Comparison of Training Programs (e.g., psychologist vs. LPC, psychiatrists, etc.)

[PsyDr]

I think the definition of "lots" may be the issue.

Eh, I know some older psychiatrists who had to complete psychoanalysis as part of their residencies. But I also had a psychiatry resident ask me if there was a catatonic version of schizophrenia. There is substantial variations in training, same as psychology programs. See my shock in threads about testing.

The ACGME requirements at minimum. It doesn't take four years of 60 to 80 hour weeks to just learn meds.

1) Love this.
2) AGME requirements are constantly changing . I know of psychiatrists without standard requirements, who were grandfathered for the boards. I also know some old physicians who were grandfathered for ER boards. Things are getting more standardized.

Now do the percentages of that to all the residencies versus the psychology diploma mills number students to all the psychology school number of students.

Eh, this competition is a little silly. Everyone has their own take, and there is more than enough business for everyone.

There are a few diploma mill graduates that get licensed, but it is uncommon for them to get residencies. It is also uncommon for them to get through licensure. It's why SDN nearly universally encourages students to avoid these programs. It the same as older FMG graduates, some of whom likely attended foreign diploma mills, and some of whom falsified education, who took psychiatry residencies when that was an undesirable specialty.

---

Members don't see this ad.

 

[Sanman]

Now do the percentages of that to all the residencies versus the psychology diploma mills number students to all the psychology school number of students.

Not sure what the point of this argument is when mid-levels exist for both professions. I know online only SW and counseling programs. I know online only NP programs. Those folks are likely more poorly trained than most physicians or psychologists.

 

[AbnormalPsych]

Pls show me a non ACGME accredited residency.

Non ACGME open residency & fellowship positions

Find currently vacant positions in non ACGME-accredited programs.

www.ama-assn.org

Non ACGME open residency & fellowship positions

Here is the link to the AMA page that lists openings for Non-ACGME residencies and fellowships.

Now do the percentages of that to all the residencies versus the psychology diploma mills number students to all the psychology school number of students.

 

[texanpsychdoc]

Most of the accredited psychiatry residency programs I’ve seen (including the one I taught in and currently teach in) do not emphasize therapy. If they do, it is nowhere near the level of psychologists’ training.

 

[Sanman]

Most of the accredited psychiatry residency programs I’ve seen (including the one I taught in and currently teach in) do not emphasize therapy. If they do, it is nowhere near the level of psychologists’ training.

Yet, in these turf wars you never hear about what other fields do better. Just complaints about encroachment and education that mean nothing.

Concerned about psychologists who want prescribing rights? Join them in fighting for better reimbursement for psychotherapy and assessment.

RN travel nurses making $250k did more to slow NP encroachment than all the AMA arguments in the world.

 

[smalltownpsych]

A lot of these arguments comparing professions (and many other arguments every day) remind me of my research methods class where understanding overlapping distributions was a key to interpreting group data or misunderstanding/misrepresenting it is key to fruitless debate. I used to use male and female height as the example when I was teaching this and some students could still not understand it because they knew some women that were taller than some men.

 

[texanpsychdoc]

Yet, in these turf wars you never hear about what other fields do better. Just complaints about encroachment and education that mean nothing.

Concerned about psychologists who want prescribing rights? Join them in fighting for better reimbursement for psychotherapy and assessment.

RN travel nurses making $250k did more to slow NP encroachment than all the AMA arguments in the world.

Indeed - I serve on two committees for RxP rights, but in all honesty, I may be re-thinking that. Not that I am opposed to it, but I am evolving on the matter where I think there are aspects of our profession that need to be safeguarded, protected, emphasized and made relevant compared to other mental health and healthcare providers. With more and more people wanting a seat at the mental health profession table, setting and maintaining appropriate boundaries I believe important. Otherwise...why the hell do we spend 5+ years getting a doctorate, doing fellowship, studying for the EPPP, etc. It really makes me feel insignificant at times, especially with the amount of time and money spent, and the constant moving/relocating. It was all done in an effort to be a licensed psychologist, and now that title and profession is becoming irrelevant and mixed up with other folks who frankly, need to be told their place in society.

 

[Freud’sMommy]

Let's face it, mid-levels generally have lower cognitive ability and their poorer services reflect it. If they could earn a doctorate, they would. Training program matters, but is less relevant if the trainee thinks horoscopes are insightful or can't digest a scientific article (i.e., placing a would-be mid-level into a PhD won't automatically make them reach a level of competence you'd expect from the typical PhD trainee).

What's more concerning is the lowering of standards at doctoral-level training programs in recent years (longer?). I'm talking about even the fully-funded programs. It's feasible for a PhD program to lower their standards, but almost impossible for a mid-level program to increase their standards. Once we allow the cognitive divide to narrow between Psychologists and mid-levels, it's game over. The merit-based hierarchy will flatten. We lose all social and political capital and will suffer in progressive irrelevance.

If I sound like an elitist it's because I am. We are better than mid-levels where it counts; that's why patients should prefer to choose us, why we should be paid more, and why society/government should defer to us on relevant matters and policy.

 

[counselor2b]

Let's face it, mid-levels generally have lower cognitive ability and their poorer services reflect it. If they could earn a doctorate, they would. Training program matters, but is less relevant if the trainee thinks horoscopes are insightful or can't digest a scientific article (i.e., placing a would-be mid-level into a PhD won't automatically make them reach a level of competence you'd expect from the typical PhD trainee).

What's more concerning is the lowering of standards at doctoral-level training programs in recent years (longer?). I'm talking about even the fully-funded programs. It's feasible for a PhD program to lower their standards, but almost impossible for a mid-level program to increase their standards. Once we allow the cognitive divide to narrow between Psychologists and mid-levels, it's game over. The merit-based hierarchy will flatten. We lose all social and political capital and will suffer in progressive irrelevance.

If I sound like an elitist it's because I am. We are better than mid-levels where it counts; that's why patients should prefer to choose us, why we should be paid more, and why society/government should defer to us on relevant matters and policy.

Wowzers there is a lot wrong with this. There are plenty of reasons why one may not choose to attend a doctoral program outside of cognitive abilities. That is a sweeping generalization. With that said, I certainly do not feel that my education is equal to that of a psychologist and would never claim it to be. We are separate professions with different scopes of practice. I received all of my pre and post grad supervision from psychologists, so I recognize the limitations, I just do not feel that you are making a fair assumption here. Just because there are some bad actors at the mid level, it does not make the entire profession a bunch of charlatans. We do not need to minimize each other. You are welcome to take the positions open to mid-levels and get paid like a mid-level. I know my worth and also know when I am outside of my lane. The choice is yours, but I ask that you please do better moving forward.

 

[Freud’sMommy]

Wowzers there is a lot wrong with this. There are plenty of reasons why one may not choose to attend a doctoral program outside of cognitive abilities. That is a sweeping generalization. With that said, I certainly do not feel that my education is equal to that of a psychologist and would never claim it to be. We are separate professions with different scopes of practice. I received all of my pre and post grad supervision from psychologists, so I recognize the limitations, I just do not feel that you are making a fair assumption here. Just because there are some bad actors at the mid level, it does not make the entire profession a bunch of charlatans. We do not need to minimize each other. You are welcome to take the positions open to mid-levels and get paid like a mid-level. I know my worth and also know when I am outside of my lane. The choice is yours, but I ask that you please do better moving forward.

You say there's a lot wrong, but then I completely agree with everything you say! Refer to post #56 to see how that's possible.

 

[Dazen]

If they could earn a doctorate, they would.

I disagree with this in the majority of cases. As @counselor2b said, masters and doctoral level are two distinctly different professions. If someone wants to be therapist and has no interest in assessment or very specific niche areas, it is frequently financially preferable for them to get a masters. They would be losing additional years of income and potentially accruing debt (even at some funded programs) to obtain a degree that would not meaningfully change their career opportunities. I don't think most people here are arguing that mid-levels should be doing neuropsych assessment or, for example, working with patients who have experienced severe trauma without additional training, but I don't think it requires writing a dissertation to be a proficient therapist for clients presenting with anxiety, depression, etc. And especially given the current mental health provider shortage in many areas, increasing the number of masters-level providers who are capable of doing this work benefits the population as a whole. Psychologists are a specialized tool and don't need to be used for everything. You could buy the world's fanciest drill ever made, but if you're using it to put together an IKEA bookshelf, the difference in quality doesn't really matter. I don't understand competing in the general therapy landscape when a doctorate is at its core a research-based degree that confers the ability to do assessment. If those are our "specialties" let's focus on that and leave things that could be done arguably equivalent well by others to those others.

What's more concerning is the lowering of standards at doctoral-level training programs in recent years (longer?). I'm talking about even the fully-funded programs.

Source? Data have shown consistently larger numbers of applications and better credentials (GPA, pubs, etc.) for entering students in the recent past. Anecdotally, a good number of tenured professors I've talked to said they wouldn't get in today and that grad school has gotten harder. What proof do you have for this decline in quality?

 

[counselor2b]

You say there's a lot wrong, but then I completely agree with everything you say! Refer to post #56 to see how that's possible.

I think we are looking at this from a different point of view. You state that mid-level providers do not possess the cognitive ability to complete a doctorate. I am saying I disagree. You now say I am right and perhaps agreed with me the whole time? Perhaps my non-psychologist brain with limited cognitive abilities is still missing something. If so, please elaborate, maybe this time write it out in crayon for me.

 

[WisNeuro]

Source? Data have shown consistently larger numbers of applications and better credentials (GPA, pubs, etc.) for entering students in the recent past. Anecdotally, a good number of tenured professors I've talked to said they wouldn't get in today and that grad school has gotten harder. What proof do you have for this decline in quality?

I will say that anecdotally, and in discussions with colleagues in many different programs who review internship and postdoc apps, doctoral programs seem to have been de-emphasizing assessment, both psychological and neuro, as years go by. Which, is one of the main things that should be differentiating doctoral vs. midlevel competencies. So I definitely agree with the lowering of standards at least in this respect.

 

[Fan_of_Meehl]

Or maybe they wanted to catch people's attention

Or maybe they're just giving in to the universal impulse these days to reduce everything these days to a catchy (if tacky) advertising slogan...like...

"You deserve a shrink today...at McTherapy!!!"

 

[Sanman]

I will say that anecdotally, and in discussions with colleagues in many different programs who review internship and postdoc apps, doctoral programs seem to have been de-emphasizing assessment, both psychological and neuro, as years go by. Which, is one of the main things that should be differentiating doctoral vs. midlevel competencies. So I definitely agree with the lowering of standards at least in this respect.

There has been more generally, but there are still applicants out there with good experience. Some programs have had issues finding assessment focused faculty and externships from what I understand. Those that have experience tend to be more neuropsych focused rather than generalist.

 

[AcronymAllergy]

There has been more generally, but there are still applicants out there with good experience. Some programs have had issues finding assessment focused faculty and externships from what I understand. Those that have experience tend to be more neuropsych focused rather than generalist.

That's also been my experience, and it came across various training-related listservs back when I was formally involved in such, which makes it a vicious cycle of sorts. Programs have, for some time it seems, de-emphasized to some extent the importance of getting trainees experience in assessment, and particularly non-neuro assessment. This results in fewer psychologists who feel competent using psychological assessment measures, which then results in fewer potential supervisors for trainees, thereby restricting their training opportunities.

On the plus side, I have seen good interest in practicing psychologists who previously were uncomfortable administering assessment measures trying to beef up their training in such (e.g., for pre-hire and re-evaluation for law enforcement, organ transplant, and spinal cord stimulator).

 

[Sanman]

That's also been my experience, and it came across various training-related listservs back when I was formally involved in such, which makes it a vicious cycle of sorts. Programs have, for some time it seems, de-emphasized to some extent the importance of getting trainees experience in assessment, and particularly non-neuro assessment. This results in fewer psychologists who feel competent using psychological assessment measures, which then results in fewer potential supervisors for trainees, thereby restricting their training opportunities.

On the plus side, I have seen good interest in practicing psychologists who previously were uncomfortable administering assessment measures trying to beef up their training in such (e.g., for pre-hire and re-evaluation for law enforcement, organ transplant, and spinal cord stimulator).

Sad on the whole, sounds good to me as someone with good assessment training looking to move into PP more in the future.

 

[Therapist4Chnge]

Psych training should focus MORE on assessment and EBTs, but those icky stats and research requirements are more. I don’t mind less competition for me, but for the survival of the profession, we already lost our hold of therapy, and RxP will likely never be mainstream.

 

[PsyDr]

…. We are better than mid-levels where it counts; that's why patients should prefer to choose us, why we should be paid more, and why society/government should defer to us on relevant matters and policy.

There is no “we”. You don’t have a doctorate.