October 5, 2016

Internship Process: The Internship Site Perspective

Dr. Jennifer Freeman is an Associate Professor (Research) at the Alpert Medical School of Brown University and Director of Research and Training at the Pediatric Anxiety Research Center at Bradley Hospital. She is also the child track coordinator for the Brown Clinical Psychology Training Consortium.

Dr. Ty Lostutter is an Assistant Professor at University of Washington. He serves as the Assistant Director of the Psychology Internship Program in the UW Department of Psychiatry and Behavioral Sciences.

Research Experiences
1. What makes a site research-oriented? How much time is actually afforded for research at these sites? How many publications typically result, if any, during the internship year? What is research mentoring like on internship?

Freeman: Some internships have research opportunities, but in the absence of protected time and structure it is challenging to make use of those opportunities.  Our internship provides a minimum of four hours of protected time for research, and all of our trainees are matched with research mentors.  That being said, the vast majority of time is spent conducting clinical work.  One of the benefits of a research-oriented internship is learning how to apply evidence-based treatments with a range of clinical groups, and working alongside investigators who are developing those very treatments.  Another advantage is establishing a research collaboration that may extend beyond the internship year, either through a postdoctoral fellowship or through an ongoing distance collaboration.  The number of publications during the internship year varies significantly by student, but the goal in many of our research placements is for the resident to publish at least one paper as part of their experience.

Lostutter: Here is our answer to this question from our website:

The University of Washington’s School of Medicine’s Psychology Internship Program has a long-standing commitment to the academic and research development of its residents. Applicants accepted into the program have sound, productive research backgrounds. Psychology residents may apply to participate in a year-long seminar on research skills and grantsmanship training. Participation in this activity includes the provision of 6 hours per week of release time from clinical rotations to participate in a seminar devoted to teaching skills needed for developing and writing grants, and to pursue development of a grant proposal or research project under the mentorship of an internship faculty member. Participation in the program is most appropriate for those residents who have either completed or are in the latter stages of their dissertation research, are interested in research areas that can be mentored by faculty members of the internship or the department and are looking towards career choices in which grant writing skills will be needed. Residents are not required to participate in the seminar program. Psychology residents not participating in the grantsmanship seminar program may apply for one half-day (4 hours) of release time, per week for research (including dissertation research) with an internship training faculty supervisor. The UW Internship Program is embedded within an extremely productive research community with exceptional resources. Please refer to the faculty page for further information about research collaboration and/or check the University of Washington web site for research interests.

The number of publications that interns complete during the year varies based on the intern’s productivity. We do not have any set criteria about this issue per se, some is good and more is better.
2. What aspects of research are most important for matching at research-oriented sites (e.g., publications, award, grant funding, etc)?

Freeman: All of these aspects of research are considered and weighted fairly equally at our site.

Lostutter: We consider all aspects of applicants’ prior research productivity and their future research interests. Our program is most interested in training individuals who are looking to pursue a career as a scientist-practitioner or clinician-researcher. Most of our trainees go on to post-doctoral fellowships with a research or clinical-research focus.  Most continue on to achieve their long-term goal of becoming faculty in academic medical settings or in a traditional academic setting. A minority of our trainees decide to go into predominantly clinical settings and even fewer become independent clinicians with a private practice.

3. At internship sites that place an emphasis on research, how important is it that there is a supervisor or researcher at the internship site that clearly matches the applicant’s research experience?

Freeman: This is very important at our site.  We are unlikely to consider applicants who plan to continue a line of research in which we have no expertise or obvious mentorship.  If someone has conducted research in a related area, however, and can make the case that they want to branch into a new area with the mentorship we have available, we would consider the applicant if they are strong across the board.

Lostutter: Given our program’s emphasis on research, we think it is important to match applicants’ current research interests, either within the internship faculty, or more broadly, within our university. For the past several years we have successfully matched individuals with research mentors in our home departments (Psychiatry or Rehabilitation Medicine), or if needed, outside our department.  We encourage applicants to suggest potential research mentors who have shared research interests. We have successfully connected interns with “outside” research mentors from other departments at the University of Washington (e.g., Psychology, Global Mental Health, Social Work) as well as within our own departments.  
4. For your internship site and other similar sites, how heavily do you consider and weigh research and clinical experiences?

Freeman: We weight research experience such as publications, poster presentations and academic fit with our program very, very highly.   That being said, we also certainly consider clinical experiences and interpersonal skills on interview.   This is primarily a clinical training year, and we want our trainees to be able to be interested and engaged, and make use of the clinical opportunities that are available.

Lostutter: See answers below.
5. There is a lot of discussion about “fit” in the match process, what exactly do you look for when you look for “fit”?

Freeman: We consider many factors related to “goodness of fit” including research match, clinical match, excitement about the program, and interpersonal strengths.

Lostutter: “Fit” refers to the ways in which an intern’s training goals would be successfully met by completing our program, as well as the clinical skills that complement our rotation sites. The better the fit, the greater the desire to have an applicant match to a program. Thus, a strong application is one in which an applicant can show that their previous training is complementary to our program and also illustrate how our training opportunities help the applicant realize their long-term career goals.  Highlighting their clinical training and research throughout their materials would help the reviewer understand the reciprocal fit for both the applicant and the program.  

Clinical Experiences
1.    How do you decide what types of applicant clinical experiences are a good match to your program? How important is it to have experience in the types of rotations/ clinical experiences offered at the site?

Freeman: It is helpful to have some similar clinical experiences that generally match the types of rotations to which you are applying but it does not need to be exact and it is somewhat dependent on the track.  If you are applying to the child track, you need to have worked with children and teens but you do not need to have had inpatient experience.  If you are applying to the pediatric track, you need to have worked with children with medical problems but not specifically that match our rotations.

Lostutter: The University of Washington School of Medicine Psychology Internship Program is looking for applicants with strong clinical experiences and research interests. Several of our rotations are located in medical settings; having relevant experience can be helpful, but is not a requirement. This is an intensive training year designed to round out applicants’ clinical experiences, thus applicants are encouraged to illustrate how their previous clinical experiences may be useful in our rotations. We have previously taken applicants with and without previous experience in the rotations that we offer.
2. What are the average number of intervention, assessment, and supervision hours that are typical among individuals who match at research-oriented sites?

Freeman: We have four different tracks, and each of those tracks evaluates applications somewhat differently.  Our overall philosophy is to evaluate fit and academic potential rather than the specifics of clinical experience in this way.

Lostutter: Here our number based on last year’s cohort. While several applicants worry about their clinical hours, we are more focused on an applicant’s ratio of clinical hours to supervision. We value quality of clinical and supervision experience not quantity.

Here is our own website FAQ specifically for Child Track answering this same question:

Our program is likely to match with individuals who have a solid foundation in clinical training with both depth and breadth of experience as part of a high quality graduate program. This encompasses course work, practicum, and supervised clinical experience. Successful applicants typically have at least 700 total practicum hours (including assessment, intervention, supervision and support), and usually substantially more than that. Our internship provides a lot of opportunities to advance assessment skills, but our program best suits individuals who come in with some experience with administration and interpretation of cognitive and achievement testing (i.e. WISCs, WJ Achievement etc), as well as some DSM-V diagnostic assessment experience. Additionally, applicants should have experience writing comprehensive integrated reports (usually at least 5) although this can vary across graduate programs. In sum, it is unusual for us to match with individuals who do not have at least some assessment experience as described above.

3. There appear to be some part- time internships that are not APA accredited. Are there limitations to non-APA accredited internships? What can I do with an APA accredited internship that I can't do with a non- accredited internship (e.g., any clinical settings that I can or can't I work in)?

Freeman: I am not familiar with the specific rules, but I believe it may affect licensure as well as eligibility for certain postdoctoral positions.

Lostutter: The University of Washington’s School of Medicine’s Psychology Internship Program does not offer part-time internships. The program has been continuously accredited by the American Psychological Association (APA) since 1965, and has built a strong national reputation as a leading medical school-based internship, providing training in general adult psychology, general child psychology, and behavioral medicine/health psychology and neuropsychology.

“ According to the APA; "Accreditation is a process that assures the educational community and the general public that an institution or a program has clearly defined and appropriate objectives and maintains conditions under which their achievement can reasonably be expected.” They have a webpage dedicated to explaining the importance of choosing accredited programs. Please review http://www.apa.org/ed/accreditation/about/about-accreditation.aspx for more information. There is also a recent APA article on this issue that might be of interest: http://www.apa.org/gradpsych/2010/11/unaccredited.aspx

4. Does it seem possible that any APA-accredited sites might be willing to take on an additional intern on a part-time, unpaid basis, after the match process has ended? In other words, if I only rank sites that seem compatible with my parenting responsibilities on a full-time basis and there are few of those so I don't end up matching, does it seem possible that sites I didn't rank might be open to hearing from me about such an arrangement, after the fact? Is this something that should or should not be brought up during the interview process?

Freeman: This is not something that we do at our site.

Lostutter: The University of Washington’s School of Medicine’s Psychology Internship Program does not offer unpaid or part-time internship slots after match. Based on our state laws and fundamental belief that unpaid internships seem unfair, we would not consider this an option for our program. We cannot speak for other internship programs, as each program has their own philosophical beliefs and institutional regulations.

5. If I decide to take the year off and apply for internship the following year instead of this year, how understanding are sites likely to be about a full year of no clinical work due to full-time new parenthood? In other words, will I be viewed as "stale" if I apply in November 2017 when my last externship ended in June 2017, if I didn't apply for another externship for the 2017-2018 year?

Freeman: I do not think this would be a concern at our site.  A year off in the absence of any clear reason for taking time off may raise more questions.

Lostutter: If an applicant has the appropriate training and a strong application, taking a year off would not necessarily cause a problem for our site. If the applicant is concerned, they could explain their year off in their cover letter or have letter writers speak to this issue in their recommendation letters.
6. How important are the essays in determining whether an applicant receives an interview? What do you look for in these essays?
Freeman: The essays are one of many factors that determine whether an applicant receives an interview.  At our site, we are particularly interested in learning about what makes the applicant stand out, learning about their research interests/career trajectory, and getting to know the applicant a more personal level.
Lostutter: Essays are an important part of an any application. They allow the program to evaluate the applicant’s writing and thinking process, and also provide an important impression when considering an application in its totality. Here is another APA article on tips for writing APPIC essays: http://www.apa.org/gradpsych/2005/09/pulling.aspx
Interview Process
1. If an applicant cannot make it to the scheduled interview day and chooses to conduct a phone interview instead, is this generally looked down upon/might it affect the site’s ranking of the student?

Freeman: It may depend on why you can’t make it.  If you can’t make it because you are interviewing somewhere else, there is an implicit message to the program about where we stand in your rankings.  It is also harder to convey enthusiasm over the phone vs. in person over the course of a day.  These factors may affect your ranking.

Lostutter: We strongly encourage applicants to attend our Open House (scheduled for Wednesday 1/4/17), but we understand that some applicants will be unable to. Our internship program has consistently matched with individuals who were unable to make it to our Open House and we do not penalize applicants who are unable to attend (i.e., it will not affect their ranking). For those individuals who are unable to attend Open House, they typically set up phone or video conferencing meetings at least with the Track Coordinators and other faculty within their perspective tracks. We do not typically meet with applicants individually on other dates outside of our Open House experience.
2.What are some of the most common interview questions applicants should prepare for?  

Freeman: Know your goals for internship year, your goals for beyond internship, your challenging clinical cases – everything your DCT has prepared you for will typically get asked by someone.
Lostutter: The applicant should be prepared to answer questions about their clinical and research experiences and how they see those experiences fitting into their training goals during their internship year.

3. During an interview, what stands out most about an applicant?  
Freeman: In my experience, when applicants have done their homework and have very specific questions about our clinical programs and our research opportunities, that is much more compelling than the “garden-variety” questions we all get (“strengths & weaknesses of the program”, etc.)

Lostutter: Ultimately, we would like applicants to be happy and successful during their internship year. The individual who stands out is well-prepared to talk about their experiences and the ways in which they see their own clinical experiences and research interests as a fit with our program. Applicants should strive to be genuine, curious, and friendly.
4. How much can/should I ask about sites being parenting-friendly during the interview process? Although a site isn’t supposed to ask about this, is it a good or bad idea to mention that I have an infant at home during the interview?

Freeman: I do not think it is a problem to be honest about your life and your family responsibilities as long as it does not take over and limit other discussion during the interview.
Lostutter: As an interviewee, applicants are within their rights to ask about work hours and other child care issues. While the APPIC website recommends that internship sites not specifically ask these types of questions, once an applicant brings up the topic, the interviewer might ask other questions regarding these issues.

The APPIC website states: “. . .  while these questions may not be inherently illegal, they may suggest to some applicants improper motivation by the interviewer: The question about being older may make the applicant suspect that being older is a disadvantage, creating a possible allegation of age discrimination. The question about child care may make the applicant suspect that being married or involved in a relationship, or having children will place him/her at a disadvantage. Of course, the question would become a permissible one if the applicant first raised the issue of the hours and concern about child care.”

Within our program we have a long history of being “a family friendly program”, supportive of diverse families with and without children. We are happy to answer questions about family related issues.  We also recommend that applicants speak to either our current or past trainees about their experiences raising children during their internship year.
5.  I'm a clinical student at a program in a somewhat rural area. My prac experience includes a UCC and two private practices. How do I make myself appealing to potential VA and academic internship sites?

Freeman: We have a VA site within our consortium and we regularly have trainees rotation through the VA who have not worked at a VA before, but have strong interest in areas relevant to that population such as PTSD, primary care, severe psychopathology, behavioral medicine and substance abuse.  Getting experiences in these populations where possible can be helpful.

6.  My direct advisor is not clinical or counseling herself, and has no experience doing internship herself. She would write me an incredibly strong letter in general, but won't necessarily be able to appeal directly to what internship sites want to hear. Should I still use her as a letter writer?

Freeman: Having a “very strong” letter is generally weighted more heavily than the background of the letter writer although it is certainly dependent on the specific applicant/letter writer.  As long as other letters are being written by a doctoral level psychologist, this does not seem like a concern.

7.  Would my DCT be a good use of a letter writer if they have to include information on me anyway?
Freeman: This depends on the specific supervisory relationship you have with your DCT.  If your DCT is also a clinical and/or research supervisor, it may make good sense for them to write a letter that goes beyond what they say for everybody in the role of DCT.

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