JW made this sound complicated and it's not. it's exactly like a med student who becomes 'dr.' when he/she graduates from med school. then they're a resident. they work, they see and treat patients, but there is an attending physician (licensed) who has to co-sign all their orders and monitor what they're doing. when they complete their residency, they may do a fellowship in their specialty area, gaining more experience. but once they're licensed in a state, they can operate independently. but the entire time, they've been 'practicing', because they've been seeing and treating patients, developing a plan of care, diagnosing, etc.
But the rules are someone different for a Ph.D in clinical psych as opposed to a medical doctor. And don't medical doctors take thier medical baoards/exams after med school before resident tenures. Or do I have that wrong.