Match Day 2015: The Dialectic of the Internship Crisis

Correction (9:00pm): Due to an editorial mistake, not the author’s, the Phase I match rate was reported in the original post to be 90%. The actual figure is 82% and has been corrected below. The 90% figure represents the possibility of all students who submitted rank lists matching to all available positions after the completion of APPIC Phases I, II, and the Post Match Vacancy Service; however, a small number of positions historically remain unfilled each year. We regret the error. 

Today is the day. The day that students enrolled in clinical, counseling, and school psychology programs have been anxiously and excitedly anticipating for months. Today is “Match Day” for internship, the culmination of a journey from applications to interviews to ranking…to waiting.

For many students, the process itself is wrought with complicated emotions, financial stress, and moments of both triumph and struggle. The match today will mean celebration for many students as they reap the rewards of their hard work. Even for some who did match, conflicting emotions may emerge as they consider the implications of moving away from friends, families, partners, and in some cases children, to complete their training. For others, it is a day of disappointment and heartache as they receive the news that they did not match and are forced to face the difficult decision of how to move forward.

The internship crisis continues to be a huge concern for many graduate students in psychology. For those who might not be familiar with this issue, trainees are required to obtain a doctoral internship to satisfy graduation and licensure requirements. Yet, there are not enough internship positions to meet demand.

In 2013 and 2014, the crisis has demonstrated some overall improvement. There have been significant efforts on behalf of many in the education and training communities to influence our numbers, including internship stimulus funds, partnering with colleagues creatively to create new sites, and other efforts. The data from 2015 again show improvement. This is the great dialectic of our time: There has been improvement, and yet we can and must do better.

The Stats

The 2015 Phase I match statistics, released today, show the following:

  • 4,247 students entered the match, with 3,928 completing the process and submitting a rank-order list
  • 3,684 positions were available in the match, including 2,732 accredited positions
  • 3,239 students matched to any internship site in Phase I of the match
  • 2,600 students matched an accredited internship site in Phase I

Taken together, the 2015 match rate for all applicants to the match in Phase I is 82% (up from 80% in 2014). Meanwhile, the rate for all applicants to an an APA- or CPA- accredited internship in Phase I is 66% (up from 62% in 2014). There is more work to be done.

The 2015 match rate in Phase I is 82% (up from 80% in 2014); it is 66% for applicants to APA- and CPA-accredited internships (up from 62%).

An important note: APPIC data at Phase I tells just some of the story. When we look at the crisis as it relates to only students from APA accredited doctoral programs going to accredited internships (source), the numbers show small signs of improvement. We don’t yet have the latest data from APA’s Commission on Accreditation, but from 2011 to 2014 we can see some modest gains:

Internship year Match rate of students from APA-accredited doc programs to any internship Match rate of students from APA-accredited doc programs to APA-accredited internships
2011-2012 83.1% 51.9%
2012-2013 88.8% 54.6
2013-2014 90.1% 57.7%

Another dialectic—improvement, but not enough.

The Crisis Continues

The fact that 34% of students from accredited programs — that were deemed to be ready for internship by their programs — did not match to an accredited site should be a concern for all in the training community. This is not just a problem for training programs or internship sites. It is the responsibility of the psychology community at large to address this issue for the future of our profession.

As APAGS past-chair Jennifer Doran highlighted last year, there is so much more to the match than the data. The emotional toll, financial stress, and consequences of not matching weigh heavily. To advocates, the data matters. To individual students, these factors will count for more than any compiled statistic when describing the internship crisis.

What is APAGS Doing?

The crisis remains a key issue that APAGS collaborates with key stakeholders to address. We have tirelessly advocated for efforts that address the crisis and are partnering with others in the training community to find innovative ways to address the crisis. Some of the highlights of our efforts and advocacy include:

  • Last year, APAGS produced a video highlighting multiple aspects of the crisis in addition to advocacy, awareness and action steps students and psychologists can take to end the crisis. We need you to help spread the message in this video.
  • APAGS partnered with APA Past-President Nadine Kaslow, Ph.D. and others in the training community during the 2014 APA Convention to present innovative solutions to the crisis. We are currently working toward ways to implement the ideas presented during this panel.
  • APAGS supported the passage of APA’s Internship Stimulus Package in 2012, providing $3 million in grant funding to increase the number of accredited internship positions. As of December 2014, this money resulted in 10 internship programs receiving accreditation, 27 internship programs with pending accreditation, and at least 57 internship positions. Remaining funds will also be allocated toward further creative efforts in ameliorating the crisis, including helping states seek Medicaid reimbursement for intern services.
  • APAGS formed an Internship Working Group to analyze and promote solutions to the internship crisis. In July 2012, APAGS released a policy and expanded response to explain how it will continue to advocate on multiple fronts for graduate students.
  • APAGS has compiled some of its actions since 2000 to mitigate this problem, and further describes its latest actions in a 2014 journal article.
  • APAGS and other departments in APA are developing a toolkit of resources to help psychology training programs advocate for Medicaid reimbursement for intern. This may help entice the creation of and funding for more internship positions.
  • APAGS staff attend several regional psychology conferences each year to teach prospective grad students how to decipher publicly available data related to internship match and 14 other factors.  We also produced a recorded webinar on this topic.
  • APAGS is attending the annual meetings of many psychology training councils to promote the development of new internships.

What the Future Holds

The trends have been positive over the last few years, but change has continued to be slow. There is no simple solution to the crisis. We know it will require multifaceted and creative solutions to continue the trend in a positive direction. There is much that trainees and psychologists alike can do to make a difference. The links I’ve shared, particularly to our video (which I’ll embed below) provide steps individuals at all levels can take today to make a difference for next year and future students.

APAGS would like to congratulate the students and programs celebrating today’s match results. We commend you on your accomplishments. You might wonder what to do now that you have matched, and APAGS has resources for you.

APAGS would also like to extend support for those of you who received disappointing news and did not match today. We have resources and support for you as well. For our colleagues and friends who did not match today, we as a psychology community need to offer them our support and encouragement.

The dialectic of change is that it is difficult and necessary. We have already made positive change, and APAGS is working to continue to advocate for students and ameliorate the crisis. I would like to encourage everyone, regardless of your outcome, to share your story, in the comments section, on our Facebook page, or personally. Please contact me or APAGS staff with your thoughts, ideas, and concerns. We are here to support you. Together, we can all make change.

9 thoughts on “Match Day 2015: The Dialectic of the Internship Crisis

  1. Ali

    It’s inappropriate for APA to continue to accredit new training programs when so many students from accredited programs seeking APA internships aren’t matching. If APA redirects some of the work they do for program accreditation into mentoring potential internship sites for a couple years, they could solve a lot of these problems.

  2. A. Chase

    I think you flubbed your maths somewhere.

    According to the official APPIC 2015 Match page, it shows that 3928 applicants submitted rankings. Of those, 3239 matched and 689 did not. That makes the overall match rate 82.5%, not 90.1%. This seems like a much more believable increase from the correctly cited 2014 match rate of 79.8%.

  3. Kevin D. Arnold, Ph.D., ABPP

    This comment is completely from the other side of the perspective–from a psychologist who is mid-career (OK, maybe a bit farther along than that) but has dedicated quite a bit of time and energy to addressing the Match Discrepancy–not from a training perspective, but from the broader professional psychology perspective.

    I want to jump into the discussion, and thank Emily for a great blog. I’ve distributed it to both state associations and to several division list serves. My reaction is to the comment suggesting that COA curtail accreditation. While limiting the size of the human resource pipeline sounds like a good idea, how would one implement that?

    Would COA set a total limit to the number of accredited programs in Clinical, Counseling or School? If so, I could see claims of trade restriction made by the excluded programs, or worse a cloistering of “anointed programs” while innovative new training programs would have no incentive to develop.

    In the milieu of Healthcare Reform, health service psychology can not afford to decrease its potential provider pool while, at the same time, psychologists work to integrate into Medical Homes and Accountable Care Organizations. I would offer that the alternative option is to increase accredited internships through better funding mechanisms (like state Medicaid payment systems or HRSA GPE) while ensuring that the COA accreditation standards limit growth based on quality standards (not simply number of programs).

    As the owner of a large group, I can tell you that our Center needs ECPs who work with children and families. Our waitlist is about 3 months for those cases…better than the reported 9 month waitlist from the local children’s hospital behavioral health program. There will be more and more people with insurance, and thus access to our services…..we must find a way to increase accredited training and education at each step, rather than limit the size of our human resource growth, I believe anyway.

  4. Jeff

    I am a practicing physician who finds it appalling that the APAGS would continue to recruit more students than they can provide an education for. It is the responsiblitiy of professional organizations to recruit only the number of candidates that they can graduate every year. It is incumbent on the institutions within APAGS to make sure that there are an adequate number of internships in order to have the students who have worked so hard for 4-5 years have the opportunity to get there license. If they cannot supply adequate training to the students that they have, then they should recruit less students! The leadership of APAGS and the universities offering doctorates in psychology should be very ashamed of themselves. They must remember that they are affecting the lives of very intelligent and motivated students who have put their faith in the leadership of this profession.

    1. Nabil

      Jeff, we agree that it is a shame that there are not enough accredited internships for students who need one to graduate. Unfortunately, APA cannot limit the number of students entering doctoral programs; that is up to each individual program. Any efforts by APA to limit the number of students entering would be in violation of federal trade laws. This is different from medicine, which to my understanding has an exemption to these antitrust issues. As a result there is an imbalance between the number of students in accredited programs and the number of accredited internships. APA does require programs to disclose outcomes data, including the match rate to accredited internships; APAGS supports these efforts and is working to educate those entering the field to understand this data and be more fully informed consumers prior to accepting graduate school offers (see http://www.apa.org/apags/resources/index.aspx and http://www.apa.org/apags/resources/compare.pdf).

  5. Jill

    I do not understand why the 319 applicants who did not submit a rank-order list are not included in the percentages calculated. I did not submit a rank-order list this year because I did not receive any invitations to interview (despite the facts that I am in an APA accredited graduate program and the DCT feels I am ready for an internship). I believe the actual percentage of applicants who did not match to an accredited site is 61%. Please let me know if I am mistaken.

    1. Nabil

      Jill, we agree that a proportion of those who do not submit a rank ordered list were those who did not receive interviews at accredited internship sites. However, there are other potential reasons that individuals may not rank (e.g. not meeting requirements to leave for internship on time; personal reasons). As a result, in this blog post we use a more conservative approach that underestimates the number of those who don’t match. However, we do take into consideration these issues in other analyses with data from the APA Commission on Accreditation (which are available about a year after the match). Data from the 2011 match from the Commission on Accreditation indicate that out of 4,203 students from APA accredited doctoral programs who needed an internship that year, only 2,180 obtained an accredited internship, resulting in a 52% match rate to accredited internships (Doran, Meyerson, & El-Ghoroury, 2014). We wish you good luck in Phase 2 and hope you obtain an internship.

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