Postdoctoral Training

At present, postdoctoral supervised experience is required for licensure in most states, for some forms of institutional employment, and for board certification (e.g., American Board of Professional Psychology) in many specialty areas. However, there is ongoing debate regarding the requirement for postdoctoral hours for licensure as well as the definition of postdoctoral training itself. Recent years have witnessed a series of conferences related to postdoctoral education and training, the development and implementation of accreditation guidelines for postdoctoral training programs, and recommendations from the American Psychological Association (APA) to eliminate the postdoctoral requirement. There is variability in existing formalized programs in terms of accreditation status, funding, training focus, structure, and setting. The decision for students regarding seeking formalized postdoctoral training remains complicated, and individuals need to consider the most appropriate postdoctoral experience for themselves given their professional and personal goals.

History of Postdoctoral Training

Postdoctoral training, or training that occurs following the receipt of the doctoral degree, has been the subject of long debate within psychology. The requirement for postdoctoral training dates back to the 1949 Boulder conference, during which conference participants asserted that to become proficient in psychotherapy, postdoctoral training would be needed. The value of postdoctoral training was further affirmed at the 1955 Stanford and 1958 Miami conferences; however, there was no consensus that it should be a required part of the education and training sequence. It was at the Chicago conference, held in 1965, that postdoctoral training was conceptualized as a vehicle for securing advanced and specialized competence.

It was not until 1972, however, that the first conference devoted specifically to education and training at the postdoctoral level was held at the Menninger Clinic. However, no specific guidelines for postdoctoral training were devised. At the 1973 Vail conference, some attention was paid to postdoctoral training related to continuing professional development and to matters of access and flexibility. At the 1987 National Conference on Graduate Education in Psychology, conference participants concluded that narrow specialization most appropriately occurred postdoctorally. At the annual APA convention in 1990, there was a meeting to discuss a model for a national program of psychology postdoctoral training that would be offered through comprehensive psychology postdoctoral centers of excellence.

Some of the most ardent supporters for accreditation at the postdoctoral level were individuals in the specialties. Throughout the 1980s, guidelines were developed for postdoctoral training in various specialty areas, such as health, clinical child psychology, and clinical neuropsychology. In 1992, in response to concerns expressed at national conferences (e.g., the Gainesville conference) regarding the lack of consistency in internship training in the postdoctoral experience and to calls articulated by the Joint Council on Professional Education in Psychology (JCPEP) for general standards in postdoctoral training and formal specialty certification, the first National Conference on Postdoctoral Training in Professional Psychology, cosponsored by APA and the Association of Psychology Postdoctoral and Internship Centers (APPIC) was held in Ann Arbor, Michigan. Conference participants crafted a policy document that addressed the purposes of postdoctoral training; entrance requirements; program content, structure, and organization; faculty-staff; and evaluation mechanisms. They developed recommendations for initiatives to foster excellence and innovation in postdoctoral education and training and called for guidelines and principles for accrediting postdoctoral programs.

In 1994, the APA held a National Conference on Postdoctoral Education in Psychology in Norman, Oklahoma. Attendees provided models for postdoctoral and continuing education and training to develop and enhance the competence necessary for psychologists to contribute maximally to teaching, research, and practice; established a taxonomy and terminology to describe postdoctoral and continuing professional education and training; proposed mechanisms for documenting program adequacy and trainee competence; identified and developed funding opportunities; and delineated the requisite steps to implement conference models for postdoctoral and continuing education and training.

Development of National Standards

APPIC first began accepting postdoctoral programs for membership in 1974-1975, and it established specific postdoctoral membership criteria in 1987. By the end of 2006, there were 103 APPIC-member postdoctoral programs. A subset of these programs receives APA accreditation. The current APPIC membership criteria for postdoctoral training programs include a planned and programmed sequence of training experiences, an appropriately qualified licensed psychologist as training director, two or more qualified and licensed psychologists on staff or faculty, 2 hours or more per week of individual supervision, additional hours of learning activities, and a requirement that candidates spend at least 25% of their postdoctoral fellowship time in professional psychological services. Programs must include a minimum of 1,500 hours of total time and can be completed on a full time or part time basis. Depending on the area of specialty, the program may be longer than 1 year in duration.

From the mid-1980s forward, there were calls for accreditation standards for postdoctoral training, and subsequently in the early 1990s, the Inter-Organizational Council for the Accreditation of Postdoctoral Training Programs (IOC) was formed. The IOC, in coordination with APA’s Committee on Accreditation, developed generic guidelines and procedures for accrediting postdoctoral programs that were formally adopted in 1996 by the APA Council of Representatives. Postdoctoral programs were first accredited by APA in 1997. As of July 2006, there were 26 accredited postdoctoral residency training programs and 20 accredited specialty practice programs; some sites have more than one accredited program.

Typically, accredited postdoctoral programs are 1 year in length, except that certain specialty areas (e.g., clinical neuropsychology) require 2 years. Some specialties, notably neuropsychology, have a national organization representing their postdoctoral programs. For some specialty areas, APA’s Council of Specialties has augmented general accreditation guidelines with specialty-specific guidelines.

Despite efforts to develop national standards, most programs fall outside of the APPIC and APA system, and thus there is insufficient quality control for many programs. There also is a lack of consistent incentive for programs to seek APPIC membership or APA accreditation, because it is not an expectation of licensing boards nor is it the norm (except for Department of Veterans Affairs medical centers and in certain specialty areas). This state of affairs also makes it difficult to accurately depict the number and types of postdoctoral programs available in North America.

Licensure

The past 20 to 25 years have witnessed dramatic shifts with regard to licensure requirements. In 1985, 28 states required postdoctoral experience for licensure. In 2007, 48 states require postdoctoral experience. However, jurisdictions vary with regard to the clinical and supervisory requirements of the postdoctoral experience, number of hours that constitute a training year, and length of time required to, and allowed to, complete training. Information on postdoctoral requirements by jurisdiction can be found at the Association of State and Provincial Psychology Boards’ Web site. The growth in the number of states requiring supervised work experience at the postdoctoral level for licensure was in response to the 1987 model act for state licensure of psychologists, in which APA recommended 2 years of supervised professional experience for licensure, 1of which needed to be postdoctoral.

The requirement for the postdoctoral year for licensure was questioned by the Commission on Education and Training Leading to Licensure, established by the APA Council of Representatives, which met in 2000. The commission recommended retaining the 2-year experience requirement but argued for increased flexibility in the timing and sequencing of this experience. While the requirement for the internship was endorsed by commission members, they stated that the second year of experience could be obtained either through a preinternship practicum or postdoctoral experience. However, participants acknowledged that it was essential that the profession study the requisite competencies for licensure and determine when in the education and training sequence such competencies were obtained. There has been an active movement focusing on these competencies and their assessment in the past 5 years.

In an effort to implement the recommendations of the Commission on Education and Training Leading to Licensure, in February 2006, the APA Council of Representatives passed a statement recommending that for licensure, applicants must demonstrate that they have completed a sequential, organized, supervised professional experience, equivalent to 2 years of full-time training, that can be completed prior or subsequent to the granting of the doctoral degree. For applicants preparing for practice as health service providers, 1 of those 2 years must be a predoctoral internship. Although they recommended elimination of the postdoctoral requirement for licensure, the Council of Representatives did affirm that postdoctoral education and training remains an important aspect of continuing professional development and the credentialing process for professional psychologists, as it is a foundation for practice improvement, advanced competence, and interjurisdictional mobility. The council also supported the further development of competency goals and assessment methods in the professional education and training of psychologists. In anticipation of this new stand by APA, one jurisdiction (i.e., Washington) has eliminated the postdoctoral requirement, and several others are considering a similar change.

The elimination of the postdoctoral year was and remains quite controversial. Proponents of this decision cite difficulties faced by students trying to secure the required experience for licensure, problems finding suitable positions with appropriate supervision, the limited financial remuneration associated with the postdoctoral year, the heavy debt load that students have upon internship completion, the protracted duration of training, and the fact that the requirements for licensure in psychology are more stringent than those in most professions.

Opponents of the elimination of the requirement express concerns that many students who complete their doctoral degrees have not yet achieved certain competencies crucial for licensure, and that further training and supervision are imperative for students to obtain these competencies. They also believe that eliminating the requirement reduces the profession’s efforts to protect the public and consumers of psychology. These concerns have arisen, in part, from the belief that many practicum experiences are not providing sufficient training or supervision necessary for the development of the competencies required for independent practice. Of note, in one survey, students (graduate, interns, postdoctoral residents), trainers (graduate, internship, postdoctoral), and APA members endorsed the value of the postdoctoral requirement, although they did not believe that a formal program should be mandatory. Furthermore, a recent national survey revealed a discrepancy in training directors’ views of trainees’ readiness to practice independently. Academic training directors reported that trainees are readier for independent practice earlier in the training sequence than internship and postdoctoral training directors reported.

Supply and Demand

As noted above, it is difficult to be certain about the number of postdoctoral training programs. There was documented evidence of 22 sites in 1960-1962, 46 in 1967, 161 in 1986, 388 in 1993, and 480 sites that had paid positions in 1998. However, there is a relative shortfall in the number of sites and available slots given the number of individuals in predoctoral internship programs. This has resulted in an insufficient number of formalized positions. However, many students choose to complete their postdoctoral experience requirements through supervised work experience rather than via a formal postdoctoral training program.

Characteristics of Postdoctoral Training

Training Emphasis and Sites

Postdoctoral training programs may emphasize clinical or research training. There are accredited programs that are broad and general in professional psychology as well as those in such specialty areas as clinical child, clinical health, clinical neuropsychology, and rehabilitation psychology. Most APPIC member programs are based in medical schools, university counseling centers, Veterans Affairs Medical Centers, and child settings. There also are positions in industry and government. The setting influences the experiences fellows will gain and the dominant populations with whom they work.

Formal and Informal Postdoctoral Training

Postdoctoral training may be informal or formal. Informal refers to on-the-job supervised experience, designed primarily to assist the individual in fulfilling licensure requirements. These positions often entail high service demands and considerable levels of professional autonomy. Conversely, formal postdoctoral training occurs in the context of an organized and structured educational program designed to develop advanced competency and expertise for the professional practice of psychology. Stipends typically are set. These positions are advertised through the APPIC Directory, the APA Monitor, and the Association for Psychological Science’s APS Observer as well as on various listservs.

A survey of interns revealed that, in general, they preferred an informal postdoctoral experience. This preference appeared to be based on personal and practical considerations, and such factors often outweigh professional considerations. Such considerations relate to finances, concerns about relocation, dual career demands, family goals, and relationship commitments.

Those who complete formal programs rate these experiences as more valuable than those who participate in informal programs, as these programs bolster their competence in professional practice, clinical research, supervision, and teaching; provide them experiences with particular populations; and enhance their job marketability. A study of individuals in formalized postdoctoral fellowships highlighted that a desire to secure focused training in specific areas and a need to obtain further experience that would increase their marketability were key in deciding to apply for formalized fellowships. Formalized postdoctoral training is essential for certain specialties and is highly desirable in certain geographic regions.

Specialty

For many years, there has been a general consensus that postdoctoral education and training are valuable in terms of specialty practice. A position first evidenced at the Boulder conference, it was solidified at the Stanford, Miami, and Chicago conferences as well as at the National Conference on Implementing Public-Academic Linkages for Clinical Training in Psychology.

Many sites offer training at multiple levels (e.g., practicum, internship, postdoctoral) within a given specialty area, despite the fact that the only specialty programs that can be accredited are at the postdoctoral level. Within each specialty area, there is heterogeneity in the types of postdoctoral training offered, raising questions about core competencies to be achieved in each specialty area at the postdoctoral level. Individuals who receive postdoctoral training in various specialty and proficiency areas reveal a high degree of satisfaction with their experience and an enhanced sense of competence. Specialty training at the postdoctoral level increases marketability and is mandatory for some specialties.

Developmental Perspective

This phase of professional development is characterized by a focus on negotiating the tasks of individual and professional self-definition. Individuals begin to develop expertise in areas of personal interest; manifest a deepening commitment to the work; experience an enhanced sense of personal efficacy, confidence, and self-acceptance as psychologists; and are perceived by others as competent psychologists.

A postdoctoral training program offers a transition period between being a student and professional employment, and making this transition is a task with which individuals often struggle. Although supervision and training continues, there typically is greater professional autonomy during a postdoctoral training program than there was during the internship year, and thus the experience facilitates transition from dependence to independence. Many postdoctoral programs pay particular attention to assisting their trainees in securing their first professional employ-ment in psychology.

Funding

One major concern for students in making decisions regarding postdoctoral experience relates to funding. There are a broad range of financial arrangements for informal postdoctoral supervised work experience. However, formal postdoctoral positions are typically funded by the institutions in which they are embedded. As of the 2006-2007 training year, the mean salary for individuals in APPIC member postdoctoral training programs was $35,000/year, with a range from $15,000 to $72,000/year. For APA accredited programs, the mean is $42,800 and the range is $29,000 to $70,000/year. For the number of programs and slots to be increased, additional funding streams need to be secured. Limited graduate psychology education funds are available for accredited postdoctoral fellowship programs. APA has made efforts toward passing legislation that would allow graduate medical education funding through Medicare to support psychology postdoctoral training programs. However, few institutions have been able to secure these funds for their programs.

Future Directions

Individuals seeking postdoctoral training should define their training objectives, be cognizant of the relevant licensure requirements, and be mindful of the advantages of securing such training in terms of specialization and networking. Young professionals should examine their professional and personal goals to ascertain whether to seek formal or informal postdoctoral training and to determine the extent to which their training will be specialty specific. As jurisdictions become more variable with regard to the postdoctoral requirement, individuals need to determine if they will even need to secure such supervised experience.

It also may behoove the profession to better standardize the postdoctoral training requirements on a national basis. In addition, greater consideration could be given to implementing a matching process for formalized postdoctoral programs akin to that already in place for the neuropsychology postdoctoral programs and for internship programs. Finally, the profession could more effectively convey the value of postdoctoral education and training, particularly that which occurs in formalized programs.

References:

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