Costs of predoctoral clinical psychology internship training in a Canadian health care setting

Financial pressures on institutional health care in Canada in recent years have led to substantial pressures on institutional psychological services. These pressures have resulted in the elimination or substantial diminution of psychological services in some of these institutions, including the discontinuation of many longstanding psychology internship programs. It is therefore important for psychologists to demonstrate their cost-efficiency in delivering services. However, evidence for this efficiency in the current Canadian context is lacking. This investigation examines the costs and clinical activities of the interns and staff at a major Canadian teaching hospital in order to determine the degree to which the internship is a cost-efficient method of delivering services. The results indicate that there is a small increased cost to having the services delivered through an internship program. The results are viewed as part of a balanced scorecard approach to the evaluation of an internship program. From such a perspective, other factors can be seen as balancing out the slightly increased cost. Also, a number of strategies are outlined for increasing internship cost-efficiency.