VA internships

[psychmama]

Hi. I'm applying for internships at the moment, and was wondering if anyone who's done their internship at a VA hospital would be willing to comment on their experience. From what I've heard, VAs have the reputation for pretty good training combined with somewhat saner hours than most hospitals. I do realize VAs differ a lot, but I'm still interested in hearing opinions from those who've been there.

Thanks.

 

[Therapist4Chnge]

Ditto. I have 4-5 VA interviews, so ANY help would be greatly appreciated. You'd earn some Mod Kudos.....who wouldn't want that?!!!

 

[Cosmo75]

Well heck, who can pass up Mod kudos?

I'm currently on internship at a VA. I've been there since July. I should note that the VA I am at is an inner city VA, which I've been told are somewhat different than those, say, out in the suburbs or "country." Here's my take:

Pros -

• The breadth of training experience. You can pretty much do anything at a VA. The one I'm at does not have a polytrauma unit though (that's at the one across town). We have major and minor rotations, that switch every 4 months. We also carry 4-5 outpatient long-term psychotherapy cases, run groups, etc. We also have the option to do research, administration, and supervise an extern. You customize your schedule on your own with agreement with the fellow interns so there's no overlap. There was so much to choose from, we didn't have an issue.
• If you're interested in PTSD work, this is obviously your place. Even if you don't specifically do a PTSD rotation, it shows up so often that you're going to at least get exposure to it, if not direct training in its treatment.
• Same statement is true with addictions.
• The hours. 8-4:30. From what I can tell (I interviewed at several VAs also) every VA holds to this schedule. It is a truly 40 hour per week internship. The staff and DCT at my site are very protective of the interns not being used as slave labor The days also fly by.
• Didactics. We have 3 hours per week of group seminars of a wide variety of topics.
• The veterans. They're a great group to work with, and are generally very appreciative of what you do for them. There's something to be said for "giving back" to those who served for us.
• You can go back to work at a VA easier if you do an internship at one. Also looks pretty good on your CV.
• The computer charting system is fabulous.
• 10 federal holidays on top of 2 weeks vacation and 10 sick days.

The cons-

• Chronic population. Unforunately many of the vets are vietnam era, and have decades of mental illness and/or substance abuse problems. The chronicity makes it difficult to see any real progress. If you're a hard core CBT-er who likes to give homework and have a shorter treatment schedule, you'll probably be disappointed. Grant it you can do CBT, but you have to be flexible.
• Fatigue. This may be true of all internship. But I feel exhausted a lot of the time when I get home. The days are jammed and you're all over the place a lot of the time. Often your only break is at lunch, or an hour here or there. You come to look forward to cancellations
• It can be depressing. See my first cons comment, as well as seeing the new OIF/OEF vets coming in.
• Dealing with federal employees/the government. Some people know they can't be fired easily, so if you need something administratively done (e.g. computer problems) it can take a long time and/or repeated asking. Things move incredibly slowly and there are a lot of "rules." You learn the loopholes in they system though

I highly recommend the VA for internship. While there are some cons, they don't come close to overshadowing what you'll get out of your year there.

Good luck!

 

[Therapist4Chnge]

I appreciate your insight! It sounds very similar to feedback I've received from others (which is a good thing).

 

[psychmama]

I appreciate your insight! It sounds very similar to feedback I've received from others (which is a good thing).

Ditto! Thanks so much for your thoughtful and comprehensive answer Cosmo. In the area of the country I'm applying, most of the sites are general hospitals. I'm trying to grasp how working in a place like that would be different than working at a VA, and your comments are very helpful in that regard.

Thanks again!

 

[Cosmo75]

One place I interviewed last year was Medical College of Georgia, which split the internship between the VA and the hospital. That gave me some insight into the difference between the VA world and the hospital world. I liked the VA because it had a lot of the qualities I mentioned above, but the hospital part had me a bit more concerned. The hours were considerably longer, you had to carry a pager to be on call for crisis management, etc. I've heard similar stories about internships at other hospitals being considerably more demanding. Not that that's a bad thing per say, but I was looking for more of a balanced year. I've done 70+ hour work weeks in my past life, and that's not something I enjoyed very much. I didn't want to burn out.

 

[psychmama]

Yes. A couple of the places I've interviewed so far (hospitals) say that the hours are about 45-50/wk. However, the interns tell a different story. Some seem fine with the longer hours, while others seem less happy with it. I too worked former jobs where I put in 70+ hrs a week. In addition, I am in a situation where moving closer to the internships for the year would be impossible, meaning I'll have to factor in commute time of 1 hr plus each way for most places.

Glad to hear you made a good choice for yourself and internship. Hopefully things will work out for me too. This process is just nuts!

 

[Therapist4Chnge]

The time committment is definitely different from what I've seen. Some hospitals will tell you up front that 55-60+ is normal, and expected. VAs seems to be good about sticking to 40 hour weeks. Some hospitals offer "protected" research time as part of their hours every week, while others strongly encourage research time....but you need to schedule it outside of your clinical duties.

 

[Cosmo75]

Ah yes, I forgot to mention we also get 4 hours of protected "dissertation or other research (if you've defended) time" per week. That's a very nice perk to have.