The doctoral internship is, for many, the last step in training prior to entering the workforce as a psychologist; therefore, it tends to be one of the most formative and important years for trainees. This chapter focuses on the experience of supervising doctoral-level interns in an inpatient psychiatric hospital in the United States, particularly focusing on clinical psychology skills including individual and group therapy as well as various types of psychological assessment. Common issues and challenges that frequently arise for interns are discussed as well as how these concerns are handled within the clinical psychology internship program and through the provision of supervision. Issues reviewed include, but are not limited to, roles of interns within an inpatient psychiatric setting, adjusting to a new setting and role, stress management, developing autonomy and independence within the workplace, navigating increased responsibility, various challenges pertaining to the severity of the patients’ psychopathology, and how interns manage their own emotions and reactions to patients within this setting. These issues will be outlined and brought to life through examples based on situations that have arisen within the author’s internship program. In addition, the chapter elaborates on some of the unique opportunities available to interns working in an inpatient psychiatric setting.