Cover Story

Internship match crisis

When you're a graduate student in psychology, it's hard to escape the grim news about internships. Last year, 21 percent of applicants to the Association of Psychology Postdoctoral and Internships Centers (APPIC) match system went unmatched. Because clinical, counseling and school psychology doctoral students need an internship to graduate, failing to match can stall their educations.

To Mike C. Parent, a counseling psychology student at the University of Florida, those results seemed a bit mysterious. His program typically matches all of its students, and the same was true at his friends' schools. Where were all these unmatched students coming from?

To answer that question, Parent conducted a series of studies that revealed some disturbing truths. Just a handful of schools — mostly PsyD programs — are producing a disproportionate number of students left unmatched.

In as-yet-unpublished research analyzing match data from 2000 to 2010, Parent found that just 24 programs, out of more than 400, accounted for 30 percent of unmatched students. He also found that these "outlier" programs accepted students with lower GRE scores and grade point averages.

And this isn't just a match problem, Parent's research suggests. He's convinced that these schools aren't equipping students to succeed, as evidenced by their consistently lower pass rates on the Examination for Professional Practice of Psychology (EPPP), the last step before licensure. Just 65 percent of students from the outlier schools pass the exam, he found, compared with 85 percent of those from other programs. "It really seems like an across-the-board failure in training integrity," says Parent. Others counter that Parent's research doesn't give a complete picture of internship placement or the reasons behind some students' failure to place. Some students find an internship outside the APPIC match process, for example. And the country's economic downturn has made it difficult to grow — or even maintain — the number of slots in the APPIC match system.

What everyone does agree on, however, is the need for the entire psychology education and training community to work together to solve the crisis. And that's already happening, with groups increasing the number of internship sites, educating students about how to successfully compete and proposing other solutions to the problem (see page 40).

Problem Programs?

Parent's first study of the internship match shortfall, which he and co-author John B. Williamson, PhD, of the University of Florida, published in Training and Education in Professional Psychology in 2010, revealed that just 15 programs — less than 4 percent of those analyzed — produced almost 32 percent of the unmatched applicants between 2000 and 2006. Fourteen of the 15 were PsyD programs.

The increase in the number of problem programs in Parent's latest research suggests that that the problem is intensifying, says Parent. "In the last couple of years, more programs have surpassed our criteria for being outliers," he says. Part of the problem, he says, is that undergraduates who are uninformed about the match problem are continuing to create a demand for programs, no matter how poor their outcomes.

For Stephen R. McCutcheon, PhD, chair of the Council of Chairs of Training Councils (CCTC), that trend spells trouble for the field as a whole.

"Internship match rates are a crude proxy for student outcomes," says McCutcheon, who also chairs the VA Psychology Training Council and serves as director of psychology training at the VA Puget Sound. "A doctoral program that consistently has a significantly poor match rate should read that outcome as feedback about their selection process or about the adequacy of the training they're providing."

APPIC is so concerned that it may tighten its requirements for programs whose students are eligible to participate in the match, says APPIC Chair Eugene D'Angelo, PhD, chief of the psychology division at Harvard Medical School. For instance, APPIC might require doctoral programs to be accredited or at least moving toward accreditation before allowing those programs' students to participate in the match.

Of course, Parent and D'Angelo add, failing to match doesn't necessarily mean applicants aren't qualified.

"The consistently frustrating part of all this has been that we know there are large numbers of individuals who don't match who are qualified to become psychologists," he says. Many students, for example, don't match because they can't move or because their past experience isn't a good fit with the internship slots available. "The possibility of being able to get in is reduced just because of the sheer volume," he says.

Wendy Paszkiewicz, PsyD, president of the National Council of Schools and Programs of Professional Psychology, believes that Parent's research doesn't give a full picture of placement rates for PsyD students. Some programs offer in-house internships, she notes. Plus, many students — especially those in California programs — get placed via the California Psychology Internship Council (CAPIC) match process instead of the APPIC match and are then eligible for licensure in California, she points out. CAPIC offers close to 500 internship positions each year and has secured more than $5 million in funding for doctoral interns since the program's inception in 2008, says CAPIC Chair Melodie R. Schaefer, PsyD. "This is truly a positive story of how psychologists working in the area of education and training were able to come together in an effort to advocate for internship training support, and succeeded in spite of the fiscal challenges we and others are facing," she says.

Though there are bright spots, the APPIC match is particularly difficult for geographically bound students, says Paszkiewicz, who's also associate vice president of academic affairs at the Adler School of Professional Psychology. "Nontraditional students who are bound to a certain location because of family, job responsibilities and things like that are more likely to have trouble matching," as do students who want to stay in their communities and give back to them, she says.

Factors outside psychology also have a huge impact on the internship crisis, emphasizes Catherine Grus, PhD, deputy executive director of APA's Education Directorate. She points to the economic slump as one example.

"One very important factor right now is the downturn of the economy that the country has experienced for the last several years," she says. "While we've seen growth in some new internship programs and some new slots, we also know that some programs have had to reduce their sizes or even discontinue their programs altogether because they can no longer afford to operate a training program."

Beyond Finger-pointing

Whether the cause of the crisis is problem programs, the economy or some combination of various factors, fixing the problem will require the full cooperation of everyone involved. "It doesn't help anyone to start pointing fingers at specific types of training models or certain types of schools," says Susan M. Wilson, past-chair of APAGS and a clinical psychology student at Ohio University. "It really creates more infighting and distracts us from the goal of finding solutions."

Grus agrees. And she wants students to understand that APA and other groups are working hard to address the crisis.

"Very often, people think nothing's happening because the imbalance continues to exist," she says. "The important point is how much the groups involved in this issue are working to have an impact."

For example, APA has been working to secure federal funding for psychology training by advocating for the Graduate Program Education program, and the CCTC is pressuring graduate programs with low match rates either to ratchet down the number of students they accept or work to expand the number of internship positions.

In addition, the National Council of Schools and Programs of Professional Psychology is challenging the 88 professional psychology programs that make up its membership to develop more internship slots. "We're enrolling students, and we need to take responsibility to ensure that there are placements available, and that we're contributing to the resource pool of internships," says Paszkiewicz.

As a result, some of the council's member programs have come together in local consortia to develop sites and apply for APPIC membership, while others have managed to add positions to existing sites.

APPIC is also striving to increase the number of internship slots available. "APPIC is committed to try to see to what extent in this very difficult economy we can bring programs of quality into the membership group and continue to try to expand the number of positions in the match," says D'Angelo. To that end, APPIC staff mentor internship programs as they work to achieve APPIC membership and accreditation.

Other groups are working to make students as competitive as they can be when it comes to applying for internship. One is the Houston Psychological Association, which brought together Houston-area training directors to share tips with graduate students last October.

"Internships are more competitive given the current economic climate, with some sites reducing their number of slots or discontinuing their programs," says HPA President Samoan C. Johnson, PhD, an assistant professor of psychiatry and behavioral sciences at the University of Texas Medical School. "As a psychological association, it's our job to nurture and empower students so they become licensed psychologists in the future."

Rebecca A. Clay is a writer in Washington, D.C.

Further Reading

  • Grus, C.L., McCutcheon, S.R., & Berry, S.L. (2011). "Actions by professional psychology education and training groups to mitigate the internship imbalance." Training and Education in Professional Psychology, 5 (4): 193–201.

  • Hatcher, R.L. (2011). "The internship supply as a common-pool resource: A pathway to managing the imbalance problem." Training and Education in Professional Psychology, 5 (3): 126–140.

  • McCutcheon, S.R. (2011). "The internship crisis: An uncommon urgency to build a common solution." Training and Education in Professional Psychology, 5 (3): 144–148.

  • Schaefer, M.R., Newman, G.H., et al. (2011). "Shifting the paradigm: Alternative perspectives and solutions to increasing the availability of quality internships." Training and Education in Professional Psychology, 5 (4): 209–212.