Internship Rotation Question

[Margo Fargo]

Hello everyone,

I am a PhD student applying for internship in the fall. I am interested in becoming a PTSD specialist in the VA system, ideally as a clinician on a PTSD clinical team. I have plans to apply to clinical postdocs at the VA focusing on PTSD, I am in a PTSD-focused research lab, my current practicum involves (but is not exclusively focused on) treating PTSD using evidence-based treatments, and I am about to commence a year long practicum at a top tier VAMC on their PTSD clinical team (I have had other practicum experiences as well).

I am aiming for a VA internship, and I am thinking about what internship rotations I should focus on to ensure that I have a broad range of training. In light of my career goals, and given that I will have quite a bit of experience treating PTSD before I go on internship, should I still aim for a PTSD rotation on internship? A substantial part of me wants to do totally different things on internship, but I am concerned that my VA PTSD postdoc chances may be limited if I do not do a PTSD rotation on internship. I would appreciate any advice on this. Thanks!

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[CheetahGirl]

I would continue on the PTSD-focused training, and request a PTSD rotation. Depending on where you end up, you may only get 3-4 cases per rotation (if you're doing PE or CPT...and that is generous). On our PTSD clinic rotation, we were assigned ~two cases per rotation, and only some us actually completed the full-course of the EBT (due to patient preparedness, patient attrition, patients' travel schedules, etc.).

If you are on a VA internship, most likely will get the chance to run the gamete (inpatient psychiatric, substance use, primary care, spinal cord injury, geropsychology, outpatient MH, neuropsych, etc.). Just check out the program brochures.

 

[deleted343839]

Given your goals, I think it's worthwhile to do a PTSD rotation if for no other reason than to generalize your skills to another setting (each VA has its own "quirks") and to train/network with people who will go on to recommend you for (or give you to the lowdown on) postdoc opportunities. There is still plenty for you to learn. For instance, you might have a chance to learn about models of care other than traditional outpatient. If there is a certain population that you'd have greater access to at a given facility (eg, women, military sexual trauma, LGBT, etc.), you can also broaden your horizons a bit in that sense.

 

[AcronymAllergy]

Agree with the above. I'd aim to do at least one PTSD rotation, although think it would be fine to expand considerably after that. Getting experience with PCTs (PTSD Clinical Teams) in more than one VA may be a significant benefit administratively, so that you can see how they're implemented in different clinics/hospitals. After all, "if you know one VA, you know one VA."

 

[Justanothergrad]

Agreed with above. The thing that I liked about VA internships is that they offer you an opportunity to continue focusing on your specialization while also branching into other areas you may be weaker. You may also want to consider exploring different types of PTSD treatments at the VA. AA mentioned PCTs, but there are also other treatment teams (SDTP in Topeka comes to mind) with very well-known training. In addition, you may want to consider looking for VAs that offer certification in PE/CPT as part of the internship year. Although not all offer this, some do.

It might also be worth considering a placement next year that is very different from PTSD just to widen your clinical experience into a different area/setting/etc. that might be useful later on.

 

[cara susanna]

I didn't get selected for the PTSD rotation on internship. In the end it worked out as I got a trauma-focused post doc. However, I was pretty anxious about it, and I had to cobble together PTSD-related experiences throughout the year on my own. So, although it is possible, I wouldn't recommend it. Granted, unlike you I didn't have previous PTSD EBT experience.

I would HIGHLY recommend CPT certification, too. AFAIK, PE certification is not available to interns.

 

[Margo Fargo]

Thanks for the feedback, everyone. This is very helpful. You brought up many things that I hadn't considered, and I will definitely be seeking opportunities for more PTSD training during internship.