Thoughts on the Match Process?

[AnonymousClinicalPsych]

Hi everyone, I just went through the match process and I absolutely hated it. I think the design of the process only benefits the training sites but at the cost of the applicants. It's just so nerve-wracking, draining, and costly for the applicants. I think it would be much easier for the applicants if we can apply to internships like how you would do for post-docs and jobs. For example, if you are a strong applicant, you may just need to apply to a few places and receive an offer, which will save you a lot of time, energy, money (especially if you need to travel for interviews), and scheduling headaches. Or in other cases, you can just apply to sites based on your preference and adjust your strategies along the way if you don't get positive feedback (you can't do this for the match), without having to apply to 15+ places all at once and hold your hopes high for the match but find out that you did not match and have to do the same thing all over again, with not many good choices left. The match benefits the sites however because they can review all of the candidates who are interested in their site and decide who to pick based on their preference, whereas if we do it like the post-docs and jobs, they will have to worry about extending an offer too early or too late and missing out on better candidates. Am I missing anything? Does the match benefit the applicants at all? Thoughts? Why do we have to do the match??

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[Sanman]

If the match did not exist, programs would just take local candidates we like and ignore someone else. We also would not offer you any money. It still would not benefit applicants because the truth is that applicants have little to offer. As it is, the match benefits applicants more than programs.

 

[AnonymousClinicalPsych]

If the match did not exist, programs would just take local candidates we like and ignore someone else. We also would not offer you any money. It still would not benefit applicants because the truth is that applicants have little to offer. As it is, the match benefits applicants more than programs.

I am not understanding your argument. Why would sites just take the locals and not offer money if the match did not exist? Applicants have little to offer regardless of the match. Why would match make a difference?

 

[bluecolourskies]

I agree about the travel costs. Absolutely absurd. I have seen others argue on here that after physically visiting a site, they ranked it way differently, etc. and sure, good for them that it made an impact, but I don’t like that when I went through the match, it really made it seem like sites valued the in person interviews more if both were offered. Many did not offer tele-interviews at all.

We already had to pay for all moving expenses, so then having to pay just to interview on top of that was bs

I disagree about there not being “good sites” left in Phase II. It depends on your interests and how you define “good sites.” I went into Phase II, and there were many great sites left. I matched to my number one pick in Phase II and had an amazing internship experience! And yes, it was APA accredited.

 

[PsyDr]

All of healthcare follows a general structure of education. Medicine determined that structure, and taught every hospital, insurance company, and legal entity, to think along the lines of that structure. We benefit from having a similar structure (e.g., practica= clinical rotations, internship=residency, post doc= fellowship, EPPP= Step1, etc). Every hospital and insurance company will qualify you, based upon those lines. The match is an important way to keep that similarity. It also creates a useful barrier to licensure for poorly trained incompetents.

The last time the APA said "we are not healthcare", psychologists lost the positions, and social workers flooded in. Thanks Carl Rogers.

 

[Sanman]

I am not understanding your argument. Why would sites just take the locals and not offer money if the match did not exist? Applicants have little to offer regardless of the match. Why would match make a difference?

Because it is easy and we can.

Why take locals? Because we already know they do good work based on externship. Why wade through 100+ applications if there is a known quantity (hint: we are required to because of the match).

Why not pay you? Because you produce no money and you need internship to graduate. APA requires all programs to list stipend amounts and provide transparency. This is why unpaid post-docs exist as they don't require accreditation or participation in the match.

It is more to ensure consistency and transparency for you. It is pretty easy for us to take advantage of whomever otherwise. How would you know what programs are out there? They are all listed in one convenient place due to the match.

 

[ClinicalABA]

I believe that the match process is best described as a good process within a bad system. It benefits candidates in that it creates a somewhat equal opportunity for trainees from all over the country to be considered by sites outside their geographic region. With the increased options for remote interviews, it's not as financially draining as it used to be. Having been on an internship faculty, the match system not only benefits the internship site, but in some cases makes it even possible to have an internship. Without the neat deadlines, standardized applications, commitment to accept the match site/trainee, etc., it would be a nightmare to organize the recruitment and hiring of candidates from around the country. Despite what it may seem, interns aren't "cheap revenue generators". They are a lot of work and almost always cost a lot more than they generate, revenue-wise. The matching algorithm also really does make it about matching candidates to their highest ranked sites that also rank the highly. And, as mentioned before, the formal match process and internship approval process promote minimum standards of training and reimbursement (protecting the trainee from gross exploitation).

The burden of multiple relocations during graduate training restricts the numbers and types of people who can participate. I also don't think that someone's degree should be reliant upon them getting training (and a substantial proportion of their training, at that) from a place not affiliated with the degree granting institution. Also, we claim to be a science guided by empirical evidence, but conveniently ignore the evidence regarding the limited utility (and inherent biases) of interviews as a predictor of success on the job.

 

[Sanman]

The burden of multiple relocations during graduate training restricts the numbers and types of people who can participate. I also don't think that someone's degree should be reliant upon them getting training (and a substantial proportion of their training, at that) from a place not affiliated with the degree granting institution. Also, we claim to be a science guided by empirical evidence, but conveniently ignore the evidence regarding the limited utility (and inherent biases) of interviews as a predictor of success on the job.

In my mind, interviews are less about a prediction of success on the job (if we invited you for an interview, you probably are able to do the work) and more about general personality factors of the students and the staff. It can be a long year all around when personality clashes arise.

As far as the burdens of relocations. Clinical Psychology training arose out of the medical traditions and the goal there, IMO, has been to ensure that certain SES classes choose the profession and others do not. Both physicians and psychologists tend to come from higher SES backgrounds. You ever notice how the major conferences are never in cheap places? I think INS or NAN was in Hawaii one year when I was training and I had a professor ask if I was going.

That said. Requiring students to travel around the country also gives us a reason to move somewhere beside where we all called home. Otherwise, there would be even more of us with no excuse to leave the coasts.

 

[AnonymousClinicalPsych]

Because it is easy and we can.

Why take locals? Because we already know they do good work based on externship. Why wade through 100+ applications if there is a known quantity (hint: we are required to because of the match).

Why not pay you? Because you produce no money and you need internship to graduate. APA requires all programs to list stipend amounts and provide transparency. This is why unpaid post-docs exist as they don't require accreditation or participation in the match.

It is more to ensure consistency and transparency for you. It is pretty easy for us to take advantage of whomever otherwise. How would you know what programs are out there? They are all listed in one convenient place due to the match.

All of the things you are saying can still happen without the match process itself. If APA can require you to wade through 100+ apps, why can't they require you not to discriminate against applicants based on their geographic location?

I still don't understand why "interns produce no money" has anything to do with the match itself. Why can't APA require training sites to provide a stipend and transparency if there is no match? If you are trying to say that because interns have no value so sites just won't recruit anybody, then APA can't require students to get something that does not exist.

How would applicants know what programs are out there? Well, APA can still require all sites list their positions somewhere, like how it is done now in APPIC. But you just apply to them like how you would apply to jobs, but knowing that you have to secure an offer by a specific deadline.

 

[Sanman]

All of the things you are saying can still happen without the match process itself. If APA can require you to wade through 100+ apps, why can't they require you not to discriminate against applicants based on their geographic location?

I still don't understand why "interns produce no money" has anything to do with the match itself. Why can't APA require training sites to provide a stipend and transparency if there is no match? If you are trying to say that because interns have no value so sites just won't recruit anybody, then APA can't require students to get something that does not exist.

How would applicants know what programs are out there? Well, APA can still require all sites list their positions somewhere, like how it is done now in APPIC. But you just apply to them like how you would apply to jobs, but knowing that you have to secure an offer by a specific deadline.

APA can require whatever it wants. Without the match and a guarantee of getting a trainee, there is no reason for the training programs be a part of APA. So, everything you have said would never happen.

 

[AnonymousClinicalPsych]

APA can require whatever it wants. Without the match and a guarantee of getting a trainee, there is no reason for the training programs be a part of APA. So, everything you have said would never happen.

Oh I'd love that. I think we should get our degree before the internship anyway.

 

[Sanman]

Oh I'd love that. I think we should get our degree before the internship anyway.

Who said you would get your degree or that the degree really matters. Counseling students are required to get their training hours after their degree. It is so difficult to do in some states that many quit the profession before ever getting licensed.

 

[WisNeuro]

Being on both sides, I fail to see how the match benefits sites over students. Pretty much in agreement with @Sanman here, students are definitely in a much better position with the match than without. You have so many more protections and benefits this way, rather than simply applying to any site that had a position in a haphazard way. If anything, you'd likely just be increasing the number of predatory sites , as what currently happens with many postdoc placements.

 

[AnonymousClinicalPsych]

Being on both sides, I fail to see how the match benefits sites over students. Pretty much in agreement with @Sanman here, students are definitely in a much better position with the match than without. You have so many more protections and benefits this way, rather than simply applying to any site that had a position in a haphazard way. If anything, you'd likely just be increasing the number of predatory sites , as what currently happens with many postdoc placements.

Then you can apply to APA-accredited internships, so you don't run into "predatory sites", whatever that means.

 

[Sanman]

Then you can apply to APA-accredited internships, so you don't run into "predatory sites", whatever that means.

What makes you think there would be any/many?

 

[WisNeuro]

Then you can apply to APA-accredited internships, so you don't run into "predatory sites", whatever that means.

So, you want to increase the administrative burden on sites, something that already keeps some sites from starting internship programs? So now you've likely just decreased the overall number of sites, and increased incentive for people to just have APPIC sites instead of APA. Not a great way to entice sites to take on revenue negative employees every year.

 

[AnonymousClinicalPsych]

So, you want to increase the administrative burden on sites, something that already keeps some sites from starting internship programs? So now you've likely just decreased the overall number of sites, and increased incentive for people to just have APPIC sites instead of APA. Not a great way to entice sites to take on revenue negative employees every year.

This just confirms that the match process benefits the sites more.

 

[WisNeuro]

This just confirms that the match process benefits the sites more.

How so? Are you aware of how much unreimbursed time goes into the process on the site end?

 

[WisNeuro]

So let's think this through, you still need internship on a certain timeline. So, you apply to a round of sites, they like other people better, you go unhired. Now all of the sites in your local area are filled. Now you have to do another round of applying and interviews, only your pool is much smaller and now you have to travel outside of your geo area to make that work. Again some people would go unhired and have to do this again. So, now you are working against time and money if you are not a top applicant. So, if anything, for the shortsighted and naive plan of the OP would greatly benefit sites in terms of time and money spent, but very likely lead to a great deal more expense and time for applicants. Let's do it!

 

[AnonymousClinicalPsych]

So let's think this through, you still need internship on a certain timeline. So, you apply to a round of sites, they like other people better, you go unhired. Now all of the sites in your local area are filled. Now you have to do another round of applying and interviews, only your pool is much smaller and now you have to travel outside of your geo area to make that work. Again some people would go unhired and have to do this again. So, now you are working against time and money if you are not a top applicant. So, if anything, for the shortsighted and naive plan of the OP would greatly benefit sites in terms of time and money spent, but very likely lead to a great deal more expense and time for applicants. Let's do it!

If someone is such an undesirable applicant, their situation would be the same with the match process in place -- apply to 20+ places, not matched, apply in Phase II, and likely have to relocate. The match does not make it easier.

 

[PsyDuck90]

As a current intern who just went through post doc apps (applying to a mix of neuro match, neuro non-match, and a site that followed UPPD common hold date), I definitely sympathize with the frustration of the application process. That being said, as the staff have alluded to here, it really is one of the more equitable ways of doing it. The uniform process allows applicants an equal opportunity for a variety of sites, with everyone ranking their preferences. Without the match, sites most likely would extend offers to their top person, who may then sit on that offer for a period of time while they wait for other sites they may prefer over that one, holding the site incapable of offering the position to someone else. Alternatively, sites may give applicants a 24-78 hour window to accept or decline the offer when this person may not have even interviewed with other sites yet to be able to make an informed decision (and interviews very much help applicants suss out poor personality fits just as much as sites), which is what happens with many non-match neuro postdocs that try to bully applicants into taking their offer without opportunity to consider all their options. The algorithm is really the best way we have as of now which allows applicants to freely consider all of their options and rank those options according to their own preferences. Is it a perfect system? No. But is it the best we have as of now? Probably yes.

 

[WisNeuro]

In your process, there is no match, so how would they go to "Phase II?" Also, how does this make it easier and cheaper for applicants?

 

[WisNeuro]

I definitely see the benefit of APA sites having visits that try to protect interns from exploitative sites! One thing that does worry me, though is the obstacles that stand in the way for many people to obtain an apa internship and how that can unfairly hurt their future career options. The ability to relocate/afford so many apps/travel for interviews creates inequality. I don’t have a solution, but I wish that the ability to have an APA accredited site didn’t cause so much fear for applicants who have fewer options and may be unsuccessful

Most sites have virtual options for interviews these days. And, before the pandemic, it was always pretty common to have about 10% of interviews via phone at my sites. So, there are ways around the travel. Not sure how match or non-match would get around the relocation issue given teh mismatch of applicants and internship spots in many areas.

 

[psychologynbooks]

Most sites have virtual options for interviews these days. And, before the pandemic, it was always pretty common to have about 10% of interviews via phone at my sites. So, there are ways around the travel. Not sure how match or non-match would get around the relocation issue given teh mismatch of applicants and internship spots in many areas.

virtual interviews have significantly helped inequality issues. The price of the apps is just too much. I think that APA internships should be available, and I love that there are site visits to protect us. It’s just the stigma that comes for people who were unable to attain one because they can’t afford to move far/etc. I’m lucky I had the option to relocate for APA, but I have a friend with kids who had fewer apa options because she didn’t want to put her kids through a move. she had less sites to apply to and isn’t going to get an apa site as a result. She’s stressed about potential stigma when she applies to future jobs. It just sucks that some qualified people without an apa site may be judged

 

[Sanman]

virtual interviews have significantly helped inequality issues. The price of the apps is just too much. I think that APA internships should be available, and I love that there are site visits to protect us. It’s just the stigma that comes for people who were unable to attain one because they can’t afford to move far/etc. I’m lucky I had the option to relocate for APA, but I have a friend with kids who had fewer apa options because she didn’t want to put her kids through a move. she had less sites to apply to and isn’t going to get an apa site as a result. She’s stressed about potential stigma when she applies to future jobs. It just sucks that some qualified people without an apa site may be judged

Welcome to the world. Technology has made huge strides in improving this, but there is always be inequality. It gets better with time, but things will never be equal.

 

[ClinicalABA]

In my mind, interviews are less about a prediction of success on the job (if we invited you for an interview, you probably are able to do the work) and more about general personality factors of the students and the staff. It can be a long year all around when personality clashes arise.

I really want to believe that I, as a trained and experienced psychologist, have the ability to accurately evaluate personalities based on a few hours of facetime (where the interviewees are coached to be on their best behavior, wearing their nicest suits) to the point that I could avoid future personality clashes. I just don't think there's any scientific evidence of that ability, do you?. Also- it ignores base rates in that such personality clashes do often arise within the current system that relies on interviews.

 

[WisNeuro]

virtual interviews have significantly helped inequality issues. The price of the apps is just too much. I think that APA internships should be available, and I love that there are site visits to protect us. It’s just the stigma that comes for people who were unable to attain one because they can’t afford to move far/etc. I’m lucky I had the option to relocate for APA, but I have a friend with kids who had fewer apa options because she didn’t want to put her kids through a move. she had less sites to apply to and isn’t going to get an apa site as a result. She’s stressed about potential stigma when she applies to future jobs. It just sucks that some qualified people without an apa site may be judged

Not sure how the match changes anything, as her options would be limited no matter the process if she does not have geographic flexibility. She'll also have the same issue with none private practice jobs. It's just s simple fact, not an issue of fairness, that if you are able to move, you have more options. Some people choose to wait to start a family for this reason. They are not unfairly favored, many simply made a choice to make this part of their life easier.

 

[R. Matey]

They are not unfairly favored, many simply made a choice to make this part of their life easier.

Presuming that everyone starts a psych degree in their 20s and biological clocks don't exist, then sure, there's no bias.

 

[Sanman]

Presuming that everyone starts a psych degree in their 20s and biological clocks don't exist, then sure, there's no bias.

Well, none of us are born with children. After that, we all make choices...

 

[WisNeuro]

Presuming that everyone starts a psych degree in their 20s and biological clocks don't exist, then sure, there's no bias.

I just fail to see how this is specific to psychology. Having kids is something that makes many things more difficult and limits you in many ways. How is this a psychology training issue vs. a simple fact of life? Same thing with coming to something later in life. If you limit your own options, I do not see that as bias, it's a choice you make. Of course I have more options if I am willing to move anywhere in the US vs someone who cannot leave their own metro. You make choices, some of them are more difficult than others, and all have consequences.

 

[Sanman]

I really want to believe that I, as a trained and experienced psychologist, have the ability to accurately evaluate personalities based on a few hours of facetime (where the interviewees are coached to be on their best behavior, wearing their nicest suits) to the point that I could avoid future personality clashes. I just don't think there's any scientific evidence of that ability, do you?. Also- it ignores base rates in that such personality clashes do often arise within the current system that relies on interviews.

In most cases, it will not make a difference. In a few it may. In any event, it is all the (imperfect) information we will get.

 

[bcliff]

Alvin Roth, 2012 Nobel Prize Winner, Completed Much of His Research at Pitt | Kenneth P. Dietrich School of Arts & Sciences | University of Pittsburgh. if it's good enough for the nobel prize...

 

[Mama Bear]

The match is an alternative to the typical hiring process of waiting for an offer, then choosing to accept or decline. What a wonderful alternative! It sounds incredibly stressful to use the traditional hiring format. What if a potential intern really wants Site B, but Site A contacts them first with a deadline to accept or decline? The potential intern is put in a difficult position of accepting the position they want less or running the risk of declining without other offers. No, no, no, such a process would have destroyed me. I wish it were possible to always use a match process when applying for jobs, but obviously it doesn’t work that way in other situations. It has been mentioned that “strong applicants” need not worry, but how does an applicant really know how they compare to other applicants?

Yes, the process is stressful, but I suggest it is still better than the alternative. Interns have the opportunity to rank their true preferences rather than experience the gamble of traditional processes.

 

[WisNeuro]

The match is an alternative to the typical hiring process of waiting for an offer, then choosing to accept or decline. What a wonderful alternative! It sounds incredibly stressful to use the traditional hiring format. What if a potential intern really wants Site B, but Site A contacts them first with a deadline to accept or decline? The potential intern is put in a difficult position of accepting the position they want less or running the risk of declining without other offers. No, no, no, such a process would have destroyed me. I wish it were possible to always use a match process when applying for jobs, but obviously it doesn’t work that way in other situations. It has been mentioned that “strong applicants” need not worry, but how does an applicant really know how they compare to other applicants?

Yes, the process is stressful, but I suggest it is still better than the alternative. Interns have the opportunity to rank their true preferences rather than experience the gamble of traditional processes.

Almost universally, after going for postdoc outside of the neuro match, our past interns always told us that they wish that postdocs also had a universal matching process. Nearly every one hates the offer, hold, reach out to someone else, etc process.

 

[AnonymousClinicalPsych]

The match is an alternative to the typical hiring process of waiting for an offer, then choosing to accept or decline. What a wonderful alternative! It sounds incredibly stressful to use the traditional hiring format. What if a potential intern really wants Site B, but Site A contacts them first with a deadline to accept or decline? The potential intern is put in a difficult position of accepting the position they want less or running the risk of declining without other offers. No, no, no, such a process would have destroyed me. I wish it were possible to always use a match process when applying for jobs, but obviously it doesn’t work that way in other situations. It has been mentioned that “strong applicants” need not worry, but how does an applicant really know how they compare to other applicants?

Yes, the process is stressful, but I suggest it is still better than the alternative. Interns have the opportunity to rank their true preferences rather than experience the gamble of traditional processes.

I hear that. I guess it's just a personal preference then. I feel the doctoral admissions are more similar to the traditional hiring format than the match. I definitely prefer the former, which I have personally gone through as well.

 

[R. Matey]

I just fail to see how this is specific to psychology. Having kids is something that makes many things more difficult and limits you in many ways. How is this a psychology training issue vs. a simple fact of life? Same thing with coming to something later in life. If you limit your own options, I do not see that as bias, it's a choice you make. Of course I have more options if I am willing to move anywhere in the US vs someone who cannot leave their own metro. You make choices, some of them are more difficult than others, and all have consequences.

I didn't take you for a free will person. Completely free choice presumes equitable access to information, resources, and opportunities and, of course, overlooks determining forces that are outside one's control, such as the lottery of birth. I thought the reason we're all here arguing with each other on the internet is so we can promote equitable access to information to become a psychologist. In 2021, the mean age for applicants to the match is 30 (+/- 5 years 1 SD)--prime age for having children. It's not unreasonable for this to be a factor that sites think about accommodating. The answer of "just don't have kids if you care about your career" seems like a line out of "Working Girl" rather than advice you'd give someone trying to balance their work and family life. I would hope in 2023, we would do more to promote work-family balance, not less. I know that our local AMC provides low cost childcare to students and residents and my friends who are doctors and had children placed in top medical training sites and, wait for it, had access to affordable childcare. I'm not saying that's true everywhere, but from my perch, it seems more common for residents and fellows to have kids than what I've seen in psychology. So, If your defense of the status quo in psychology involves claiming that people who choose to have children should hold off having kids lest they be seen in some negative light, then it is a psychology training issue since this advice wouldn't be there if psychology training sites provided this for their trainees either in the form of voucher payments for local daycares or enough money to actually live on. Sites don't because it can't afford it or haven't historically paid for it so they won't.

Think about this: your average psychology intern has more training and as much experience as a newly licensed mid-level therapist, but they are paid around $30k less because they are a trainee. At my internship, both were employed and we were paid significantly less. I take it that's probably the same as the VA, where many/most psychologists go for internship. I don't buy the hand-waving that training sites are doing this purely out of the goodness of their hearts because they love the field that much. There are financial benefits to having interns, otherwise no one would do it. The returns might be smaller than the average intern thinks they are, but there are still returns.

FWIW, I'm probably more in the match camp than no match camp. I do think the bias is in mostly in how people are ranked (algorithms are only as good as their inputs). And while zoom interviews cut down on travel costs, they do so at the expense of provided less information, IMO. That said, match is probably the best we can do in response to more trainees than sites in a given 100 or so miles. I agree with earlier comments that working within a broken system is probably the best we can do.

 

[jdawg2017]

I hear that. I guess it's just a personal preference then. I feel the doctoral admissions are more similar to the traditional hiring format than the match. I definitely prefer the former, which I have personally gone through as well.

Doctoral programs are not exactly like the real job market, though, since there is a universal offer date for APA sites of April 15, so you definitely know where you stand by a certain point. I've known people who wind up in jobs after months and months of waiting because a) HR/their boss is incompetent or way overtaxed by their current demands or b) their employer was pursuing someone else for a long time and things fell through.

 

[R. Matey]

Well, none of us are born with children. After that, we all make choices...

A Theory of Justice - Wikipedia

en.wikipedia.org

 

[jdawg2017]

I think the the midst of everyone yelling at the sky we often miss the key point -- sites often cannot bill for trainee services under certain circumstances (think Medicare, for example). Of course intern salaries are trash... we are a cost-neutral at best or barely a tiny cost-win for services that can be billed.

I personally am more in the match camp than non-match camp for the reasons folks have stated. Having just gone through the non-match process for neuropsych post-docs, it truly was a dumpster fire. Thankfully I had my ducks in a row and what was likely my top site offered me the gig very early in the process, but it was weird since I had 4 other sites I had to interview at and I had to make the call in 48 hours to decline the offer and take the other interviews or take their offer.

In my perfect world I would see us move the "internship" to be post-doctoral, like is the case for medical residency. In this model general psychology post-docs would be an intern in year one, and then a fellow in year 2 (PGY 1, PGY2). If you are specializing and need more post-doc training, such as in the case of neuropsych, your post-doc would be three years (PGY 1-3). This would be ideal for so many reasons, the biggest being eliminating at least one possible move for trainees and hopefully raising pay. Medical residents I know at my institution make double what I make as an intern. Moreover, we all know the PhD/PsyD student who never in a million years after internship wants to work clinically, so by eliminating the hostage internship year you can allow that person to move on to a research post-doc.

The biggest drawback to this post-doctoral residency is that it could possibly cause many sites that offer internships, but not post-docs, to close their slots entirely, dropping the number of APA accredited sites for the "internship/post-doc 2 year experience." Large AMCs and VAs could likely adjust, but I bet a lot of community health clinics, college counseling centers, etc. would be facing tough choices. The pros of this model outweigh the cons in my opinion, but these are some major cons.

 

[AnonymousClinicalPsych]

Doctoral programs are not exactly like the real job market, though, since there is a universal offer date for APA sites of April 15, so you definitely know where you stand by a certain point. I've known people who wind up in jobs after months and months of waiting because a) HR/their boss is incompetent or way overtaxed by their current demands or b) their employer was pursuing someone else for a long time and things fell through.

I did not say doctoral programs are exactly like the real job market. I said they are more similar to the real job market than the match is. Your HR incompetency argument is not relevant here. That's a site's admin issue which has nothing to do with the how you hand out offers. Regarding your second point, I think APA can implement relevant regulations like you have to decide whether you take the offer or not within a certain period of time and once that happens it's a binding agreement, etc. like how doctoral admissions work.

 

[Sanman]

Medical residents I know at my institution make double what I make as an intern.

This is little to do with training and everything to do with funding. CMS (medicare/medicaid) funds graduate medical education. No external source funds for psychology training.

 

[Sanman]

A Theory of Justice - Wikipedia

en.wikipedia.org

Utilitarianism - Wikipedia

Problems with Rawl's Theory

Amazon product

Are we having a philosophical debate now? I thought we were arguing about the match process.

 

[R. Matey]

Utilitarianism - Wikipedia

Amazon product

Are we having a philosophical debate now? I thought we were arguing about the match process.

Hey, you're the one that invoked free will (if there is such a thing). But, if you're a utilitarian, then why are we disagreeing? Unless you believe the white middle class is the group that represents the majority for whom the ethical decision maximally benefits. Based on your book suggestion though, I tend to think not.

Also, directed at no-one specifically. There's a lot of is-ought stuff happening on this thread. Just because that's the way that it is doesn't mean that it can't be better.

 

[WisNeuro]

I didn't take you for a free will person. Completely free choice presumes equitable access to information, resources, and opportunities and, of course, overlooks determining forces that are outside one's control, such as the lottery of birth. I thought the reason we're all here arguing with each other on the internet is so we can promote equitable access to information to become a psychologist. In 2021, the mean age for applicants to the match is 30 (+/- 5 years 1 SD)--prime age for having children. It's not unreasonable for this to be a factor that sites think about accommodating. The answer of "just don't have kids if you care about your career" seems like a line out of "Working Girl" rather than advice you'd give someone trying to balance their work and family life. I would hope in 2023, we would do more to promote work-family balance, not less. I know that our local AMC provides low cost childcare to students and residents and my friends who are doctors and had children placed in top medical training sites and, wait for it, had access to affordable childcare. I'm not saying that's true everywhere, but from my perch, it seems more common for residents and fellows to have kids than what I've seen in psychology. So, If your defense of the status quo in psychology involves claiming that people who choose to have children should hold off having kids lest they be seen in some negative light, then it is a psychology training issue since this advice wouldn't be there if psychology training sites provided this for their trainees either in the form of voucher payments for local daycares or enough money to actually live on. Sites don't because it can't afford it or haven't historically paid for it so they won't.

Think about this: your average psychology intern has more training and as much experience as a newly licensed mid-level therapist, but they are paid around $30k less because they are a trainee. At my internship, both were employed and we were paid significantly less. I take it that's probably the same as the VA, where many/most psychologists go for internship. I don't buy the hand-waving that training sites are doing this purely out of the goodness of their hearts because they love the field that much. There are financial benefits to having interns, otherwise no one would do it. The returns might be smaller than the average intern thinks they are, but there are still returns.

FWIW, I'm probably more in the match camp than no match camp. I do think the bias is in mostly in how people are ranked (algorithms are only as good as their inputs). And while zoom interviews cut down on travel costs, they do so at the expense of provided less information, IMO. That said, match is probably the best we can do in response to more trainees than sites in a given 100 or so miles. I agree with earlier comments that working within a broken system is probably the best we can do.

I am definitely a person who believes that there are large number of life choices completely within your control, having children (notwithstanding cases of rape that result in conception), is one of those choices that you have 100% control over. You also generally get a choice on when to have those children within a certain time frame. It's not unreasonable to plan out career options based on the reality of the situation. It's also not unreasonable to make that choice and plan ahead for that. Ton of people out there have kids at different stages of the process, many without a lot of or no family financial support. I don't believe that we need to cut others off at the knees to make things easier for you given the choices that you have made.

As for reimbursement, I'm all about advocating for changing the reimbursement for trainees. We agree there. As for not buying the "hand-waving," it's up to you about whether or not you but the fiscal reality of a many sites and the fact that they are revenue negative in many places. Particularly sites in metros that have a large share of Medicare/Medicaid patients. I've seen the numbers at several sites, I don't need to speculate there. Others here who also have direct experience are telling you the same thing. We're not saying we agree with it, just that it is a reality.

As for the match, I don't claim that it's the best system, but it sure as hell beats any alternative that I've heard about.

 

[Sanman]

Hey, you're the one that invoked free will (if there is such a thing). But, if you're a utilitarian, then why are we disagreeing? Unless you believe the white middle class is the group that represents the majority for whom the ethical decision maximally benefits. Based on your book suggestion though, I tend to think not.

Also, directed at no-one specifically. There's a lot of is-ought stuff happening on this thread. Just because that's the way that it is doesn't mean that it can't be better.

Better for whom? You can't make it better for everyone. That is the point. Everyone cannot be a psychologist. Making it better for one group makes it worse for the others. It changes the hedonic calculus. The suggestions made about the match, relocating for internship, etc are all about what is best for the trainee. It is not just about the trainee. That was my point.

Similarly, making it easier for those with children disadvantages those that do not have children in a competitive situation.

 

[R. Matey]

I am definitely a person who believes that there are large number of life choices completely within your control, having children (notwithstanding cases of rape that result in conception), is one of those choices that you have 100% control over. You also generally get a choice on when to have those children within a certain time frame. It's not unreasonable to plan out career options based on the reality of the situation. It's also not unreasonable to make that choice and plan ahead for that. Ton of people out there have kids at different stages of the process, many without a lot of or no family financial support. I don't believe that we need to cut others off at the knees to make things easier for you given the choices that you have made.

Seems a bit extreme to say that I'm cutting others off at the knees by advocating for better pay and trainee support, don't you think? Not sure how you got there. Also, I'm not just talking about myself. I have more privilege than most of the folks who had kids in my program. I'm speaking to you on their behalf and other people who have written in to SDN inquiring about what to do in this situation. It was annoying for people to make comments, but ultimately I matched to my top site, was paid pretty well for an intern, and am doing just fine today.

Similarly, making it easier for those with children disadvantages those that do not have children in a competitive situation.

How does more money and childcare vouchers disadvantage people without kids?

 

[WisNeuro]

Seems a bit extreme to say that I'm cutting others off at the knees by advocating for better pay and trainee support, don't you think? Not sure how you got there. Also, I'm not just talking about myself. I have more privilege than most of the folks who had kids in my program. I'm speaking to you on their behalf and other people who have written in to SDN inquiring about what to do in this situation. It was annoying for people to make comments, but ultimately I matched to my top site, was paid pretty well for an intern, and am doing just fine today.



How does more money and childcare vouchers disadvantage people without kids?

More of a broad statement aimed at poorly thought out DEI initiatives, which you seemed to be hinting at. If that's not so, apologies to you. As for advocating for better pay and childcare, sure, I'm all for that. As for the former, that's been on the APA advocacy slate for some time, declining membership isn't helping. As for the childcare, all about who is going to pay for it. Sites almost certain can't given the tight or losing margins on these employees as is.

I guess I'm wondering what practical solutions, based in reality, that people have for the situation. Aside from "burn this mother down." It's nice to have the "you have a magic wand" type answer, but that's hardly realistic. So, what does change look like, and how to you conceivably get there with what you have to work with?

 

[Sanman]

Seems a bit extreme to say that I'm cutting others off at the knees by advocating for better pay and trainee support, don't you think? Not sure how you got there. Also, I'm not just talking about myself. I have more privilege than most of the folks who had kids in my program. I'm speaking to you on their behalf and other people who have written in to SDN inquiring about what to do in this situation. It was annoying for people to make comments, but ultimately I matched to my top site, was paid pretty well for an intern, and am doing just fine today.



How does more money and childcare vouchers disadvantage people without kids?

By changing the calculus. Each person that does not drop out the job market, internship match, etc. increases the competition for others. In the end, someone will not be picked. You just made it a different someone.

 

[R. Matey]

More of a broad statement aimed at poorly thought out DEI initiatives, which you seemed to be hinting at. If that's not so, apologies to you. As for advocating for better pay and childcare, sure, I'm all for that. As for the former, that's been on the APA advocacy slate for some time, declining membership isn't helping. As for the childcare, all about who is going to pay for it. Sites almost certain can't given the tight or losing margins on these employees as is.

Ah, ok. Not a worry. I've been on the business end of a lot of poorly thought out DEI initiatives so that wasn't it. I'm just saying that I think that there is more that can be done to support this type of trainee, which I do think ultimately benefits everyone or at least creates more choices for family planning. I know that some UCCs (including my former ones) have raised pay for interns just recently. On the second issue, and I think that's the issue with training psychologists. There isn't as much money in it. Some of the bigger sites (such as my current institution) can absorb the cost since it's just a matter of hiring staff, but it might be harder for CMHCs, UCCs, etc.

So, what does change look like, and how to you conceivably get there with what you have to work with?

In response to jdawg's earlier comments about money, allowing psychology interns to bill under supervision would be revolutionary. This could involve a training license that states adopt (they exist for all master's level providers), giving interns NPI numbers, or advocating for legislation that allows insurance companies to recognize them as providers. Institutions should recognize them as employees if they don't already and training plans may need to accommodate FMLA, which may include an extended training year if necessary.

 

[WisNeuro]

Ah, ok. Not a worry. I've been on the business end of a lot of poorly thought out DEI initiatives so that wasn't it. I'm just saying that I think that there is more that can be done to support this type of trainee, which I do think ultimately benefits everyone or at least creates more choices for family planning. I know that some UCCs (including my former ones) have raised pay for interns just recently. On the second issue, and I think that's the issue with training psychologists. There isn't as much money in it. Some of the bigger sites (such as my current institution) can absorb the cost since it's just a matter of hiring staff, but it might be harder for CMHCs, UCCs, etc.



In response to jdawg's earlier comments about money, allowing psychology interns to bill under supervision would be revolutionary. This could involve a training license that states adopt (they exist for all master's level providers), giving interns NPI numbers, or advocating for legislation that allows insurance companies to recognize them as providers. Institutions should recognize them as employees if they don't already and training plans may need to accommodate FMLA, which may include an extended training year if necessary.

So, it really wouldn't matter at the state level unless you change CMS guidelines, which currently state something to the effect that it is not reimbursable if the work is part of a requirement for finishing their degree/program. Also, insurance companies can recognize some of them, but many choose to simply cut and paste CMS guidelines when putting together their LCDs. So, I agree, but the federal change is what you need. So, how do you get that done?