I am a psychiatrist at a large VA hospital in Chicago. Not the same as a psychologist, but I work very closely with a ton of psychologists and social workers.
My background is that I majored in Biomedical Engineering in college (Northwestern University- on the verge of their first NCAA’s!!), never took a single psychology course in college (too soft for me, I thought, as I was a hard science guy), then went to medical school (The Ohio State University) to be a primary care physician and/or cure cancer, preferably both. In med school, I did fine in the bookwork, but pretty didn’t like anything I did in clinicals. I had scheduled Psychiatry last in my clinical rotations, because it was the last thing I thought I’d go into. Several weeks into that rotation, I decided I loved it, and I would spend my career as a psychiatrist. Go figure. But I liked studying it, I liked spending time with the patients and learning their stories. I liked the people who worked in the field, as they are very kind, with really good hearts. They’re a little odd, to be sure, but I’m a little odd, so it was a good fit. I’m still happy doing what I do. I scratch my technology itch a bit by co-directing the Telemental Health and Technology program for my department, along with my Psychologist partner/co-director.
The psychologists I work with at the VA are mostly Ph.D’s and a few Psy.D.’s. In general, Ph.D.’s tend to be more research oriented, and Psy.D.’s tend to be more clinically oriented, but that’s a generalization about their training, and both can do both research and clinical work. The folks I work with see patients clinically and are program managers. At the VA, there is a ton of PTSD, Substance/Alcohol abuse, as well as a fair amount of the usual bread and butter- Depression, Bipolar, Anxiety/Panic, and The Oi’s favorite, Schizophrenia. There’s some Antisocial characters, but not a ton, as they don’t tend to come in for help. Serial killers – not so much, as they also don’t come in; they typically hide themselves away and do their killing in secrecy. We have a couple of folks who go Rambo and hole themselves up then kill/attack themselves and a family member. But not that often – those cases that make the news are pretty rare, but of course they get lots of media attention, and everyone freaks out and thinks everyone returning from war is dangerous.
As clinicians, they conduct psychotherapy, with the current movement towards evidence based therapies, so that they tend to run through specific procedures/protocols in their psychotherapy, rather than it being the old fashioned analysis that you see in the movies (patient lies down, faces the other way, talks for an hour and the doctor rubs chin and nods for an hour. This only happens in the wealthiest areas of California, New York, and Chicago, any more.) As program managers, they develop those protocols, develop and run research studies, apply for grants, put out clinical ‘fires’, and answer to departmental-hospital-regional-national administration when there are questions or problems.
They are very detail oriented people and bright, particularly in the social-emotional and verbal realm. They write up big, long reports, LOVE details and sit at many meetings discussing details, ad nauseam, that no one else gives a shit about (IMHO). Not that that shit isn’t important, it IS important … it’s just … a lot … and it’s minutia that no one else thinks about. No offense, Hydroponic, just my perception and opinion. J
I’d say they have very stable, challenging, and interesting jobs. The salaries are solid, but not great, and the benefits of a Federal job are excellent. We have the same health insurance as congressmen, and a very well funded retirement plan. Most people who look at financial compensation packages would say that that stuff is worth 30-50% of your total package, so it needs to be considered strongly, as opposed to only looking at salary. The hours are very set, generally 8a-430pm, unless you request flex time due to family obligations (as I do), in which case it can vary day to day, but it is still 42.5 hours per week. I believe psychologists who work in the private sector can make a higher salary, but work more hours to earn that salary. The salary at the VA is a fair salary for the 42.5 hour week, the problem being that if you’re motivated and able to work more than that, you won’t get paid more for those efforts. The younger folks who are still on the lower end of the pay scale and still have energy, often moonlight. I ran my own solo practice part time for 20 years until I closed it 2 years ago to spend more time with my wife and kids. Plus, the VA is a great place to retire for the above-mentioned reasons.
I think most psychologist feel underpaid. I would say that for the number of years, rigorousness and cost of training/education and the selectivity of the training programs, I think they are justified in feeling that way. But I’d also say that almost everyone I know feels underpaid. Everyone thinks that what they do is the hardest, most important thing in the world, and if they spend so much time and effort doing what they do, well then it must be true. In reality, there are many market forces at play when compensation is concerned, and in the end, people are paid what they’re paid due to many factors. As in any career, go into it because you like the topic, you like the people, you like the day to day, and are paid enough to feel reasonably satisfied. You can look up salaries before you go into a field. Don’t go into it if it’s not adequate, and don’t go into it if you don’t like the field. The problem of course, is it’s hard to really know if you like the field, until you’re head deep into debt and feel like there’s no turning back. But then this can and does happen in any field that requires an advanced degree. And that does suck.
Regarding social work, there are different tracks in social work. The ones in the hospital are generally LCSW level (Master’s degree in social work, plus a minimum number of clinical hours and pass a test to demonstrate clinical competency). They either do medical social work or mental health social work. Medical social work involves helping medical patients get their lives in order after they leave the hospital/clinic. For instance, finding a place to stay for the homeless, getting finances in order, making sure someone is around to help them if they need it, etc… Mental Health social work involves mostly psychotherapy surrounding all the stuff mentioned above for psychologists. Some social workers are program managers, like the psychologists are, but it’s less common, and usually only in programs where social services are more pertinent, such as the Homeless Program, Substance Abuse programs, etc … I believe a Master’s degree usually takes 2 years, and then the requirements for the LCSW 1-2 more years. That’s off the top of my head. That’s no walk in the park, but it’s a bit shorter than a Ph.D. or Psy.D. Social workers also feel underpaid, and also under-respected. Again, probably justified, but again, it’s life (see above).
In summary, it’s a good field, to be sure! You won’t be rich, but will be very comfortable. You have to like details and writing, and be really good with people and be very patient. It’s a long road of education/training, and it’d be nice to have a really good sense of what they really do day to day, before you embark on that road. I wonder if you can spend some time volunteering and hanging out with these folks somehow? Hope that helps a bit! Good luck!
