The competition to become a Clinical Psychologist is fierce. In the UK, the constituent parts of the training are a three-year undergraduate degree which is accredited by the British Psychological Society (BPS), and a three-year taught Clinical Psychology doctorate. The doctorate is full-time; candidates are employed by the NHS and complete a series of six-month placements in addition to coursework and a research project.
Psychology undergraduate students self-fund their degrees and as such, courses have flexibility about the number of students they can enrol. Psychology is consistently the second most popular degree in the UK, with an estimated 13,000 graduating each year. However, until recently, the only places offered on the doctorate were NHS funded, and therefore carefully regulated. Between 2012 and 2018, doctorate courses enrolled around 590 students per year altogether; just 15% of the total number of applicants. While three courses now include self-funded places, these come with a price tag of £20k+ a year, putting them out of reach of most graduates.
Here, I offer 10 tips for aspiring Clinical Psychologists:
1. Know the bottom-line. If you are at the point of applying for the doctorate, look at the particular courses you are interested in on the Clearing House website. What are their non-negotiables? Many courses now stipulate that candidates must have a 2:1 or a score above 65% in their undergraduate degree. Others require that applicants have a year’s clinical experience supervised by a qualified psychological therapist. If you don’t meet their stipulations your application will be automatically excluded, even if it is otherwise strong. It is therefore worth researching each course’s bottom-lines before you apply.
2. Look into placement-year degrees. Several universities including Aston, Bath and Leeds (where I am based) offer applicants the opportunity to undertake a placement year ‘in industry’ between the second and third year. This means that students can gain relevant clinical experiences which can help them to be competitive applicants for graduate jobs. These placements are overseen by the universities, helping to ensure that they provide students with more useful experiences than they may gain through general volunteering. Some placements also offer a contribution towards expenses or a stipend, which volunteer roles generally do not.
3. Consider the ‘Increasing Access to Psychological Therapies’ (IAPT) initiative for an alternative career as a psychological therapist. IAPT was launched in 2007 to provide greater access to psychological interventions for people with mild-to-moderate anxiety and depression. It is now planned to expand in order to provide therapies to 1.5million adults per year by 2020/2021. There are two main types of psychological therapists working in IAPT: Psychological Wellbeing Practitioners (PWPs) and High-Intensity CBT Therapists (HITs). PWPs are recruited into training positions with IAPT services on an NHS band 4; once they are qualified, they are paid at band 5 and can progress to band 6 (for information on NHS pay bands, see here). Similarly, HITs apply to train with specific NHS services. They train on band 6 and are paid on band 7 once qualified. Sign up to NHS jobs for alerts about these roles. A follow-up of HITs suggested that 79% stay in IAPT services after qualifying, 61% become CBT supervisors and 23% progress to more senior roles. It also possible to self-fund training to qualify as a CBT therapist, by undertaking a postgraduate course accredited as Level-2 by the British Association for Behavioural and Cognitive Psychotherapies (BABCP).
4. “Remember at the end of the day, it’s just a job”. This was the best advice I was given before I attended my interviews for the Clinical Psychology Doctorate. A qualified Clinical Psychologist called me to give me some advice, and these words helped remind me that I wasn’t auditioning for the X-Factor: at absolute best, I would become a qualified psychological therapist. Imminent fame, stardom and riches were not around the corner. Being a Clinical Psychologist in the NHS is a wonderful job, but it is not without stress and strain, like any other healthcare related job. So, relax: it’s just a job.
5. Vary your experiences. Working as a research assistant or assistant psychologist will give you great experience for the Clinical Psychology doctorate, but more than a year in any one post will have diminishing returns. While you will always need to balance the opportunity to gain varied experience with the need to pay your rent and bills, it’s worth remembering that having a broad skillset will give you the strongest CV and application.
6. Treat applications like assignments and interviews like exams. You cannot assume that the knowledge and experience you have will naturally shine through: work hard to sell yourself. Consider carefully the range of experiences you have had. For example, what is the range of client groups you have worked with? What experiences have you gathered? Think carefully about the knowledge you have in relation to engaging different client groups, conducting assessments, collecting and storing sensitive data, managing risk, and applying psychological theory to individuals, for example by contributing to formulations or interventions. Also consider carefully the job which you are applying or interviewing for: who is interviewing you, and what is their area of interest? Which client group will you be working with, and what things might you need to be conscious of? Which therapeutic modalities might you be using, such as CBT or psychodynamic approaches? One way to impress your interviewers is to appear prepared for the opportunity they are offering.
7. Consider alternative psychology disciplines. If you have a BPS-accredited undergraduate degree, Clinical Psychology is not your only option for working therapeutically. For example, many posts which are open to Clinical Psychologists are also open to Counselling Psychologists. To train as a Counselling Psychologist, you can either do a self-funded doctorate degree or the BPS qualification in counselling psychology; this involves three years of supervised practice. More information is available here. Alternatively, for psychologists interested in working with forensic populations, Forensic Psychology may offer a fulfilling alternative career to Clinical Psychology. In some secure hospitals, much of the work of Forensic Psychologists involves delivering psychological therapy. To train as a Forensic Psychologist you can either complete a Doctorate in Forensic Psychology or a Masters in Forensic Psychology followed by two years of BPS training and supervised practice. More information on becoming a Forensic Psychologist is available here. It is also worth noting that the University of Birmingham now runs a four-year doctorate which offers candidates a dual qualification in both Forensic and Clinical Psychology (see here).
8. Look for research opportunities. As an undergraduate I undertook some voluntary work as a research assistant with a professor and lecturer in my department. It was one of the best decisions I made: it paved the way to my Medical Research Council-funded PhD in Resilience to Suicidality and kick-started my love of improvement in healthcare. It also helped me to gather a range of experiences in working with clinical populations, as my PhD involved undertaking psychological assessments with people with psychosis and testing a novel mood-boosting intervention in this group. I would highly recommend seeking research opportunities to aspiring Clinical Psychologists. If you are currently a psychology undergraduate, seek opportunities with clinically-oriented researchers in your department. If you are a psychology graduate, sign up for job alerts at jobs.ac.uk and look for opportunities which would allow you to gain experience working with clinical psychologists and/or researching with clinical populations.
9. Keep your eye on the proposed role for ‘Clinical Associate Psychologists’. This is anticipated to take the form of an apprenticeship which will last 18 months and produce psychology professionals who undertake psychological assessment and formulation, and who deliver psychological interventions. At the moment, it is suggested that each Clinical Associate Psychologist will train on a Band 5 salary and be paid at Band 6 once qualified. The plans are currently in development, but should be in place in the coming year.
10. Take heart: the need for psychologists is not diminishing. While the sense of competition may feel overwhelming, the demand for psychological therapies is increasing, which is reflected in the introduction of the IAPT initiative and the new role of the Clinical Associate Psychologist. While getting a place on the Clinical Psychology Doctorate may be challenging, if you have a passion for psychological work, the future is bright!
Finally, I want to note that while the cap on funded places for the Clinical Psychology doctorate produces a low success rate at the point of enrolment, I believe it also offers significant benefits. First, the competition that the cap creates means that aspiring Clinical Psychologists need to seek additional experience and training after their undergraduate degrees to strengthen their applications. This experience ensures that all doctoral trainees know the discipline they are working in and can feel confident in their career choice before they sign-up to the three-year course. This is reflected in the high retention rates of courses (99.4%): students rarely fail to complete their doctorate, once they’re on it. Second, it means that once qualified, Clinical Psychologists have good job prospects: 95% are employed in a clinical psychology job within 12 months of graduating. Deregulating the number of doctorate training places could shift this balance, creating the possibility that qualified Clinical Psychologists could become unable to find employment. By ensuring that applicants are experienced and committed, I believe that continuing to fund all forms of postgraduate psychological training offers the best outcome for applicants, healthcare providers and clients.