Monthly Archives: February 2011

Predoctoral Clinical Psychology Internships

For the last six weeks or so I was interviewing for a position with various predoctoral psychology internship programs. All Ph.D. candidates in Clinical Psychology are required to complete a one-year internship as a capstone clinical training experience (and a dissertation, the capstone of the research and scholarship side of the Ph.D.). It’s advisable to defend the diss before the late day of the internship, since one is a Ph.D. after these requirements are met, and hence one can start collecting postdoctoral training hours immediately after the internship ends. 1-2 years worth of full-time postdoc hours are required for licensure in most states and in the District, along with passing or scoring at a particular level on the licensure examination (the EPPP, or Examination for Professional Practice of Psychology). There’s also opportunity to apply for an advanced certification five years later (by the American Board of Professional Psychology), which saves a lot of trouble when you’re moving between states since it’s more transferrable than a regular state license and makes it clear that you are very highly qualified.

Internships are very competitive, as there are far fewer internship spots than there are applicants. “Accredited” internships, those that have been approved by the American Psychological Association, are the most desirable since having one of these means you won’t have trouble getting licensed (whereas for a non-accredited internship, you’re burdened to produce proof that your training was worthwhile) and increases the pool of jobs and postdoctoral positions available to you. Hence, these are typically the most competitive programs. I put a lot of work into this process (which involves carefully selecting sites based on recommendations from others and publicly available information, carefully calculating my total hours of relevant experience, and crafting multiple essays and cover letters that distill my qualifications, professional identity, and unique suitability to any particular site down to around 2500 words per application) and applied to a lot of sites, and I was offered a relatively large number of interviews, all at accredited sites.

Interviews themselves are quite variable, some lasting a couple of hours, some taking the whole day. They might include meetings with individual or two-person teams of staff members, a group interview with other applicants, a funny cocktail-party type mingle session, you sitting at the end of a table while twelve people wearing masks of analytic neutrality ask questions about psychoanalytic theory. Sometimes there’s a facility tour, sometimes there’s a non-evaluative meeting with current interns (always a good sign when the interns can speak freely about where they’re working), sometimes they give you lunch. Questions vary widely—I’ve discussed sample clinical vignettes, presented my own cases, responded to inquiries about what I do for fun, the last song I listened to (Beyoncé… too revealing?), and what a suitable metaphor might be for how I engage with a treatment team. I’ve been asked to talk about conflicts with colleagues and supervisors and how I resolved them. I’ve been asked about how I handle sexual and aggressive feelings I might experience toward my patients. I’ve talked about mistakes I’ve made as a therapist, my weaknesses, my hopes for the future. I’ve spoken carefully, attempting to appear confident but not narcissistic, competent but not unwilling to learn, about my strengths. I’ve been asked how I address crises and surprises, how I screen for suicidality, how I would feel about sending someone to the hospital against her will. I’ve talked about the challenges and self-exploration involved in working with clients who are culturally different from me, and times I would do things differently if given a second chance. I’ve responded to complex questions about what I imagine to be the mechanism for change in psychotherapy and what distinguishes my clinical position from others. I’ve talked about how I can be a feminist and like psychoanalysis at the same time, and where existential-phenomenological psychology fits into my current clinical practice. These are probing and tough questions and not all that easy to prepare for. Some questions are predictable, like “why do you want to work here?,” but there are often curveballs, so you just have to handle the pressure and know what you’re talking about.

The next step was to submit a rank-order list by the deadline (Feb. 2 this year). All of the sites submit rank lists, too. An online matching program, which I had to pay a fee to participate in, puts these lists together to give the candidate her highest ranked site that also ranked her/ is willing to work with her. Unless, that is, applicants who the site ranked more highly fill those spots because they did not match with a place ranked more highly on their own rank lists (most sites have 2-6 available slots, mode of 3 for the places I ranked). This is apparently done using the same algorithm that matches med students to residency programs. It causes a lot of distress among applicants trying to figure out whether or not the official instruction to rank in the order of their genuine preferences (excluding any site that’s so undesirable it would be worth going through this process all over again next year in order to avoid ending up with that internship program) is really the best way to end up matching anywhere, if not to their favorite site. An acquaintance conducting mathematical research in the area of ranking systems, introduced to me by an old friend who was aware of my dilemma, advised me to go ahead and rank based on genuine preferences, as did a number of friends from my graduate program for whom the system worked: “go with your gut.”

Although I anticipate a favorable outcome, I feel pretty worn down after this process. Overall, it’s inconvenient, expensive, difficult, and deeply stressful. It requires travel in December and January, most sites do not offer phone/ Skype interviews, as demand is high enough that they can require/ almost require (you might be regarded by a site less favorably, seen as not seriously considering the site, if you opt for a phone interview) people travel to BFE to interview. I didn’t make it to one of my sites because of snowstorms, and they were unable to accommodate me with a phone interview. A few places, aware that graduate students are typically not earning much of a living, nor are independently wealthy, waive this requirement and conduct no on-site interviews, but this is the exception. It’s also not an option these days to restrict one’s applications by geographic location too narrowly, and candidates almost always have to travel for interviews and relocate for the internship year (which occasionally turns into a second, postdoc year, or even a job, so the move can be worthwhile—this isn’t an option for most interns, though, and many don’t want to stay in the town where they land an internship). Applicants have to apply to a lot of places to make sure they get enough interviews to match, and each application costs something—the price per application goes up after a certain amount of apps, too, to discourage sending out a huge number of apps. This discouragement is supposedly justified by statistics from past years which show that more applications doesn’t equal a greater likelihood of matching after a certain number (because applicants get sloppy/ generic after so many applications? because if you’re not getting invited to interview at some of the first sixteen you apply to, then probably it means that nobody will have you?). It’s also meant, probably, to counterbalance applicant anxiety about applying to a ton of places to make sure you get plenty of interviews (I did this, but not as extremely as some, and felt justified because I was applying to many sites that are known for their excellence or uniqueness, and therefore are particularly popular) or to make life easier for the system—not having to handle a glut of applications, not having less attractive applicants crowded out of interview schedules by applications from more qualified applicants who probably won’t end up ranking their “fall back” sites very highly, anyway.

The overall process also involves a lot of waiting punctuated by stressful situations: first waiting for phone calls from interview sites, then waiting for interview dates to arrive (with highly stressful, competitive interviews every few days), then composing a final and obligating rank list (you must accept the site you ranked that offers you a position—if you turn down a match, there’s little chance that any program will accept an application from you in the future). I agonized over producing a rank list quite a bit and submitted my list close to the deadline. I even made a change to my list after this deadline and faxed it to the matching service (aside to psychology folk: you can do that, guys, but it has to be within a couple of days), and now have a list that reflects a stable set of preferences.

Following submission of a rank-order list, there’s about a three week wait to see if and where one has matched. The date is Friday, Feb. 25 this year.  If it’s a no-go, there’s a round two where any remaining spots/ remaining people scramble to hook up, like the last week before prom or something.  If you get one, especially if you get one of your favorite ones, it’s glorious.

Update: Yes, I got one!  I think it will be good.