Those who work at a VA or a similar setting

[Dirkwww]

---

Members don't see this ad.

I am trying to figure out what a typical "work" day is, being a clinical psychologist at a hospital setting such as a VA. I know it varies day to day and no single day is like the other. But for those if you who work at such a place, would you mind giving me a typical daily run though of what you do, what you come across, hours and what all your job entails? It would be really helpful to me.

thanks

 

[Pragma]

I am trying to figure out what a typical "work" day is, being a clinical psychologist at a hospital setting such as a VA. I know it varies day to day and no single day is like the other. But for those if you who work at such a place, would you mind giving me a typical daily run though of what you do, what you come across, hours and what all your job entails? It would be really helpful to me.

thanks

Just so that you know, most VA folks are going to have a shorter day compared to people who work in private hospital settings. They generally protect your time better there.

 

[JeyRo]

I am trying to figure out what a typical "work" day is, being a clinical psychologist at a hospital setting such as a VA. I know it varies day to day and no single day is like the other. But for those if you who work at such a place, would you mind giving me a typical daily run though of what you do, what you come across, hours and what all your job entails? It would be really helpful to me.

thanks

I could, but like you said, there is no "typical" VA psychologist and moreover, the work requirements for VA psychologists with the *same* job description seem to vary depending on which VA / VISN you work in. There are VA psychologists that do telehealth, compensation and pension exams, research, substance abuse treatment, work in mental health care, work in extended care, ambulatory care, psychiatry, etc., etc., etc....... some work part time, some work full time. Some have university appointments on top of their VA priveleges. Really runs the gamut.

 

[JeyRo]

Just so that you know, most VA folks are going to have a shorter day compared to people who work in private hospital settings. They generally protect your time better there.

That's one of the great things. When my shift is over, I'm outta here! - excepting, of course, there's some rare instance of an emergency I have to deal with.

There's also both official and unofficial flex time built into my schedule, which all of the staff take advantage of (physicians and psychologists alike). Very useful for a working dad like myself. Also I've been able to arrange nontraditional schedules which work well for my home situation (part of the benefit of working in a 24/7 hospital).

 

[erg923]

For the VA (as well as public sector hospitals) beyond the hours worked (8-4:30 or 5pm) "see patients," "write notes/reports," and the occasional (or not so occasional) "attend a staff meeting", the typical day is a functioin of what your job is, what kind of clinic you are in, what kind of patient population you see, etc. The typical day for one wouldnt even resemble the typcial day for another.

 

[Dirkwww]

That's one of the great things. When my shift is over, I'm outta here! - excepting, of course, there's some rare instance of an emergency I have to deal with.

There's also both official and unofficial flex time built into my schedule, which all of the staff take advantage of (physicians and psychologists alike). Very useful for a working dad like myself. Also I've been able to arrange nontraditional schedules which work well for my home situation (part of the benefit of working in a 24/7 hospital).

sounds like they treat employees fairly nice, and from what i have read, pretty good pay, im a 3rd year in my undergrad so i am doing some research on all of this stuff. For a starting point you could tell me what you last few days of work were like

 

[Dirkwww]

SO perhaps a better general question would be to ask people to describe their last work week or last few days.

 

[Pragma]

That's one of the great things. When my shift is over, I'm outta here! - excepting, of course, there's some rare instance of an emergency I have to deal with.

There's also both official and unofficial flex time built into my schedule, which all of the staff take advantage of (physicians and psychologists alike). Very useful for a working dad like myself. Also I've been able to arrange nontraditional schedules which work well for my home situation (part of the benefit of working in a 24/7 hospital).

You could contrast that to a private hospital. Now, I am still a postdoc, but it isn't unusual for me to be at work from 7-7 and to do some clinical writing at home on nights and weekends. Now the full time psychologists here seem to work more of an 8:30-5:30 or 6. Some chart at home and some don't.

Government jobs are very good in that sense.

 

[JeyRo]

sounds like they treat employees fairly nice, and from what i have read, pretty good pay, im a 3rd year in my undergrad so i am doing some research on all of this stuff. For a starting point you could tell me what you last few days of work were like

OK. Let's see. So, I'm a geropsychologist, and I work at a long-term care facility with the VA. Here's what I did the last few days.

On Sunday I worked a 1/2 day because my wife's back got thrown out and I needed to help her in the morning with the kiddies (I work Sundays - again, nontraditional, family-friendly schedule). I saw one patient when I got to work in the afternoon, for an hour (weekly session). I did the documentation and then spent the rest of the day researching two symposia I'll be presented at APA in August, otherwise farted around on the internet (posting here). Attended 3:30pm nursing report and discussed with nursing some simple behavioral techniques to address some combative behavior they are dealing with in a demented patient.

Monday I also saw three patients for supportive / psychotherapy contacts. Attended nursing report at 3:30pm. Wrote a routine assessment report, did documentation. Walked to the exercise room during my lunch break and lifted some weights, chatted with some nurses there. Worked some more on my presentations. Left on time.

Yesterday, read some student papers for an awards committee I am on for APA. Saw another two patients. Attended our interdisciplinary care planning meeting and consulted about a few cases there. Chatted with some people in the county about some conservatorship cases I am working with them on. Cleaned up some computer files, cleaned up my email box. Left late, but my wife was with the kids and I stayed late because I felt like it.

 

[JeyRo]

You could contrast that to a private hospital. Now, I am still a postdoc, but it isn't unusual for me to be at work from 7-7 and to do some clinical writing at home on nights and weekends. Now the full time psychologists here seem to work more of an 8:30-5:30 or 6. Some chart at home and some don't.

Government jobs are very good in that sense.

I worked like a dog on internship and postdoc, similar hours to yours.

 

[Pragma]

I worked like a dog on internship and postdoc, similar hours to yours.

At a VA? That's not what I hear from my intern/postdoc colleagues who do them at the VA.

 

[erg923]

no, I think he has said he wasnt at VA for those.

 

[JeyRo]

no, I think he has said he wasnt at VA for those.

Medical schools.

 

[Sanman]

At a VA? That's not what I hear from my intern/postdoc colleagues who do them at the VA.

It really depends on who your supervisors are on internship/post-doc and what you are doing. I had supervisors that gave me ample time to complete paperwork and those that expected me to see patients pretty much all day and stay late to complete paperwork/write reports. To one supervisor an 8-4:30 tour of duty meant getting to work at 8, to another it meant being downstairs ready to see patients at 8 (of course that supervisor worked 7-3:30) Some VA centers will give you dissertation writing time/research time built into your schedule and others will expect you to complete these things on your own time. Some require research projects to be completed as well. Same as anywhere else, it really all depends on how much of a slave driver your supervisor is as we all need to get our certificates and letters of rec/ references at the end of the day/year.

 

[AcronymAllergy]

I'm currently (like erg) on internship, but can give a little info both on my own schedule/duties as well as those of my supervisors. Given that my internship is a consortium, I can also provide my take on the differences between the typical VA and academic medicine work days.

As others have said re: the VA, the hours are generally steadfast, with mine being 8 to 4:30. Workload varies from rotation to rotation, but I've yet to feel overwhelmed by anything, and all of my supervisors have provided built-in time for writing. For neuropsych, with a major rotation (i.e., 3 days a week) at the VA, I would conduct two four-hour assessment sessions per week, and would spend the rest of my time scoring and writing reports. My supervisor on that rotation had, I believe, 4-5 evals/week scheduled in addition to a few feedback appointments each day. With non-neuro rotations, the expected caseload has varied, but seems to average out to 3-5 patients/day plus a group or two each week. My supervisors tend to see a few more patients/day than that (closer to 6 on average).

On my academic medicine rotations, the neuro schedule was about the same with regard to full-on assessments (i.e., 1-2/week, depending on how many days I was there). However, I would also see 5-10 inpatients/day doing brief bedside cognitive screenings, and observed Wada evals while rotating through an epilepsy clinic. Unlike the VA, the academic med rotations generally had psychometrists available to conduct the actual testing, so more of my time was spent writing and occasionally supervising/training grad students. The academic med supervisors definitely worked longer hours than those at the VA, and also more consistently came in on weekends to catch up on reports (which essentially never happened at the VA).

 

[Pragma]

On my academic medicine rotations, the neuro schedule was about the same with regard to full-on assessments (i.e., 1-2/week, depending on how many days I was there). However, I would also see 5-10 inpatients/day doing brief bedside cognitive screenings, and observed Wada evals while rotating through an epilepsy clinic. Unlike the VA, the academic med rotations generally had psychometrists available to conduct the actual testing, so more of my time was spent writing and occasionally supervising/training grad students. The academic med supervisors definitely worked longer hours than those at the VA, and also more consistently came in on weekends to catch up on reports (which essentially never happened at the VA).

Wow, you got to use techs as an intern? I don't even get that as a fellow - I guess there is a lot of variability from place to place!

Edit: I certainly WOULD use a tech if I had one, but would still want to do a long interview myself.

 

[AcronymAllergy]

Wow, you got to use techs as an intern? I don't even get that as a fellow - I guess there is a lot of variability from place to place!

Edit: I certainly WOULD use a tech if I had one, but would still want to do a long interview myself.

Yeah, it definitely spoiled me a bit, particularly when going from the university hospital (where we had techs) to the VA (where we didn't). Then again, I generally enjoy testing itself, so it was never horrible for me. Plus, I cut my teeth on 6-8 hour batteries, so the 2-4 hour variants we use here are usually a cakewalk by comparison. We did/do always conduct the interviews, though. And we almost always handle testing for the inaptients ourselves regardless of whether or not a tech is available.

If it makes you feel any better, though, I don't think my postdoc has tech support, either.

 

[Shatani]

I worked like a dog on internship and postdoc, similar hours to yours.

i havent done VA work (yet!) but i can vouch for this even in a totally different setting. i thought to myself (and then said out loud), "i do 1/12th of the work i did as an intern and now i'm actually getting paid!"

 

[JeyRo]

i havent done VA work (yet!) but i can vouch for this even in a totally different setting. i thought to myself (and then said out loud), "i do 1/12th of the work i did as an intern and now i'm actually getting paid!"

IMHO it's true (generally) what they say about government work. I try to keep challenging myself and taking on projects (publications, committees, etc.) because I get the sense sometimes that VA work is ruining me for the private sector. There's a whole bunch of folks who have it a lot harder than I do.

 

[Dirkwww]

General question, those of you were work at a VA. DO you have a PHD or a PSYD

 

[erg923]

General question, those of you were work at a VA. DO you have a PHD or a PSYD

VAs that are teaching hospitals or otherwise university-affiliated will tend to have more Ph.Ds because scholarly productivity will be more valued there, and may even be expected as part of being on staff. Mine is all Ph.Ds, save for one person, and our chief is very biased against the Psy.D....so I'm be this is part of the reason. But again, this is VA specific. Plenty of Psy.Ds in the system overall. But given the competitive nature of the positions, I would certainly not recommend something like Argosy, or other such schools where your chances of getting an APA internship (which is required for future VA employment) is very low.

 

[PhDToBe]

I am currently doing a PRACTICUM at a VA in a small city, and can tell you what a psychologist and intern do to the best of my knowledge.

I am on a neuropsych unit where there are two neuropsychologists. I haven't really interacted with one, but know a pretty good amount about another. She has several meetings (i.e. IRB committee) each week, does not seem to provide any traditional therapy, and spends a lot of time writing reports. She typically sees about 2-3 patients each week. She spends 1-2 hours interviewing them, does 1 test with them, and provides feedback to them. She also spends time on research and traveling to conferences. The practicum students or the interns do the actual testing. Both the practicum students and the interns are NOT allowed to write the actual reports but can write ones for practice that count for hours. This is (obviously) NOT an APA-accredited internship, as it is pathetic that the practicum students and interns do mostly testing and write MAYBE 1-2 fake reports. The hours are 8-4:30.

I surely hope not all VAs are like this, because it is poor training for both the practicum students and the interns. I am pretty sure this is atypical, and that students do a lot more at other VAs.

I advise interns to ask exactly what they will be doing at any internship to avoid places like this!

 

[Ollie123]

That sounds like absolute nonsense. Why not have the students produce reports that are co-signed like everyplace else?

If any of my prac sites wanted me to write a report that wouldn't be used for anything and served no purpose other than "practice" I'd likely refuse to do it. Not a good use of my time.

 

[PhDToBe]

I have no idea why it's like that. I think the psychologists are anal and/or narcissistic.

I am glad I am only there for a short period of time. They don't make the practicum students write a report, but I am going to try to write a couple because they still count toward my number of integrated reports.

 

[AcronymAllergy]

That sounds like absolute nonsense. Why not have the students produce reports that are co-signed like everyplace else?

If any of my prac sites wanted me to write a report that wouldn't be used for anything and served no purpose other than "practice" I'd likely refuse to do it. Not a good use of my time.

It does sound unusual to me as well, yes, although I'm not sure how it stacks up practicum-wise with other VAs. My grad school never had a practicum available at a VA (the nearest one is an hour away), so my experience has only been on internship, where the neuropsychologist will interview the patient for a bit themselves, then hand the veteran off to us (the interns), who do the testing, scoring, and report writing. This is actually very similar to how things worked for me in grad school, as I never wrote a "fake" or practice report; everything "counted" from day one, we just received greater amounts of supervision/revision early on. However, the grad students at my current internship site definitely receive a bit less autonomy than did I, as they don't seem to write integrative reports until perhaps their third or fourth year.

I could see the above being preferred for high-stakes evals, such as forensic cases; my current site has a faculty member who conducts a good number, and only the postdocs are allowed to write those reports (although my grad school was again seemingly unique here, as I wrote multiple forensic-oriented reports for my advisor, conducted records reviews, etc.). I guess it just depends on the standards of practice in the area, and how comfortable a given faculty member is with a given setup.

Edit: To answer Dirkwww's question about my current (consortium) site--to the best of my knowledge, all of the staff psychologists at the VA here hold PhDs. Then again, right across the street at the med school, there are two PsyDs on staff.

 

[Psychadelic2012]

I hope this isn't a dumb question, but what about psychologists (PhD or PsyD) who are not neuropsychologists? I always thought there were all types of psychologists employed by the VA, but here I'm seeing descriptions of mostly neuropsych. There are other specialties, too (i.e., geropsych, health psych, substance abuse, etc.), right?

 

[erg923]

I hope this isn't a dumb question, but what about psychologists (PhD or PsyD) who are not neuropsychologists? I always thought there were all types of psychologists employed by the VA, but here I'm seeing descriptions of mostly neuropsych. There are other specialties, too (i.e., geropsych, health psych, substance abuse, etc.), right?

Yes, of course.

 

[Dirkwww]

It does sound unusual to me as well, yes, although I'm not sure how it stacks up practicum-wise with other VAs. My grad school never had a practicum available at a VA (the nearest one is an hour away), so my experience has only been on internship, where the neuropsychologist will interview the patient for a bit themselves, then hand the veteran off to us (the interns), who do the testing, scoring, and report writing. This is actually very similar to how things worked for me in grad school, as I never wrote a "fake" or practice report; everything "counted" from day one, we just received greater amounts of supervision/revision early on. However, the grad students at my current internship site definitely receive a bit less autonomy than did I, as they don't seem to write integrative reports until perhaps their third or fourth year.

I could see the above being preferred for high-stakes evals, such as forensic cases; my current site has a faculty member who conducts a good number, and only the postdocs are allowed to write those reports (although my grad school was again seemingly unique here, as I wrote multiple forensic-oriented reports for my advisor, conducted records reviews, etc.). I guess it just depends on the standards of practice in the area, and how comfortable a given faculty member is with a given setup.

Edit: To answer Dirkwww's question about my current (consortium) site--to the best of my knowledge, all of the staff psychologists at the VA here hold PhDs. Then again, right across the street at the med school, there are two PsyDs on staff.

hmm that is good to know as a VA is an ideal future job for me and im not sure which one i want

 

[PhDToBe]

I don't think this is a typical experience, but if you're worried, PM me and I will tell you in which city this crappy VA is. 🙂 Also, there are a few other psych units; this is just the neuropsych one. Perhaps the interns have more autonomy at the other units. I am not exposed to the other units.

 

[JeyRo]

I'm a VA supervisor and I can tell you I don't run my program like that. If you work with me and you do assessment, I try to have you write reports pretty much from the beginning. If I have to edit them extensively before I co-sign them, that's what I do, but I don't just have my students be psychometricians and otherwise deny them the opportunity to try their hand at the stuff I'm doing. That would be kind of cheesy.

 

[mcvcm92]

I hope this isn't a dumb question, but what about psychologists (PhD or PsyD) who are not neuropsychologists? I always thought there were all types of psychologists employed by the VA, but here I'm seeing descriptions of mostly neuropsych. There are other specialties, too (i.e., geropsych, health psych, substance abuse, etc.), right?

This also might be a "dumb question" but are children of vets treated at VA centers? So would a speciality that hires some people be childhood / adolescent psych?

 

[AcronymAllergy]

This also might be a "dumb question" but are children of vets treated at VA centers? So would a speciality that hires some people be childhood / adolescent psych?

From what I've seen/heard, in general, no.

 

[erg923]

From what I've seen/heard, in general, no.

Some have the availability of family therapy. But, no. dependents are not treated independently by the VA

 

[AcronymAllergy]

Some have the availability of family therapy. But, no. dependents are not treated independently by the VA

That was the caveat I would've added (i.e., family therapy), but figured someone else would point it out (thanks, btw).

 

[Pragma]

The practicum students or the interns do the actual testing. Both the practicum students and the interns are NOT allowed to write the actual reports but can write ones for practice that count for hours. This is (obviously) NOT an APA-accredited internship, as it is pathetic that the practicum students and interns do mostly testing and write MAYBE 1-2 fake reports. The hours are 8-4:30.

I surely hope not all VAs are like this, because it is poor training for both the practicum students and the interns. I am pretty sure this is atypical, and that students do a lot more at other VAs.

Interesting - sounds like poor training. I actually hear the opposite most places - the externs/interns/fellows are essentially free labor and if anything, there may be a tendency to rely too heavily on their conclusions..From my first practicum on, I did all the testing and scored/wrote everything, they edited it, and it was finalized (sometimes with me making revisions first).Seemed like an excellent deal for them!

 

[Dirkwww]

I'm a VA supervisor and I can tell you I don't run my program like that. If you work with me and you do assessment, I try to have you write reports pretty much from the beginning. If I have to edit them extensively before I co-sign them, that's what I do, but I don't just have my students be psychometricians and otherwise deny them the opportunity to try their hand at the stuff I'm doing. That would be kind of cheesy.

Being a VA supervisor, is a PhD viewed more favorably?

 

[JeyRo]

Being a VA supervisor, is a PhD viewed more favorably?

It's actually not a bad question for me since I've served on the intern and postdoc selection committee at my VA (which is a pretty reputable one, if I do say so myself) for the past several years.

In all the discussions I've had in our selection committee no one has indicated that they really care if you're a PsyD or a PhD. The real questions we ask when evaluating students are whether the student has a publication track record, a solid record of interest in the area we train students in (in our case, geropsych. and neuropsych.) and comprehensive clinical training relevant to our specialty area, along with the usual stuff (do you interview well, etc).

PsyD students sometimes get filtered out of this process because they often come from FSPS, which sometimes means they have meagre research and publication experience. However, there have been some standout PsyD students that have applied to our postdoc and internship classes that have been in the top tier - it's just that we usually have our pick of the litter from quality funded programs as so we don't have to take students from PsyD / FSPS programs if there are students from funded programs with similar chops.... so, well, we really usually don't.

There are a handful of grads from PsyD programs on staff at my VA, along with a few PhD grads from FSPS (I am one). However, we're a pretty small minority. In my case, I got my VA appointment because I had rock-solid internship and post-doc training, several publications under my belt, solid research experience, worked with some luminaries in the field, and had over a year of post-license work experience, all solidly fitting into the specialist position I was applying for. Basically when I applied for the job I got the feeling I had basically trained for exactly the position I got, it was a lock and key, hand and glove kind of situation. So there it is.

 

[Sanman]

In all the discussions I've had in our selection committee no one has indicated that they really care if you're a PsyD or a PhD. The real questions we ask when evaluating students are whether the student has a publication track record, a solid record of interest in the area we train students in (in our case, geropsych. and neuropsych.) and comprehensive clinical training relevant to our specialty area, along with the usual stuff (do you interview well, etc).

Is your VA one of the more research oriented centers? From my experience at a couple of different VAMCs, research was not a big deal not PhD/PsyD, but internship/post-doc experiences, experience in the area being hired (gero/health/primary care/etc), and previous VA experience were the large factors. If you did not have previous VA experience, you really needed good credentials, though just about everyone on staff had interned at a VA hospital at least.

 

[JeyRo]

Is your VA one of the more research oriented centers? From my experience at a couple of different VAMCs, research was not a big deal not PhD/PsyD, but internship/post-doc experiences, experience in the area being hired (gero/health/primary care/etc), and previous VA experience were the large factors. If you did not have previous VA experience, you really needed good credentials, though just about everyone on staff had interned at a VA hospital at least.

I guess we're "research oriented..." (although the positions I select for are 100% clinical) but I just get the sense that the committee I work with really puts a premium on research productivity when they make selections. I see it as a positive as well (the whole scientist-practicioner thing).

 

[Hope4Grad]

I am currently doing a PRACTICUM at a VA in a small city, and can tell you what a psychologist and intern do to the best of my knowledge.

I am on a neuropsych unit where there are two neuropsychologists. I haven't really interacted with one, but know a pretty good amount about another. She has several meetings (i.e. IRB committee) each week, does not seem to provide any traditional therapy, and spends a lot of time writing reports. She typically sees about 2-3 patients each week. She spends 1-2 hours interviewing them, does 1 test with them, and provides feedback to them. She also spends time on research and traveling to conferences. The practicum students or the interns do the actual testing. Both the practicum students and the interns are NOT allowed to write the actual reports but can write ones for practice that count for hours. This is (obviously) NOT an APA-accredited internship, as it is pathetic that the practicum students and interns do mostly testing and write MAYBE 1-2 fake reports. The hours are 8-4:30.

I surely hope not all VAs are like this, because it is poor training for both the practicum students and the interns. I am pretty sure this is atypical, and that students do a lot more at other VAs.

I advise interns to ask exactly what they will be doing at any internship to avoid places like this!

Hey Guys (and Gals),

About this post...I'll be at a VA this coming year for a psych practicum. Does it count as "report" writing for APPIC hours if the report you generate (based on history gathering, and the required other types of tests that constitute the APPIC's definition of report writing) were done for practice and not any sort of official chart purpose?

Thanks,

Hope4Grad