VA Chicago Health Care System

General Track Preference Form

PLEASE PRINT THIS FORM OUT AND ENCLOSE IT WITH YOUR APPLICATION
(you need not reformat it to one page if it prints out on more than one)

General track interviews will be comprised of the following elements, each 30 minutes long:

• A group meeting with Director of Training

• A group tour of the medical center led by current interns

• An individual meeting with an individual therapy supervisor

• An individual meeting with the Dr Van Denburg, the director of training

• Two periods to visit with current interns

• Two individual or group meetings (dependent on scheduling) with supervisory staff of your choice—as chosen below.

Morning interviews will be from 8 am to 12:30 pm.  Afternoon meetings will be from noon to 4:30 pm.

These meetings with the supervisory staff of your choice will provide you an opportunity to learn more about specific rotations that you may be interested in.  Depending on scheduling issues, you may meet with the supervisor individually or in a small group. 

This form is to provide you with the opportunity to make choices of the staff you would like to interview with.  Please mark your top two choices with the number 1.  Please mark a third choice with the number 2, in the possibility that one of your preferred staff will be unavailable for urgent personal reasons when you are here. 

_____                    Neuropsychology, major rotation, Linda Wetzel, Ph.D., ABPP
_____                    Health Psychology, major rotation and Biofeedback, minor rotation, Susan Payvar, Ph.D.
_____                    Day Hospital Program, major rotation, John Mundt, Ph.D.
_____                    Addictions, minor rotation, and Psychology Administration, minor rotation, Mark Zerwic, Ph.D.
_____                    Geropsychology, minor rotation, Daniel Rataj, Ph.D.
_____                    Inpatient Psychiatry, minor rotation
_____                    Treatment of PTSD from Vietnam combat, group and individual therapy, Joseph Yount, Ph.D.
_____                    Psychodynamic psychotherapy supervision, individual therapy, David Eisenberg, Ph.D.
_____                    Research, minor rotation, Robert Craig, Ph.D., ABPP
_____                    Psychological assessment minor rotation, Janet Kamer, Ph.D.
_____                    Psychiatric Assessment Clinic, minor rotation, Daniel Rataj, Ph.D.
_____                    Women’s mental health and treatment of sexual trauma, minor rotation, groups and individual therapy

If you are interested in the following rotations, please discuss them with Dr Van Denburg during your scheduled interview with him:
Supervision of extern psychotherapy
Internship administration, minor rotation
Outpatient mental health, major rotation

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