Doctoral students in Clinical Psychology are under significant pressure to publish in graduate school, recognizing that this is often a highly-sought accomplishment and skill-set when applying to predoctoral internship sites and subsequent fellowships. For those interested in the world of academia, this pressure becomes more pronounced. As a Clinical Psychology student specializing in Neuropsychology, I am consistently confronted with the reality that publications are exceedingly important for each professional stage and grant opportunity, all of which exert a synergistic, upstream impact along one’s professional trajectory in academia. However, there is no universal rubric related to publication expectations because each training program is unique in this respect. Instead, graduate students are exposed to statements such as ‘publish or perish’ and become enmeshed in the idea that productivity is the ultimate definition of who they can realistically become as a professional. This definition, though, is neither operationalized nor sufficiently quantified.
There are multiple pathways for students in Clinical Psychology – PhD programs are generally rooted in a scientist-practitioner model of training that incorporates lab work, while PsyD programs are frequently known for the practitioner-scholar model that focuses more intently on empirically-supported clinical work. This is an important distinction, as many students revisit and revise their vocational objectives while in graduate school. In many ways, this demonstrates an evolution of ideas through exposure to broad training. Therefore, it is not uncommon for a PsyD student to engage in cold-calls and pursue routes to solid research assistantships while upholding substantial, rigorous clinical obligations. Quite often, these students are neither tied to nor guaranteed research positions at a particular location. This shift in professional objectives, however, is often unrecognized and, arguably, invalidated by a bias toward PsyD programs both explicit and implicit. This view of the PsyD as a newer degree-type varies by region in the United States, with some remaining steadfast in their opinions. One will notice fewer PsyD faculty members at sites that accept few or no PsyD students for internship or postdoctoral fellowships. There are several viable reasons for this stemming from both sides of the equation, but it is a noteworthy point – there is clearly ground in need of covering to accommodate the ever-changing field of Clinical Psychology. In fact, as this article is being written, ‘PsyD’ is the only degree unrecognized by the word processor.
According to the Association of Psychology Postdoctoral and Internship Centers (APPIC, 2019), 1,407 PhD students and 1,604 PsyD students from Clinical Psychology programs applied for predoctoral internships during the most recent application cycle. Therefore, these two degree-types are entering the field in similar crude numbers. However, match rates for these applicants were 89.4% and 79.0%, respectively, demonstrating a significant difference in overall outcomes. While PsyD students may be viewed as more interested in work in private practice or college counseling centers, this is not necessarily the case and is often complicated by factors that are not analyzed. These factors are likely not analyzed due to the sheer heterogeneity of site rotations and tracks, as well as their respective labels and intricacies therein. This results in decreased ability to sufficiently compare these applicants on site- and rotation-level bases. One of these factors is specialization, such as in Neuropsychology or Forensic Psychology. Both PhD and PsyD students are competing for these positions, which are notably competitive across the United States, but many sites offering strong Neuropsychology training, for example, report preference for those trained as scientist-practitioners. While a student may exemplify this model in such domains as research productivity, fact-finding, and the integration of empirical evidence in treatment, he or she is often defined by the degree being sought and, occasionally, eliminated from consideration on this basis. This dilemma is certainly improving over time due to an imbalance between numbers of positions and trainees, in the favor of trainees. Neuropsychology, however, is one of those specialties that, site-by-site, accepts a limited number of trainees each year in comparison to more generalist tracks, essentially remaining impervious to these imbalances.
PsyD students involved in research labs certainly possess the ability to publish, but face unique obstacles due to their implied focus. Many PsyD programs, though not all, do not possess the resources of large academic medical centers, requiring PsyD students to pursue and onboard with larger settings that align with their research interests. In this fashion, they face significant barriers to publishing depending on the particular site and position they manage to obtain. For example, certain research settings include research assistants on manuscripts that report data with which they have worked. Others, however, require specific time commitments prior to being eligible for authorship. Sites also exist that do not entertain involvement in manuscript preparation but, instead, serve to only provide lab experience for students who would otherwise go without – this is meaningful experience, of course, but does not confront the issue at-hand. All of this, though, depends on the research setting’s productivity and resources. This also extends beyond the ethics of authorship status, which is operationalized differently across journals, to the perception of one's need to publish. One must question, then, how serious the perceived pressure to publish is and, if the perception is accurate, how much time and effort one should allocate to these endeavors.
Presuming, admittedly based on a non-representative sample of reports, that graduate students should publish prior to predoctoral internship in Clinical Psychology, another question that arises is how this should be operationalized when lab productivity in itself varies tremendously. Publishing one or more articles in a high-impact journal, for example, may hold significantly more weight than numerous publications in low-impact journals. Ironically, this falls into an ongoing debate regarding the utility of impact factors (IFs) in determining quality of individual articles. The ability to publish in the commonly-cited high-impact journals depends on a wide array of factors that is likely well beyond the control of graduate students. While excellent and novel findings are disseminated through these journals and many others with high IFs, highly useful findings and well-written articles are also published in journals with lower IFs. With this being said, the degree to which students can ascertain that which is expected by prospective training directors and supervisors is, at best, limited. With unknown expectations due to heterogeneity of sites and confounds such as IF, the process of publishing and allocating reasonable resources to the desired outcome becomes extremely difficult.
My personal conclusion is one of healthy and realistic optimism. I place tremendous value in science – a process of rational thought and empirical inquiry. I will venture far enough to state that the unrelenting world in which we live would be significantly worse without science. I enjoy writing clinical reports and manuscripts, recognizing that it is only due to the extant literature I have the ability to cite any information of value. Therefore, I understand the expectation, albeit vague and elusive, that graduate students should publish. It is true that this could serve as one sign of future productivity. For students being trained as practitioner-scholars, publishing can be accomplished through careful selection of labs and conducting systematic reviews and other articles that do not require the same type of data collection. Even certain conferences will publish abstracts of presentations, for example, which may not be a peer-reviewed publication but is at least a ‘published abstract’ for a scholarly presentation. With adequate determination, time-management, and passion, as well as helpful mentors, publishing is possible even with limited resources. Under limiting circumstances, however, articles may not be reviewed or accepted by the same caliber of journals. Supervisors, training directors, and employers should consider this reality when reviewing an applicant’s CV and overall professional trajectory. In any calculation of a student’s ability to engage productively in research, his or her productivity must be contextualized to the degree possible, thereby ensuring that it is the student who is being evaluated, not the faceless degree or training model.
The individual student may face significantly more barriers than those mentioned. Across all degree programs and career trajectories, underrepresented groups face barriers that others, such as myself, do not face. This is due not to any laudable acts but on unearned privilege that affords me certain opportunities unavailable to others. These groups include but are not limited to age, ethnicity, country of origin, gender, language, disability, sexual orientation, and marital status. One may vehemently deny these barriers as a component of academia and, further, claim that Clinical Psychology is ‘above’ this injustice because of its training on treating people as individuals. This is simply untrue, however. There are certain sites, such as college counseling centers, that have eliminated in-person interviews to avoid any potential bias on the basis of appearance. Whether or not the removal of in-person interviews is an ideal method is not the point of focus, but sites have certainly recognized the potential for bias, serving as an important step in reducing barriers for underrepresented groups. The denial of these barriers serves to perpetuate, not obviate, the systemic and systematic inequities in both psychology and neuropsychology.
In the current world of academia, it is no surprise that the perceived pressure to publish during graduate school is potentially magnified for PsyD students who are interested in traditional academic internships, or any internship demonstrating a preference for scientist-practitioners and expecting this characterization to be exemplified by a University rather than the individual. When and how frequently to publish become cognitive activities of guesswork and simply engaging in that which is within one’s realm of possibility. Still, one may also question whether or not publications are viewed equivalently across degree-types, irrespective of the authors behind the publications. Either way, the accuracy of graduate-student perceptions and the diplomacy of academia’s expectations are likely less important to affected students than the perceptions themselves. As individuals who must market themselves in some fashion to be competitive among a large pool of colleagues, graduate students in Clinical Psychology and Neuropsychology certainly face intense pressure to ‘publish or perish.’ The elusive benchmark and ambiguous expectations suggest that publishing and perishing are not asynchronous events, leaving some with an omnipresent fear of perishing.
Association of Psychology Postdoctoral and Internship Centers (2019). 2019 APPIC match statistics – phase 1. Retrieved from https://appic.org/Internships/Match/Match-Statistics/Match-Statistics-2019-Phase-I (accessed 12 June 2019).