PsyD - Do you regret graduating with a PsyD

[Therapist4Chnge]

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Speak of the devil, BCBS literally just sent out e-mails to many of our state members auditing their use of 90837 for the past year as they consider them "extended" visits. Our next two largest insurers pay the same for 90837 as they do for 90834.

While it should be a surprise to no one, BCBS and similar companies have made numerous efforts over the years to suppress use of certain codes. Back when I took insurance (req. to work at various public hospitals 5-8yrs ago), one of the largest insurers in the state attempted to claw back $12k-$15k from my private practice through a "random utilization review". I dug into this and working w. my state psych association to shut it down bc our state was likely a test balloon to see if their tactics would work. The "random utilization review" (what they called it) just happened to be EVERY neuropsych billing code I did for them over 6mon. The wording in the letters were always aggressive, which is a common tactic to confuse and imply limitations that they swear aren't there. While they claimed they were just confirming billing info and it wasn't about money, they attempted to claw back nearly all of those cases with the exception of a few that I actually underbilled by mistake. When I pushed back, they claimed it was a "miscommunication" w. the 3rd party scumbags, shocking no one.

Fast-forward a bunch of years, similar tactics (per various list servs including one specifically on billing) just get repeated, but now for 90837. The tired argument from the insurance companies continue to be merely "notifying" providers of their utilization and they wanted to ensure it was "reasonable and necessary" to use 90837. Many companies would "notify" providers of utilization and make it much harder to use 90837, often requiring pre-auth for EVERY session....which sure seems like a violation of parity laws. The added hoops are used clearly to suppress the use of 60min sessions and encourage downcoding.

Just typing that pissed me off.

 

[WisNeuro]

Many companies would "notify" providers of utilization and make it much harder to use 90837, often requiring pre-auth for EVERY session....which sure seems like a violation of parity laws. The added hoops are used clearly to suppress the use of 60min sessions and encourage downcoding.

Just typing that pissed me off.

Issue with the parity laws is that there is very little in the way of regulatory "teeth" written into them, so it's pretty easy for payors to violate them with little to no repercussions.

 

[foreverbull]

While it should be a surprise to no one, BCBS and similar companies have made numerous efforts over the years to suppress use of certain codes. Back when I took insurance (req. to work at various public hospitals 5-8yrs ago), one of the largest insurers in the state attempted to claw back $12k-$15k from my private practice through a "random utilization review". I dug into this and working w. my state psych association to shut it down bc our state was likely a test balloon to see if their tactics would work. The "random utilization review" (what they called it) just happened to be EVERY neuropsych billing code I did for them over 6mon. The wording in the letters were always aggressive, which is a common tactic to confuse and imply limitations that they swear aren't there. While they claimed they were just confirming billing info and it wasn't about money, they attempted to claw back nearly all of those cases with the exception of a few that I actually underbilled by mistake. It took leveraging personal connections in my state's gov to lean on the insurance oversight ppl to drop the hammer on this attempt. They claimed it was a "miscommunication" w. the 3rd party scumbags, shocking no one.

Fast-forward a bunch of years, similar tactics (per various list servs including one specifically on billing) just get repeated, but now for 90837. The tired argument from the insurance companies continue to be merely "notifying" providers of their utilization and they wanted to ensure it was "reasonable and necessary" to use 90837. Many companies would "notify" providers of utilization and make it much harder to use 90837, often requiring pre-auth for EVERY session....which sure seems like a violation of parity laws. The added hoops are used clearly to suppress the use of 60min sessions and encourage downcoding.

Just typing that pissed me off.

lol, what in the world are you talking about? This board sometimes...for someone to bill 80 hours and not come “close to getting a gross of 200” they’d be getting like $40 per 60 minute session. Medicaid pays something like 150% of that in most areas and they are typically considered the worst, often by wide margins, as far as reimbursement.

$75-92 or so is typical insurance reimbursement per full session in my area, although Kaiser offers to funnel their overflow clientele to out of network psychologists for $60/session (I.e. try to underpay community psychologists rather than hiring more psychologists in house to meet the demand).

Medicare/Medicaid pays the highest but is likely to audit successive 90837s in my area—I was warned by another ECP not to use that code often, largely because of “overuse” of 90837 being an issue to insurance companies (just like what @Therapist4Chnge said). On top of that, you’re more likely to spend “work” time to have to deal with back and forth with insurance companies unless you hire a biller who will take care of that for you.

Aren’t CMS reimbursements dropping next year? I saw an email about that recently. One website said 7%, but APA said something like a proposed 10.6% reduced reimbursement for services.

Medicare proposals for 2021: Psychologists’ payments impacted

APA asks the Centers for Medicare and Medicaid Services to preserve and increase payments for psychological services.

www.apaservices.org

 

[Sanman]

$75-92 or so is typical insurance reimbursement per full session in my area, although Kaiser offers to funnel their overflow clientele to out of network psychologists for $60/session (I.e. try to underpay community psychologists rather than hiring more psychologists in house to meet the demand).

Medicare/Medicaid pays the highest but is likely to audit successive 90837s in my area—I was warned by another ECP not to use that code often, largely because of “overuse” of 90837 being an issue to insurance companies (just like what @Therapist4Chnge said). On top of that, you’re more likely to spend “work” time to have to deal with back and forth with insurance companies unless you hire a biller who will take care of that for you.

Aren’t CMS reimbursements dropping next year? I saw an email about that recently. One website said 7%, but APA said something like a proposed 10.6% reduced reimbursement for services.

Medicare proposals for 2021: Psychologists’ payments impacted

APA asks the Centers for Medicare and Medicaid Services to preserve and increase payments for psychological services.

www.apaservices.org

Yes, CMS is talking about a 10.6% cut to all medical services and instead of just targeting psych and physical therapy is my understanding. Initially it was just those two areas taking cuts.

From a larger perspective, I think you are going to continue to see a strengthening of the tiered system of mental health care. Cash pay was always at the top, but from what we are talking about even insurance is seeming to span between $70 and $200, which is larger than I have seen prior. For CMS in my area 90791 and 90837 are in the $140-150 range. A cut in this rate compared to what T4C ($205-215) quoted is large delta.

 

[SportsNeuroPsych]

$75-92 or so is typical insurance reimbursement per full session in my area, although Kaiser offers to funnel their overflow clientele to out of network psychologists for $60/session (I.e. try to underpay community psychologists rather than hiring more psychologists in house to meet the demand).

Medicare/Medicaid pays the highest but is likely to audit successive 90837s in my area—I was warned by another ECP not to use that code often, largely because of “overuse” of 90837 being an issue to insurance companies (just like what @Therapist4Chnge said). On top of that, you’re more likely to spend “work” time to have to deal with back and forth with insurance companies unless you hire a biller who will take care of that for you.

Aren’t CMS reimbursements dropping next year? I saw an email about that recently. One website said 7%, but APA said something like a proposed 10.6% reduced reimbursement for services.

Medicare proposals for 2021: Psychologists’ payments impacted

APA asks the Centers for Medicare and Medicaid Services to preserve and increase payments for psychological services.

www.apaservices.org

Just saw this as well - crazy.

Excuse me but WTF is this all about: "CMS is also proposing and requesting input on whether non-physician practitioners such as nurse practitioners and physician assistants should be allowed to supervise diagnostic testing including psychological and neuropsychological testing if allowed under state law and their scope of practice."

 

[foreverbull]

Just saw this as well - crazy.

Excuse me but WTF is this all about: "CMS is also proposing and requesting input on whether non-physician practitioners such as nurse practitioners and physician assistants should be allowed to supervise diagnostic testing including psychological and neuropsychological testing if allowed under state law and their scope of practice."

I also had an immediate reaction to this statement when I read it, too. NPs and PAs supervising psychological assessments? Are you kidding me?

 

[AcronymAllergy]

I also had an immediate reaction to this statement when I read it, too. NPs and PAs supervising psychological assessments? Are you kidding me?

I should just send them lists of pts who've been misdiagnosed by other psychologists, who supposedly had training in things like test construction and interpretation, statistics and psychometrics, etc. In case, you know, they're thinking there's little risk of harm.

 

[Sanman]

I should just send them lists of pts who've been misdiagnosed by other psychologists, who supposedly had training in things like test construction and interpretation, statistics and psychometrics, etc. In case, you know, they're thinking there's little risk of harm.

I'll give them testing supervision privileges if they give us prescribing rights in all 50 states. It will be a free-for-all, what could go wrong?

 

[PsySeeker]

I guess we can follow up with the 60 min code here, as unlikely as it would be for someone fully billing that, 127. 127 at 30 a week is 3810, 48 weeks of that is 182. Once again, assuming full slots all round, cancellations, no shows, etc. We're still not in psychiatry income territory.

You are in bottom tier psychiatry territory. Regardless, I thought you said 80 hours a week wouldn’t land you near 200k a few posts up? Here you are almost there at 30. Not only that some areas are higher than your rate for that code and many insurers are allowing it. BCBC sends letters like that, have since 2017. I’ve yet to here of them not paying or doing anything about it. Others don’t send letters and pay it. Also, some of us average closer to high 30s a week....

Of course all this varies by region, personal capacity, personal reputation, so on and so forth. It just doesn’t make sense to me that you hold yourself out as an expert and you’re involved with all the stuff but you make statements the contradict themselves only to roll off of them when confronted with evidence and still try to find a reason why it can’t be true. Maybe it is possible for certain people....


Also for those interested, number one code billed through a major EMR last year.

 

[beginner2011]

We work with other state associations, the issuer of insurers either auditing, not covering, or paying the same for 45 and 60 is a mostly national issue. Heck, do a google search and you'll see a good deal of this pop up. One of the many reasons why "parity" is a joke.

As for telehealth, also a mixed bag, we're currently fighting with multiple insurers who reimburse lower, or who are proposing going back to not reimbursing phone and such. It's a constant lobbying and legislative struggle.

You are in bottom tier psychiatry territory. Regardless, I thought you said 80 hours a week wouldn’t land you near 200k a few posts up? Here you are almost there at 30. Not only that some areas are higher than your rate for that code and many insurers are allowing it. BCBC sends letters like that, have since 2017. I’ve yet to here of them not paying or doing anything about it. Others don’t send letters and pay it. Also, some of us average closer to high 30s a week....

Of course all this varies by region, personal capacity, personal reputation, so on and so forth. It just doesn’t make sense to me that you hold yourself out as an expert and you’re involved with all the stuff but you make statements the contradict themselves only to roll off of them when confronted with evidence and still try to find a reason why it can’t be true. Maybe it is possible for certain people....


Also for those interested, number one code billed through a major EMR last year.

This seems to be a contentious issue. I did a brief dig to see the frequency of code usage in most recent data (2018).

Comparing 90834:90837 it's about 5:6 (5,029,571:5,879,669). So 90834 is billed at almost the same rate as 90837. Source

DESCRIPTION

HCPCS

MODIFIER

ALLOWED SERVICES

ALLOWED CHARGES

PAYMENT

MEDICINE	90834		5,029,571	$392,288,268.43	$293,899,725.96
MEDICINE	90834	TOTAL	5,029,571	$392,288,268.43	$293,899,725.96

MEDICINE	90837		5,879,669	$667,331,965.93	$504,328,109.40
MEDICINE	90837	TOTAL	5,879,669	$667,331,965.93	$504,328,109.40

 

[Sanman]

You are in bottom tier psychiatry territory. Regardless, I thought you said 80 hours a week wouldn’t land you near 200k a few posts up? Here you are almost there at 30. Not only that some areas are higher than your rate for that code and many insurers are allowing it. BCBC sends letters like that, have since 2017. I’ve yet to here of them not paying or doing anything about it. Others don’t send letters and pay it. Also, some of us average closer to high 30s a week....

Of course all this varies by region, personal capacity, personal reputation, so on and so forth. It just doesn’t make sense to me that you hold yourself out as an expert and you’re involved with all the stuff but you make statements the contradict themselves only to roll off of them when confronted with evidence and still try to find a reason why it can’t be true. Maybe it is possible for certain people....


Also for those interested, number one code billed through a major EMR last year.

180k seems very bottom tier psychiatry to me. 200/hr seems like the current minimum pay nowadays for psychiatry. That said, I have billed out more than 200k/yr (possibly more than 250k) to insurance, but I did not take close to that home. However, it was a lot of work and involved seeing 40-60/patients wk at times. 200k is definitely on the upper end of billables for a solo psychology practitioner when billing insurance.

 

[AcronymAllergy]

The more psychologists there are making 150k, 180k, or 200k/year, the better. Do I wish it would be easier to do so via standard 9-to-5 work? Yep. But the more folks pulling in that much via whatever means possible can translate into more widespread benefits for the field as a whole.

 

[Sanman]

The more psychologists there are making 150k, 180k, or 200k/year, the better. Do I wish it would be easier to do so via standard 9-to-5 work? Yep. But the more folks pulling in that much via whatever means possible can translate into more widespread benefits for the field as a whole.

More is better. The problem becomes that if you stand out too much, you just become a target for audits and added stress.

 

[AcronymAllergy]

More is better. The problem becomes that if you stand out too much, you just become a target for audits and added stress.

Yep. Which is why we all just need to start clearing 200k. Easy peasy.

 

[Sanman]

Yep. Which is why we all just need to start clearing 200k. Easy peasy.

If I wanted the headaches, I very much could do it in the future (Actually, quite easily as COVID has thrown everything for a loop and I am getting calls). Not sure it is worth it in the long-run. I am also not sure if COVID will lead to significant consolidation.

 

[AbnormalPsych]

Oh boy, I use 90837 all the time. This was interesting to hear about.

 

[WisNeuro]

You are in bottom tier psychiatry territory. Regardless, I thought you said 80 hours a week wouldn’t land you near 200k a few posts up? Here you are almost there at 30. Not only that some areas are higher than your rate for that code and many insurers are allowing it. BCBC sends letters like that, have since 2017. I’ve yet to here of them not paying or doing anything about it. Others don’t send letters and pay it. Also, some of us average closer to high 30s a week....

Of course all this varies by region, personal capacity, personal reputation, so on and so forth. It just doesn’t make sense to me that you hold yourself out as an expert and you’re involved with all the stuff but you make statements the contradict themselves only to roll off of them when confronted with evidence and still try to find a reason why it can’t be true. Maybe it is possible for certain people....


Also for those interested, number one code billed through a major EMR last year.

1, 30 billing hours is not hours worked. 2. Very few people are getting those rates for 60 minute sessions. 3. As was stated, it's still fairly short of 200k, which is pretty much the basement in terms of psychiatry salaries. Heck, even family med easily makes 225+ in a 40 hr week.

 

[WisNeuro]

This seems to be a contentious issue. I did a brief dig to see the frequency of code usage in most recent data (2018).

Comparing 90834:90837 it's about 5:6 (5,029,571:5,879,669). So 90834 is billed at almost the same rate as 90837. Source

DESCRIPTION

HCPCS

MODIFIER

ALLOWED SERVICES

ALLOWED CHARGES

PAYMENT

MEDICINE	90834		5,029,571	$392,288,268.43	$293,899,725.96
MEDICINE	90834	TOTAL	5,029,571	$392,288,268.43	$293,899,725.96

MEDICINE	90837		5,879,669	$667,331,965.93	$504,328,109.40
MEDICINE	90837	TOTAL	5,879,669	$667,331,965.93	$504,328,109.40

🙂 Billing an amount, and receiving that amount are two very different things. Also, you'd have to see 3rd party payor figures, of which I can guarantee you, many will reimburse 45 and 60 at essentially the same fee.

 

[beginner2011]

🙂 Billing an amount, and receiving that amount are two very different things. Also, you'd have to see 3rd party payor figures, of which I can guarantee you, many will reimburse 45 and 60 at essentially the same fee.

Also of note, based off those numbers, the total payment for both codes was about 75% of the total charges.

Average charge for 45m = $78, but insurance only payed an average of $58 per 45m session.

Average charge for 60m = $113, but payment was only $86 on average.

 

[PsySeeker]

It would be entry levelish according to lots of sites when I search, but you know, those numbers are aren’t always accurate.

180k seems very bottom tier psychiatry to me. 200/hr seems like the current minimum pay nowadays for psychiatry. That said, I have billed out more than 200k/yr (possibly more than 250k) to insurance, but I did not take close to that home. However, it was a lot of work and involved seeing 40-60/patients wk at times. 200k is definitely on the upper end of billables for a solo psychology practitioner when billing insurance.

 

[PsySeeker]

The more psychologists there are making 150k, 180k, or 200k/year, the better. Do I wish it would be easier to do so via standard 9-to-5 work? Yep. But the more folks pulling in that much via whatever means possible can translate into more widespread benefits for the field as a whole.

Agreed. I think too many of us are willing to work for too little. I think some folks on this board are quick to try tear down folks that share because it doesn’t fit with their experience. I never said it was common, or that it didn’t involve skill sets not taught in graduate school and not everyone possesses. It’s clearly not the straight shot it appears to be out of med school. That said, I was just sharing my experience, the reaction from some is predictably cynical here, but, as a very stupid man once said about something far more disgusting “it is what it is”.

 

[PsySeeker]

1, 30 billing hours is not hours worked. 2. Very few people are getting those rates for 60 minute sessions. 3. As was stated, it's still fairly short of 200k, which is pretty much the basement in terms of psychiatry salaries. Heck, even family med easily makes 225+ in a 40 hr week.

1. Thank you for the education. 30 hours billed is also very decidedly very much not 60 or 80 hours worked either. It’s more like mid 30 hours worked. Many people bill for and work much more than that, I can promise you.

2. Many major regional hospital insurance networks, BCBS companies, and Medicare do indeed pay those rates or higher for that code, without fuss. Perhaps this isn’t the case for all states or regions, but it most certainly is the case for some, just because apparently it isn’t the where you are does not mean it isn’t the case for others.

3. You really are a riot. First you said 80 hours worked would be grossly shy of 200k which was just pure nonsense, now you’ve pivoted to making a production over 30 billed hours, a number of hours you selected, at 60 minutes, is only 182k... Just own that you were spouting off or leave it be.

4. Try your experiment with 32 billable hours at 60 minutes and 5 at cash rates of $150. Apply a 5% no show rate. That person is working about 40 to 42 hours a week give or take a couple or so. Take off two weeks vacation, what’s their gross? Don’t like it? Think that’s too much work? Couldn’t do it yourself? Doesn’t change the number. It’s kind of like COVID in some ways. For example, I don’t like COVID. I don’t want COVID. Not everyone gets COVID. Only a relative few people that get COVID die from COVID. Alas, COVID remains unfortunately real, and just because only a small portion of those infected go on to die from it regrettably does not mean that it’s impossible for anyone to die from it, despite my very best machinations.

5. Family med doesn’t easily make that everywhere in just 40 hours worked and psychiatry often doesn’t make much more than family med...

6. While this is fun, kind of, it’s also kind of pointless. I really only intended to communicate that not all Psy.D.s are wracked with debt and saddled with low incomes. Many are, yes. Much like in my above example though that doesn’t mean that there aren’t some paths to a Psy.D. that aren’t worthwhile and it doesn’t mean that no psychologists earn reasonably good livings by primarily billing insurance.

 

[futureapppsy2]

It's much easier to live a good life on any income when you have no or little debt. Debt eats up a considerable, constant chunk of income.

 

[PsyDr]

@beginner2011

I’d encourage you to evaluate who you think is a neuropsychologist. It’s a nice blanket term, but many people on sdn are not neuropsych exclusive.

@Sanman @WisNeuro @AcronymAllergy

who cares if insurances are mad?! Document what you do correctly. Bill for what you do. Get the license number of any agent who gives you a hard time. If they “threaten” to audit you, who cares? Let them. You haven’t done anything wrong . If there’s an argument, immediately go toyour states insurance department. Here’s agent X, license number 12345. It is my my understanding that He is saying as an agent of xyz insurance that they will not honor their legal obligations. Can you look into this? I’m not an attorney?”. Get a friend with a JD to call afterwards. And make a phone call to the secretary of the CEO of that insurance company. I promise that this works with most insurance companies. I ain’t doing anything wrong, and I’m not dealing with peons.

 

[WisNeuro]

4. Try your experiment with 32 billable hours at 60 minutes and 5 at cash rates of $150. Apply a 5% no show rate. That person is working about 40 to 42 hours a week give or take a couple or so. Take off two weeks vacation, what’s their gross? Don’t like it? Think that’s too much work? Couldn’t do it yourself? Doesn’t change the number. It’s kind of like COVID in some ways. For example, I don’t like COVID. I don’t want COVID. Not everyone gets COVID. Only a relative few people that get COVID die from COVID. Alas, COVID remains unfortunately real, and just because only a small portion of those infected go on to die from it regrettably does not mean that it’s impossible for anyone to die from it, despite my very best machinations.

I never claimed someone could not do it with cash pay, I said it was very unlikely with all insurance, which is correct. Cash pay, if you can get people to pay it, people can definitely top 200k. But, with insurance rates and non-payment of those codes, unlikely in may jurisdictions.

@beginner2011

I’d encourage you to evaluate who you think is a neuropsychologist. It’s a nice blanket term, but many people on sdn are not neuropsych exclusive.

@Sanman @WisNeuro @AcronymAllergy

who cares is insurances are mad?! Document what you do correctly. Bill for what you do. Get the license number of any agent who gives you a hard time. If they “threaten” to audit you, who cares? Let them. You haven’t done anything wrong . If there’s an argument, immediately go toyour states insurance department. Here’s agent X, license number 12345. It is my my understanding that He is saying as an agent of xyz insurance that they will not honor their legal obligations. Can you look into this? I’m not an attorney?”. Get a friend with a JD to call afterwards. And make a phone call to the secretary of the CEO of that insurance company. I promise that this works with most insurance companies. I ain’t doing anything wrong, and I’m not dealing with peons.

I don't care of they're mad, we threaten legal and legislative action against them all the time 🙂

 

[deleted106747]

Just saw this as well - crazy.

Excuse me but WTF is this all about: "CMS is also proposing and requesting input on whether non-physician practitioners such as nurse practitioners and physician assistants should be allowed to supervise diagnostic testing including psychological and neuropsychological testing if allowed under state law and their scope of practice."

I can't with this. I just can't.

 

[Sanman]

@beginner2011

I’d encourage you to evaluate who you think is a neuropsychologist. It’s a nice blanket term, but many people on sdn are not neuropsych exclusive.

@Sanman @WisNeuro @AcronymAllergy

who cares if insurances are mad?! Document what you do correctly. Bill for what you do. Get the license number of any agent who gives you a hard time. If they “threaten” to audit you, who cares? Let them. You haven’t done anything wrong . If there’s an argument, immediately go toyour states insurance department. Here’s agent X, license number 12345. It is my my understanding that He is saying as an agent of xyz insurance that they will not honor their legal obligations. Can you look into this? I’m not an attorney?”. Get a friend with a JD to call afterwards. And make a phone call to the secretary of the CEO of that insurance company. I promise that this works with most insurance companies. I ain’t doing anything wrong, and I’m not dealing with peons.

It isn't so much about them being mad as the added headache for me. Optum used to hold payments until you called and completed their utilization review. Two level of phone calls spanning 2+hours of time and one person wanted me to see the patient for an updated MMSE so they could determine appropriateness after they had already withheld 3 sessions of 90832 payments. Multiply that by 12 for the clinicians I was supervising and it was a tremendous headache for not enough money in my pocket. We would stop seeing them altogether, but they recruit LTC facility patients, sign up 60 to 80% and then your contract to see patients is worthless without playing ball with them.

The VA is honestly less headache for me. Add in cash side PP and I am happy.

 

[foreverbull]

Part of what folks of higher SES have above and beyond folks from lower SES Isn’t just money, but information and connections leading to more information, experiences, and resources.

Large public universities don't do a very good job of prepping psych majors for grad school because the experience can feel impersonal compared to small private schools with more personalized attention. I’ve seen the differences having taught in a private school but having myself attended a school with 15,000 students overflowing with psychology majors—relationships were far more superficial in bigger schools, which usually translates to less mentoring and fewer opportunities. I didn’t know psychology faculty well and didn’t have classes with many of the professors, and never had one professor for more than one class (graduate teaching assistants taught many of my psych classes).

In contrast, in the private school setting, I’ve seen students form deeper connections with faculty, take multiple classes with the same faculty, and many get through their undergraduate major having taken classes with most of the faculty in a smaller department, so there is far more familiarity with the department and faculty overall. The student body is also small enough that there are many events and ways to connect with the department so that folks don’t get “lost” in the system as easily (still can happen, but not as easily). These differences may result in further academic/research opportunities and networking, as well as having more mentoring one-on-one and stronger letters of recommendation by the end, which can easily translate to real world differences in opportunity.

As someone who provided a fairly steady dose of career mentoring with private school students in addition to teaching, I realized how valuable information is at this stage for students interested in grad school, and being available to mentor undergrads who have career questions is not something that all faculty/teachers have the time for.

 

[WisNeuro]

a hazard of big schools, but one that can be overcome. Simply sign up for directed individual study. You’ll get one on one faculty exposure. Join a psych honors society. Part of the problem is people pick their majors late. but, arranging these sorts of individualized experiences is a path to success. I get a range of students who do this. Many though have parents who are physicians or professors. Especially the ones who show up as freshmen. That’s a sprinting start. It’s hard to beat that kind of inside knowledge with outsider presented education. This isn’t just SES. If your parents are in the finance world, they won’t know either.

This, or volunteer for a lab as an undergrad. I did undergrad at a large state uni, enrollment >35k undergrad. Psych labs recruited very semester for lab assistants. You could either take it for credit, or simply volunteer. Lots of time with faculty, especially if you took on more responsibility within the lab.

 

[BuckeyeLove]

Yeah I didn't have this issue and you can likely guess where I was at; a PLETHORA of opportunity. Still in touch with my undergrad mentor. I used to go to his office and we would talk guitars.

 

[WisNeuro]

Yeah I didn't have this issue and you can likely guess where I was at; a PLETHORA of opportunity. Still in touch with my undergrad mentor. I used to go to his office and we would talk guitars.

The only way your Alma Mater would have been worse is had you been a Wolverine...

 

[Sanman]

The only way your Alma Mater would have been worse is had you been a Wolverine...

Do I smell a Spartan?

 

[WisNeuro]

Do I smell a Spartan?

Why yes, that is the sweet scent of excellence wafting through your nostrils. I'm glad you can smell it, means you probably don't have the 'rona.

 

[Therapist4Chnge]

The only way your Alma Mater would have been worse is had you been a Wolverine...

*Side Eye*

 

[futureapppsy2]

Part of what folks of higher SES have above and beyond folks from lower SES Isn’t just money, but information and connections leading to more information, experiences, and resources.

Large public universities don't do a very good job of prepping psych majors for grad school because the experience can feel impersonal compared to small private schools with more personalized attention. I’ve seen the differences having taught in a private school but having myself attended a school with 15,000 students overflowing with psychology majors—relationships were far more superficial in bigger schools, which usually translates to less mentoring and fewer opportunities. I didn’t know psychology faculty well and didn’t have classes with many of the professors, and never had one professor for more than one class (graduate teaching assistants taught many of my psych classes).

In contrast, in the private school setting, I’ve seen students form deeper connections with faculty, take multiple classes with the same faculty, and many get through their undergraduate major having taken classes with most of the faculty in a smaller department, so there is far more familiarity with the department and faculty overall. The student body is also small enough that there are many events and ways to connect with the department so that folks don’t get “lost” in the system as easily (still can happen, but not as easily). These differences may result in further academic/research opportunities and networking, as well as having more mentoring one-on-one and stronger letters of recommendation by the end, which can easily translate to real world differences in opportunity.

As someone who provided a fairly steady dose of career mentoring with private school students in addition to teaching, I realized how valuable information is at this stage for students interested in grad school, and being available to mentor undergrads who have career questions is not something that all faculty/teachers have the time for.

I went to a midsize flagship state university (about 10,000 undergrad and 3,000 grad) and this wasn’t my experience at all. There were abundant undergrad research opportunities with faculty and lots of opportunities to interact with faculty personally. I even scored a paid RAship at research institute on campus as an undergrad.

 

[Sanman]

I went to a midsize flagship state university (about 10,000 undergrad and 3,000 grad) and this wasn’t my experience at all. There were abundant undergrad research opportunities with faculty and lots of opportunities to interact with faculty personally. I even scored a paid RAship at research institute on campus as an undergrad.

Same for me at a flagship state U. That said, I also think you needed to be in the fold (involved in research, psi chi, etc) to know what was going on. It certainly helped that we had a clin psych PhD program on campus.