Rehab Psych Competitiveness

[PsyDuck90]

Hi all,

I'm wondering how competitive rehab psych internships are. I am at a rehab/health psych externship right now, and I really love it and feel like this is something I want to do going forward. The problem is that I am applying for internship next year (cycle after this one). I'm going to try to get another relevant practicum experience for next year as well, but I'm worried about how competitive the subfield is. I originally came into grad school thinking I wanted to work with trauma/PTSD and have extensive experience working with intimate partner violence, so this is kind of a shift. Also, I don't have a whole ton of neuropsych assessment experience, but I will get some in my current placement. Since rehab and neuro are often talked about as closely linked, do internships expect a similar intervention/assessment ratio for rehab psych sites as they do for neuro?

For those of you who are rehab psychologists, is there anything in particular that you know internship sites are looking for in strong applicants? I'm just trying to figure out if this is a hopeful pipe dream at this point or if there are things I can do within this next year to make myself a better applicant.

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[summerbabe]

What rehab setting were you in that you really enjoyed?

I'm not a rehab psychologist so this is based on doing rehab rotations during my VA internship and VA postdoc (blind rehab, spinal cord, residential polytrauma) and my general observations so take this with a grain of salt.

Internship is primarily focused on general competencies. Even with sites that offer tracks, the majority of your clinical time could still occur outside of your track. At my postdoc site, the interns had 'tracks' but it really just meant they were guaranteed at least one rotation in their track but some would still end up doing 2 major rotation experiences outside their track and 1 in their track. In an internship without tracks, not everybody can be guaranteed every rotation they want due to demand and available supervision so you do leave more up to chance.

I would look really carefully at brochures for internship sites at major hospitals and VAs that list rehab rotations that interest you since these settings are most likely to have the resources to offer quality rehab training. I also imagine your application will be most likely judged on overall competitiveness and fit, rather than subject to subtype competitiveness. I would also try to confirm with those sites that these rehab rotations are likely to be offered in your internship year during interviews.

Postdoc would be a great time to specialize more although from my experiences, staff psychologists in the VA rehab settings I've worked in didn't necessarily have extensive internship/postdoc/career rehab experiences (not sure how this applies to other settings). Some had health psych backgrounds, some had neuro backgrounds (but not board certified), and some just move around the VA system. This won't apply to rehab jobs that require board certified neuropsychologists but a robust program would hopefully have funding for both more generalist rehab psychologists and neuropsychs (if that's relevant to the setting).

 

[PsyDuck90]

What rehab setting were you in that you really enjoyed?

I'm not a rehab psychologist so this is based on doing rehab rotations during my VA internship and VA postdoc (blind rehab, spinal cord, residential polytrauma) and my general observations so take this with a grain of salt.

Internship is primarily focused on general competencies. Even with sites that offer tracks, the majority of your clinical time could still occur outside of your track. At my postdoc site, the interns had 'tracks' but it really just meant they were guaranteed at least one rotation in their track but some would still end up doing 2 major rotation experiences outside their track and 1 in their track. In an internship without tracks, not everybody can be guaranteed every rotation they want due to demand and available supervision so you do leave more up to chance.

I would look really carefully at brochures for internship sites at major hospitals and VAs that list rehab rotations that interest you since these settings are most likely to have the resources to offer quality rehab training. I also imagine your application will be most likely judged on overall competitiveness and fit, rather than subject to subtype competitiveness. I would also try to confirm with those sites that these rehab rotations are likely to be offered in your internship year during interviews.

Postdoc would be a great time to specialize more although from my experiences, staff psychologists in the VA rehab settings I've worked in didn't necessarily have extensive internship/postdoc/career rehab experiences (not sure how this applies to other settings). Some had health psych backgrounds, some had neuro backgrounds (but not board certified), and some just move around the VA system. This won't apply to rehab jobs that require board certified neuropsychologists but a robust program would hopefully have funding for both more generalist rehab psychologists and neuropsychs (if that's relevant to the setting).

Thank you so much for your response! The rehab setting is an acute inpatient hospital, and I mainly work with stroke/spinal cord injury patients, as well as some people with Parkinson's Disease, Multiple Sclerosis, and post-operative surgeries such as hip fractures and such.

I know there are some internships like Rusk (NYU Langone) that are labeled as primarily rehab, but I'll definitely be digging deeper into various VAs and other hospitals to see who else offers rehab rotations. Fortunately, I won't be geographically restricted for internship.

That's also an excellent point about making sure the track is going to be offered. It doesn't look like COVID is going away anytime soon, and I know so many sites have had to drop rotations and specific training opportunities due to logistics around COVID. It's a crazy time to be in training, so I can only imagine the craziness on the other end.

 

[summerbabe]

I know there are some internships like Rusk (NYU Langone) that are labeled as primarily rehab, but I'll definitely be digging deeper into various VAs and other hospitals to see who else offers rehab rotations.

Every VA is required to offer some type of spinal cord service. Many are only outpatient but some larger VAs also have robust inpatient services. My current VA only offers outpatient SC and doesn't employ a psychologist so we can't offer this as a training experience.

You're more likely to see CLC (Community Living Center) rotations but some only focus on palliative care and long-term nursing needs. But some VAs with larger CLC facilities also include shorter term med rehab while other VAs keep rehab on medicine floors that usually don't employ psychologists. In short, everything varies and what you may find at one VA training program may not translate for others.

I identify as a generalist and can't ever see myself working in 1 type of setting for my whole career so I prioritized getting varied training experiences, which is how I ended up exploring rehab psych and could very well see myself working in a med rehab setting later in my career. Internship is your last required 'free' opportunity to try totally new things with good supervision before the more limiting components of full-time employment kicks in haha!

 

[telemental90]

I am a rehab psych postdoc at an AMC. Also attended an internship with a major rehab psych focus. It can vary greatly depending upon the site what they may prefer, but in my experience prior to internship, I had a great deal of health psych training and a decent base of assessment experience. I did not necessarily have an even split between intervention and assessment. I would not have been competitive for the more Neuro-rehab positions for internship, but I was adequately competitive for the more generalist rehab positions with a splash of neuro, if that makes sense. If you’re doing a neuropsych practicum soon then you’ll be setting yourself up well in general.

Feel free to shoot me a message if you want to talk more I’d have further questions.