To Post-Doc or Not to Post-Doc?

[psychguy158]

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I'm wondering if folks might be able to share the advantages and disadvantages to completing a post-doc year versus going straight into the workforce. For me specifically, I am interested in a field within Behavioral Medicine/Health Psychology (likely staying within the VA system), so if there are certain board certification requirements responders might be aware of, could you also address those concerns as well?

 

[WisNeuro]

Could make it much more difficult to get licensed in many states if you ever moved out of the VA system and/or wanted to moonlight.

 

[AcronymAllergy]

The main advantages of a formal postdoc are the additional year of dedicated, advanced training, meaning you'll be learning much of what you might in a year of supervised practice, but with generally lower workload expectations, more supervisory support, and other training perks (e.g., didactics). It can also be easier to have someone verify/document your hours now and in the future. I don't know if there are specific board certification reqs in health psych for a postdoc, so I'll leave that to others, but you'll also want to check the ABPP website. Formal postdocs also have explicit due process and grievance procedures. Depending on the site, trainees may be better protected overall than employees.

The main advantages to going straight into the workforce are primarily better pay and more independence. For VA specifically, it also gives you one more year toward your pension. It may also give you one more year toward retirement contributions via TSP (I can't remember if fellows are eligible, but I don't think they are).

If you skip postdoc, just be sure to receive scheduled supervision during the first year and obtain written documentation of such. I'd recommend at least two hours weekly, although you can check individual state requirements if you know where you'll be practicing. Otherwise, like WisNeuro mentioned, it can make obtaining licensure in states that require the year of supervised practice difficult if not impossible.

 

[R. Matey]

They want a postdoc

Specialty Specific Requirements - ABPP

Clinical Health Psychology In addition to the general foundation requirements, the clinical health psychology specialty requires completion of an organized doctoral education and training program in professional psychology that includes an internship. The specialty also requires postdoctoral...

abpp.org

 

[Sanman]

They want a postdoc

Specialty Specific Requirements - ABPP

Clinical Health Psychology In addition to the general foundation requirements, the clinical health psychology specialty requires completion of an organized doctoral education and training program in professional psychology that includes an internship. The specialty also requires postdoctoral...

abpp.org

They actually don't require a formal post-doc from my read, but it takes longer. If you can get the job you want at the VA right out the gate, then you may want to skip it. However, The post-doc with make ABPP easier and will make you more competitive if you are applying for jobs in more desirable locales and, as mentioned above, gets you some credit in VA land.

 

[R. Matey]

They actually don't require a formal post-doc from my read, but it takes longer. If you can get the job you want at the VA right out the gate, then you may want to skip it. However, The post-doc with make ABPP easier and will make you more competitive if you are applying for jobs in more desirable locales and, as mentioned above, gets you some credit in VA land.

Curious where you got "no postdoc" from the following:

Postdoctoral Practice Experience and Supervision Requirements
By its nature, the specialty of Clinical Health Psychology denotes a level of practice requiring preparation beyond doctoral requirements. An individual whose degree is from an APA or CPA accredited program in Professional Psychology must have completed one of the three following training experiences:

• The applicant can apply for certification after one postdoctoral year upon successful completion of at least one year of an APA/CPA accredited Clinical Health Psychology postdoctoral fellowship OR
• The applicant can apply for certification after two postdoctoral years upon successful completion of either:

1. An APA/CPA accredited postdoctoral fellowship in an area other than clinical health psychology if at least 50% of the training was in clinical health psychology, and one additional postdoctoral year of clinical health psychology experience OR
2. A non-accredited but APPIC listed clinical health psychology fellowship and one additional postdoctoral year of clinical health psychology experience OR
3. The applicant can apply for certification after three postdoctoral years including a one-year postdoctoral supervised experience in professional psychology, and two additional years of post doctoral experience in clinical health psychology.

 

[Sanman]

Curious where you got "no postdoc" from the following:

Postdoctoral Practice Experience and Supervision Requirements
By its nature, the specialty of Clinical Health Psychology denotes a level of practice requiring preparation beyond doctoral requirements. An individual whose degree is from an APA or CPA accredited program in Professional Psychology must have completed one of the three following training experiences:

• The applicant can apply for certification after one postdoctoral year upon successful completion of at least one year of an APA/CPA accredited Clinical Health Psychology postdoctoral fellowship OR
• The applicant can apply for certification after two postdoctoral years upon successful completion of either:

1. An APA/CPA accredited postdoctoral fellowship in an area other than clinical health psychology if at least 50% of the training was in clinical health psychology, and one additional postdoctoral year of clinical health psychology experience OR
2. A non-accredited but APPIC listed clinical health psychology fellowship and one additional postdoctoral year of clinical health psychology experience OR
3. The applicant can apply for certification after three postdoctoral years including a one-year postdoctoral supervised experience in professional psychology, and two additional years of post doctoral experience in clinical health psychology.

This could be a three years at a paid position. First year supervised by a fellow clinician. So, pretty much any GS-11/12/13 job with two extra years experience would meet the requirement.

 

[Sanman]

Postdocs are paid

Post-docs are usually paid (not always). Not all paid positions are formal post-docs. It's that thumbs and fingers thing. My point was that if you accept a permanent position straight out of internship, you can still ABPP as long as you get one year of supervision and two years of additional job experience.

 

[R. Matey]

Post-docs are usually paid (not always). Not all paid positions are formal post-docs. It's that thumbs and fingers thing. My point was that if you accept a permanent position straight out of internship, you can still ABPP as long as you get one year of supervision and two years of additional job experience.

I deleted the last post because I didn't want to engage any further. But since we're here: Sure, ok. I think we're getting into what defines a postdoc, which is not necessary since we're both saying that some type of training past the doctorate is necessary.

Edit: If some individual supervisor somewhere wants to pay a person in a staff position and call it a postdoc to further their career, I can see how it might meet technical requirements, but I'd have questions about that person's training to do whatever it is they're doing.

 

[Therapist4Chnge]

A formal post-doc will provide the clearest path to licensure and board eligibility. I wouldn’t recommend skipping post-doc, even if some states decided to stop requiring them, a mistake IMHO.

 

[Sanman]

I deleted the last post because I didn't want to engage any further. But since we're here: Sure, ok. I think we're getting into what defines a postdoc, which is not necessary since we're both saying that some type of training past the doctorate is necessary.

Edit: If some individual supervisor somewhere wants to pay a person in a staff position and call it a postdoc to further their career, I can see how it might meet technical requirements, but I'd have questions about that person's training to do whatever it is they're doing.

Happens all the time. I have supervised new grads so that they could get licensed in other states. Certainly would count as a supervised year. The VA even has dedicated supervision groups for those in staff positions to qualify for ABPP.

 

[R. Matey]

Happens all the time. I have supervised new grads so that they could get licensed in other states. Certainly would count as a supervised year. The VA even has dedicated supervision groups for those in staff positions to qualify for ABPP.

Hopefully they're getting good training.

 

[Sanman]

Hopefully they're getting good training.

Well, even if they are not, the groups were setup by folks sitting on the ABPP board. What does that tell you?

 

[R. Matey]

Well, even if they are not, the groups were setup by folks sitting on the ABPP board. What does that tell you?

It tells me that (1) the ends still don't justify the means and (2) provides further evidence that board certification in psych holds little water outside of neuro and rehab where the paths seem to be more well-defined.

Edit: This conversation reminds me of my board certification in counseling. I received a decal sticker with "board-certified counselor" in big letters along with a letter citing a study that counselors who referred to themselves as board-certified were perceived by their clients as more competent thus we were being encouraged to refer to ourselves as board certified. I cancelled my board certification that same day.

 

[Sanman]

It tells me that (1) the ends still don't justify the means and (2) provides further evidence that board certification in psych holds little water outside of neuro and rehab where the paths seem to be more well-defined.

Edit: This conversation reminds me of my board certification in counseling. I received a decal sticker with "board-certified counselor" in big letters along with a letter citing a study that counselors who referred to themselves as board-certified were perceived by their clients as more competent thus we were being encouraged to refer to ourselves as board certified. I cancelled my board certification that same day.

Don't want to the member of a club that would have you as one of its members, eh !?

 

[R. Matey]

Don't want to the member of a club that would have you as one of its members, eh !?

Lol, I won't. No matter how high your leather backed chairs are!

 

[Sanman]

It tells me that (1) the ends still don't justify the means and (2) provides further evidence that board certification in psych holds little water outside of neuro and rehab where the paths seem to be more well-defined.

Edit: This conversation reminds me of my board certification in counseling. I received a decal sticker with "board-certified counselor" in big letters along with a letter citing a study that counselors who referred to themselves as board-certified were perceived by their clients as more competent thus we were being encouraged to refer to ourselves as board certified. I cancelled my board certification that same day.

There is a fine balance between improving expertise and becoming so esoteric in your requirements as to be irrelevant. It is a fine line.

 

[R. Matey]

There is a fine balance between improving expertise and becoming so esoteric in your requirements as to be irrelevant. It is a fine line.

Still an ends-means argument though and an unnecessary one considering the training models to gain sufficient knowledge exist. Granted, in my opinion, many specialties in psych are fairly arbitrary as they do not have a sufficient content base to warrant an entire certification process. So, whatever ppl are doing to skirt their own stated training requirements is probably fine, but a bit of a hustle considering it's likely unstandardized across settings.

 

[Sanman]

Still an ends-means argument though and an unnecessary one considering the training models to gain sufficient knowledge exist. Granted, in my opinion, many specialties in psych are fairly arbitrary as they do not have a sufficient content base to warrant an entire certification process. So, whatever ppl are doing to skirt their own stated training requirements is probably fine, but a bit of a hustle considering it's likely unstandardized across settings.

Depends on the training. We already have doctorates. How much more specialization do you want to push while society is going the opposite direction (more midevels). Non-standardized training does not mean bad training. Psychology has not setup the funding to create standardized training that is universal in all areas at the post-doc level. IMO, skip the requirements and just have a test to determine competence. You either know your stuff or you don't. I've learned plenty on the job.

 

[R. Matey]

Depends on the training. We already have doctorates. How much more specialization do you want to push while society is going the opposite direction (more midevels). Non-standardized training does not mean bad training. Psychology has not setup the funding to create standardized training that is universal in all areas at the post-doc level. IMO, skip the requirements and just have a test to determine competence. You either know your stuff or you don't. I've learned plenty on the job.

Maybe, and to your point, CACREP, for instance, has yet to justify its own existence given that their programs do not produce better counselors on any measurable outcome as far as I know. Nevertheless, I'm hoping I don't have to harangue you on the dangers of unstandardized training in healthcare, regardless of whether the money is there. The only point I'm making is that I wouldn't want to take shortcuts if those shortcuts compromised the care I can deliver to patients.

However, if it could be shown that on-the-job training is just as good as a formal postdoc, then there is no reason for the postdoc to exist. I personally think health psychology should be integrated into treatment plans at least to some extent since its mostly MI and CBT anyways. I perceive on these points we largely agree.

 

[Therapist4Chnge]

Maybe, and to your point, CACREP, for instance, has yet to justify its own existence given that their programs do not produce better counselors on any measurable outcome as far as I know. Nevertheless, I'm hoping I don't have to harangue you on the dangers of unstandardized training in healthcare, regardless of whether the money is there. The only point I'm making is that I wouldn't want to take shortcuts if those shortcuts compromised the care I can deliver to patients.

However, if it could be shown that on-the-job training is just as good as a formal postdoc, then there is no reason for the postdoc to exist. I personally think health psychology should be integrated into treatment plans at least to some extent since its mostly MI and CBT anyways. I perceive on these points we largely agree.

I guess if someone is a generalist and they have 800-1000hr of mostly therapy and supervision, maybe. Since specializing has become more of a thing, I view post-docs as even more important. From a pure learning perspective, I learned more from 2 years (albeit 55-70+hr wks) of fellowship than I did from doctoral training. Of course the information was much more applicable to my day-to-day work, but there was also the volume of work. I can look back and laugh at what I thought was a lot of work in my first year of fellowship. You just get more efficient, but it takes time and volume of cases.

The vast majority of trainees still don't know what they don't know, which is where a post doc / fellowship would be particularly helpful.

 

[PsychPhDone]

I'm wondering if folks might be able to share the advantages and disadvantages to completing a post-doc year versus going straight into the workforce. For me specifically, I am interested in a field within Behavioral Medicine/Health Psychology (likely staying within the VA system), so if there are certain board certification requirements responders might be aware of, could you also address those concerns as well?

You may have difficulty securing a bmed staff psychologist position in a flagship VA without a postdoc. Might be less of a factor in places where it's harder to recruit.

 

[Sanman]

However, if it could be shown that on-the-job training is just as good as a formal postdoc, then there is no reason for the postdoc to exist. I personally think health psychology should be integrated into treatment plans at least to some extent since its mostly MI and CBT anyways. I perceive on these points we largely agree.

As the quality of doctoral training, post-docs, and job training varies. Not sure how you accurately measure that in the current system. Not to mention that health psych itself is such a broad term as to be a bit pointless at times. Does spending a year in pain clinic and smoking cessation programs qualify you better to take a job doing transplant or bariatric surgery evals? It is all health psych after all. Agree that much of this could be integrated more broadly. Not to mention that specialization is not required to perform the activity in psychology. Outside of neuropsych, I am less sold on the merits of post-doc as I get older. Training post-docs for several years, there are things that job training does better (knowledge of proper billing for example) and things that post0docs do better. Not sure we consistently produce someone better than a clinician with an equivalent year of job experience.

However, it is easier to just go along and do the post-doc if you don't land the intended job immediately.

 

[Sanman]

I guess if someone is a generalist and they have 800-1000hr of mostly therapy and supervision, maybe. Since specializing has become more of a thing, I view post-docs as even more important. From a pure learning perspective, I learned more from 2 years (albeit 55-70+hr wks) of fellowship than I did from doctoral training. Of course the information was much more applicable to my day-to-day work, but there was also the volume of work. I can look back and laugh at what I thought was a lot of work in my first year of fellowship. You just get more efficient, but it takes time and volume of cases.

The vast majority of trainees still don't know what they don't know, which is where a post doc / fellowship would be particularly helpful.

Specialized training has become more of a thing. On the therapy side of things especially, I don't always see a consistent pathway for clinicians into relevant jobs. I know health psych folks that work in geropsych and vice versa, I know some that specialized in health psych and took generalist of PTSD jobs once finished at the VA. Most rehab jobs outside VA are in sub-acute working for companies that hire anyone with relevant experience. Outside of neuropsych/assessment, which is a separate skillset, It really depends on how serious you are about your career. PP is the wild west where most are not hiring on quality of training.

 

[BuckeyeLove]

Single handedly the most important part of my training. Invaluable. An entire year where you can take in and digest and learn all while getting paid and having fun. If you’re doing neuro or forensic work (or both) absolutely necessary today IMHO.

 

[WisNeuro]

Single handedly the most important part of my training. Invaluable. An entire year where you can take in and digest and learn all while getting paid and having fun. If you’re doing neuro or forensic work (or both) absolutely necessary today IMHO.

Agreed, there was a metric ****ton of learning that went on in postdoc. There was no way the additional experiences (med school coursework, wada, many didactics, LTEMU,, etc) would have been able to be done in a work til license or PP postdoc setting. I would not refer out to another neuropsych who did not do a formal postdoc at this point.

 

[R. Matey]

I guess if someone is a generalist and they have 800-1000hr of mostly therapy and supervision, maybe. Since specializing has become more of a thing, I view post-docs as even more important. From a pure learning perspective, I learned more from 2 years (albeit 55-70+hr wks) of fellowship than I did from doctoral training. Of course the information was much more applicable to my day-to-day work, but there was also the volume of work. I can look back and laugh at what I thought was a lot of work in my first year of fellowship. You just get more efficient, but it takes time and volume of cases.

The vast majority of trainees still don't know what they don't know, which is where a post doc / fellowship would be particularly helpful.

Largely agree though I do wonder how specialty specific that experience is. Still, I did a postdoc in primary care and am now doing a fellowship at the local AMC and I've learned a ton in the last two years.

 

[boomshakalaka]

Single handedly the most important part of my training. Invaluable. An entire year where you can take in and digest and learn all while getting paid and having fun. If you’re doing neuro or forensic work (or both) absolutely necessary today IMHO.

100% true. I have this conversation with trainees every year. A formal postdoc served as a springboard for the rest of my career and board certification. Not only are you gaining another year of specialized experience, but you are cultivating professional relationships that you’ll have for the rest of your career. For forensic or neuro practice, postdocs are absolutely essential. I’ll even go out on a limb and say that a formal postdoc in any speciality is well worth it. Why not give yourself the best opportunity to be competitive in a saturated job market?

 

[summerbabe]

Single handedly the most important part of my training. Invaluable. An entire year where you can take in and digest and learn all while getting paid and having fun. If you’re doing neuro or forensic work (or both) absolutely necessary today IMHO.

I’m a generalist therapist and would also support non neuro or forensic postdocs (at quality training sites).

Continued exposure to different experiences and career paths (did postdoc at a ‘flagship’ VA medical center that has tons of rotations) plus a year of transitioning from student to professional was invaluable and gave me a lot of needed clarity and confidence compared to if I’d gone into the workplace after internship.

I also came out of postdoc with some great references and have helped me to land both of my early career jobs since you are seen more as a colleague than as a trainee.

Lastly I think many employers look favorably upon people making a commitment to pursue additional training that comes with some financial sacrifice. Not everybody’s life circumstances can allow for this but if one is able to, I think there are more pros than cons.