Is a post doc in neuropsychology imperative to board certify?

[MPRage]

I may catch some flack for this but am trying to get some thoughts and feedback about the necessity of pursuing a post-doc in neuropsychology and the longterm pros vs cons of bypassing this step, particularly as it applies to the board certification process. I want to preface that this question is motivated by my age and capacity to continue to live with a limited salary, particularly because I have a lot of student loans, including private (not federal) loans that are in repayment no matter what my status is (I used up all my in-school deferment).

-Sans post-doc, would I be "looked down on" as a professional?
-Are there folks here who did not pursue a post doc that could speak to their QoL and/or professional opportunities?
-Can you still work as a neuropsychologist if you license via EPPP, even though you didnt complete the post-doc? (I see the lack-there-of being a limitation for AMCs and VAs more than private practice for example but I could be wrong).

any insights would be sincerely appreciated!

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[WisNeuro]

YMMV, but I will not refer out to someone who is not boarded. Getting boarded without a postdoc is possible, but fairly difficult, you have to prove equivalency. You can still practice without a postdoc as a psychologist who does neuropsych testing. We love those providers, shredding those reports is what makes me a lot of money in IME work. Without being boarded, there are some lucrative doors that are closed, generally speaking. Also, many hospital systems will require boarding, or boarding within a certain time frame.

 

[Sanman]

Are you talking formal post-doc vs informal or no post-doc at all?

Frankly, if you are not going to do a post-doc at all, I would consider other areas of practice as neuropsychology is the most regulated area of the field and you are unlikely to be hired by anyone as a neuropsychologist.

 

[cara susanna]

We're in the process of hiring for a neuropsychologist and we are only considering candidates with the formal 2 year neuropsych post docs

 

[PsyDr]

I am not a fan of the HCG.

1) This line of reasoning opens the door to the idea that you should just get a masters degree and practice neuropsychology. Or graduate from elementary school, move to Colorado, and practice unlicensed coaching.

2) You would be looked down upon, similar to a physician who did not do a residency.

3) You are proposing to gain 2 years of education … (shrugs). How would you acquire that knowledge? Who would recognize your knowledge base, after you acquired it? I could probably watch the first few years of medical school lectures, acquire some of the academic knowledge, but I would be missing the procedural knowledge. And no one would recognize me as a physician. You would have the same problem.

4) At a minimum, it would be unfair to the first few years of patients.

5) Legally, you could bill for it in most states. However, there are some states that would not allow you to practice neuropsych including Louisiana and Maine.

6) Malpractice suits against you would be a slam dunk. “Dr X, did you do a 2 year post doc? Isn’t that the standard of the field? So you deviated from the standard of the field, and someone was harmed?”. Boom, lawsuit over.

7) The ethics code ensconced the requirement to seek supervision when outside your merit of education, and the field already standardized the education requirements.

8) If I were you, I’d rush towards rehab or geri psych. Those areas use neuropsych tests, and haven’t really established strict training requirements. Plus, neuropsych CPT codes are being reimbursed less and less. Everyone is moving towards treatment.

 

[MPRage]

thanks all for feedback!

 

[AcronymAllergy]

To add to the l limited income bit from an anecdotal perspective--I haven't crunched the actual numbers, but I'd be very surprised if my postdoc hadn't essentially paid for itself (and then some) at this point, if considering the difference in starting salary for two years (i.e., postdoc vs. salaried position) and assuming I'd invested that difference at an average rate of return. Postdoc was key for making me eligible for pretty much every position I applied to, and it (and board certification) have afforded me opportunities that have significantly increased my income over the course of my career. And akin to what PsyDr mentioned RE: malpractice, if you ever plan on doing medicolegal work, having to explain and rationalize my qualification as an expert without a postdoc (for anyone having graduated in the past 20 years or so) is not a question-and-answer session I'd enjoy having in depo.

 

[MPRage]

To add to the l limited income bit from an anecdotal perspective--I haven't crunched the actual numbers, but I'd be very surprised if my postdoc hadn't essentially paid for itself (and then some) at this point, if considering the difference in starting salary for two years (i.e., postdoc vs. salaried position) and assuming I'd invested that difference at an average rate of return. Postdoc was key for making me eligible for pretty much every position I applied to, and it (and board certification) have afforded me opportunities that have significantly increased my income over the course of my career. And akin to what PsyDr mentioned RE: malpractice, if you ever plan on doing medicolegal work, having to explain and rationalize my qualification as an expert without a postdoc (for anyone having graduated in the past 20 years or so) is not a question-and-answer session I'd enjoy having in depo.

Thank you so much for your perspective and namely your feedback regarding finances. I always figured I would follow through with postdoc especially given my training background and goals but have heard recently with more frequency that folks in the field are forgoing the step altogether for tenure track positions or private practice positions etc (these folks come from a spread of PsyD and PhD at R1 university backgrounds). While I'm not keen on making a livable salary for the first time at the ripe age of 37, I know I can't forgo the training step. It is immensely helpful to know that in the long run, it will pay for itself.

 

[Sanman]

Thank you so much for your perspective and namely your feedback regarding finances. I always figured I would follow through with postdoc especially given my training background and goals but have heard recently with more frequency that folks in the field are forgoing the step altogether for tenure track positions or private practice positions etc (these folks come from a spread of PsyD and PhD at R1 university backgrounds). While I'm not keen on making a livable salary for the first time at the ripe age of 37, I know I can't forgo the training step. It is immensely helpful to know that in the long run, it will pay for itself.

Academic and clinical positions are completely different things. When it comes to the clinical end of things, are you financially in a position to open a private practice and take on additional debt with no/minimal income or do you need a job initially? If you need someone to employ you, best to think of what they might want to see until you are in a place to open your own practice.

 

[GT_Neuro]

Neuropsychologist here.

1. Most neuropsychologists would agree that you need a Neuro Post-Doc simply to practice Neuropsychology. No one coming straight out of 50% Neuro Internship is ready for prime time.

2. All Boards require a 2-year post-doc for Board Certification.

 

[Therapist4Chnge]

At a minimum, you’ll want a 2yr formalized post-doc that qualifies for boarding. From a training perspective, there really isn’t an equivalent informal post-doc experience. Didactics will be vastly different too. It is hard to quantify the amount of learning done during those two years.

In regard to legal work, you *really* don’t want to get skewered on the stand bc you only have neuro experience at the internship level or prior.

 

[Sanman]

Mentioned above by @PsyDr, but if loans and salary are a concern, the VA has a lot of geriatric positions posted (particularly HBPC and CLC/nursing home). If you are willing to be in person and a bit flexible about location, the starting salary is decent and they are offering up to $200k in loan repayment over 5 years with EDRP and they will start you even unlicensed.

 

[MPRage]

Thank you folks, so much. I am also wondering if having an F31 in grad school facilitates loan repayment eligibility in the long run?

 

[szymk1sm]

Thank you folks, so much. I am also wondering if having an F31 in grad school facilitates loan repayment eligibility in the long run?

I can't speak to the VA EDRP route, but you could be eligible for the NIH LRP if you're in a qualified position that has at least 50% research FTE. I did not have a F31 in graduate school and was able to obtain LRP after postdoc. There are other LRP requirements you have to meet, but having a previous F31 is not one (but having one could speak to your dedication to research and further support your application)... not sure if that answers your question...

 

[MPRage]

I can't speak to the VA EDRP route, but you could be eligible for the NIH LRP if you're in a qualified position that has at least 50% research FTE. I did not have a F31 in graduate school and was able to obtain LRP after postdoc. There are other LRP requirements you have to meet, but having a previous F31 is not one (but having one could speak to your dedication to research and further support your application)... not sure if that answers your question...

Yes, thank you so much!

 

[texanpsychdoc]

To add a little diversity to the topic (and possibly shake the hornets' nest), I would say that you would still likely be able to do neuropsychological assessments without a post-doc if your training could support such a thing from other aspects of your experience, knowledge, etc. I don't think you not having the post-doc experience being a 100% dealbreaker. Feel free to private message me if you'd like to discuss further. Just wanted to add my $.02 since others have.

 

[WisNeuro]

To add a little diversity to the topic (and possibly shake the hornets' nest), I would say that you would still likely be able to do neuropsychological assessments without a post-doc if your training could support such a thing from other aspects of your experience, knowledge, etc. I don't think you not having the post-doc experience being a 100% dealbreaker. Feel free to private message me if you'd like to discuss further. Just wanted to add my $.02 since others have.

No one is telling the OP that it's not possible, or even probable. They're informing OP of the financial and potential legal ramifications of practicing without the post-doc. The bottom line has pretty much been, Can you? Sure. Should you? Probably not.

 

[Sanman]

To add a little diversity to the topic (and possibly shake the hornets' nest), I would say that you would still likely be able to do neuropsychological assessments without a post-doc if your training could support such a thing from other aspects of your experience, knowledge, etc. I don't think you not having the post-doc experience being a 100% dealbreaker. Feel free to private message me if you'd like to discuss further. Just wanted to add my $.02 since others have.

To clarify, do you mean that you are legally able to do so, or are you suggesting that most reputable hospitals in desirable metro areas would hire you to do so? Different standards....

 

[AcronymAllergy]

To add a little diversity to the topic (and possibly shake the hornets' nest), I would say that you would still likely be able to do neuropsychological assessments without a post-doc if your training could support such a thing from other aspects of your experience, knowledge, etc. I don't think you not having the post-doc experience being a 100% dealbreaker. Feel free to private message me if you'd like to discuss further. Just wanted to add my $.02 since others have.

As was said, if it's a matter of can a person do this, yes, they probably can (outside of a couple states). It's not unusual for me to see other psychologists in my area offering "neuropsychological assessment" services. Whether a person should do this, and whether the service they're providing the patient is of adequate quality, are other matters. Also, the question did specifically reference board certification, which is going to be essentially impossible without a fellowship (or the attempt at piecing together an equivalent experience).

Anecdotally, I began my neuropsych training on day 1 of grad school, which included probably a half-dozen different practicum sites + coursework and research, and had a neuropsych-tracked internship. I was not ready before postdoc, although I also underestimated how much I would learn on postdoc until I was knee deep in it. I know many others with similar experiences. I don't know that it's possible for a person to have had more pre-fellowship neuropsych training than me.

 

[Therapist4Chnge]

There is no substitute for the two-year fellowship training. I learned more in those two years, than the prior 6 years of training. I had a great mentor during internship, and I learned a ton, but it really doesn't all come together until the fellowship years. It's like drinking from a fire hose, and it isn't really easy to replicate. There are also the connections made throughout. I still contact my old mentors and others I've worked with over the years.