Research career after internship?

[the_path_less_followed]

Hey all, I'm looking for some advice.

I am on internship right now, and thought my whole PhD career that I wanted to do clinical work in neuropsychology. Now that I am finally at the stage where I am doing clinical work full time, I realize that clinical work is not the way to go for me, and it would honestly feel like torture to have to do a two year clinical postdoc. I feel like I really enjoy research work and teaching/mentorship, and would be interested in a career potentially at a SLAC.

I was wondering...

Are there other sdn members here who have foregone clinical postdoctoral training to go into academia/research/teaching? What did your career trajectory look like? Did you do a research postdoc?

If you didn't do post-graduate clinical work, were you able to still get your psychology license?

I've seen a lot of clinical psychology faculty ads that prefer candidates to be licensed. I've also seen that states vary with their requirements for licensure. If you are not actually using the license in your job description/duties - does it matter if your faculty positon is in a state that is not the one you are licensed in?


Any other related advice is greatly appreciated! 🤗

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[WisNeuro]

Can you do a neuropsych postdoc that has a bigger research component? You've come this far, personally, I'd want to keep the flexibility of being board eligible, as that is a pre-requisite for many jobs at hospitals and AMCs in the neuro area.

 

[Therapist4Chnge]

I'd look to see what training people have had that are in positions I would like to be in. You might not need to bring in 6-7 figure research grants, but they'll still want you active at conferences and to demonstrate some productivity w scholarly work. Teaching and mentorship need to be positive things for applicants, and not viewed as something you need to do to get the position. I'm not sure if ppl still do teaching portfolios, but that would probably help for SLAC applications.

Foregoing a post-doc/fellowship all together is not advisable, as I'd expect most/all people applying for faculty positions would have completed one, sometimes multiple post-docs depending on the discipline. Given you are 80% of the way there with the neuropsych stuff (assuming you are competitive for neuro fellowships), you would likely help your application having that on your CV, even if you don't plan on doing a lot of clinical work. There are 50/50 fellowship positions in neuro that will provide you with more research time, but also still qualify you for boarding. There are also some research heavy fellowship spots that have left the match over the years, but I'm not sure if those are a good fit because they are probably more R1/R2 focused paths.

 

[summerbabe]

A few (possibly misguided) thoughts since I am a clinician who never had any interest in academia (but did my undergrad at a well-known SLAC).

- Did you attend a SLAC or have direct experience? As SLAC faculty, you'll be heavily geared towards teaching (I think teaching 3 undergrad courses per semester was standard at mine) and much less so towards research. I also wonder if research that fits more broadly with the typical undergrad curriculum (social, cognitive) might be more appealing to a SLAC since those are some of the most popular undergrad courses, especially if the institution will be providing research funding (versus external grants). There are obviously SLAC faculty who have external grant funding but at least at my institution, the emphasis was still placed on having 'star' faculty teach as many classes as possible since that helped to justify the tuition price tag.

- Foregoing a clinical postdoc for either a research postdoc or going directly into the academic market is definitely possible and I know peers who are currently tenure track assistant profs at a variety of institutions who have done both. 2 people who bypassed postdoc both had very robust CVs and were hired out right out of internship so your current competitiveness seems very relevant for next steps. I also know others who did multi-year research postdocs so it really depends.

- Being licensed in the state of the school is necessary to provide clinical supervision independently. There were a couple of younger unlicensed professors in my PhD program and they had to receive supervision from our training director when they taught prac (until they received their license). But licensure would be moot at a SLAC.

- Lastly, how confident are you that you aren't experiencing some version of burnout/bad internship fit/etc as opposed to having truly figured out that clinical work/full-time clinical work is not the path for you? Is it all clinical work or just neuro? Something more specific like report writing?

 

[PsyDr]

You’ll notice almost every big name in neuropsych research has a clinical license. It’s one of the things that distinguishes us from a PhD in neuroscience.

I would ask around through mentors, find a research heavy post doc, and try to come to an arrangement where your face to face research hours can be counted towards licensure.

One of my research grants was used to hire an MD who forewent residency in favor of research. Good to Excellent research credentials. We paid him $80k. His life would have been so much better if he just completed a BS residency.

 

[thebalmofhurtminds]

What are your current options - e.g., have you applied for neuropsych postdocs? Because this late in the year, it might be difficult to give advice with limited options to continue to pursue the clinical option anyway.

 

[oldneuro]

50/50 research/clinical post docs aren’t uncommon in neuro. That way you can get licensed and boarded but still keep up with research. Seems like the best option when it comes to keeping all your doors open.

 

[cara susanna]

I did a research post doc and now have a clinical job.

 

[the_path_less_followed]

Thanks for your replies everyone!

This advice has definitely solidified my choice to make sure I pursue a postdoc afterwards. It was also helpful to know that as clinical psych faculty you may very likely have the responsibility of supervising practicum students which is why the license is beneficial to have (and to get the license in the state you are teaching in).

I'm taking the year after internship to finish my dissertation before I apply for postdocs. So the advice would be applicable for the next application cycle.

A few (possibly misguided) thoughts since I am a clinician who never had any interest in academia (but did my undergrad at a well-known SLAC).

- Did you attend a SLAC or have direct experience? As SLAC faculty, you'll be heavily geared towards teaching (I think teaching 3 undergrad courses per semester was standard at mine) and much less so towards research. I also wonder if research that fits more broadly with the typical undergrad curriculum (social, cognitive) might be more appealing to a SLAC since those are some of the most popular undergrad courses, especially if the institution will be providing research funding (versus external grants). There are obviously SLAC faculty who have external grant funding but at least at my institution, the emphasis was still placed on having 'star' faculty teach as many classes as possible since that helped to justify the tuition price tag.

- Foregoing a clinical postdoc for either a research postdoc or going directly into the academic market is definitely possible and I know peers who are currently tenure track assistant profs at a variety of institutions who have done both. 2 people who bypassed postdoc both had very robust CVs and were hired out right out of internship so your current competitiveness seems very relevant for next steps. I also know others who did multi-year research postdocs so it really depends.

- Being licensed in the state of the school is necessary to provide clinical supervision independently. There were a couple of younger unlicensed professors in my PhD program and they had to receive supervision from our training director when they taught prac (until they received their license). But licensure would be moot at a SLAC.

- Lastly, how confident are you that you aren't experiencing some version of burnout/bad internship fit/etc as opposed to having truly figured out that clinical work/full-time clinical work is not the path for you? Is it all clinical work or just neuro? Something more specific like report writing?

This information in particular was super helpful for me!

I went to a SLAC (that is now slowly turning into an R2 institution) and loved the atmosphere there! I definitely love teaching, so the 3/3 would be right up my alley. And I heard that if you can bring in a research grant, you can buy out some of the teaching time to do a 2/2 instead. I also would prefer to be on soft money. I have some research productivity, but not at the rockstar level yet lol. So I would likely need a research postdoc.

To your last point - that is definitely important to consider. I matched at a site that had a very poor fit (tbh I was very surprised I matched there on match day). I'm also pretty burned out at this stage. I actually enjoy some of the therapy work I am doing on internship, but at this point a lot of the assessment work I am doing is a bit rote/understimulating at times and feels like it lacks meaning.

I did a research post doc and now have a clinical job.

I am very curious to know about your path to your current career. Did you do clinically oriented work at your research postdoc?


Lastly, if I ended up at a 100% research postdoc and got the clinical hours through assessing clinical research participants, would the responsibilities look the same as if I was seeing the patients in a clinical environment? (i.e., interview, testing, report writing, feedback?)

 

[cara susanna]

Thanks for your replies everyone!

This advice has definitely solidified my choice to make sure I pursue a postdoc afterwards. It was also helpful to know that as clinical psych faculty you may very likely have the responsibility of supervising practicum students which is why the license is beneficial to have (and to get the license in the state you are teaching in).

I'm taking the year after internship to finish my dissertation before I apply for postdocs. So the advice would be applicable for the next application cycle.


This information in particular was super helpful for me!

I went to a SLAC (that is now slowly turning into an R2 institution) and loved the atmosphere there! I definitely love teaching, so the 3/3 would be right up my alley. And I heard that if you can bring in a research grant, you can buy out some of the teaching time to do a 2/2 instead. I also would prefer to be on soft money. I have some research productivity, but not at the rockstar level yet lol. So I would likely need a research postdoc.

To your last point - that is definitely important to consider. I matched at a site that had a very poor fit (tbh I was very surprised I matched there on match day). I'm also pretty burned out at this stage. I actually enjoy some of the therapy work I am doing on internship, but at this point a lot of the assessment work I am doing is a bit rote/understimulating at times and feels like it lacks meaning.


I am very curious to know about your path to your current career. Did you do clinically oriented work at your research postdoc?


Lastly, if I ended up at a 100% research postdoc and got the clinical hours through assessing clinical research participants, would the responsibilities look the same as if I was seeing the patients in a clinical environment? (i.e., interview, testing, report writing, feedback?)

My research post doc was 25% clinical. I was in a VA research post doc with the hopes of a research career, but as I learned the reality of it (basically applying for grants, doing the study, and applying for another grant while doing that study, rinse and repeat) I decided it wasn't for me. First, I was enjoying clinical work more than I thought I would; I was in a specialty trauma clinic and learned that I really enjoyed clinical work if it was within that specific area. Second, I didn't want to be on the hamster wheel of continuously applying for grants. Third, I just wanted stability, like not having my future or even where I'd be living so up in the air.

 

[bcliff]

Thanks for your replies everyone!

This advice has definitely solidified my choice to make sure I pursue a postdoc afterwards. It was also helpful to know that as clinical psych faculty you may very likely have the responsibility of supervising practicum students which is why the license is beneficial to have (and to get the license in the state you are teaching in).

I'm taking the year after internship to finish my dissertation before I apply for postdocs. So the advice would be applicable for the next application cycle.


This information in particular was super helpful for me!

I went to a SLAC (that is now slowly turning into an R2 institution) and loved the atmosphere there! I definitely love teaching, so the 3/3 would be right up my alley. And I heard that if you can bring in a research grant, you can buy out some of the teaching time to do a 2/2 instead. I also would prefer to be on soft money. I have some research productivity, but not at the rockstar level yet lol. So I would likely need a research postdoc.

To your last point - that is definitely important to consider. I matched at a site that had a very poor fit (tbh I was very surprised I matched there on match day). I'm also pretty burned out at this stage. I actually enjoy some of the therapy work I am doing on internship, but at this point a lot of the assessment work I am doing is a bit rote/understimulating at times and feels like it lacks meaning.


I am very curious to know about your path to your current career. Did you do clinically oriented work at your research postdoc?


Lastly, if I ended up at a 100% research postdoc and got the clinical hours through assessing clinical research participants, would the responsibilities look the same as if I was seeing the patients in a clinical environment? (i.e., interview, testing, report writing, feedback?)

Look for fellowships with tech/psychometrist support if you're feeling burned out on testing administration...

Once you start working with psychometrists, clinical neuropsychology tends to develop a more research-y feel to it (e.g., hypothesis generation, data collection, data analysis, conceptualization, writing, etc.). I enjoy conducting interviews and giving feedback, so that being the bulk of my face-to-face patient interaction works well for me. I had similar ambivalence about continuing my clinical training in neuropsychology, albeit at a slightly earlier stage (post-internship match day; before starting internship). I felt overwhelmed by the idea of having to spend an additional 3 years in clinical training. Now, on the other side, I'm very happy with my decision to complete internship and fellowship training in neuropsychology. I imagine my clinical burnout would have continued to escalate if I hadn't had the opportunity to start working almost entirely with psychometrists on fellowship, although I did end up liking internship (without psychometrist support) more than I had initially anticipated.

ETA: Look at the SF VA and Salisbury VA MIRECCs (links added)... I'm not sure how they do it, but they claim to offer HCG compliant fellowship training with very few clinical responsibilities. I personally wanted more robust clinical training on fellowship, but I've worked with alumni from those fellowship programs, both of whom were highly competent.

 

[WisNeuro]

Look for fellowships with tech/psychometrist support if you're feeling burned out on testing administration...

Once you start working with psychometrists, clinical neuropsychology tends to develop a more research-y feel to it (e.g., hypothesis generation, data collection, data analysis, conceptualization, writing, etc.). I enjoy conducting interviews and giving feedback, so that being the bulk of my face-to-face patient interaction works well for me. I had similar ambivalence about continuing my clinical training in neuropsychology, albeit at a slightly earlier stage (post-internship match day; before starting internship). I felt overwhelmed by the idea of having to spend an additional 3 years in clinical training. Now, on the other side, I'm very happy with my decision to complete internship and fellowship training in neuropsychology. I imagine my clinical burnout would have continued to escalate if I hadn't had the opportunity to start working almost entirely with psychometrists on fellowship, although I did end up liking internship (without psychometrist support) more than I had initially anticipated.

ETA: Look at the SF VA and Salisbury VA MIRECCs (links added)... I'm not sure how they do it, but they claim to offer HCG compliant fellowship training with very few clinical responsibilities. I personally wanted more robust clinical training on fellowship, but I've worked with alumni from those fellowship programs, both of whom were highly competent.

I would caveat this somewhat. If you do not have a TON of admin experience, administration is pretty valuable as long as you're getting a breadth of patient types in. It can be very important to see different presentations and to learn how to test limits outside of standard test admin. I know too many providers who actually do not know how tests are even administered anymore, and do not know how to adequately add or subtract tests from a battery depending on what the patient is doing. Only way to do this is still have hands on testing experience.

 

[bcliff]

I would caveat this somewhat. If you do not have a TON of admin experience, administration is pretty valuable as long as you're getting a breadth of patient types in. It can be very important to see different presentations and to learn how to test limits outside of standard test admin. I know too many providers who actually do not know how tests are even administered anymore, and do not know how to adequately add or subtract tests from a battery depending on what the patient is doing. Only way to do this is still have hands on testing experience.

Sure, I guess.

The flip side is that it's also important to become proficient (and efficient) in conceptualizing cases without the luxury of 3-5h of in-vivo patient interaction and observation. I think it's better to gain that skillset in a training environment than to try and wing it post-fellowship. I would rather refamiliarize myself with the nuts and bolts of testing administration than to try and build that repertoire from scratch without supervision post-fellowship.

To that point, I would argue that the 80% research-oriented MIRECCs that still somehow generate board eligible neuropsychologists are probably a bigger threat to that level of proficiency/skill than whether or not a fellow is administering their own tests on an 80-100% clinical fellowship.

 

[WisNeuro]

Sure, I guess.

The flip side is that it's also important to become proficient (and efficient) in conceptualizing cases without the luxury of 3-5h of in-vivo patient interaction and observation. I think it's better to gain that skillset in a training environment than to try and wing it post-fellowship. I would rather refamiliarize myself with the nuts and bolts of testing administration than to try and build that repertoire from scratch without supervision post-fellowship.

To that point, I would argue that the 80% research-oriented MIRECCs that still somehow generate board eligible neuropsychologists are probably a bigger threat to that level of proficiency/skill than whether or not a fellow is administering their own tests on an 80-100% clinical fellowship.

I mean, you should already be doing this in your chart review and supervision prior to seeing a case, it's not mutually exclusive.

 

[bcliff]

I mean, you should already be doing this in your chart review and supervision prior to seeing a case, it's not mutually exclusive.

I meant learning how to write a report for a patient with whom your only interaction was the interview (as opposed to the hours spent administering the testing). My thought is that learning how to delegate and communicate with psychometry is an important skill that often isn't possible to really start acquiring until at least fellowship. My next thought is that most competitive applicants neuropsychology fellowship likely already have hundreds of testing administration hours under their belts.

 

[roryportman]

Look for fellowships with tech/psychometrist support if you're feeling burned out on testing administration...

Once you start working with psychometrists, clinical neuropsychology tends to develop a more research-y feel to it (e.g., hypothesis generation, data collection, data analysis, conceptualization, writing, etc.). I enjoy conducting interviews and giving feedback, so that being the bulk of my face-to-face patient interaction works well for me. I had similar ambivalence about continuing my clinical training in neuropsychology, albeit at a slightly earlier stage (post-internship match day; before starting internship). I felt overwhelmed by the idea of having to spend an additional 3 years in clinical training. Now, on the other side, I'm very happy with my decision to complete internship and fellowship training in neuropsychology. I imagine my clinical burnout would have continued to escalate if I hadn't had the opportunity to start working almost entirely with psychometrists on fellowship, although I did end up liking internship (without psychometrist support) more than I had initially anticipated.

ETA: Look at the SF VA and Salisbury VA MIRECCs (links added)... I'm not sure how they do it, but they claim to offer HCG compliant fellowship training with very few clinical responsibilities. I personally wanted more robust clinical training on fellowship, but I've worked with alumni from those fellowship programs, both of whom were highly competent.

what percentage of fellowships actually have tech/psychometry support? very broadly, is it a minority of sites, or do most fellowships have the support?

maybe it was just the sites I interviewed with, but very few had tech/psychometry/grad trainees available to do testing for fellows

 

[bcliff]

what percentage of fellowships actually have tech/psychometry support? very broadly, is it a minority of sites, or do most fellowships have the support?

maybe it was just the sites I interviewed with, but very few had tech/psychometry/grad trainees available to do testing for fellows

No clue what percentage of sites have this support, but I only seriously considered sites that offered it.

 

[WisNeuro]

No clue what percentage of sites have this support, but I only seriously considered sites that offered it.

I get that, but there are a lot of great sites that do not employ psychometrists. So I can see it as a consideration, but you're also throwing out a lot of great training opportunities by eliminating them.

 

[bcliff]

I get that, but there are a lot of great sites that do not employ psychometrists. So I can see it as a consideration, but you're also throwing out a lot of great training opportunities by eliminating them.

Sure -- Different strokes for different folks. I matched to an APPCN program at a major academic medical center with full psychometrist support... No regrets on my end. No judgment on my end either for folks who make different decisions about their training.