PhD/PsyD switching from research to clinical focus on/after internship

[temppsych123]

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Apologies in advance for length...

I came into grad school loving research, chose to work with a research-focused advisor whose students have typically gone on to A&S academic careers, and spent all of grad school heavily invested in the idea of having a full-time research career myself. I thought I would enjoy clinical work when I started grad school, but ultimately found it frustrating in many of my practica placements, where I would be working with few patients at a time, or only working with them for brief periods, in a way that didn't feel useful. I applied to research-focused internships and matched to an outstanding site that is heavily invested in training researchers. I've told all my friends and family that I love research, I want to do it forever, and all this grad school pain is worth it to get to where I want to be. I'm also, objectively speaking, really good at research; I've been told by reputable people that I can have an academic career if I want it.

Now, I'm on internship, and...I don't know anymore. I enjoy my daily clinical work much more than my research work, which could be attributable to a variety of different factors. I'm getting to be more independent about my clinical work now, which I like; I'm able to have more control over the types of settings I'm in and the patients I see, which is also nice. I think I am a really good clinician (and feedback from supervisors supports this belief). I genuinely care about my patients, but I don't "take my work home" with me the way I do with research. With papers, data analyses, grant writing, etc., I *always* feel (and have felt throughout grad school) that I'm never doing enough; with my clinical work, I prepare, I do what I need to do, I come home, and I get to be a real human for awhile without a lingering guilt cloud over my head. Also, obviously, it's internship, so squeezing in time to do research on top of the clinical stuff would be hard for even the most research-focused person.

I'm having a hard time figuring out what I want, in part because I've never seriously considered a primarily clinical career before, but also because I don't really have people I can talk through this issue with - anyone at my research-focused site would be aghast at me talking about my concerns, and it would definitely have an impact on my ability to stay on at the site in the future if I decided I want to stay in research. Friends and family can be supportive to some extent, but they don't really understand what I'm talking about when I hash out the pros and cons of an A&S tenure-track position, a soft-money research job at an AMC, a split research/clinical position at a hospital, etc. On the one hand, if I leave the research field now, it's incredibly hard/impossible to come back in the future, so I don't want to shoot myself in the foot if my current feelings turn out to be a passing fad. BUT, I also don't know that I should keep slogging through doing research that I find incredibly stressful and demoralizing for the sake of "well what if I regret it later???".

So, I turn to you, dear SDN brethren! Help!

 

[DynamicDidactic]

Do what you are most best at, usually that leads to the best outcomes.

 

[Therapist4Chnge]

Friends and family can be supportive to some extent, but they don't really understand what I'm talking about when I hash out the pros and cons of an A&S tenure-track position, a soft-money research job at an AMC, a split research/clinical position at a hospital, etc.

Family may never understand what's involved (I gave up long ago trying to explain what I do)....so I'd rec looking locally/regionally for a peer consultation group. You could also contact your state psych association to see if they have any groups/gatherings.

You should also consider looking for a couple different mentors as you get established. It's strongly recommended (I'd argue imperative) if you are in an AMC setting bc it's easy to get lost and look up five years later and you are just treading water.

On the one hand, if I leave the research field now, it's incredibly hard/impossible to come back in the future, so I don't want to shoot myself in the foot if my current feelings turn out to be a passing fad. BUT, I also don't know that I should keep slogging through doing research that I find incredibly stressful and demoralizing for the sake of "well what if I regret it later???".

That's a legit concern.

I'm at an AMC and i'm involved w research, but I don't run my own lab. There can be some nice opportunities to collaborate, but I am a clinician first and buy out time as funding allows. Doing it the other way around has a host of other considerations. Hopefully some of our research-heavy folks can chime in.

 

[Ollie123]

What do/did you like about research? I think that will inform this discussion.

Some of it is also about autonomy. I fully agree that one of the challenges with research is the fact that you can "always" be doing more of it. One consideration is that a faculty job might actually take some of the pressure off since it will allow you to dictate where/when/how/etc. I'm junior faculty in an AMC and 60% research/40% clinical right now (soon to be 80/20). I'm working crazy hard, but I'm able to draw slightly better boundaries than I was in graduate school. Part of that is because I have more autonomy and am not beholden to others as much, part of that is just experience.

Another consideration is to what extent research just feels burdensome right now BECAUSE you are on internship. I hated it on internship too because I was just trying to do too much (of course, I also hated my clinical work, location, life and just about everything else during that year). If you felt like you could focus on projects YOU want to do during normal working hours and then go home in the evenings and rest...would that change things?

We can't answer which one you will enjoy more, but I do think the points above are worth considering. Another is that you don't need to decide immediately. This is what post-docs are for. I'd look at AMCs and VAs that allow you to do a little of both and see how it goes. It IS tougher to make the leap back to research, while clinical gigs are a dime a dozen (at least if you aren't picky about location/setting). I agree with the above that it makes sense make sure you are OK with letting it go before closing that door. That isn't to say it can never be reopened, but it would be a very rough road back to a research-heavy tenure-track position from a 100% clinical position.

 

[cara susanna]

I actually just did that! I'm a research post doc and I just got a clinical job because 1. I really enjoy clinical work, more than I thought I would 2. I just want stability, not living off of grants, and the only jobs that wouldn't involve that don't pay as much as I want to be making and 3. I don't actually think I'd want to be PI on a large grant, given what I've observed from my involvement on those types of studies on post doc. FWIW, I know a lot of research rock stars who've gone on to take clinical jobs, which is part of what helped me realize that it's okay. It seems to be pretty common, actually. I think the toughest part is giving up that identity as a researcher, but you don't have to entirely do that. You can still be involved in research, just maybe in different ways.

 

[temppsych123]

Thanks everyone! Such thoughtful questions/comments 🙂

To be honest, research has felt stressful and burdensome for awhile now. BUT, when I am actually able to get into it/avoid avoiding, I enjoy it a lot, and I'm good at it. I enjoy lit reviews, developing research/data analytic questions, and manuscript writing; I am much less interested in the actual data analysis/stats piece (I'm not terrible at it, I just find it very stressful). My dissertation is already defended, so I literally just have to finish internship and I'm off to do whatever I want. The "path of least resistance" would be to stay at or near my internship site for postdoc, do more research and enough clinical work for licensure, and then go from there. But I'm concerned that if I "coast" research-wise through internship and then decide I do want to stay in research, I'll end up screwed during/after postdoc when I'm on the job market. BUT, if I actually don't want to stay in research, then busting my butt during my limited internship "free time" to try to get more research work done is just a wasted endeavor.

FWIW, there are lots of non-professional factors at play as well - a desire for a "normal" lifestyle, geographic flexibility, managing my own well-being in the context of chronic illnesses - that are confusing to sift through as well, but I don't think a message board is going to help me with that stuff...