Academy of Psychological Clinical Science (APCS) Recommendations for Internship Flexibility

From the Executive Committee (EC) of APCS with input from the Summit Internship Flexibility Workgroup

November 1, 2023

The APCS Executive Committee (EC) is committed to moving the field of clinical science training forward based on the discussions and findings from the Summit on Clinical Science Training. The EC has put out a call to fund work in critical areas, but for some the topic of internship will have been noticeably absent from the priority topics. In the case of internship, the EC believes the best way forward is through cooperation across a variety of groups, including the sharing of ideas for innovation.  

Accordingly, given the clear issues with structure and equitability of clinical psychology internship programs, the EC of APCS recommends the following steps. Some APCS member programs may note the specific omission below of any opinion on whether the internship should be predoctoral or postdoctoral. The APCS EC recommended over a year ago (in spring 2022) that the notion of a postdoctoral internship be seriously considered. Since then it has become apparent that such a change faces many barriers (including a need to change state licensure laws and the fact that the vast majority of internship training directors are against that proposal). We believe that internship flexibility is the superseding issue, and thus the possibility of making the internship postdoctoral is a part of our point (8) below. Importantly, discussion about internship flexibility continues at a variety of levels in our field; APCS is aware of ongoing discussion across multiple organizations. These discussions should continue and common ground must be sought. In addition, we recommend:

1. When possible and not already implemented, individual PhD programs should consider the creation of a proactive alternative PhD path for those students who, upon initial clinical training, determine that they will not be seeking the ability to practice after their PhD. Currently, many programs accomplish this by transferring students to other programs within their department. We are suggesting an alternative: A path that does not lead to altered requirements for the student, but rather a redirection away from clinical practice training at later stages of training. Some universities, for example, have had “Experimental Psychopathology” programs that are of the character and course that we are suggesting here. 
2. Internship programs continue to use, and APPIC to continue to support, virtual interviews for applicants. The advent of virtual interviews has made an important difference to students and addresses many, although not all, equity issues.
3. Internship programs reclassify, where possible and appropriate, their interns as residents. In the medical training model, the term “resident” refers to an advanced trainee in a final stage of training, whereas in most professional spaces, the term “intern” refers to trainees in an early stage of learning. In many programs, this change in terminology will lead interns to have a clearer role in the organization that is more consistent with their existing training and experience. 
4. Internship training directors, in consultation with APPIC and DCTs,  determine whether setting a cap on reported clinical hours could alleviate student burden in seeking to increase numbers of hours rather than other important aspects of training such as demonstrated skills and competencies.
5. APPIC to undertake streamlining the AAPI application process, which significantly impacts applicants and may not be meeting the needs of many internship training directors.
6. Internship programs provide clearer information about their preferences that can help prospective applicants determine when they are not a good fit for a program. For example, programs could include in their public materials a sentence starting with “A good match for our site would be a student who. . .”; followed by “A student who would not be a good match would be. . .”.
7. When possible and not already implemented, individual PhD programs set aside funding for students so as to assist with expenses associated with the internship application process and relocation, in much the same way that programs may provide support for other expenses that are important to their students’ success. In a recent survey of clinical science students, the most commonly cited issue with the internship model was the financial burden of applying to and moving for internship. Any efforts to reduce this burden serve to improve equity for our trainees. Individual PhD programs are in the best position to support their students’ needs. One important area to consider is whether students can receive summer funding for the summer before internship: In some programs, students may not receive any funding at all at the time they need it the most. 
1. Individual internship programs should also consider joining together with PhD programs to help alleviate this issue, perhaps especially for students making a long-distance move. Internships could also consider whether benefits their other employees receive (e.g., childcare costs) could be extended to interns.
2. Individual PhD programs should also consider, when possible, reducing or waiving program costs such as tuition and other fees during the year a student is training at an internship site. Of course, this issue is often complicated by institutional policies, and in many instances programs are already doing everything they can think of to move in this direction.
8. It is evident that there are considerable barriers to large increases in internship flexibility, including institutional, financial, and programmatic factors. We recommend continued discussion that includes internship directors, directors of clinical training at PhD programs, and organizations such as APPIC and CCTC, to determine what these barriers are and how to address them. One of the key barriers in the past has been lack of dialogue across silos of training; we must move past this and continue discussions between those who train our students at various levels.