure how I feel about that...

Yeah, it depends on what you're classifying as "neuro." If it's only neuropsych assessment, then I'd be a bit surprised if many people were able to pull an 80/20 split. I could see this happening if the person came in with a good bit of therapy training, but had decided late in the game that they wanted to go the formal neuropsych route, so their site was helping them to play "catch up" so as to be competitive for fellowship. But if a neuro-heavy person came in and was given 80% neuropsych assessment, then yep, that'd seem like it might not be the best use of the intern's time or site's resources.

However, if it's more like 50/50 or 60/40, with half of the non-neuro time being spent in cog rehab, inpatient therapy (e.g., on a polytrauma or spinal cord injury unit), and related work, then I'd imagine it's not unusual.

I personally opted to go the route of gaining some exposure to therapies and settings I'd always been interested in, hadn't yet had much experience with, and knew I likely wouldn't do much with again after internship. My overall split was probably right at 60/40 neuro/non-neuro.

 

[54321]

Super.
From this thread, I've learned that I'll gain nothing from internship except jumping through one more hoop.
Jump, bmed, Jump. Would also love to study and get to take the EPPP during internship year, but I get that I cant get away with that in my state.

The way that I heard internship was originally conceived is to give you generalist training and then post-doc is when you specialize. I was reading that "Things I learned from internship applications" thread and it struck me how internship seems to no longer be a way to fill in gaps in your training--it seems to be expected that you'll have practicum experience in the areas you'll be applying to. Seems kind of sad that the imbalance has made people feel like they have to be experts before they even apply for internship (and honestly, that perception seems pretty accurate).

Edit: This is pretty much what Mindfulpsych and a few others' posts were getting at.

bmedclinic- It's not that bad. I'm not saying I haven't learned anything but that I don't think I have learned enough to justify all the craziness that went on before internship (e.g. the time and effort put into apps and interviews, the continued low salary). What Cara Susanna is saying is what I think. I haven't filled in any gaps in my training- just strengthened existing areas, which is why I think it seems better suited to be a post doc year. From this board, it seems like the neuro-oriented people feel like they have learned the most, which again, points towards the year being less necessary for development of generalized skills.

I'm also a little bitter about pay because I have one rotation where I can clearly see that I contribute to clinic income AND i'm not learning anything new so I feel like cheap labor. I would feel a lot more positive about internship where it not for that.

 

[Therapist4Chnge]

However, if it's more like 50/50 or 60/40, with half of the non-neuro time being spent in cog rehab, inpatient therapy (e.g., on a polytrauma or spinal cord injury unit), and related work, then I'd imagine it's not unusual.

I matched to a "generalist" site at a VA, though they had significant neuropsych needs and a supportive faculty willing to work with me as long as I met all of the required competencies of the internship. I still had to do a 1/2 day of out-pt therapy (met my EBT pt. caseload req. here and volunteered to take most of the Axis-II referrals), a 1/2 day of group therapy (mostly psycho-ed), a couple hours of DBT/psycho-ed groups per week, and all of the EBT psychotherapy training experiences. In the end I was able to turn a 20% neuropsych rotation into a 60%+ experience by adding in cog rehab, picking up more/all of the cog screening opportunities through the ED and Primary Care Depts, and taking on additional C&Ps that had a neuropsych slant (as we had a 3-6mon backlog). It ended up being more work for me than the standard 40hr VA workweek, but the experience was well worth it.

 

[KillerDiller]

I've had a great experience on my internship this year. The specifics of my (non-neuro) site have allowed me to start to develop a specialization in a particular set of disorders. I've also solidified my generalist skill set. I feel pretty much ready to be an independent practitioner now. I know I still have a year of supervision left, so we'll see how I feel about that in another year's time.

As for whether my experience was "worth it", that's tough to say. Despite the terrific training, this year has been very personally difficult. Moving across the country from your spouse into a completely new city will do that to you. The stress of making the move work financially and practically was grueling. All that is not to even mention the stress of the match process itself. So, was it worth it? Seems a little like asking if a bushel of apples is worth a bushel of oranges.

I don't see how moving the internship to after graduation will change the net worth of the process. There will still be too many candidates and not enough spots, so geographic flexibility will still be all-but required for those who want/need APA accredited positions.

 

[EmotRegulation]

I loved my internship experience. I knew I was headed toward academia (OK, at the time I merely hoped I would be able to land an academic job, but I knew that was the plan) and I really wanted to find out if I could hack it doing full time clinical work. I wanted a training focused internship where I could do things I hadn't been able to do before, and for the most part, that was the case, though everything I did was supposed by the basic (and excellent) training in empirically supported treatments I'd received in grad school. I just used/sharpened my skills with different populations (SMI, couples), different settings, and different modes (group). My internship site was all about "filling in the gaps" in training, and compared to the 60+ hour weeks I worked as a grad student, the strict 40-hour VA gig was really easy. I spent my free time learning about an area of the country I'd never expected to live in, did a lot of cultural stuff with my fellow interns, and I even met a guy via online dating who proposed to me at the end of my internship year.

 

[psychRA]

I've learned a ton on internship - there is just no way that I ever could have gotten training of this depth and breadth during graduate school. Granted, I am at a VA where all of the interns work more than 40 hours per week, but even if I had fewer hours at work, I still have access to populations and specialty training that weren't available to me before. I don't yet know whether postdoc will add anything significant to my experience, but internship has absolutely been worth it.

 

[LPPSYD]

As for whether my experience was "worth it", that's tough to say. Despite the terrific training, this year has been very personally difficult. Moving across the country from your spouse into a completely new city will do that to you. The stress of making the move work financially and practically was grueling. All that is not to even mention the stress of the match process itself. So, was it worth it? Seems a little like asking if a bushel of apples is worth a bushel of oranges.

I don't mean to take this thread off into a new tangent, but I will be facing this when I begin internship this year. Any tips for managing this? We are not married but I am in a serious relationship and I know this will be difficult, on top of moving to a new city. I'd appreciate any input you can offer.

 

[KillerDiller]

I don't mean to take this thread off into a new tangent, but I will be facing this when I begin internship this year. Any tips for managing this? We are not married but I am in a serious relationship and I know this will be difficult, on top of moving to a new city. I'd appreciate any input you can offer.

I'll send you a PM later today with some tips I've learned 🙂.

 

[serotonin]

I don't mean to take this thread off into a new tangent, but I will be facing this when I begin internship this year. Any tips for managing this? We are not married but I am in a serious relationship and I know this will be difficult, on top of moving to a new city. I'd appreciate any input you can offer.

a girl in my program has weekly video chat "dates" with her long-distance husband- they will buy the same food and watch the same movie at the same time while on video chat so can talk with each other about stuff while experiencing the same stimuli. Pretty smart, I think! They spoke every day, saw each other about once a month, and attended conferences together.

Also make friends outside of the program so you can still hang socially while not at work and when not with SO.

 

[LPPSYD]

I'll send you a PM later today with some tips I've learned 🙂.

a girl in my program has weekly video chat "dates" with her long-distance husband- they will buy the same food and watch the same movie at the same time while on video chat so can talk with each other about stuff while experiencing the same stimuli. Pretty smart, I think! They spoke every day, saw each other about once a month, and attended conferences together.

Also make friends outside of the program so you can still hang socially while not at work and when not with SO.

Thank you! The video chat dates are a great idea. We have been a shorter distance away (2 hours) while I've been in school so we actually use Skype to watch our favorite shows together sometimes. I love the idea of the same food/movie! 🙂

 

[PhDToBe]

I'll send you a PM later today with some tips I've learned 🙂.

Can you PM me these tips too? 🙂

 

[BorntoRun]

Seems to me that the specialization vs. generalist approach could be good or bad depending on what the person is planning to do once licensed.

 

[Pragma]

Seems to me that the specialization vs. generalist approach could be good or bad depending on what the person is planning to do once licensed.

Yeah I think that is where your school and practica experiences come in. To use myself as an example...I didn't have as extensive of a neuropsych background as others here when I applied for internship. As such, I only looked at places that would give me at least 6 months worth of training in that area as a primary rotation. This is in line with training standards for the specialty, and ultimately helped me land my postdoc.

Internship is basically a great place to smooth out any rough edges in your training. It probably matters a little less if you are more of a generalist...but it is still an important time to immerse yourself in clinical work.

 

[futurepsydoc]

I have mixed opinions about the debate above. On the one hand, I feel like things would be much smoother if the internship was turned into a post-doctoral residency, akin to the medical model, like many of the posters have said above. We could be referred to as "Dr" as opposed to "intern," which would help communicate our role, skill set, and level of training much more effectively to colleagues on interdisciplinary teams. It would negate the pervasive ABD problem in our field. It vary well could improve the benefits we receive (i.e., pay, vacation, medical, etc) and positive influence the reimbursement rates for post-doctoral residency (i.e., current internships) programs. Practica would serve as predoctoral training and post-doc would more specialized. If this were the case, I would vote for more generalized training for predocs, perhaps even a standardized placement schedule of some sort. This would ensure that people had comparable experiences in training.

On the other hand, I think we call agree that everyone does not enter internship with the same level of training or related clinical skill. I have heard about, as well as seen, incredibly variable degrees of competency across individuals. I have also seen, as well as heard of, a great deal of willingness to receive corrective feedback. Therefore, I sincerely question whether the field can operate in such a way that would allow these individuals to actually graduate without a complete year-long internship. Whether we like it or not, this would be a big problem for the profession. I see it this way. Practicum and externships have little to no oversight --> Completing an accredited internship makes complete sense. At least there is some oversight.......The imbalance, however, is threatening this to unbearable degree, so I can see an argument against this from a feasibility perspective.

Nonetheless, I believe that much of this boils down to doctoral level training on a more foundational level. I think the models we currently have are completely broken and in desperate need of repair. The nature, quality, and quantity of clinical training people receive is so incredibly variable, both on internship and before it, I am not really sure how to feel about any of it. It is very individualistic. For the record, I am not lamenting on my own issues, as I was writing I got the sense that it may sound that way (APA Program, APA Internship, Diss Defended, Reputable Post-Doc secured). I just feel like we need broad reform. I am not sure APA and APPIC are going to get the job done.

Finally (I apologize for the rant), while it seems that people get increasingly more and more prior to internship, I am not completely sold that this will make the internship obsolete. I think we can all agree that 1,000 hours versus 500 hours is big difference in terms of quantity. However, capturing which contains the most "quality hours" is hard to determine. I think we need to develop ways of evaluating competence much more effectively. Once we have that type of assessment in place, we will be able to make more meaningful improvements to the system.