Let me begin by saying that going on internship (at Kings County Hospital Center) has genuinely been a very good learning experience. I specifically ranked KCHC high expecting that its variety of rotations and opportunities would both stretch and expand my knowledge and skills base. On this front, I have gotten what I hoped for. Seminars and practicums (in short-term dynamic therapy, psychopharmocology, anxiety disorders and group therapy) helped do exactly this. Three months in the Psychiatric Emergency Room and two stints on inpatient units have improved my diagnostic interviewing skills to the point where the DSM is now my friend, or at least a good acquaintance. Also, (Steve you can skip over the rest of this sentence) I have taught myself and done Exner Scoring on the Rorschach and feel only slightly sullied.

Depending on where you end up doing your internship, it can feel like a year of both continuity and change. For me, continuity is being in an internship program with a psychodynamic focus. Concretely this translates into psychodynamically-oriented supervisors and a long-term treatment emphasis when needed. More substantially, the psychodynamic nature of the internship involves a general commitment to thinking about clinical work and the lives of our patients in complex ways that appreciate the importance of unconscious conflict, transference-countertransference dynamics, and the ever-presence of the past in present-day life.

Being a member of an internship group is also a familiar experience. Quite frankly, it resembles the feeling, though more concentrated at times, of being a member of your class at City. I mean that with all of its plusses and minuses. While you are considered an individual staff member at the hospital, you are also part of this collective. People relate to you as you are, but also as “an intern,” which leads to all kinds of transference phenomena (both positive and negative). While you don’t travel as a part of an amoeba-like group like in first year, you do have to co-exist and find ways of working around differences.

It is a transitional year. There are times when I feel like a full-fledged professional. A grown-up psychologist, you might say. These are not just the times when a random patient in the hospital passes me, and sees the shirt-and-tie and the pseudo-confident look on my face, and says “Hey doc.” These are also the times when I’m sitting across from a patient in the midst of a transference enactment and I know it’s a transference enactment. And the time I’m asked to consult on the case of a mentally retarded inpatient I tested, who is now driving the staff crazy with his spitting and impulse control problems.

On the other hand, there are the times when I feel like I novice, not to psychology or clinical practice, but to the ways of “the real world” can work out there. This is the world of hospital-based treatment. This brings up the complications and competing priorities of being in an internship program, within a larger behavioral health department, within the larger culture of the hospital. The divides between psychology’s “talking therapy,” psychiatry’s biologically-driven pharmacological solutions, and hospital management’s cost efficiency agendas can seem vast. Another task of developing your professional identity then becomes learning about your ability to negotiate these tensions. Something tells me, though, that resolving this task does not get completed during internship year.

Coming from City, you will feel comfortable with conceptualizing the richness of patients’ difficulties. You may also be well-equipped to handle the chaos and sometimes disorganized structure of internship life at a hospital. What I lacked in possibly more practical aspects of training (certain test administrations, DSM fluency, cognitive-behavioral techniques) I was more than able to learn and integrate into the solid core of dynamic thinking that City provided. Our City training clearly helps instill a quality of deep thinking about clinical matters that internship cannot provide, but requires.

Internship year is challenging, both on a psychological level and on a practical one. Depending on your internship, you may find yourself wistfully longing for the days of consistently getting six hours of sleep and having the caseloads of fewer than five patients. You may also have more supervisors in one year, like in my case, than you had during your whole time at City—each with their own idiosyncratic way of working and particular theoretical orientation. At times you will be expected to perform as a professional psychologist, and not a student. And you know what, you will find that you are able to successfully answer that call. You will more often than not prove to yourself that you actually remember everything you thought you wouldn’t from your training at City.

In closing, one of the most important things that I think I have come to realize eight months into my one-year internship is just that—it’s just one year. I remember people telling me this while I was applying, and it didn’t seem to register with me. Application year feels so intense and stressful that internship year seemed like it had to be this momentous life changing event. If it wasn’t then why the heck was I obsessively tallying my estimated hours of charting time for my application and pondering the differences between whether my orientation was psychoanalytic or psychodynamic? However, now as I near the end of my year, internship feels like one year in the process of becoming a psychologist.

Fortunately, I did have some of this insight when I ranked my internship sites and factored in quality of life issues. You see I like having some free time and having a personal life in order to treat myself well. I mean, this is hard work we’re doing. I’ll tell you that I would be less capable to be as available and present as I have to be for patients if I couldn’t come home at a reasonable hour, have a drink and watch a Nets basketball game.

So those are just some of my thoughts about internship year. Now back to the paperwork and finishing that dissertation (which is almost impossible to work on while on internship). One bad thing about internship being only one year is that before you know it, you have to start thinking about life after internship and "what’s next?" Anyone hear of any job openings?