Questions About USUHS - Clinical Psych

[PsychLu]

Hi everyone,

I am going to be applying to multiple clinical psych PhD programs, but USUHS is my top pick. I have been trying to look up information about it on SDN, but whenever it's brought up it always seems to be by medical doctors and not psychologists. I wanted to get a clinical psych perspective.

I was wondering if anyone could provide some insight on what the interview is like?

Also, I will be applying to AF, but I have no previous military experience....will that negatively impact my chances?

What is it like after graduation (duties - what officer responsibilities do military psychologists have?/daily life/jobs - obviously therapy, but what else? personnel screening?)?

Finally, are there any psych specific cons I should be considering? I know the general ones (bad pay compared to civilian, deployment, having to move, how it impacts family life) and I've heard the MD ones (such as difficulty sub-specializing ie. ob vs. er vs. cardiology etc.) but are there psych ones I should be aware of? I'm not in it for the money (all the other programs I'm applying to are fully funded), I don't care where I live or if I have to move around, I don't plan to ever have children or get married, I like routine, and I don't mind the fitness aspect (I've lost 20lbs in preparation). The normal reasons people provide to advise against going into the military don't apply to me. However, I want to know if there's some psych-related drawbacks that I haven't yet considered or seen discussed.

Thank you in advance to anyone who can help - I know this is a lot of questions.

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[forcefive17]

More than likely you haven't heard about clinical psychology USUHS folks because they're unicorns. It is an extremely competitive program. I can't speak to the Air Force, as it's not my branch, but I can imagine there are some generalities. Within the Army, they accept 3 students per year. Generally, these students have some experience with the military. For example, in my cohort year, the students from USUHS had 25 years of military service combined in branches of the Army that the Army cares about (not medical).

I think you have some misconceptions, at least regarding finances. At USUHS, you come in as an active duty Captain. Add in your base pay ($4051), basic allowance for housing($2745), and basic allowance for subsistence ($250ish) in the DC metro area and you're looking at a pretty incredible stipend of $84,552/year just for attending school. Add in some free health care and specialty pay once licensed ($5,000/year). Now, this will level out as you gain experience in the field, but IMHO for someone just starting out, the compensation is excellent.

The cons may be branch specific. From an Army perspective:
1. Bureaucracy and loss of freedom relative to your ability to practice when/where/how you want. Make friends with EBTs as you will not do long-term therapy. Further, your "boss" who impacts your ability to promote may not even be someone within your field. It's commonplace to have social workers outrank psychologists. Further, the individual who rates your performance and creates performance objectives for you will outrank you, yet may have a degree in something like business management. As you progress, you lose your ability to focus on patient care. Once you achieve the rank of Major, you will become a staff officer with less than 10% of your time devoted to psychotherapy. This leads to point 2.

2. Your job is the mission. As psychologists, we're taught to focus on patient care and that health and well-being are the priority. In the military healthcare system, the focus is on resilience and mission readiness. Did you diagnose a patient with Bipolar-II, Bulimia, or gender dysphoria? Great! Your job is to assist their commander in getting them of the military, due to a loss of fitness for duty.

3. Day-to-day life is not therapy and you will not work in a big medical center. You will maintain a caseload, but your time spent in the clinic with be 20 hours or less per week. Your job is to be where the soldiers are. Your job is also to further the mission of the command you serve. The other 20 + hours will be spent in meetings with commanders and others who have an interest in the health and well-being of your unit. If you have an interest in assessment, that will serve you well. A lot of the work is I/O and personnel selection and screening. Psych slots currently are focused on war-fighting units and away from hospitals or large clinics.

 

[WisNeuro]

So, essentially take everything that is terrible about the military, shift out some clinical time with even more admin BS, and you have the Med Corps. Hard pass.

I actually considered Med Corps, but after talking to several Neuropsychs in the military, was wholeheartedly convinced I would hate it. Point #1 would be my main sticking point.

 

[PsyDr]

I've had some contact with some colleagues in the military and NHSC over the years. The thing I found interesting from the DoD ones was that they don't really treat severe cases, because those get kicked out of the military.

 

[PsychLu]

More than likely you haven't heard about clinical psychology USUHS folks because they're unicorns. It is an extremely competitive program. I can't speak to the Air Force, as it's not my branch, but I can imagine there are some generalities. Within the Army, they accept 2 students per year. Generally, these students have some experience with the military. For example, in my cohort year, the students from USUHS had 25 years of military service combined in branches of the Army that the Army cares about (not medical).

I think you have some misconceptions, at least regarding finances. At USUHS, you come in as an active duty Captain. Add in your base pay ($4051), basic allowance for housing($2745), and basic allowance for subsistence ($250ish) in the DC metro area and you're looking at a pretty incredible stipend of $84,552/year just for attending school. Add in some free health care and specialty pay once licensed ($5,000/year). Now, this will level out as you gain experience in the field, but IMHO for someone just starting out, the compensation is excellent.

The cons may be branch specific. From an Army perspective:
1. Bureaucracy and loss of freedom relative to your ability to practice when/where/how you want. Make friends with EBTs as you will not do long-term therapy. Further, your "boss" who impacts your ability to promote may not even be someone within your field. It's commonplace to have social workers outrank psychologists. Further, the individual who rates your performance and creates performance objectives for you will outrank you, yet may have a degree in something like business management. As you progress, you lose your ability to focus on patient care. Once you achieve the rank of Major, you will become a staff officer with less than 10% of your time devoted to psychotherapy. This leads to point 2.

2. Your job is the mission. As psychologists, we're taught to focus on patient care and that health and well-being are the priority. In the military healthcare system, the focus is on resilience and mission readiness. Did you diagnose a patient with Bipolar-II, Bulimia, or gender dysphoria? Great! Your job is to assist their commander in getting them of the military, due to a loss of fitness for duty.

3. Day-to-day life is not therapy and you will not work in a big medical center. You will maintain a caseload, but your time spent in the clinic with be 20 hours or less per week. Your job is to be where the soldiers are. Your job is also to further the mission of the command you serve. The other 20 + hours will be spent in meetings with commanders and others who have an interest in the health and well-being of your unit. If you have an interest in assessment, that will serve you well. A lot of the work is I/O and personnel selection and screening. Psych slots currently are focused on war-fighting units and away from hospitals or large clinics.

Thank you so much for replying and providing such a comprehensive answer.

Do you think admission is so skewed towards military experience as to be a barrier? I am applying to other programs and considering doing HPSP too as I think I would have better chances that way. But I really feel like USUHS is the best way to go when you want an actual career as a military psychologist. HPSP seems a little military lite.

Oh I know the finances are good as a student (although I wasn't aware they were that good) but I've heard once you're actually licensed, your pay compared to civilian psychologists is slightly less. Is that wrong?

I appreciate you making the cons so clear. While I'm not pleased by how uneven the balance is between officer vs. psychologist duties, I don't think it would bother me too much. I have considered going into the military most of my life (my father is a vet), so I'm not exactly unhappy doing more traditional military things. I wouldn't mind doing personnel selection and screening.

Are most military psychologists deployed then?

 

[PsychLu]

So, essentially take everything that is terrible about the military, shift out some clinical time with even more admin BS, and you have the Med Corps. Hard pass.

I actually considered Med Corps, but after talking to several Neuropsychs in the military, was wholeheartedly convinced I would hate it. Point #1 would be my main sticking point.

I think you have to really want to be in the actual military. I was reading the threads on USUHS that were by medical doctors, and they were so unhappy. But most of the things they were talking about being dissatisfied with were...pretty standard military things. Like, I expect going in that I'm going to have to deploy and follow orders and relocate. It's not a job for people who value personal freedom or individuality.

 

[WisNeuro]

I think you have to really want to be in the actual military. I was reading the threads on USUHS that were by medical doctors, and they were so unhappy. But most of the things they were talking about being dissatisfied with were...pretty standard military things. Like, I expect going in that I'm going to have to deploy and follow orders and relocate. It's not a job for people who value personal freedom or individuality.

I think one of the bigger problems is that it's not a good job for people who actually spent the years of training to practice psychology, considering you are doing very little of what we are trained to do, and when you do, you are performing it in an ethical grey area.

 

[forcefive17]

Thank you so much for replying and providing such a comprehensive answer.

Do you think admission is so skewed towards military experience as to be a barrier? I am applying to other programs and considering doing HPSP too as I think I would have better chances that way. But I really feel like USUHS is the best way to go when you want an actual career as a military psychologist. HPSP seems a little military lite.

Oh I know the finances are good as a student (although I wasn't aware they were that good) but I've heard once you're actually licensed, your pay compared to civilian psychologists is slightly less. Is that wrong?

I appreciate you making the cons so clear. While I'm not pleased by how uneven the balance is between officer vs. psychologist duties, I don't think it would bother me too much. I have considered going into the military most of my life (my father is a vet), so I'm not exactly unhappy doing more traditional military things. I wouldn't mind doing personnel selection and screening.

Are most military psychologists deployed then?

Everything I know about USU is anecdotal, as I didn't even attempt to apply there. I would think that an admissions committee would look at a candidate more favorably if they had 10 years of combat unit experience, deployments, etc. vs. someone who has a family member who has served. As with most things in the government, they're most likely assessing who has the greatest capacity to commit to the Armed Forces for a career. It's understandable as retention is difficult in .mil psychology.

HPSP is definitely "military lite" in that students are not active duty and the military expects a complete focus on school. That doesn't really matter in the grand scheme of things, though. I did HPSP and I'm thankful for that. It allowed me to attend a civilian program where I learned about other healthcare systems and insurance companies, was exposed a wide variety of theoretical orientations, and had diverse practica experiences with diverse patient populations. USU prepares students for military work, in military facilities, with military people. It is a generalist program, and an excellent one at that (see their outcomes RE: EPPP, Internship). I personally value wider exposure, though, and internship/post-doc prepared me to work within the military just fine.

As I'm still early-career, I'm not sure. I can tell you that I made a lot more than my peers on internship, post doc, and first year out. I imagine it'll level out eventually.

Regarding deployment: Most are not actively deployed, no. As psychologists, we belong to specific units. Military psychologists oversee the mental health and well being of the unit. Therefore, your office may be in a small clinic where the unit is.

I didn't really speak about the pros of military medicine. Again, may be branch specific:

1. Benefits: Base pay, BAH, BAS, Licensure Pay ($5,000/year), Board-Cert Pay ($5,000/year), free health care, tax-free shopping, and bumps in pay every 2 years + a raise at the beginning of the fiscal year. Other incentives include: guaranteed post-doc, free EPPP materials and support, licensure reimbursement, 30 days paid leave per year + all federal holidays, and possible student loan repayment up to 120,000. The last one changes depending on the federal budget. Additionally, the Army offers robust fellowships that are APA-accredited or working towards it. These include: Child, Adolescent and Pediatrics, Clinical Health, Clinical Neuropsychology, Forensic, and an I/Oish focused (can't remember the name of it right now). Most are two years and you're in student-status.

Caveat of fellowship: As wis and others in military medicine forums state: Just because you have completed a fellowship and are board certified does not mean that you work solely within this specialty. Fellowship is an incentive which requires an additional contract. I would imagine it would be tough being an ABCN-certified neuropsychologist that is expected to complete mental status exams and PAIs to determine fitness for duty.

I think you have to really want to be in the actual military. I was reading the threads on USUHS that were by medical doctors, and they were so unhappy. But most of the things they were talking about being dissatisfied with were...pretty standard military things. Like, I expect going in that I'm going to have to deploy and follow orders and relocate. It's not a job for people who value personal freedom or individuality.

Agreed with the above. However, a main component of our field is assisting others to develop their personal freedom/individuality. That's part of the ethical grey area mentioned above.

I've had some contact with some colleagues in the military and NHSC over the years. The thing I found interesting from the DoD ones was that they don't really treat severe cases, because those get kicked out of the military.

That's accurate. By definition, to be eligible for service, individuals have to be healthy. The interaction between diathesis-stress will occur during basic training when 18-24 year old minds are maxed out. It should be noted that we do support service members who develop severe and persistent mental illness, like psychosis, while in the military. Further, we as psychologists don't participate in stress-inducement. We also provide referrals and have case management to assist with the transition to civilian life. It is ethically grey in that on one hand, we support service members. On the other, we support their command with removing them from service. Gets tricky.

I think one of the bigger problems is that it's not a good job for people who actually spent the years of training to practice psychology, considering you are doing very little of what we are trained to do, and when you do, you are performing it in an ethical grey area.

Agreed. If people believe that therapy is the main focus of what a psychologist should do, the military is probably not for them. I will say that I've found an interest in other areas of the field to include consulting, recruitment, performance measurement, and human factors. Granted, that's not the most clinical thing in the world, which I fully recognize.