PhD/PsyD Just how realistic is the research/clinical combination?

[R. Matey]

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I'm in need of a little perspective. I'm on internship in a UCC and it's not a good fit for me. I'm a good sport so I'll make it through the year, but I just want to get a gauge on whether or not the research/clinical combination is a vocational fantasy or people actually do this AND are happy. I'm open to a faculty position, but I've been involved enough in research to see how the sausage is made and not sure I want to handcuff myself to that life. Plus, I really like clinical work and don't want to hang it up completely. It's been my experience that this is what is typically expected of faculty in need of tenure. I have a few apps for postdocs out to as well, but reading the VA research career thread was discouraging.

I need to decide quickly. Interviews are coming up and I've already been contacted by some PPs in the area who are hungry for psychologists. I'd stay in my UCC or take a similar type job for a year or two just to knock the licensing requirements out of the way, but then what? I'd be curious to hear from people with similar interests.

 

[Justanothergrad]

What tasks are you referring when you say 'do research'? And what sort of topic are you looking to be part of? Both of those will interact substantially with the type of setting you may find yourself.

If you mean that you spend a majority of your time designing research studies and conducting them while supervising students collecting the data directly, that is difficult and atypical. If you mean that you partner with others and provide input on questions and feedback on papers while your contribution centers around contributing research data and ideas- that's easy. We researchers are always looking for clinical data. I publish with FT clinicians regularly in exactly this role (assessment data, treatment outcome data, etc.). It doesn't mean that they're relegated to 'just supplying data' either. What they do and the role that they take depending on their interest/flexibility in role/etc. They may write/take lead some as well. The trade off is that your money comes from the clinical practice so slashing your time to focus on research doesn't produce income, thus it is more frequent that the actual writing gets shipped off to others.

If you are talking about 'research clinical' positions as a formal title, that's a different boat that I can't offer as much insight into. Those are going to be tied (more frequently) to AMC and soft money positions.

 

[AcronymAllergy]

I'll leave a more thorough answer to folks here who actually conduct research as a part of their jobs. But I second everything Justanother grad said. Another thought, similar to what was mentioned, is that folks in private practice (with adequate administrative support) can be involved in clinical trials.

If I wanted to do research as a part of my (clinical and training) job, I could. We have the institutional framework for it. But it'd come out of my own time and would be in addition to everything I'm required to do.

 

[R. Matey]

What tasks are you referring when you say 'do research'? And what sort of topic are you looking to be part of? Both of those will interact substantially with the type of setting you may find yourself.

If you mean that you spend a majority of your time designing research studies and conducting them while supervising students collecting the data directly, that is difficult and atypical. If you mean that you partner with others and provide input on questions and feedback on papers while your contribution centers around contributing research data and ideas- that's easy. We researchers are always looking for clinical data. I publish with FT clinicians regularly in exactly this role (assessment data, treatment outcome data, etc.). It doesn't mean that they're relegated to 'just supplying data' either. What they do and the role that they take depending on their interest/flexibility in role/etc. They may write/take lead some as well. The trade off is that your money comes from the clinical practice so slashing your time to focus on research doesn't produce income, thus it is more frequent that the actual writing gets shipped off to others.

If you are talking about 'research clinical' positions as a formal title, that's a different boat that I can't offer as much insight into. Those are going to be tied (more frequently) to AMC and soft money positions.

Thanks. This is useful info. I wouldn't mind supplying data as a full time clinician in PP if it meant that I could contribute to the process. By "research," I mean clinical and measurement research. I plunged two feet into learning measurement development during graduate school and would like to continue to use those skills while retaining some connection to actual clinical practice with the hope being to develop or strengthen accessible tools that people can use in making diagnostic or treatment decisions. But to actually do that work, I would need to retain some ties to an organization with a credible IRB or it sounds like work with a PI conducting a clinical trial. Is that accurate?

 

[Ollie123]

I think we just need more info on what you want. Obviously this is possible. Virtually everyone in an AMC setting will do both and a sizable portion of those in a VA. There are usually separate research and clinical paths but even purely clinical folks will usually not get promoted without <some> research, though in many cases this can be a fairly negligible amount or even just ill-defined "scholarly activity" that doesn't entail research as most of us think of it. It is for the most part dictated by what you can do to pay the bills. Measurement development stuff is a little hard since no major agency is going to fund much time for just that (though its also almost unbelievably dirt cheap work to do - at least for self-report measures - so that helps). If you see yourself as more on a clinical path, just get hired as clinical faculty and see if you can get a small buyout for some research time or just get it in the system and work your way into it.

If you just want to do it out of interest, most of us in AMCs are delighted to let people do add-ons. Even if you aren't appointed there but are decent at networking and willing to volunteer some time, institutions give out zero-salary adjunct appointments like candy. I also can't imagine NOT letting someone add a measure to my trial unless it was extremely burdensome or I thought they were an idiot and it was unlikely to produce anything worthwhile. Most of us collect 20x more data than we will ever actually use, so making that 21x is not a big deal...

Whether you are happy with it or not depends on many factors. AMCs are usually far from "cushy" gigs if that is the goal.

 

[Justanothergrad]

Thanks. This is useful info. I wouldn't mind supplying data as a full time clinician in PP if it meant that I could contribute to the process. By "research," I mean clinical and measurement research. I plunged two feet into learning measurement development during graduate school and would like to continue to use those skills while retaining some connection to actual clinical practice with the hope being to develop or strengthen accessible tools that people can use in making diagnostic or treatment decisions. But to actually do that work, I would need to retain some ties to an organization with a credible IRB or it sounds like work with a PI conducting a clinical trial. Is that accurate?

The best route, for many reasons, is being a +1 on an existing team that works to increase data collection sites for a given study. This is easiest with assessment data related to diagnosis or outcomes. As an assessment researcher, I'm always hungry for +1s that would contribute clinical data. If they want to write some - I'm going to send them Christmas gift baskets. This sort of +1'ing is less easy with RCTs because clinical trials require a lot of work. Besides all that, its a good idea to get IRB from a reputable institutions and partnerships help you do that, especially with zero-salary appointments. I'll echo what Ollie said - I'd be happy to have someone join me as part of one of my projects. Heck, I was shopping around the community for someone with knowledge on eating disorders to help me on part of one this fall for some data I had.

In terms of scope of research: I'd encourage you to steer away from measurement develop and focus more on measurement validation. Minor detail of difference, but as an assessment psychologist there are already far too many measures. Its a matter of making sure they are all useful and good. That may be what you meant (you mention strengthening), but it was worth saying anyway. I'll repeat the steer clear on RCT without it being part of a paid appointment advice as well. Effectiveness studies are useful. More so, in some ways. So it isn't all about efficacy studies anyway.

Honestly, I don't see a need to rush into making a career decision related to this. Unless you are interested in building a career based off of making salary on the research (e.g., AMC or TT gig), then I don't see any reason why your goals require some sort of immediate decision. Focus on your career and think about how to get there. Research partnerships come once that's established, not before.

 

[ClinicalABA]

There are primarily-clinical positions that encourage and support research. In my experience, these tend to be larger human services agencies where more traditional psych (tx and assessment) is just a component. I seen lowered productivity requirements (e.g. ~50-60% billable time- though often with a close to break even reimbursement-salary+benefits ratio), bonus pay for publications, conference attendance and expense reimbursement, and access to IRB's through affiliate agreements). You probably aren't going to find such an arrangement in a typical community outpatient gig. However, if you look to make yourself as valuable as possible (e.g., mulitiple licenses/certifications; ability to bill multiple sources; be at the top of the "billing pyramid" where your services make other billable services possible), everything is negotiable in the right setting.

 

[cara susanna]

Can only speak for the VA, and here I think it's difficult without funding. There are some VAs where it's less difficult, but from my experience generally you will be working more outside of your hours than you may want to. I do full time clinical work and I remain involved in research, but with outside collaborators and I generally play more of a minor role (e.g., helping with lit searches or writing). I don't have any involvement with IRBs or data or anything.

 

[PsyDaVinci]

from my experience generally you will be working more outside of your hours than you may want to.

This.

Early in my career I got lucky enough to start working in a program where a lot of the directors had their fingers in some research. Anyone who wanted to participate was welcome to, as long as they put the work in (which meant after your 40 hours). It didn't have to be a huge commitment, but it did weed out the people who like the idea of doing research more than actually wanting to do it. I'm passionate about doing research, not exclusively though and I have no desire to teach full time.

These days, I work strictly residential clinical for my 40-hours, which gets my bills paid and benefits, as well as potential access to participants. I'm in the process of trying to jump facilities but whenever I interview I always ask about their perspective on research. I won't work somewhere openly research hostile, but 95-99% of my research work takes place on my time in my home office (which includes writing, background reading, occasional email consults, and if lucky providing a couple trainings a year). If I can use a facility to grow my research, I will, but having collaborators is always helpful regardless. One of the things I end up marketing myself as is to be the "hard research" or stats guy to organizations wanting to do research but without the technical know-how, like working with state probation/parole departments. Unless you build in some protected research time, it's effectively a second job for me and most of my friends who do this.

 

[R. Matey]

I think we just need more info on what you want. Obviously this is possible. Virtually everyone in an AMC setting will do both and a sizable portion of those in a VA. There are usually separate research and clinical paths but even purely clinical folks will usually not get promoted without research, though in many cases this can be a fairly negligible amount or even just ill-defined "scholarly activity" that doesn't entail research as most of us think of it. It is for the most part dictated by what you can do to pay the bills. Measurement development stuff is a little hard since no major agency is going to fund much time for just that (though its also almost unbelievably dirt cheap work to do - at least for self-report measures - so that helps). If you see yourself as more on a clinical path, just get hired as clinical faculty and see if you can get a small buyout for some research time or just get it in the system and work your way into it.

If you just want to do it out of interest, most of us in AMCs are delighted to let people do add-ons. Even if you aren't appointed there but are decent at networking and willing to volunteer some time, institutions give out zero-salary adjunct appointments like candy. I also can't imagine NOT letting someone add a measure to my trial unless it was extremely burdensome or I thought they were an idiot and it was unlikely to produce anything worthwhile. Most of us collect 20x more data than we will ever actually use, so making that 21x is not a big deal...

Whether you are happy with it or not depends on many factors. AMCs are usually far from "cushy" gigs if that is the goal.

Thanks so much for this very useful info! Cushy isn’t the goal as much as looking at my family once or twice a year. I entered grad school with the full intent of pursuing TT faculty position. I’ve been checking the boxes in that area: a few pubs, stats exp, a coherent research program (that’s still in the works), presenting a conferences, mentoring other students, etc.

I’d be interested in AMC/VA life, but my internship is in a UCC and I’m imagining steering my career towards that direction would mean a post-doc in a AMC. That’s okay, I’m working on that right now anyways and I did do one year of practicum in an AMC. But it wasn’t the original goal and I’m now wondering if it’s worth pursuing or whether I should just accept PP life and support others who have those full time positions (something I didn’t even consider until justanothergrad pointed it out).

Why I’m hesitating on TT positions is my viewpoint of the TT life. I’m open to hearing other perspectives, but my experience was quantity over quality was the reward structure of that process. As others have implied elsewhere on these forums, I wonder how much that reward structure contributes to some of the replication problems in quant psych. Personally, I’d rather support someone with a grant do a fantastic study than push out a bunch of pork to “get my name out there.”


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[R. Matey]

The best route, for many reasons, is being a +1 on an existing team that works to increase data collection sites for a given study. This is easiest with assessment data related to diagnosis or outcomes. As an assessment researcher, I'm always hungry for +1s that would contribute clinical data. If they want to write some - I'm going to send them Christmas gift baskets. This sort of +1'ing is less easy with RCTs because clinical trials require a lot of work. Besides all that, its a good idea to get IRB from a reputable institutions and partnerships help you do that, especially with zero-salary appointments. I'll echo what Ollie said - I'd be happy to have someone join me as part of one of my projects. Heck, I was shopping around the community for someone with knowledge on eating disorders to help me on part of one this fall for some data I had.

In terms of scope of research: I'd encourage you to steer away from measurement develop and focus more on measurement validation. Minor detail of difference, but as an assessment psychologist there are already far too many measures. Its a matter of making sure they are all useful and good. That may be what you meant (you mention strengthening), but it was worth saying anyway. I'll repeat the steer clear on RCT without it being part of a paid appointment advice as well. Effectiveness studies are useful. More so, in some ways. So it isn't all about efficacy studies anyway.

Honestly, I don't see a need to rush into making a career decision related to this. Unless you are interested in building a career based off of making salary on the research (e.g., AMC or TT gig), then I don't see any reason why your goals require some sort of immediate decision. Focus on your career and think about how to get there. Research partnerships come once that's established, not before.

Yes, the goal is measurement validation as much as or even greater than measurement development. The advice on doing free work is also noted. Are people in PP paid to supply data or contribute to RCTs?


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[R. Matey]

This.

Early in my career I got lucky enough to start working in a program where a lot of the directors had their fingers in some research. Anyone who wanted to participate was welcome to, as long as they put the work in (which meant after your 40 hours). It didn't have to be a huge commitment, but it did weed out the people who like the idea of doing research more than actually wanting to do it. I'm passionate about doing research, not exclusively though and I have no desire to teach full time.

These days, I work strictly residential clinical for my 40-hours, which gets my bills paid and benefits, as well as potential access to participants. I'm in the process of trying to jump facilities but whenever I interview I always ask about their perspective on research. I won't work somewhere openly research hostile, but 95-99% of my research work takes place on my time in my home office (which includes writing, background reading, occasional email consults, and if lucky providing a couple trainings a year). If I can use a facility to grow my research, I will, but having collaborators is always helpful regardless. One of the things I end up marketing myself as is to be the "hard research" or stats guy to organizations wanting to do research but without the technical know-how, like working with state probation/parole departments. Unless you build in some protected research time, it's effectively a second job for me and most of my friends who do this.

Thank you for that perspective. I imagine if I’m working a FT clinical job, it will be an optional activity for me as well. Working through the responses to this thread, the core of it is that I don’t want to lose the stats skills that I’ve been the last few years of graduate school cultivating.


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[erg923]

I admire the true scientist-practitioners out there. Is Paul Lees-Haley still alive? But, unless its built into a full-time job as split/carve-out time, many will not be so keen to do uncompensated work once they are full engaged practicing psychologist and have family responsibilities and obligations.

Its easier on the wife (and kids) when I can say that that said labor will help with tuition, a planned vacation, new stuff for the house, an investment fund, etc.

 

[R. Matey]

*Places idealism in a boat and sends it out to sea. Taps plays in the background.


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[R. Matey]

Thanks everyone for your thoughtful responses! You’ve given me a lot to think about.


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[EmotRegulation]

Just to chime in here, I'm a tenured faculty member and there is a lot of variety in TT positions, it depends on how research heavy the department is and how much grant funding is required for tenure. Some places are more training/teaching focused than research. Even at my R1 there is a faculty member who takes a day per week for a private practice. It's also becoming more common now to see Clinic Director positions at universities which are adminsitrative and potentially clinical--there were a lot of these jobs this year. This positions do a lot of clinical supervision, may have space/time available for clinical work, and probably run the research program at the training clinic. That kind of position might be nice for you--look for them!

 

[PsyDr]

Thanks everyone for your thoughtful responses! You’ve given me a lot to think about.


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a few thoughts:

1)It’s very achievable. Even a ***** such as myself holds a research position at an AMC. @PsyDaVinci is right in his/her experience of splitting duties and revenue generating vs non revenue generating pressures.

2) there are several tests that are written by psychologists in private practice. Ruff did neuropsych. Hartman is publishing a test now. Bruns has a few for health psych. Meyers has consistently been in PP. And despite what one of the old guard says: Pearson is evil.

3) You should really ask about how tests get developed. It’s not how I thought. Being in an amc may affect copyrights and financial proceeds. Keep in mind that Minnesota is a unique state for this, so don’t factor it in.

 

[eclipse77]

Thought I would chime in with a different perspective. Merry Christmas, by the way! I also aspired to do a clinical-research split, but decided I didn't want the stressed out research life that was reliant on tenure or grants. So, I decided to take a pretty cush clinical position that pays pretty well (120+; large agency; only therapy; salaried) but that doesn't require such a heavy clinical load (aprox 15-20 pts/week). That way, I am still able to do research and write papers at work in my spare time for fun, but am not feeling stressed out about it. Down the line, i'm hoping to set up an adjunct/clinical prof. position at an AMC where hopefully I can keep working on research as a side gig mostly for fun.

I am curious -- for people who have held a clinical assistant position at an AMC, etc, as well as a PP, have you found that being associated with a university has helped your practice given extra credibility, etc? I know most laypeople could care less about publications, but I thought being established as a professor at a prestigious university might help?

 

[Therapist4Chnge]

If you go after clinical positions, likely ALL research will be on your own time. A 5-10% buyout of time will feel like you are still researching 100% on your own time. You'll really need at least 20% and it's easiest with your own funding. One thing I enjoyed working at AMCs and also the VA was being able to collaborate w/o having to be "the guy". Some collaborators do well in that setup and some do not.

 

[deleted343839]

I am curious -- for people who have held a clinical assistant position at an AMC, etc, as well as a PP, have you found that being associated with a university has helped your practice given extra credibility, etc?

I'm late to the thread but since I live and breathe that AMC life I thought I'd take a minute to respond.

I am a full-time faculty member at a medical school. My practice is integrated with that of the other (mostly physician) faculty members of my department, so marketing is not much of an issue for me. I seldom even accept patients who are self-referred anymore since I have plenty of business from within my own system. For the private practice folks I know who have an adjunct appointment at the same institution, I don't think it's a huge marketing point, TBH.

Why I’m hesitating on TT positions is my viewpoint of the TT life. I’m open to hearing other perspectives, but my experience was quantity over quality was the reward structure of that process. As others have implied elsewhere on these forums, I wonder how much that reward structure contributes to some of the replication problems in quant psych. Personally, I’d rather support someone with a grant do a fantastic study than push out a bunch of pork to “get my name out there.”

After research-focused training through postdoc, I took a job as a non-TT clinical faculty member at an AMC. I don't have any large grants as a PI; I've applied for a couple of federal grants as PI and the best I can say is that I've been scored. However, I'm a collaborator on a few grants, working with folks I really admire and respect. Their funding pays for a portion of my time. At this moment I'm approaching a 50/50 clinical/research split, not to mention some educational activities that fit into the cracks.

Lifestyle-wise, this is not bad at all. Career-wise, I'm not so sure. I'm pulled in multiple directions and, at least in my scenario, it doesn't add up to a totally coherent career "narrative." Personally I don't care, but strategically it is cause for concern. Institutions want to see direction, not just achievement, when making tenure and funding decisions. But, if you want to flex your research/scholarly skills and are comfortable as a supporting actor, so to speak, then this is one way to do it while maintaining a clinical practice.

 

[R. Matey]

Lifestyle-wise, this is not bad at all. Career-wise, I'm not so sure. I'm pulled in multiple directions and, at least in my scenario, it doesn't add up to a totally coherent career "narrative." Personally I don't care, but strategically it is cause for concern. Institutions want to see direction, not just achievement, when making tenure and funding decisions. But, if you want to flex your research/scholarly skills and are comfortable as a supporting actor, so to speak, then this is one way to do it while maintaining a clinical practice.

Thanks for that perspective. I think I'd be happy with something like this. The aim really is to use all of the skills I was trained in while still maintaining some kind of work-life balance. Sitting in a office just doing therapy or just publishing for the sake of the publishing is what I'm trying to avoid. It's nice to know that some opportunities like this exist.