Postgraduate Questionnaire
Department of Psychology
University of Wyoming

The Department of Psychology at the University of Wyoming is interested in what you, as a graduate of our Ph.D. program, have accomplished since graduating. In particular, we are interested in learning about professional activities and achievements since leaving UW. Your answers to the following questions will be very significant to us as we aim to provide the best graduate training possible for our current and future graduate students. Please brag about yourself, so we can brag about you. Indeed, if you have received training, honors, awards, and/or recognitions not addressed in this questionnaire, please provide us with the details. Thank you for taking the time to help us.
 

Name:

Last:

First:

Street Address:

City:

State:

Zip:

Country:

 

Phone Number:

E-Mail:

Is this your work or home contact information? Work Home

In what year did you earn your doctoral degree from the University of Wyoming Department of Psychology?

Graduate and Postgraduate Training

1. Did you graduate with a doctoral degree in clinical, experimental, or general psychology?
 

Clinical Psychology

 

Experimental Psychology

 

General Psychology

2. If your Ph.D. is in experimental psychology, in what discipline did you concentrate your training?
 

Cognitive 

 

Developmental

 

Neuroscience

 

Psychology and Law

 

Social

 

Other

3. After graduation, did you complete any postdoctoral training? Yes   No

4. If you answered yes to question 3, please provide the title, location, and years of your postdoctoral position? If you completed postdoctoral training at more than one site or in more than one specialty, please list all of these experiences.
 

5. Was your postdoctoral training supported by a grant? If yes, what was the mechanism for funding (e.g., individual grant to you, individual grant to your postdoctoral mentor, or institutional grant to the training site)?
 

Psychology Licensing Exams

If your doctoral training was in clinical psychology, please complete questions 6 – 9.

6. Have you taken the national psychology licensing exam?  Yes   No

7. Have you passed the national psychology licensing exam?  Yes    No

8. Are you currently licensed as a psychologist?  Yes  No

9. If you are currently licensed, in what state?

Current Employment

10. We are interested in your current employment circumstances. Please indicate the setting, job title, whether you are working full time (FT) or part time (PT) at your current place of employment as well as the years you have been in this position. If your primary employment situation is not full-time and you have a secondary position, please indicate this as well.

Primary Employment

    

*Department Name:

**Other Job Description:

Job Title:

FT PT

Years

Secondary Employment

    

*Department Name:

**Other Job Description:

Job Title:

FT PT

Years

 

11. Please approximate the percentage of your current work time that is spent in each of the following activities:
 

% of your time

    

A. Administration

   

B. Assessment

   

C. Consultation

   

D. Psychotherapy

   

E. Supervision

   

F. Teaching

   

G. Research

   

H. Program Evaluation

   

I. Other

   

First Employment

12. We are interested in the first job you held after completing your Ph.D. For your first employment situation, please indicate the setting, job title, whether you worked full time (FT) or part time (PT) at this position, and years in this position. If your primary first employment situation was not full-time and you had a secondary position, please indicate this as well. If you completed postdoctoral training, we are interested in your employment circumstances after completing your postdoctoral work.

Primary Employment

    

*Department Name:

**Other Job Description:

Job Title:

FT PT

Years

Secondary Employment

    

*Department Name:

**Other Job Description:

Job Title:

FT PT

Years

 
13. Please approximate the percentage of your work time at your first place of employment that was spent in each of the following activities:
  % of your time    
A. Administration    
B. Assessment    
C. Consultation  
D. Psychotherapy    
E. Supervision    
F. Teaching
G. Research
H. Program Evaluation    
I. Other    

Scholarly Activities

Since finishing your Ph.D.:
14. Have you published in any of the following outlets?      
  Refereed journals    
  Non-refereed journals    
  Book chapters    
  Authored books    
  Edited books    
  Other (please explain)  
     
     
15. Have you submitted any grant or contract proposals to help fund your research?  Yes No 
16. If yes, to what organizations have you submitted grant or contract proposals?
17. How many of these grant or contract proposals received funding?
18. Have you taught any college courses in psychology or a related discipline? Yes    No
19. Have you given any formal presentations on subjects related to psychology? Yes    No
20. If yes, what types of presentations? A. Presentation(s) at a professional meeting
  B. Workshops
  C. Guest lectures
  D. Other
21. Have you reviewed manuscripts for scientific or professional journals?  Yes   No

 Contributions to Clinical Practice

(Experimental or General Ph.D. students, please skip to question 26.)

22. Have you (co)founded your own independent practice?  Yes   No 
23. Have you supervised another psychologist for licensure purposes?  Yes    No 
24. Other than those people to whom you refer in question 28, have you supervised any other practitioners (e.g., Bachelor- or Masters-level practitioners) or students (e.g., undergraduate or graduate trainees)?  Yes    No 
25. In clinical practice, do you provide services to any of the following populations?
 

Practice/Service Delivery Activities

Currently

Anytime since Ph.D.

  
  A. Clients/communities in rural areas

 
  B. Children and families

 
  C. Elders/geriatric clients

 
  D. Ethnically/culturally diverse clients/communities

 
  E. Clients with physical or developmental disabilities

 
  F. Gay/lesbian/bisexual/transgendered clients

 
  G. Low socioeconomic status clients/communities

 
  H. Clients with serious mental illness (SPMI/SED)

 
  I. Clients with substance abuse/dependence

 

Professional Activities

26. Are you a member of any of the following professional organizations?
  A. American Psychological Association
  B. American Psychological Society
  C. State Psychological Association
  D. Canadian Psychological Association
  E. Discipline Specific (e.g., American Association on Cognitive and Behavioral Therapy or Society for Research on Child Development)
  D. Other:
27. Do you participate in any of the following additional professional activities?
  Additional Professional Activities Currently Anytime since Ph.D.  
  A. donate professional time pro bono (or reduced rate)  
  B. officer or board member of professional organization  
  C. involved in professional advocacy activities  
  D. member of state licensing board  
  E. subscribe to professional journals  
  F. serve on editorial boards of scholarly journals  
  G. serve as APA accreditation site visitor  
28. Have you served as an administrator or researcher for a community, state, or federal agency?  Yes   No 
29. Have you served as a research consultant outside your own agency or organization?  Yes    No  
30. Have you served as an expert witness in court proceedings?  Yes    No 

Honors and Awards

31. Have you received any honors or awards related to your professional accomplishments in psychology? Yes    No 

  If yes, please specify all honors and awards you have received: