Internship Ranking for Neuro Track

[neuropuzzles]

Hi everyone,

I am seeking guidance on how to approach ranking internship programs for neuropsychology. My goal is to work in a hospital setting, but I’m torn between whether an internship at a VA hospital or a private hospital is considered more prestigious. For example, are there advantages to training at Long Island Medical Center or Mount Sinai compared to VA hospitals with strong neuropsychology tracks?

I have already considered program fit, but I would appreciate insight into this to help finalize my decision.

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[Neurocaterpillar]

Hiya, it really depends on what you want. I’d start off by looking at rotations and then thinking of the populations you want to work with. I also considered the stipend. Private hospitals pay kinda less compared to the VA. Also work life balance is awesome in the VA vs AMC. So again, I don’t think it matters. Both sites produce competitive applicants!

 

[AcronymAllergy]

After a certain point, prestige of the training site doesn't necessary matter a whole lot. Who you work with can matter, at least in terms of professional networking (e.g., they know someone where you're looking for a postdoc or job). And as was said, the types of opportunities available is ultimately more important for your own professional development. Inherently, I wouldn't say a VA or an AMC is more prestigious by default.

I trained at both VAs and AMCs, and can agree that based on this, and on my own internship and fellowship interviews at the time, the work-life balance at VAs (even for trainees) was better.

 

[RxPsych]

Prestige aside, to what extent does your internship setting affect opportunities for postdoc? For example, if I matched at a neuro track AMC, would it hinder my opportunities to get a neuro VA postdoc position? Do VA postdocs prefer interns that trained at a VA?

 

[AcronymAllergy]

Prestige aside, to what extent does your internship setting affect opportunities for postdoc? For example, if I matched at a neuro track AMC, would it hinder my opportunities to get a neuro VA postdoc position? Do VA postdocs prefer interns that trained at a VA?

VA sites generally prefer trainees who have had prior VA experience at some point. But I'd say the bump from having VA experience is pretty small, and I'd be shocked if any postdoc would substantially penalize an applicant solely for not having any VA experience.

If you have absolutely no VA experience and think you may want to go to a VA for fellowship, then doing your internship at a VA or consortium could be worthwhile. Doubly so if you think you want to work at VA, if for no other reason than just to get some actual time seeing that setting and population.

 

[RxPsych]

VA sites generally prefer trainees who have had prior VA experience at some point. But I'd say the bump from having VA experience is pretty small, and I'd be shocked if any postdoc would substantially penalize an applicant solely for not having any VA experience.

If you have absolutely no VA experience and think you may want to go to a VA for fellowship, then doing your internship at a VA or consortium could be worthwhile. Doubly so if you think you want to work at VA, if for no other reason than just to get some actual time seeing that setting and population.

Thanks for the insight. It's difficult because generally it seems like the AMCs I'm interviewing at offer much more training experiences than the VAs so I'm tempted to rank them higher, though 2 of them are Consortiums and I know I will be ranking them at least in my top 5. One will likely be first.

I intend on working at a VA for a few years to get EDRP (assuming the facility offers it and it's still around at that time) since I can't imagine a different setting offering such a greater pay disparity to make up for EDRP. My hope is to only be there for 2-3 years to fully pay off all loans, and I want to do what I can to ensure I'll be competitive for a VA staff neuro position even if I don't complete my internship or maybe even postdoc at a VA, if that does happen.

 

[WisNeuro]

Thanks for the insight. It's difficult because generally it seems like the AMCs I'm interviewing at offer much more training experiences than the VAs so I'm tempted to rank them higher, though 2 of them are Consortiums and I know I will be ranking them at least in my top 5. One will likely be first.

I intend on working at a VA for a few years to get EDRP (assuming the facility offers it and it's still around at that time) since I can't imagine a different setting offering such a greater pay disparity to make up for EDRP. My hope is to only be there for 2-3 years to fully pay off all loans, and I want to do what I can to ensure I'll be competitive for a VA staff neuro position even if I don't complete my internship or maybe even postdoc at a VA, if that does happen.

Oh, it's pretty easy to make up that disparity in PP.

 

[RxPsych]

Oh, it's pretty easy to make up that disparity in PP.

Even for someone straight out of postdoc? I'd worry about job stability in a PP, particularly since at that time my partner and I will be strongly considering children, saving for a downpayment for a home, etc.

 

[WisNeuro]

Even for someone straight out of postdoc? I'd worry about job stability in a PP, particularly since at that time my partner and I will be strongly considering children, saving for a downpayment for a home, etc.

If you saw purely Medicare patients, and had a month of vacation, you'd still gross ~200k in a year working 35-40 hours/week If you diversify your payor source, only take the better insurances, and explore better paying options, you can go a decent amount above that.

 

[AcronymAllergy]

Thanks for the insight. It's difficult because generally it seems like the AMCs I'm interviewing at offer much more training experiences than the VAs so I'm tempted to rank them higher, though 2 of them are Consortiums and I know I will be ranking them at least in my top 5. One will likely be first.

I intend on working at a VA for a few years to get EDRP (assuming the facility offers it and it's still around at that time) since I can't imagine a different setting offering such a greater pay disparity to make up for EDRP. My hope is to only be there for 2-3 years to fully pay off all loans, and I want to do what I can to ensure I'll be competitive for a VA staff neuro position even if I don't complete my internship or maybe even postdoc at a VA, if that does happen.

It can definitely vary by site. I've seen multiple VAs that offer a wide variety of training experiences, on average, AMCs probably have a bit more variety. That said, if you want to work at a VA, then getting some training in a VA beforehand would be recommended. If nothing else, it gets you access to the job fairs (can't remember the actual name) they have for VA trainees, assuming those are still a thing right now.

EDRP can be great, but the amount you're approved for is impacted in part by your loan balance. So if your loan balance isn't substantial and you aren't approved for the full $40k/year, then other employed positions outside VA may be able to compete once you're looking at total compensation. I see it as: 1) a great option for people who were going to be working at VA anyway, and 2) a good option for people with high loan balances who want to pay them down ASAP rather than bank on (and wait around for) PSLF. For people with moderate to low loan balances, it's a bit less of an incentive (although still nice).

And yes, I earn enough in PP to make up for an EDRP difference vs. VA pay. But I also wouldn't have wanted to go into PP straight out of postdoc. Although that's based primarily on personal comfort level (and opportunities in your area).

 

[Sanman]

Thanks for the insight. It's difficult because generally it seems like the AMCs I'm interviewing at offer much more training experiences than the VAs so I'm tempted to rank them higher, though 2 of them are Consortiums and I know I will be ranking them at least in my top 5. One will likely be first.

I intend on working at a VA for a few years to get EDRP (assuming the facility offers it and it's still around at that time) since I can't imagine a different setting offering such a greater pay disparity to make up for EDRP. My hope is to only be there for 2-3 years to fully pay off all loans, and I want to do what I can to ensure I'll be competitive for a VA staff neuro position even if I don't complete my internship or maybe even postdoc at a VA, if that does happen.

I would rethink that plan.

1. EDRP is spread over 5 years with a max of $40k/yr (200k). Whatever you owe will be split into five equal reimbursement periods. If you owe $20k, that is $4k/year. You pay it and they reimburse you at the end of every 12 months. It is tax free money though.

2. It only applies to grad school loans and not undergrad

3. With the current budget crisis and Trump in office, I don't know that EDRP will be offered any longer.

 

[PsyDuck90]

I intend on working at a VA for a few years to get EDRP (assuming the facility offers it and it's still around at that time) since I can't imagine a different setting offering such a greater pay disparity to make up for EDRP.

In terms of pay, VA, as of now, is paying more than some posted salaries at AMCs. For instance, NYU Langone is currently advertising for an early- to early-mid career neuropsychologist position with a salary range of $100k-$130k (which does not include incentive compensation, etc.), while the locality table shows a GS-13 step 1 (so entry psych/neuropsych at a VA in that area) as $124,189. And VAs typically have lower RVU expectations than AMCs, from my experience anyway. I may have misinterpreted your comment, but I took pay disparity to mean VA paying less than AMC, and at this time, I don’t know if that is necessarily true, especially in certain markets (we’ll see what happens in the next couple of years). I’m currently looking for jobs and the incentive bonus at an AMC I’m interviewing at still puts me below what a GS-13 would make at the local VA, but they unfortunately don’t have any open neuro positions at the moment.

 

[coffee&CBT]

I would rethink that plan.

1. EDRP is spread over 5 years with a max of $40k/yr (200k). Whatever you owe will be split into five equal reimbursement periods. If you owe $20k, that is $4k/year. You pay it and they reimburse you at the end of every 12 months. It is tax free money though.

2. It only applies to grad school loans and not undergrad

3. With the current budget crisis and Trump in office, I don't know that EDRP will be offered any longer.

I am in the process of getting a low amount (less than 20K) approved for EDRP and they are allowing me to pay it off in 2 years. You can request it to be spread over a shorter period of time, especially if your debt is more "minimal." I requested a period of 1 year and they said it had to be 2.

 

[Sanman]

I am in the process of getting a low amount (less than 20K) approved for EDRP and they are allowing me to pay it off in 2 years. You can request it to be spread over a shorter period of time, especially if your debt is more "minimal." I requested a period of 1 year and they said it had to be 2.

That is good to know. Did you negotiate that when coming on board? Most of the folks I know got it during the pandemic and were already VA employees. Our dept was told there was no flexibility in the reimbursement period when people asked.

 

[WisNeuro]

That is good to know. Did you negotiate that when coming on board? Most of the folks I know got it during the pandemic and were already VA employees. Our dept was told there was no flexibility in the reimbursement period when people asked.

Like everything in the VA, I bet this varies significantly by facility.

 

[RxPsych]

I am in the process of getting a low amount (less than 20K) approved for EDRP and they are allowing me to pay it off in 2 years. You can request it to be spread over a shorter period of time, especially if your debt is more "minimal." I requested a period of 1 year and they said it had to be 2.

This was how I was hoping it would pan out. My loans are in the upper 5 figures primarily due to financial incompetence during my masters program, which I'm hoping would qualify since its graduate training that prepared me for doctoral training, but I'm not too sure. I'm not banking on EDRP by any means, I can make do without it, but it would be nice if I could get it for a few years to easily pay my loans off.

 

[WisNeuro]

This was how I was hoping it would pan out. My loans are in the upper 5 figures primarily due to financial incompetence during my masters program, which I'm hoping would qualify since its graduate training that prepared me for doctoral training, but I'm not too sure. I'm not banking on EDRP by any means, I can make do without it, but it would be nice if I could get it for a few years to easily pay my loans off.

I would consult the statute/policy, as I thought I remembered somewhere that only loans from the degree which is required for your job (PhD/PsyD) are eligible. So, if your masterss debt was a wholly separate program, there's a chance it does not qualify. Not sure, but I would definitely clarify before you make any choices that hinge on EDRP.

 

[Sanman]

I would consult the statute/policy, as I thought I remembered somewhere that only loans from the degree which is required for your job (PhD/PsyD) are eligible. So, if your masterss debt was a wholly separate program, there's a chance it does not qualify. Not sure, but I would definitely clarify before you make any choices that hinge on EDRP.

That is the policy as far as I know.

 

[PsyDuck90]

This was how I was hoping it would pan out. My loans are in the upper 5 figures primarily due to financial incompetence during my masters program, which I'm hoping would qualify since its graduate training that prepared me for doctoral training, but I'm not too sure. I'm not banking on EDRP by any means, I can make do without it, but it would be nice if I could get it for a few years to easily pay my loans off.

You can ask, but I believe EDRP only covers the degree required to get the job (meaning, the degree that made you eligible for your license). By the logic you’ve laid out, someone needs a bachelors before entering a doctoral program, so they should cover that to, which they explicitly don’t. So I definitely wouldn’t bank any future plans on the idea of getting EDRP.

 

[RxPsych]

I would consult the statute/policy, as I thought I remembered somewhere that only loans from the degree which is required for your job (PhD/PsyD) are eligible. So, if your masterss debt was a wholly separate program, there's a chance it does not qualify. Not sure, but I would definitely clarify before you make any choices that hinge on EDRP.

I figured that might be the case. When the time comes I will clarify that before making any decisions. It would help with doctoral loans but they have been minimal compared to masters loans. At that rate, if EDRP is only eligible for doctoral loans, I would strongly consider other job settings assuming similar salary and benefits. The eventual goal is PP including forensic work, though it would likely take awhile to reach competency in that area unless things fall in line with supervisors that have experience during internship and/or postdoc.

 

[AcronymAllergy]

That is the policy as far as I know.

Yes, it only covers the degree needed for your job.

 

[coffee&CBT]

That is good to know. Did you negotiate that when coming on board? Most of the folks I know got it during the pandemic and were already VA employees. Our dept was told there was no flexibility in the reimbursement period when people asked.

I did not. My sense is that no one really knows what will/won't be approved until the application goes up the chain.

 

[bcliff]

Didn't read all the other comments, so apologies if already posted -

My recommendation is to do internship at the VA, especially if you haven't done practicum training there before. This lets you add a VA line to your CV (possibly helpful if and when applying for a VA staff position later on). It also lets you get some (full-time) experience there before deciding if you want to spend another 2y in that environment for neuropsychology postdoctoral training (and beyond if considering a VA staff position).

IMO, 1y of neuropsychology internship in VA, and 2y of neuropsychology postdoc in an AMC was the right fit for me. The AMC I completed residency at has great name reputation; it was nice submitting materials for jobs with an @prestigious-university email address. Also, the site where I completed fellowship had adult and peds fellows; we all participated in nearly identical didactics and related educational activities. I learned A LOT from the more peds-focused lectures and would have really missed that exposure in a VA setting. This exposure / training has been helpful in boards preparation. YMMV! Good luck.