Tag Archives: graduate school

Are we producing too many trainees for internship—but not enough for the nation?

The psychology workforce is a numbers game. Are we winning or losing? (Source: Numbers by Stimpdawg on Flickr. Some rights reserved.)

The psychology workforce is a numbers game. But with the internship crisis, are we winning or losing? (Source: Numbers by Stimpdawg on Flickr. Some rights reserved.)

Given that 1 in 4 students who enter the APPIC match do not actually match (and nearly 1 in 2 fail to match directly from APA accredited programs to APA accredited internships – see #11) it seems natural to entertain the idea that we have too many trainees. Or that we are producing too many psychologists who are flooding the market, cheapening the field, and so forth. But is any of this really true?

Researchers Parent and Williamson (2010) did find that some programs contribute disproportionately to the match imbalance by sending significantly more students on internship each year. That might be enough for some to jump to the conclusion that these programs are just too big. Although, I ask: too big for what?

See, I worry that the internship crisis is causing us to identify red herrings, or fake culprits. While lots of students are unequivocally a problem in the crucible of poor match rates and failed matches, this doesn’t say anything about the need for more or less psychologists in the workforce.

Whether you agree or disagree with Malcolm Gladwell, who said in his latest book that we should stop connecting class size with educational outcomes, it’s important to think through what a change in the number of healthcare providers means in the United States. As a baseline, I found that about 5,400 people sit annually for the EPPP, our profession’s licensing exam and on average, 3,800 pass the exam each year. And now I’ll provide three and a half data sources suggesting we may actually need more psychologists in years to come:

1)      New psychologists are finding jobs. According to the latest data we have available—the Doctorate Employment Survey (APA, 2011)—psychologists within one year of graduation had an unemployment rate of 6%, at least 2-3% points lower than the historical national average. More than two thirds of graduates had a job within the first three months of completing their programs and 72% said their current job was their first preference.

2)      NAMI estimates that 11 million people in the U.S. with mental illnesses lack insurance coverage. The Affordable Care Act (better known to some as Obamacare), combined with our earlier Mental Health Parity and Addiction Equity Act, will bring more people than ever before into our nation’s insured healthcare system, almost certainly increasing demand for mental health services.

3)      As of January 1, 2014, the United States counted 3,896 known, designated mental healthcare professional shortages across the country. These are shortages of core professionals—psychologists included—that by definition cannot meet the basic mental health needs of whole geographic areas, specific facilities, and/or underserved groups before there are so few practitioners relative to the population. Every state has a demand for more mental health care in some way or other. 

3.5)     As of this month, the US Bureau of Labor Statistics estimates increased employment of 18,700 psychologists by 2022. They say, “Employment of clinical, counseling, and school psychologists is projected to grow 11 percent from 2012 to 2022, about as fast as the average for all occupations. Greater demand for psychological services in schools, hospitals, mental health centers, and social services agencies should drive employment growth.” Notes: This estimate doesn’t cleanly separate the need for doctoral-level psychologists from those with Masters training, and also includes non-health-service psychologists. This data point only gets a “3.5” instead of a standalone “4” because the newly released BLS numbers are not as strong as they were a month ago (a 2010 to 2020 projection), and I’m curious to see what this means for workforce demand. You can see how projections are calculated here.

If you are quick to ask for smaller class sizes, especially in light of the internship crisis, it is crucial that you have some understanding about how this could impact our nation’s ability to care for its people. For what appears to be a problem in one light may actually be a solution in another.

My data points are by no means a substitute for a workforce analysis, and one is needed to definitively answer the question: Just how many psychologists do we need?  (An even better analysis would tell us where in the country to send providers based on their training.) If we come to find that we actually need more psychologists than there are internship positions, what else can we do to responsibly get rid of this bottleneck in the internship match? That’s the real million dollar question.

Paying It Forward

In my January 2014 gradPSYCH column, I described the idea of paying it forward and helping out the generation of graduate students following us, as well as publicly thanking those who helped us while we were in school. I am happy to start this feature off, and here are the many people I’d like to thank for their assistance, support and encouragement while I was in grad school.

  • First year blues – Moving across country to a rural town was tough for a California raised city boy like myself. Tracy Rachmiel was an advanced student when I started grad school and gave me numerous tips on surviving the academic hurdles and how to survive the long winters in Binghamton.
  • Struggling in supervision –
    Tamra Holtzer & Nabil El-Ghoroury (El-Ghoroury, 2000)
    Tamra Holtzer & Nabil El-Ghoroury (El-Ghoroury, 2000)

    I shared a very challenging clinical supervisor withTamra Holtzer; we’d prepare for supervision together & discuss long cases on walks around campus.

  • Changing advisors – After struggling for several years with a very challenging mentor (think Voldemort from Harry Potter), talking with Susan Latham encouraged me to take the scary step of switching labs and mentors. She was already in the lab I planned to move to, and without her encouragement I might never have switched.
  • Applying for internship – While the internship situation when I applied had not quite hit the crisis stage, the application process was complicated and stressful. My internship prep group, Tanya Williamson and Roxanne Manning, made this process less painful and more enjoyable (and even better when Tanya and I matched to the same internship).

    Nabil El-Ghoroury, Tanya Williamson & Roxanne Manning, celebrating their graduation with their PhDs!!! (El-Ghoroury, 2002)

    Nabil El-Ghoroury, Tanya Williamson & Roxanne Manning, celebrating their graduation with their PhDs!!! (El-Ghoroury, 2002)

  • Difficult dissertation – Who doesn’t have a problem completing the dissertation? For me, it was compounded by the death of my mother while I was on internship and dissertating. Coaching and support from Elisa Krackow helped me wrap up and graduate!

If it takes a village to raise a child, perhaps it takes a department and a cohort of friends to help one earn a doctorate! This list is incomplete; I don’t have enough space to thank everyone for their assistance in graduate school. I know without the support of these friends and others, graduate school would have been a much more difficult (and lonely) journey.

Who helped you get through graduate school? Share your thanks to them in the comments. We’ll invite a couple of you to share your stories in your own article on gradPSYCH Blog!

Overwhelmed, but let’s be honest: I did it to myself

Overwhelmed.

What a small word to describe such a large feeling.

Can that one word truly describe the weight I feel right now? Can that word fully portray my stress, my failed attempts to prioritize, my feeling of being so far buried that maybe it’s not even worth attempting to dig out? Can that word express the fear that one more thing, just one more insignificant little thing, will break me?

No.

Yet, it’s the only word I have to describe and classify these feelings.

A day when there isn't enough caffeine in the world! (Source: "day 300, clutching my morning coffee" by massdistraction, on Flickr. Some rights reserved.)

A day when there isn’t enough caffeine in the world! (Source: “day 300, clutching my morning coffee” by massdistraction, on Flickr. Some rights reserved.)

The good news? Whatever my most overwhelmed moment was up until this point, I clearly made it through. So have you! You may have felt broken, trampled, and/or lost…but you made it. You survived. And, hopefully it made you stronger, more resilient, more ready to take on those feelings that are way to ominous to be embodied by one tiny word.

For those of you who struggle with feeling overwhelmed, who find themselves giving up when those feelings begin to build, let me share with you how I manage it.

Many people ask me how I do it. How I raise a very young family, work part-time, and work towards my doctorate degree. I usually tell them, I just do. But, that’s not the real answer.

I choose to fight the feeling of being overwhelmed in these ways:

  • I do my best to bar negative feelings from clouding my successes, erasing my hope… Granted, this is not an easy process, but I look at it as choosing to survive rather than worry over my ability to meet every demand.
  • I take my semester one day, one assignment at a time. I start each day with my girls as a new day. When I feel my patience slipping–which it seems to be doing by 8:30 am these days–I hold whichever one is starting to drive me crazy (if they allow me to) for a full minute, reminding myself that not every moment with her is a mini hell.
  • I remind myself–force myself, rather–to believe that there is an end in sight. That I am alive, that things can be so much worse, and that those things that are weighing down on me are actually things I am so very grateful for, that I would be lost without, that I could lose if I do not continue to fight and survive.
  • I take ownership. I am an individual who thrives when overwhelmed, who purposefully adds and adds and adds to my plate until it is at that point. I admit that am overwhelmed because I want so much out of life, and life wants so much out of me. It’s a give and take.

My plan, humble as it may be, is to not only allow life to take what it needs from me, but to give it my all. I have the hope that pushing into it allows me to receive more resilience and strength when it is time for the pendulum to swing back in my direction. And it always swings back.

When were you at your most overwhelmed? How do you manage? Do you see it as an obstacle to overcome or a learning and growing process? Talk about it in the comments.

Read more about raising three kids under three while pursuing a PhD at my blog.

Dressed by Jess

Jessica 1Hi, my name is Jessica Andrade (I am not a psychologist, but am happily employed by APA) and I truly have a LOVE for fashion! Dressed by Jess is a series of articles that will help students feel confident in pieces that make them feel good and in style when attending important events, including internship interviews, your first day of teaching, presenting at a national conference, etc. I’m inviting you to explore this series of articles from my fashion perspective. I will provide tips on pairing pieces together as well as “do’s and don’ts” to help you put your best foot forward for all occasions. And most importantly, all of my tips will be….wait for it…on a graduate student budget!

Expect lots of colors, outfits that should never be worn in public, and FUN! Hold on to your tablets, this is going to be an adventure!