Internship Update: Report from the APPIC Board Meeting

Tamara Duckworth
APAGS Member-at-Large, Education
University of Florida

On April 7-8, 2000 I served as the APAGS liaison to APPIC’s board meeting. Based on feedback I received about the 1999-2000 Match process from students via conversation and listservs, I addressed with the board three prominent issues. These issues, and the response of the APPIC board members, are outlined below.

Internship Site Violations of APPIC Standards

In the weeks following Match Day, there was a great deal of activity on the APPIC-sponsored listserv for internship applicants. A number of non-traditional female applicants reported being asked inappropriate questions by internship interviewers, including queries about age, marital status, and child/family obligations. Unfortunately, the APPIC application does not ask for demographic information, making a systematic investigation of these allegations impossible. However, the conversation sparked by these reports highlighted two needs: 1) to make students more aware of the grievance process available through ASARC (APPIC Standards and Review Committee); and 2) to educate clinical training directors (TDs) about appropriate questions and communication with applicants.

ASARC's "Procedures For Handling Grievances and Violations of APPIC Policies" is printed in the first section of the internship directory each year. What I learned at the meeting, and what is not clear from reading the policy alone, is that both a formal and an informal process for making complaints exists. The informal process, which appears less daunting than the formal process, involves talking with a member of ASARC who then follows up by talking with the training director at the site. No paperwork needs to be filed. A formal complaint, however, requires completion of the form, which is available on-line. If ASARC determines that a violation has occurred, it recommends one or more courses of action to the full APPIC board of directors. Sanctions of sites comes in two forms depending on the severity of the violation: private actions and public actions. In making its recommendation, ASARC may take into account factors such as intent, consequences to individual or the profession, and /or single or multiple occurrences.

There are three type of private actions and three types of public actions. Private actions are: (1) a directive - a written statement only to the TD that serves as an "educative communication"; (2) reprimand - a private written statement to the training director with copies to the training director's immediate supervisor; and (3) reprimand with monitoring - same as reprimand plus ASARC monitoring for a year. Public actions, which are considered more serious, involve: (1) censure (one year only) -- a public written statement to the TD and other appropriate administration as well as a letter to all APPIC members and directory subscribers announcing the public censure; the censure is published in the APPIC directory and two consecutive issues of the APPIC newsletter; (2) probation - same as censure plus ASARC monitoring for a year; and (3) explusion - APPIC Board of Directors removes the site from its membership roster and reports this violation via the Directory and two copies of the APPIC newsletter.

At this point, two questions generally arise. First, what about reprisals to the student? This is the most commonly cited reason intern applicants do not report violations. According to APPIC officials, there are no documented cases of reprisal against a student after filing a complaint. Moreover, what form could the reprisal take -- not being offered a position at that site? Would you want to go to a site that violated APPIC policy? Wouldn't you want the site to face some consequences so that future applicants do not have to have the same experience? Second, what about anonymous reporting of violations? According to APPIC officials, this is impossible because it does not allow both sides the right to due process. If concerns persist, an alternative is to have an intern applicant's Director of Clinical Training (DCT) file the complaint on the student's behalf.

APPIC agreed to consider several steps to improve the grievance process. One is to advertise the informal process more widely. Another is to suggest to TD's that the give all interviewees a copy of the grievance process when they come for interviews. A further step is to educate TDs about acceptance interview questions. Finally, APPIC will consider placing vignettes on the APPIC website along with "questions and answers" and instructions about allowable communications at each step of the process -- interview, match and post-placement.

The Financial Burden of the Application Process

Many internship applicants indicated frustration with the travel costs associated with interviewing for internship. Several students noted that they had to fly to same geographical location more than once during the application process. In addition, applicants also noted that the 10-15% travel discounts offered by APPIC were not as competitive as discounts offered by travel agents, online travel sites, email notification programs for last-minute deals, or online bidding services such as Priceline.

A common suggestion for dealing with this problem is to have APPIC set a uniform application deadline and/or interview notification date. This would help to keep down travel costs by enabling students to better manage interview schedules. APPIC Board members discussed difficulties associated with moving to a uniform interview notification date, particularly the diverse needs and schedules of internship sites as varied as counseling centers and VAs. Moreover, a vote was taken by the APPIC membership some years ago, which indicated strong opposition to a uniform application deadline and/or interview notification date.

Another strategy for dealing with travel expenses is to consider telephone interviews at sites that allow them. Most TDs understand the financial burden of the process and are willing to do telephone interviews. In the future, internship sites and intern applicants may be able to take advantage of video-conferencing technology to conduct interviews. Of course, there are at least two significant drawbacks to telephone or video interviews. Students fear that a telephone interview will make them less competitive than other applicants. More important, by not going to visit a site, applicants do not have the opportunity to evaluate the site and its facilities -- and whether or not it matches the description in promotional brochures and other materials.

The Chaotic Nature of the Clearinghouse Process for Non-matched Students

The post-Match Clearinghouse process was perceived by several applicants as "unfair," particularly because the openings and closings of some sites took only a matter of hours. One former applicant, for example, suggested a process in which "the student with the fastest fax machine doesn't 'win.'" Another reported receiving an email that a site had closed, while waiting to attempt to re-send a fax to machines that were continuously occupied for 24 to 36 hours. Time zone differences between East and West Coast sites also apparently contributed to this perception of unfairness.

It is important to note that APPIC officials view the Clearinghouse as a "bulletin board service" -- nothing more and nothing less. Attempting to regulate the Clearinghouse process would only result in a "Match II," a project that APPIC is not willing to undertake. The Board considered two suggestions that would allow sites with openings and students without internship to coordinate information less frantically: advance notification to students who did not match and a three-day post-Match moratorium on offers. It was finally concluded, however, that, more education about the process as a bulletin board service at three steps in the process -- before interviews, before Match Day and after Match Day -- was a more feasible alternatives for helping to alleviate some of the anxiety for students and sites that do not match. In addition, it was agreed to open the Clearinghouse after 8:00 a.m. Pacific Standard Time.

These are the meeting highlights. Other issues I had hoped to raise for discussion were the length of the standardized application, setting standards for additional application materials, and the development of a more formal process of soliciting student feedback on the internship application process, including an independent evaluation of sites. Conversations continue regarding development of a policy for dealing with applicants who violate Match guidelines. I, Tamara Duckworth, always welcome your thoughts and comments.