Non-accredited internship

[pumpkinsoda]

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Hello all.

Unfortunately, I did not match in either Phase I or Phase II. I am also a 5th-year PhD student, so already advanced in my practicum and academic studies. I have the opportunity to complete my internship requirement by remaining with my current practicum position at a major AMC and moving to full-time work. While I understand there are many downsides to completing a non-accredited internship, this is something I am heavily considering, given the positive reputation of this AMC.

I am child-focused, so I have no interest in ever working for a VA. If you were in my shoes, would you also consider this opportunity, or wait to reapply next year?

 

[R. Matey]

Is it at least listed in APPIC or are we talking an unaccredited, unlisted, ad hoc internship?

I know it really sucks, but I would probably apply next year and stay on as an advanced practicum student if possible to build experience to be competitive. Here it seems the only upside is graduating faster only to face future hurdles later on down the road. Honestly, I'm a bit surprised your program would even let you do something like that. My PhD program did not allow anyone to graduate without obtaining an APA-accredited internship (not sure how common that is though).

The downsides, as you know, are numerous. Top of mind is licensure. Will your state board license you if you were to make this move? What about other states? Similarly, while your AMC dept might be fine with it, if you go out on the top market for other peds positions you will find that many require at APA-accredited internship to meet the basic job requirements. I hated my awful UCC internship, but APA-accreditation did end up opening doors for me, even in unrelated settings.

Provided that this is an ad hoc internship experience, another set of considerations is that your AMC dept is under no obligation to fulfill the training standards for psychologists (i.e., concentrations, didactics, adequate supervision) or compensate you adequately for your labor and time (including benefits). It would be also unclear what protections you have should things go sideways during the training year. Internship is a hassle for sure, but the structure is partly there to protect you as well as the public.

 

[psy.d. 2021]

Might be a good idea to look at the post match vacancy stuff being posted tomorrow. I'm guessing that's already on your radar.

 

[ThatPsyGuy]

From someone that just went through all of this recently and talked to some cohort mates about Match II, I say look at the Post-Vacancy first, then decide after those options are spent.

Accreditation can mean a lot depending on what states/what industries you want to work in.

So set up an alarm for 8AM EST, and get to cooking those cover letters and an email really selling yourself.

 

[WisNeuro]

It's not just the VAs, many other hospital systems require an accredited internship, not too mention hassles with licensure. If you think you can shore up any weaknesses in your application this year and be a very strong candidate next year, I'd do that if I couldn't get a PMVS position.

 

[AcronymAllergy]

I'll second/third/fourth the recommendations to take a look at the post-match vacancy listings first before making any final decisions.

If it were me, I'd stick around for another year and then consider alternatives if needed; 6 + 1 vs. 5 + 1 isn't all that unusual in the grand scheme of things. I'd also try to do everything I could to either finish my dissertation or get it as close to done as possible during that time. Not having that hanging over your head while on internship is huge.

 

[Ollie123]

I'm surprised no one has asked so far, but best guesses as to WHY you didn't match? I think that is the elephant in the room. If its something easily correctable (I only had X clinical hours), I think waiting and reapplying is a pretty obvious choice. If its something that can't really be fixed (e.g., transcript shows you failed ethics class twice) unaccredited might be the only option. I'm assuming its either the former, bad luck or some combination of the two but wanted to confirm.

VAs won't hire you, but it will pose challenges other places too. Even at AMCs, many places might be happy to take you as an intern but when it comes time for hiring you as an attending provider the credentialing office tells you to piss off and there's really nothing your supervisors can do. I understand the temptation to go the unaccredited route, but be very cautious if you make that choice.

 

[BuckeyeLove]

To be blunt, why didn't you match? This isn't 2013 when it was horrible, so...let's figure out what's going on here. Also, don't take the unaccredited spot. Not worth it.

 

[WisNeuro]

To be blunt, why didn't you match? This isn't 2013 when it was horrible, so...let's figure out what's going on here. Also, don't take the unaccredited spot. Not worth it.

Combined Phase I/II match rate of 87% this year, 81% in 2013, so better than back then, but worse than pre-2025. But I also agree. Clinical PhDs matched at about a 90% clip this year, I'd wonder what other things looked like in the application and where they applied to see if there are any patterns that explain it.

 

[Sanman]

Combined Phase I/II match rate of 87% this year, 81% in 2013, so better than back then, but worse than pre-2025. But I also agree. Clinical PhDs matched at about a 90% clip this year, I'd wonder what other things looked like in the application and where they applied to see if there are any patterns that explain it.

Man looking at 81% as a bad year and remembering pre-2010 with 70-75ish percent match rates and no phase II match.

 

[WisNeuro]

Man looking at 81% as a bad year and remembering pre-2010 with 70-75ish percent match rates and no phase II match.

I also walked uphill both ways, in the snow, to the post office, to pay a lot of money to send giant application packets to internship sites.

Edit: I am glad that the costs have come down considerably for applicants. Though, I still think they are doing applicants a disservice by not having in-person interviews at some sites. Those visits drastically changed my rankings.

 

[Sanman]

I also walked uphill both ways, in the snow, to the post office, to pay a lot of money to send giant application packets to internship sites.

You just reminded me that we located the postal facility at the airport to drop off applications late so they had the correct date stamp. That and "the scramble". These kids don't know what they are missing.

 

[oliversacks4thewin]

 

[Sanman]

 

[WisNeuro]

That's exactly what an old white guy would say to throw us off... 😉

 

[Sanman]

That's exactly what an old white guy would say to throw us off... 😉

 

[PsyDr]

@pumpkinsoda

You know when you have a friend who is dating someone, and they do all these things to "make the relationship work"? They do all sorts of things to try to fit a square peg in a round hole. You know how that ends, right? Even if it "works", it is a cluster and they end up breaking up anyway.

 

[oliversacks4thewin]

Discusses the mail system. Tries to convince you they are not a boomer. Pretty sus... lol

 

[psy.d. 2021]

I'll second/third/fourth the recommendations to take a look at the post-match vacancy listings first before making any final decisions.

If it were me, I'd stick around for another year and then consider alternatives if needed; 6 + 1 vs. 5 + 1 isn't all that unusual in the grand scheme of things. I'd also try to do everything I could to either finish my dissertation or get it as close to done as possible during that time. Not having that hanging over your head while on internship is huge.

Internship sites give more points on rubrics to folks already done with dissertation too...so that might mean something here.

 

[WisNeuro]

Internship sites give more points on rubrics to folks already done with dissertation too...so that might mean something here.

This was always pretty low on the ranking points for most cases. If people were like "I haven't started data collection yet," yeah, red flag. But between someone who was in the process of analysis and writeup and being done, wasn't a huge boost in rankings.

 

[psy.d. 2021]

This was always pretty low on the ranking points for most cases. If people were like "I haven't started data collection yet," yeah, red flag. But between someone who was in the process of analysis and writeup and being done, wasn't a huge boost in rankings.

Sure, I don't think it is make or break for OP. But every little bit helps.

 

[Sanman]

Discusses the mail system. Tries to convince you they are not a boomer. Pretty sus... lol

 

[pumpkinsoda]

To try to answer all the questions above:

• I am in a School Psychology PhD program, so there is less of a focus on needing to do an APA-accredited internship, as people who would like to remain within the K-12 school system don't need that for their job.
• My state board will allow for an unaccredited internship for licensure, and there are several psychologists at this current AMC who completed their internship in an ad hoc manner through that same hospital.
• I have applied to some of the PMVS sites, though only 20(!) are listed, with 7(!!!) being APA-accredited
• My larget concern with needing to move onto internship is funding. I am unsure if I can be supported through funding in any capacity next year, which is both a financial and mental burden
• As for why I didn't match, i've received some feedback that's overall confusing. I've gotten many generic "this was an especially competitive year" emails, one said I lacked assessment experience (I have documented 350+ hours and 70+ integrated reports); one said one of my recommenders wrote I was still beginning in one cinical area (which makes sense as it was my first therapy practicum position).

 

[WisNeuro]

Did you make sure that the sites you applied to have admitted School Psych students? Many do not. That may also been a barrier if that part of the fit wasn't there.

 

[R. Matey]

I was wondering if this was a school psych situation. That makes a lot more sense to me. How many intervention hours do you have? I recall getting enough therapy hours was always a problem for school psychs in our department who wanted to go the APA-accreditation route (which is always a smart career move, IMHO). My guess is that you're low on your intervention hours compared with clinical psych peds, especially if you're shooting for a hospital/AMC internship and since you said it's your first therapy prac. Publications could be also be a factor. It sucks that the TDs aren't being more straightforward with you on how to improve.

I understand the temptation given that several other folks in your department have gone down a similar path and it seems like it worked out ok. Again, something to consider may be licensure and career portability. If you ever want to move or work a different hospital or AMC, not having an accredited internship can be a permanent barrier. It's still a short-term costs vs. long term rewards calculation. On the costs side, do you have to take classes to maintain enrollment or will you be in your dissertation phase where a few credits are all that is needed to maintain fulltime enrollment?

 

[pumpkinsoda]

Did you make sure that the sites you applied to have admitted School Psych students? Many do not. That may also been a barrier if that part of the fit wasn't there.

I did. I filtered any site that outright stated they don't accept School Psych, and then looked for sites that have accepted at least one in the past 5 years.

 

[pumpkinsoda]

I was wondering if this was a school psych situation. That makes a lot more sense to me. How many intervention hours do you have? I recall getting enough therapy hours was always a problem for school psychs in our department who wanted to go the APA-accreditation route (which is always a smart career move, IMHO). My guess is that you're low on your intervention hours compared with clinical psych peds, especially if you're shooting for a hospital/AMC internship and since you said it's your first therapy prac. Publications could be also be a factor. It sucks that the TDs aren't being more straightforward with you on how to improve.

I understand the temptation given that several other folks in your department have gone down a similar path and it seems like it worked out ok. Again, something to consider may be licensure and career portability. If you ever want to move or work a different hospital or AMC, not having an accredited internship can be a permanent barrier. It's still a short-term costs vs. long term rewards calculation. On the costs side, do you have to take classes to maintain enrollment or will you be in your dissertation phase where a few credits are all that is needed to maintain fulltime enrollment?

I think my low intervention hours was a contributing factor. At the time of applying, I had ~350 hours (individual therapy, group/family therapy, behavioral interventions). I'm now closer to 500, but definetly lower than most at the time of applying. I thought my high intervention hours could partially offset, but maybe not.

Portability is definelty important for me, so you're right about that being a huge barrier. I don't need to take any more courses, but I do still need some income to come in, and ideally I would want to continue with a practicum position to keep gaining intervention hours for any future applications.

 

[R. Matey]

Portability is definelty important for me, so you're right about that being a huge barrier. I don't need to take any more courses, but I do still need some income to come in, and ideally I would want to continue with a practicum position to keep gaining intervention hours for any future applications.

Ah, ok. This is a really tough position to be in. I know some people were able to find extra-department assistantships or part time work to sustain themselves over an additional training year, but hustling like that does suck. What's the TD's/faculty's take on the situation?

 

[bcliff]

I also walked uphill both ways, in the snow, to the post office, to pay a lot of money to send giant application packets to internship sites.

Edit: I am glad that the costs have come down considerably for applicants. Though, I still think they are doing applicants a disservice by not having in-person interviews at some sites. Those visits drastically changed my rankings.

RE: in-person interviews.

I don't know...internship isn't that big of a deal--with the exception that it needs to be APA accredited (relevant here). For aspiring neuropsychologists, it also generally needs to have neuropsychology either in its title or clearly within its program of study (with training that actually offers appropriate preparation for fellowship) and ideally with boarded folks on faculty. That's pretty readily discernible from online materials and Zoom interviews, IMO.

I'm a big proponent of doing internship as cheaply, non-disruptively, conservatively, etc. as possible, while receiving the training necessary to move on to the next rung of training or career. It would have taken A LOT for me to pay to move across the country just to make $30k/yr and then do the whole thing over again 12 months later (which is why I stayed put).

With that mental model, I was incredibly glad to not have to pay out of pocket to fly for interviews--internship was just a box I had to check (and--for me--only one year of a three-year, full-time clinical residency). I might have felt differently if I had planned to go on the job market directly from internship.

To OP: I would without hesitation not do an unaccredited internship, unless--like others have said--I was confident that I would not match to an accredited program next year. If you have close to 900 direct contact hours and 70+ reports, then I would strongly consider reapplying next year with maybe a slightly broader focus. I've supervised school psychology PhDs who have done internship at fantastic training programs (who themselves are fantastic clinicians), but I know how hard the climb can be. Feel free to DM me if interested in chatting more.

 

[cara susanna]

Yeah, I think it's awesome that internships now don't require in-person interviews.

 

[pumpkinsoda]

Ah, ok. This is a really tough position to be in. I know some people were able to find extra-department assistantships or part time work to sustain themselves over an additional training year, but hustling like that does suck. What's the TD's/faculty's take on the situation?

My DCT tells me they are supportive, but funding at the larger University level is limited and typically cut off for people past their 5th year.

 

[oliversacks4thewin]

Given that you are in a school psychology program, did you apply to any APPIC school-district internships? I understand the draw of wanting to stay in an AMC and the idea of thinking you need to do so for internship to eventually land a job at one, but you might be surprised by the long-term nuances of the pathway to working at a pediatric AMC. For example, a lot of AMC's have really begun to expand their psychology school-based services, and are honestly looking for individuals with school experience to work as a liaison between the hospital and the schools. Broadening your future applications to these types of internships, could actually help you eventually get back to an AMC, and as others have mentioned above, may put you in a general advantageous position, as opposed to a non-accredited internship.

I recognize the current bind you are in, regarding funding. My sympathies go to you, as the concern seems like a unique one. Is it possible to explore options for work options to off-set the cost? TA or research assistant positions within the university? Scholarships?

 

[R. Matey]

Given that you are in a school psychology program, did you apply to any APPIC school-district internships? I understand the draw of wanting to stay in an AMC and the idea of thinking you need to do so for internship to eventually land a job at one, but you might be surprised by the long-term nuances of the pathway to working at a pediatric AMC. For example, a lot of AMC's have really begun to expand their psychology school-based services, and are honestly looking for individuals with school experience to work as a liaison between the hospital and the schools. Broadening your future applications to these types of internships, could actually help you eventually get back to an AMC, and as others have mentioned above, may put you in a general advantageous position, as opposed to a non-accredited internship.

Case-and-point, I know more than one person who did a APA-accredited child-focused, residential treatment center internships than are now clinical educators at their local AMC. It's definitely possible and a better path than the ad hoc option, IMHO.

 

[WisNeuro]

RE: in-person interviews.

I don't know...internship isn't that big of a deal--with the exception that it needs to be APA accredited (relevant here). For aspiring neuropsychologists, it also generally needs to have neuropsychology either in its title or clearly within its program of study (with training that actually offers appropriate preparation for fellowship) and ideally with boarded folks on faculty. That's pretty readily discernible from online materials and Zoom interviews, IMO.

I'm a big proponent of doing internship as cheaply, non-disruptively, conservatively, etc. as possible, while receiving the training necessary to move on to the next rung of training or career. It would have taken A LOT for me to pay to move across the country just to make $30k/yr and then do the whole thing over again 12 months later (which is why I stayed put).

With that mental model, I was incredibly glad to not have to pay out of pocket to fly for interviews--internship was just a box I had to check (and--for me--only one year of a three-year, full-time clinical residency). I might have felt differently if I had planned to go on the job market directly from internship.

To OP: I would without hesitation not do an unaccredited internship, unless--like others have said--I was confident that I would not match to an accredited program next year. If you have close to 900 direct contact hours and 70+ reports, then I would strongly consider reapplying next year with maybe a slightly broader focus. I've supervised school psychology PhDs who have done internship at fantastic training programs (who themselves are fantastic clinicians), but I know how hard the climb can be. Feel free to DM me if interested in chatting more.

Always a YMMV situation. My internship definitely set me up for my #1 choice in postdoc, as my internship letter writer was mentioned quite a bit. For generalists, probably not as much of a big deal. Personally, I was glad to make the visits, and would have done it anyway, even if optional.

 

[Therapist4Chnge]

You just reminded me that we located the postal facility at the airport to drop off applications late so they had the correct date stamp. That and "the scramble". These kids don't know what they are missing.

I remember using our pool table to organize my apps...each had a manila folder w the requirements taped to them. I still remember standing in line at the post office wondering where I'd end up.

 

[Therapist4Chnge]

FWIW, I didn't match my first time and I was faced w the same dilemma, at the height of the internship imbalance. My first go around was after my 4th year and I secured something like 8 out of 12 interviews, all at competitive AMCs; I thought I was golden, so not matching was rough. I sat down with my mentor and talked about the options, and thankfully he strongly encouraged me to only consider APA-acred bc my goal was to work at an AMC. I talked to a few sites but made peace with pulling out and applying next cycle. I sought feedback from every site I applied and received back useful responses from about half of them, which helped my next application cycle. Everything worked out, and my internship mentor played a big role in helping me get a top-notch fellowship. Taking that extra year sucked in the moment, but I'm very thankful I did it. I cobbled together a gap year by getting a job at a prior practica, doing some RA and TA work, and I took some classes.

Being in school psych, I can see the appeal and less emphasis on APA-acred. Being able to attain an APA-acred provides the most flexibility and is what I'd recommend, but everyone's situation is different. The licensure process is easier with an APA-acred and board-eligible if you want that route. I'd talk with a bunch of different professionals at diff points of their career to get a wider perspective and see how I feel about things after that. Best of luck.

 

[pumpkinsoda]

Given that you are in a school psychology program, did you apply to any APPIC school-district internships? I understand the draw of wanting to stay in an AMC and the idea of thinking you need to do so for internship to eventually land a job at one, but you might be surprised by the long-term nuances of the pathway to working at a pediatric AMC. For example, a lot of AMC's have really begun to expand their psychology school-based services, and are honestly looking for individuals with school experience to work as a liaison between the hospital and the schools. Broadening your future applications to these types of internships, could actually help you eventually get back to an AMC, and as others have mentioned above, may put you in a general advantageous position, as opposed to a non-accredited internship.

I recognize the current bind you are in, regarding funding. My sympathies go to you, as the concern seems like a unique one. Is it possible to explore options for work options to off-set the cost? TA or research assistant positions within the university? Scholarships?

I did apply to and receive a couple interviews to school-based sites, but ultimately did not match.

I am currently exploring some options. I currently TA for a different department, but it is unclear of whether this could potentially continue next semester. Either way, I will not have any income for this summer.

 

[pumpkinsoda]

This is also a tangent, but it make a difference to complete an internship that is an APPIC member but would not be APA-accredited by the time you graduate?

 

[ForensicPsychFightClub]

I did apply to and receive a couple interviews to school-based sites, but ultimately did not match.

I am currently exploring some options. I currently TA for a different department, but it is unclear of whether this could potentially continue next semester. Either way, I will not have any income for this summer.

If a lack of income is the primary consideration barring you from taking an additional gap year, have you considered looking for psychometrist positions near you? This was how I supported myself during the second half of grad school, after getting enough assessment experience. With 70+ integrated reports, it sure sounds like you’d have enough to find something.

Grad Plus Loans are an option until July, but I would generally exhaust literally every other option before those as the current administration will not be kind to borrowers. Still, if it’s that or losing your apartment, it could be an option to get you through the summer.

I agree with others that taking a gap year is best. It sounds like this unaccredited position at your AMC will likely still be available next year if you get all the way past PMVS once more. If you can make ends meet and try again, I bet your future self would thank you.

 

[psych.meout]

I think my low intervention hours was a contributing factor. At the time of applying, I had ~350 hours (individual therapy, group/family therapy, behavioral interventions). I'm now closer to 500, but definetly lower than most at the time of applying. I thought my high intervention hours could partially offset, but maybe not.

This is the likely culprit. For this year's cycle, I distinctly recall reviewing applications from student's whose overall hours were low and/or heavily weight towards group therapy or other types of interventions that weren't individual therapy. We didn't interview any of these applicants.

Being on the low(er) end of overall hours and having a substantial proportion being group/family and other intervention that isn't typical individual therapy is likely what hurt your applications the most. If you have been able to ameliorate this issue to some degree already and have several months before the next cycle begins, I'd strongly lean towards reapplying.

 

[bcliff]

Always a YMMV situation. My internship definitely set me up for my #1 choice in postdoc, as my internship letter writer was mentioned quite a bit. For generalists, probably not as much of a big deal. Personally, I was glad to make the visits, and would have done it anyway, even if optional.

YMMV for sure. My internship and APPCN fellowship did not require a move. Both were my top choice for their respective matches.

Solid neuropsychology training and APA accreditation were my only "mandatory" criteria for internship training. APPCN membership and access to my populations/settings of interest were my only "mandatory" criteria for fellowship. Not having to move was one rung down from those "must haves" (e.g., I applied all over the country for both internship and fellowship and ranked sites all over).

I moved for an AMC faculty position at which point my employer covered all moving expense (plus a sign on bonus). I don't think trainees are given enough information on how common relocation assistance is for AMC faculty positions. I at least hadn't known to expect that before going on the job market.