PhD/PsyD Possible new internship imbalance

[ForensicPsychFightClub]

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Anyone see the Match News email that just went out?

There’s another mounting imbalance between applicants and positions for internships, with 666 more applicants than positions to accommodate them.

A huge part of this imbalance - 89% of the growth in the applicant population - are from PsyD students. I really try not to buy in to the dogma against PsyD students who often get an unfair and undeserved rep but I can’t help but think this is sort of the downstream consequences of the ever increasing diploma mill cohort sizes and the general lack of the gatekeeper function in most training sites. Unfortunately, most of those operate under PsyDs, which isn’t helping the situation.

We have two PsyD students going out for the match and despite being well qualified, their interview rates are not great, especially for the sites they actually want to go to (re: not UCCs)

What do you all think - particularly people who work in some capacity that sees practicum/externship and intern applicants? Have you noticed this trend?

 

[Sanman]

Anyone see the Match News email that just went out?

There’s another mounting imbalance between applicants and positions for internships, with 666 more applicants than positions to accommodate them.

A huge part of this imbalance - 89% of the growth in the applicant population - are from PsyD students. I really try not to buy in to the dogma against PsyD students who often get an unfair and undeserved rep but I can’t help but think this is sort of the downstream consequences of the ever increasing diploma mill cohort sizes and the general lack of the gatekeeper function in most training sites. Unfortunately, most of those operate under PsyDs, which isn’t helping the situation.

We have two PsyD students going out for the match and despite being well qualified, their interview rates are not great, especially for the sites they actually want to go to (re: not UCCs)

View attachment 413759

What do you all think - particularly people who work in some capacity that sees practicum/externship and intern applicants? Have you noticed this trend?

The devil is in the details.

I imagine that with these kind of numbers trending for candidates, it is going to be a great year for VA training programs to fall apart due to lack of supervisors.

 

[The Cinnabon]

The devil is in the details.

I imagine that with these kind of numbers trending for candidates, it is going to be a great year for VA training programs to fall apart due to lack of supervisors.

I imagine current PhD students, myself included, are far more worried about the future of VA training rather than a growing imbalance.

If I recall correctly, past imbalances disproportionately effected diploma mill students in the past.

If/when the VA starts rapidly shrinking intern slots/closing down training programs then I'll start panicking.

 

[WisNeuro]

I imagine current PhD students, myself included, are far more worried about the future of VA training rather than a growing imbalance.

If I recall correctly, past imbalances disproportionately effected diploma mill students in the past.

If/when the VA starts rapidly shrinking intern slots/closing down training programs then I'll start panicking.

Correct, legitimate programs still had very high match rates, even in the worst years of the "imbalance." Anecdotally, we had one person not match the entire time I was in my program, and it was not a surprise.

 

[cara susanna]

On average our program had 1-2 students not match every year. And I went to a solid, funded PhD program at a state university. Unfortunately, while the imbalance does disproportionately impact PsyD students, it still trickles down to some extent. No one should have to worry about the possibility of not matching at all for what's ultimately a training position.

 

[WisNeuro]

On average our program had 1-2 students not match every year. And I went to a solid, funded PhD program at a state university. Unfortunately, while the imbalance does disproportionately impact PsyD students, it still trickles down to some extent. No one should have to worry about the possibility of not matching at all for what's ultimately a training position.

While that is fair, at the same time, from a decade of reviewing applications, there were many applicants who were in no way ready to apply for internship/were zero percent competitive for our site. The match difference is not merely about number of slots and applicants. Sometimes its programs pushing unqualified applicants to apply before they are ready.

 

[AcronymAllergy]

While that is fair, at the same time, from a decade of reviewing applications, there were many applicants who were in no way ready to apply for internship/were zero percent competitive for our site. The match difference is not merely about number of slots and applicants. Sometimes its programs pushing unqualified applicants to apply before they are ready.

I would agree. It wasn't the norm, but with probably a couple cases each year, it became apparent that the applicant probably needed another year (or two) of training to be ready for internship.

That said, I also saw trickle down effects from the past imbalance in my program, although not substantially. Basically, a small number of folks during my time in grad school didn't match, whereas in the past, it was expected that everyone would match. From what I know, it was a combination of applying to a limited number of sites, applying to sites that weren't a good fit, and on rare occasion, probably some bad luck.

I think when the prior imbalance was gearing up, more traditional programs may not have fully grasped the significance of the situation and therefore did not encourage their students to start applying more widely and broadly. And when internship programs were getting increasing numbers applications for the same number of spots, they had to figure out ways to adjust their screening and selection processes, which took some time.

 

[futureapppsy2]

Broke this out into its own thread!

 

[Ollie123]

Unfortunate, but not surprising to me in the least. From everything I can tell, APA has made absolutely no effort to reel in questionable/predatory programs and if anything, has done things to encourage them. Demand for training on the student-side will certainly be there and its not surprising that institutions view expanding slots as a cash grab. I'm a bit removed from things now, but assuming the above is APPIC and not APA the imbalance is likely to be even worse when you factor that into the equation. I would be interested to see a breakdown by institution on these numbers - e.g., did every PsyD increase enrollment by 5% or did just a few increase enrollment by 200% + some new universities with large cohorts open? I strongly suspect the latter.

I agree with the above that - in general - students from legitimate programs generally have little cause for concern on this front. There will certainly always be edge cases and otherwise perfectly qualified folks who go unmatched in any given year for a variety of reasons. We had a few in my program too and they were always usually explainable - folks heavily geographically restricting, folks on the edge about whether they should wait another year deciding to give it a shot, etc. I think only one I would consider just plain rotten luck.

I don't know how it may have changed, but I really cannot overstate how poor training was at some of these programs and how wildly unqualified huge portions of applicants were during the last imbalance. We had an Argosy student at one of my practicum sites. They were in their 2nd last year and prior to joining had effectively zero clinical experience. In their previous practicum, they were basically made to serve as a secretary in a private practice. They had a vague knowledge of psychoanalytic theory, limited ability to apply even that and literally zero experience with evidence-based interventions. They were astounded by the quality of that practicum site (a UCC) relative to what they had seen and heard about....to me, it was by far the lowest quality training I received at a practicum and one we considered dropping after that year (e.g., I was actively discouraged from implementing exposure therapy because going around initiating conversations for someone with social phobia would be "traumatizing"). They had zero research training and their dissertation was just going to be an extended case formulation. My understanding is that this was not an uncommon scenario for this program and I believe they had cohorts of ~150. I don't know if this sort of thing is what is driving the present numbers, but if it is - I wouldn't lose sleep over match rates if you are a student in a traditional program.

Now the potential implosion of the entire federal funding infrastructure and broader US government.....that is another matter....

 

[RxPsych]

This is not surprising at all. The sheer number of students applying for internship from the large cohort programs (~100-150 in some cases) is the cause for this. My current internship site received about 100 applications this year for 2 neuropsych interns. During an initial review of these applications, the VAST majority were people from these large cohort diploma mill PsyD programs that clearly 1) competed for practicum placements, 2) had zero guidance on hours requirements, CV formatting, essays, etc., and 3) were not qualified for neuro in the first place (e.g., 20 assessment hours across all practicum placements). If I recall correctly, we only had around 20 solid applicants, and the majority of those were from funded PhD programs or PsyD with smaller cohorts and more program support.

I am thankful every day that I put in the extra time and effort to go the funded PhD route, especially after being on the application reviewer side of things.

 

[chicandtoughness]

I don't know how it may have changed, but I really cannot overstate how poor training was at some of these programs and how wildly unqualified huge portions of applicants were during the last imbalance. We had an Argosy student at one of my practicum sites. They were in their 2nd last year and prior to joining had effectively zero clinical experience. In their previous practicum, they were basically made to serve as a secretary in a private practice. They had a vague knowledge of psychoanalytic theory, limited ability to apply even that and literally zero experience with evidence-based interventions.

The lack of support from these free-standing/diploma-mill-adjacent PsyD programs in assisting with proper practicum/externship placements is a huge issue and I wish APA would crack down on it. No one should be training in private practice. Students should not be left on their own to beg for preceptors by literally spam-emailing everyone on a professional newsgroup. If an institution doesn't have affiliations or can't point to high quality placements, it should not be operational. You'd think we'd be better than this but alas.

 

[WisNeuro]

Yeah, a good deal of the applications from the diploma mills I remember seeing were...bad. As said above, it looked like they had zero guidance on formatting, had no one look over their essays, and had multiple errors throughout (e.g., typos, hours didn't make sense/line up, etc). This is why the "what are my chances based on this many applications for this many slots" thinking is fundamentally flawed. Many of those applications are not even considered in way whatsoever.

 

[jdawg2017]

While that is fair, at the same time, from a decade of reviewing applications, there were many applicants who were in no way ready to apply for internship/were zero percent competitive for our site. The match difference is not merely about number of slots and applicants. Sometimes its programs pushing unqualified applicants to apply before they are ready.

Reviewing internship apps for the first time this year as faculty and I was honestly shocked by the number of applicants for our spot who were clearly applying too early or with minimal support from their mentor and/or DCT. Basically every applicant in this spot was from a PsyD or PhD program that is known to have enormous cohorts. It’s really unfortunate because it’s not really the fault of the student, but rather the fault of a (capitalist?) system that prioritizes low-quality, high cost training.

 

[Ollie123]

That's one of the biggest concerns. My program had pretty tight oversight of practicums. If they didn't feel they provided good training experiences, adhered to at least reasonably evidence-based practices they were not kept as a site. The program would jump through every hoop imaginable to make sure students got the experiences they wanted/needed. All students were supervised by program faculty at the in-house clinic, partly to make sure program faculty could play an integral role in guiding clinical development and provide some assurance that students who came out of the program met their standards for competence.

Was it perfect? Heck no, but relative to what the local PsyD offered it was night and day. And this was a program so research-focused that at the interview day they opened with "Our focus is on training people to become researchers, if your goal is to become a clinician you should think carefully about whether this is the right program for you." Yet this was our experience relative to the other local program that marketed itself as being "For people who want to focus on clinical training"...

 

[WisNeuro]

That's one of the biggest concerns. My program had pretty tight oversight of practicums. If they didn't feel they provided good training experiences, adhered to at least reasonably evidence-based practices they were not kept as a site. The program would jump through every hoop imaginable to make sure students got the experiences they wanted/needed. All students were supervised by program faculty at the in-house clinic, partly to make sure program faculty could play an integral role in guiding clinical development and provide some assurance that students who came out of the program met their standards for competence.

Was it perfect? Heck no, but relative to what the local PsyD offered it was night and day. And this was a program so research-focused that at the interview day they opened with "Our focus is on training people to become researchers, if your goal is to become a clinician you should think carefully about whether this is the right program for you." Yet this was our experience relative to the other local program that marketed itself as being "For people who want to focus on clinical training"...

We had a very similar style. One student did get special dispensation to do a prac at a site that we hadn't used before and they had to get a ton of extra documentation and oversight than those of us at established, well-known sites.

 

[futureapppsy2]

I think the practicum quality control issue is closely tied to the size of the larger PsyD programs.

 

[The Cinnabon]

I think the practicum quality control issue is closely tied to the size of the larger PsyD programs.

Elephant in the room may also be urban vs rural. It's one of the bigger caveats of my own rural program that certain training experiences are going to be much harder to get. We're not a program that's known for pumping out neuropsychologists as an example.

 

[PsyDr]

I’m really having no trouble with the use of the term “diploma mill”.

I’m not challenging the difference in quality between FSPPs and university based programs. However, there is a difference between doing an online PhD/PsyD with practica that have no equivalent value, and someone who did full time training with actual training.

Also: this forum has discussed graduates of HIGHLY respected PhD program who have no testing experience. I’m sure the could research everyone under the proverbial table, but I’m pretty sure that doesn’t make them a qualified clinician.

 

[Sanman]

I’m really having no trouble with the use of the term “diploma mill”.

I’m not challenging the difference in quality between FSPPs and university based programs. However, there is a difference between doing an online PhD/PsyD with practica that have no equivalent value, and someone who did full time training with actual training.

Also: this forum has discussed graduates of HIGHLY respected PhD program who have no testing experience. I’m sure the could research everyone under the proverbial table, but I’m pretty sure that doesn’t make them a qualified clinician.

I think this brings up a good point. The lowest quality programs will struggle. However, PCSAS type programs may as well. Research in general is struggling right now and those on the far end of research spectrum might struggle to find a fit with more clinically minded placements. That said, this being time number two, I am curious how those programs with captive internships will fair and if we will see more of this. Sticking with your home program and nearby placements for internship may be the best strategy for those who can. I regret not doing so in many ways.

 

[LM02]

I'm involved in training at an AMC internship with a solid research/academic reputation, and we do not typically see applications from the PsyD programs that we are discussing; and we have not seen an appreciable increase in total applications this year (though our number is always high). So, although anecdotal as an N=1 program, it does speak to the idea that the increase of new applicants might hit some parts of the internship landscape more than others.

 

[The Cinnabon]

I think this brings up a good point. The lowest quality programs will struggle. However, PCSAS type programs may as well. Research in general is struggling right now and those of the far end of research spe trump might struggle to find a fir woth more clinical .indes placements. That said, this being time number two, I am curious how those programs with captive internships will fair and if we will see more of this. Sticking with your home program and neqeby placements for internship may be the best strategy for those who can. I regret not doing so in many ways.

I really hope captive internships don't "catch on" during this imbalance. Outside of the obvious competency concerns, I just don't want our greatest defense against saturation to be undermined.

I already struggle with our fields general lack of interest in developing business accumen, or at least a sizable portion of the field.

 

[jdawg2017]

I really hope captive internships don't "catch on" during this imbalance. Outside of the obvious competency concerns, I just don't want our greatest defense against saturation to be undermined.

I already struggle with our fields general lack of interest in developing business accumen, or at least a sizable portion of the field.

I’m not sure how realistic this is for huge programs that already struggle to support their growing cohort sizes at baseline.

I can think of exactly one program with a captive internship that I think actually does it decently well (i.e., many students from this program land great fellowships and jobs, IMO, and there’s a lot of alumni who I respect clinically and/or in research). I’m curious how many captive internships exist, as this is also the only program captive internship I’m aware of…

 

[chicandtoughness]

I can think of exactly one program with a captive internship that I think actually does it decently well (i.e., many students from this program land great fellowships and jobs, IMO, and there’s a lot of alumni who I respect clinically and/or in research). I’m curious how many captive internships exist, as this is also the only program captive internship I’m aware of…

Do you mind sharing which program?

 

[jdawg2017]

Do you mind sharing which program?

UT Southwestern.

Last I checked they are sort of in the middle of the pack in terms of their program structure/cohort sizes and funding, but I think everyone does get an individual mentor and their training seems solid IMHO. The captive internship IIRC consists of two part-time years, during which students are also finishing their dissertation the other 20 hrs/week.

 

[AcronymAllergy]

UT Southwestern.

Last I checked they are sort of in the middle of the pack in terms of their program structure/cohort sizes and funding, but I think everyone does get an individual mentor and their training seems solid IMHO. The captive internship IIRC consists of two part-time years, during which students are also finishing their dissertation the other 20 hrs/week.

I've known probably a couple folks who've gone to UTSW and they've been solid. I haven't looked into cohort sizes, but my understanding has been that it's a relatively traditional program in that respect.

 

[BuckeyeLove]

We had a grad student from a historically respectable program last week spell the word "police" as "poliese." She is not from another country. When informed by a patient that she spelled the word wrong, she got embarrassed and defensive. So yeah...things aren't great. You can't be 84-92 FSIQ AND defensive.

 

[Sanman]

I've known probably a couple folks who've gone to UTSW and they've been solid. I haven't looked into cohort sizes, but my understanding has been that it's a relatively traditional program in that respect.

UT Southwestern has a good PhD program, or it did when I applied there many years ago.

Widener and, I believe, Alliant, also have captive internships.

 

[PsyDr]

You can't be 84-92 FSIQ AND defensive.

I see you've missed the last few decades of American politics, news, sports, and television.

 

[cara susanna]

Elephant in the room may also be urban vs rural. It's one of the bigger caveats of my own rural program that certain training experiences are going to be much harder to get. We're not a program that's known for pumping out neuropsychologists as an example.

That's interesting, because our program at the same university actually had quite a few neuropsychologists. Maybe the prac situation has changed (wouldn't shock me, honestly).

 

[LM02]

Not sure that they still do, but I recall that the PsyD program at the University of Denver had a captive internship - but it was competitive, and they did not have a spot for all of their students. Not sure what the status of that is, though?

 

[The Cinnabon]

That's interesting, because our program at the same university actually had quite a few neuropsychologists. Maybe the prac situation has changed (wouldn't shock me, honestly).

It's prac related, yup. Part of this could be self-selection too, I only know one student going for it.

 

[Therapist4Chnge]

I've known probably a couple folks who've gone to UTSW and they've been solid. I haven't looked into cohort sizes, but my understanding has been that it's a relatively traditional program in that respect.

Yeah, UTSW is a solid program. Captive internships outside of them are mixed at best. I personally think students should train outside of their programs, but I don’t have a dog in that fight; nor do I want one.

 

[ForensicPsychFightClub]

Here’s my perspective of someone who admittedly hasn’t ever worked at a place with an internship program, and thus there could be a lot of nuance here that I am missing.

Ultimately, I think my concern is that the squeeze is most felt by the students of these programs, not the programs themselves. It is reasonable to assume that the lack of avaliable spots is going to hit PsyD students from less than reputable sources the hardest. The programs with massive cohort sizes already have abysmal metrics anyway, so a few years of even worse match rates isn’t going to affect their bottom line too much. But for the students, already going into debt, the prospect of doing another year of training in hopes that the next year is somehow kinder to them, or worst case scenario accruing a ton of debt and no license to show for it if they age out of the program - I feel for them. I get that part of it is their choice in program but to me this discrepancy is a failure of regulation by the APA which still accredits organizations with cohort sizes of 80 or more. I wonder if there should be a restriction on cohort sizes - at least a charitable upper limit.

Per the email the last imbalance that was this bad - in fact, close to double this - was in 2012. Details about what fixes were implemented were sparse. Anybody remember what the field did to address this imbalance back then?!

 

[chicandtoughness]

Oh 100%. The programs don't care - they've already taken the tuition money. And as we've seen, abysmal match rates don't seem to be preventing people from applying and attending, so what's it to them?

UTSW's program is really good, I'm actually not surprised that they have a captive internship as many of their health training programs prefer to keep it "in the family". Widener is the one that everyone usually points to when discussing captive internships. Carlos Albizu also has a captive program I believe (they're just "Albizu University" now lol).

 

[futureapppsy2]

If not captive internships (which I have no problem with if held to adequate standards, tbh), I think it would make sense to at least link internships with postdocs--such an extensive application and unpaid moving process for one year of training, IMO.

 

[jdawg2017]

If not captive internships (which I have no problem with if held to adequate standards, tbh), I think it would make sense to at least link internships with postdocs--such an extensive application and unpaid moving process for one year of training, IMO.

I agree and hope that this change at some point down the line, but I feel like the inertia of the field and the “old guard” makes this unlikely to change. I’ve talked quite a bit with trainees and some leaders in my specialty about this issue, as even in the best financial situation (family or partner financial support), it still can be a big financial/life hit.

I think part of the problem merging internship and fellowship together is funding streams since some places have support for interns and others for postdocs; a growing number of sites have both, though it’s still rare. That doesn’t even touch the problem created by specialties that require longer postdocs (e.g., two years for neuropsych). I actually wish good captive internships were the norm, as it would address this problem, but I’m not sure how smaller programs could realistically create the same experience of internship and I do agree conceptually that there’s value in training with different people in our advanced training stages.

 

[AcronymAllergy]

Here’s my perspective of someone who admittedly hasn’t ever worked at a place with an internship program, and thus there could be a lot of nuance here that I am missing.

Ultimately, I think my concern is that the squeeze is most felt by the students of these programs, not the programs themselves. It is reasonable to assume that the lack of avaliable spots is going to hit PsyD students from less than reputable sources the hardest. The programs with massive cohort sizes already have abysmal metrics anyway, so a few years of even worse match rates isn’t going to affect their bottom line too much. But for the students, already going into debt, the prospect of doing another year of training in hopes that the next year is somehow kinder to them, or worst case scenario accruing a ton of debt and no license to show for it if they age out of the program - I feel for them. I get that part of it is their choice in program but to me this discrepancy is a failure of regulation by the APA which still accredits organizations with cohort sizes of 80 or more. I wonder if there should be a restriction on cohort sizes - at least a charitable upper limit.

Per the email the last imbalance that was this bad - in fact, close to double this - was in 2012. Details about what fixes were implemented were sparse. Anybody remember what the field did to address this imbalance back then?!

From what I remember, it was primarily addressed by increasing the number of internship spots available, particularly accredited internship spots. APA tried to help by making the internship accreditation process a bit more streamlined (it's still a beast) and adding the contingent accreditation level so that programs didn't need to wait for outcome metrics to gain accreditation.

I remember at one point, APA kicked around the idea of tying accreditation status to internship match rates. I don't remember what ever happened with that idea.

 

[The Cinnabon]

I remember at one point, APA kicked around the idea of tying accreditation status to internship match rates. I don't remember what ever happened with that idea.

I presume people making a lot of money would no longer be able to, as easily, make a lot of money.

 

[PsyDr]

We did what psychologists always do: wrote some publications, turned against each other, said “I’m better trained than this other guy”, said how important our profession is, acted like cms pays more if there are 12 total psychologists, simultaneously complained that masters level people are taking jobs, and then waited it all out until argosy went bankrupt because the federal government got involved.

 

[AcronymAllergy]

We did what psychologists always do: wrote some publications, turned against each other, said “I’m better trained than this other guy”, said how important our profession is, and then waited it all out until argosy went bankrupt.

Also that.

 

[PsyDr]

Also that.

It was a wild time. Some California family started Amway, and bribed an actor turned president to make sure that MLMs are never charged for breaking the law. The daughter eventually became the secretary of education, who invested in student loan debt collection and biofeedback clinics for students, and created policies to ensure people went into student loan debt. After a different actor turned president “had a peaceful tour of the capital”, she resigned due to moral reasons. Which was weird because her brother began building concentration camps for the Chinese, after selling his “definitely not a mercenary army”.

 

[Harry3990]

It was a wild time. Some California family started Amway, and bribed an actor turned president to make sure that MLMs are never charged for breaking the law. The daughter eventually became the secretary of education, who invested in student loan debt collection and biofeedback clinics for students, and created policies to ensure people went into student loan debt. After a different actor turned president “had a peaceful tour of the capital”, she resigned due to moral reasons. Which was weird because her brother began building concentration camps for the Chinese, after selling his “definitely not a mercenary army”.

 

[Fan_of_Meehl]

From what I remember, it was primarily addressed by increasing the number of internship spots available, particularly accredited internship spots. APA tried to help by making the internship accreditation process a bit more streamlined (it's still a beast) and adding the contingent accreditation level so that programs didn't need to wait for outcome metrics to gain accreditation.

I remember at one point, APA kicked around the idea of tying accreditation status to internship match rates. I don't remember what ever happened with that idea.

Between (circa) 2002 and 2008 the application packet for our internship program went from twenty-something pages to 200+ pages in length. God knows what it is now. I think that APA is caught in the bureaucratic frenzied loop of 'more and more complexity/ length/ oversight' = 'higher quality sites' with no end in sight. I don't think that the original thrust of 'accreditation' standards was micromanagement (but, rather, ensuring basic standards and ensuring that mainstream/core curricula were present). I'd love to think that there would be the possibility of downsizing or streamlining the requirements but also think that it just isn't going to happen. And I also don't believe that the increase in bureaucracy, complexity, and length of the application process and micromanaging oversight from 'accrediting' bodies has resulted in 'higher quality' training over the years. Barlow (and folks from his cohort) received excellent training.

 

[The Cinnabon]

Between (circa) 2002 and 2008 the application packet for our internship program went from twenty-something pages to 200+ pages in length. God knows what it is now. I think that APA is caught in the bureaucratic frenzied loop of 'more and more complexity/ length/ oversight' = 'higher quality sites' with no end in sight. I don't think that the original thrust of 'accreditation' standards was micromanagement (but, rather, ensuring basic standards and ensuring that mainstream/core curricula were present). I'd love to think that there would be the possibility of downsizing or streamlining the requirements but also think that it just isn't going to happen. And I also don't believe that the increase in bureaucracy, complexity, and length of the application process and micromanaging oversight from 'accrediting' bodies has resulted in 'higher quality' training over the years. Barlow (and folks from his cohort) received excellent training.

I loved his APF fireside chat with Keane! Turns out the old guard's warnings/insights for the field aren't completely unfounded, shocker right.

 

[BuckeyeLove]

Did they even have internships back in the 70s when Barlow et al were being trained? That wasn't ubiquitous until the 80s i thought.

 

[jdawg2017]

Did they even have internships back in the 70s when Barlow et al were being trained? That wasn't ubiquitous until the 80s i thought.

It may have even been more into the 90s. I remember talking with the first neuropsychologist I knew (a family friend from my hometown in private practice for 20+ years at that point) about applying for internship and she had no idea what I was talking around. She trained in the early 90s IIRC. I get the parity of having internship with physician training, but golly our current system is screwed up in so many ways.

 

[bcliff]

It may have even been more into the 90s. I remember talking with the first neuropsychologist I knew (a family friend from my hometown in private practice for 20+ years at that point) about applying for internship and she had no idea what I was talking around. She trained in the early 90s IIRC. I get the parity of having internship with physician training, but golly our current system is screwed up in so many ways.

My understanding is that fellowship training became the norm for neuropsychologists around the mid 90s. I worked with two neuropsychologists on internship who graduated within years of each other in the early-to-mid 90s. One completed fellowship training and the other did not; the one who did, said that it was essentially just becoming the norm when she completed hers.

I think internship training has been around (at least to some degree) since the Boulder Conference (late 1940s/early 1950s). For example, I think the internship program at the Menninger Clinic has been around since the 50s. I think there are several programs older than that. I'm not sure when internship became required for APA accreditation.

 

[LM02]

Did they even have internships back in the 70s when Barlow et al were being trained? That wasn't ubiquitous until the 80s i thought.

Barlow got his doctorate in the late 1960s. But for context, he was working at Brown when their internship started in 1975.

 

[ninim]

Unfortunate, but not surprising to me in the least. From everything I can tell, APA has made absolutely no effort to reel in questionable/predatory programs and if anything, has done things to encourage them. Demand for training on the student-side will certainly be there and its not surprising that institutions view expanding slots as a cash grab. I'm a bit removed from things now, but assuming the above is APPIC and not APA the imbalance is likely to be even worse when you factor that into the equation. I would be interested to see a breakdown by institution on these numbers - e.g., did every PsyD increase enrollment by 5% or did just a few increase enrollment by 200% + some new universities with large cohorts open? I strongly suspect the latter.

I agree with the above that - in general - students from legitimate programs generally have little cause for concern on this front. There will certainly always be edge cases and otherwise perfectly qualified folks who go unmatched in any given year for a variety of reasons. We had a few in my program too and they were always usually explainable - folks heavily geographically restricting, folks on the edge about whether they should wait another year deciding to give it a shot, etc. I think only one I would consider just plain rotten luck.

I don't know how it may have changed, but I really cannot overstate how poor training was at some of these programs and how wildly unqualified huge portions of applicants were during the last imbalance. We had an Argosy student at one of my practicum sites. They were in their 2nd last year and prior to joining had effectively zero clinical experience. In their previous practicum, they were basically made to serve as a secretary in a private practice. They had a vague knowledge of psychoanalytic theory, limited ability to apply even that and literally zero experience with evidence-based interventions. They were astounded by the quality of that practicum site (a UCC) relative to what they had seen and heard about....to me, it was by far the lowest quality training I received at a practicum and one we considered dropping after that year (e.g., I was actively discouraged from implementing exposure therapy because going around initiating conversations for someone with social phobia would be "traumatizing"). They had zero research training and their dissertation was just going to be an extended case formulation. My understanding is that this was not an uncommon scenario for this program and I believe they had cohorts of ~150. I don't know if this sort of thing is what is driving the present numbers, but if it is - I wouldn't lose sleep over match rates if you are a student in a traditional program.

Now the potential implosion of the entire federal funding infrastructure and broader US government.....that is another matter....

I gasped at least 4 times reading this. 150?! In one year?

 

[smalltownpsych]

Between (circa) 2002 and 2008 the application packet for our internship program went from twenty-something pages to 200+ pages in length. God knows what it is now. I think that APA is caught in the bureaucratic frenzied loop of 'more and more complexity/ length/ oversight' = 'higher quality sites' with no end in sight. I don't think that the original thrust of 'accreditation' standards was micromanagement (but, rather, ensuring basic standards and ensuring that mainstream/core curricula were present). I'd love to think that there would be the possibility of downsizing or streamlining the requirements but also think that it just isn't going to happen. And I also don't believe that the increase in bureaucracy, complexity, and length of the application process and micromanaging oversight from 'accrediting' bodies has resulted in 'higher quality' training over the years. Barlow (and folks from his cohort) received excellent training.

Unfortunately committees don’t ever seem to be able to simplify things and a lot of organizations like this rely on committees. If only there was a profession that studied human thinking, behavior, and decision making and the ways that groups do that…