Neuropsych Timeline

[bcliff]

Hi all - I'm in my first year of a clinical PhD, and I'm pursuing balanced research-clinical training in neuropsych. I have several years of neuropsych related research experience prior to enrolling in my PhD program, and my mentor now is a neuropsychologist with a neuro- related research program.

I'll start internal practicum at the beginning of year 2 (Summer 2016), and then I'll be on external practicum in years 3 & 4 (2017-2019), and I'm hoping to be on internship in year 5 (2019-2020). My program has good neuropsych supervisors and often takes on interesting neuropsych cases at our own clinic, so I'm hoping to start getting hands on neuro experience this summer.

I wanted to (a.) check and see if anyone has any recommendations on things I should be working on now to be competitive for neuropsych extern placements and internship matching and (b.) see if anyone is willing to share their own neuropsych timeline - I'm thinking that if I wrap up internship in 2020 and do a two year neuro- post-doc, I should be eligible for ABPP-CN in 2022, does that seem realistic? Also, (c.) what does compensation tend to look like for neuro internship, post-doc, and then early career positions?

Since I haven't started any type of practicum, I'm hesitant to talk about my ideal "post-grad school" job description, but as of right now, I see myself pursuing a faculty position with an AMC, where I have an opportunity to teach, engage in research, and supervise. My interests are balanced, but I think that if I had to pick I'd like to lean more clinical than research (maybe a 60/40 split), so (d.) does this career goal seem possible as a neuropsychologist, and what would be some good things for me to focus on now, with this goal in mind?

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[Pragma]

Your timeframe of 7 years is exactly what I did so it can be realistic, just keep jumping through the hoops in a timely manner.

My advice is to get non neuro pracs for 1-2 years. Candidates that do basically all neuro before internship are weaker clinicians IMO. Still do a neuro prac of course, but develop your broader skills so that you can specialize during internship/fellowship.

Also go to neuro conferences, present, and network. It pays off in the long run for all kinds of selection processes.

 

[Pragma]

Oh and you'll probably have to do 80/20 at an AMC but other splits are possible, just less common

 

[Pragma]

Re: compensation, check this out. A new one should be out soon.

http://www.ncbi.nlm.nih.gov/m/pubmed/21253962/

Internship i saw ranges from 15-35, postdoc 30-45, entry level 60-100 depending on the position.

 

[Therapist4Chnge]

I think your timeline can work, it just depends how far you get on your dissertation and if you can match the first time. I was on the 8yr plan (5 in grad school, 1yr internship, 2yr fellowship) because I didn't match my first go around (too geographically restricted and all top tier places). Some of the best neuro training isn't on a Coast, so don't get sucked into the NYC/BOS/CA bias.

As for training, I agree completely with Pragma. Become a solid generalist and pursue some foundational training in neuropsych (neuroanatomy, neurophysiology, etc) and try and get an advanced practica doing testing. Honestly, you need a good foundation as a psychologist before you jump into neuro. There are some programs that specialize too early, and their students are too narrowly trained, which really shows on internship and fellowship.

 

[Pragma]

The extra year of prac hours might make you more competitive for top match sites. If you do internship on year 5 just make your pracs count. In my case I didn't get interviews at the best of the best sites, but I still matched somewhere decent that gave me great neuro and nonneuro experience. If I had waited a year I probably could have had more choices but it all worked out. Networking got me a great postdoc and I interviewed at competitive sites.

So it can be done but it takes preparation, luck, networking and in my case willingness to take a middle of the road internship placement in order to graduate year 5.

 

[AcronymAllergy]

I think your timeline can work, it just depends how far you get on your dissertation and if you can match the first time. I was on the 8yr plan (5 in grad school, 1yr internship, 2yr fellowship) because I didn't match my first go around (too geographically restricted and all top tier places). Some of the best neuro training isn't on a Coast, so don't get sucked into the NYC/BOS/CA bias.

As for training, I agree completely with Pragma. Become a solid generalist and pursue some foundational training in neuropsych (neuroanatomy, neurophysiology, etc) and try and get an advanced practica doing testing. Honestly, you need a good foundation as a psychologist before you jump into neuro. There are some programs that specialize too early, and their students are too narrowly trained, which really shows on internship and fellowship.

I've seen this as well, unfortunately, and it often seems to show up day-to-day as trying to force/shoe-horn every case and conceptualization into a supposed neuropsychological framework (e.g., variable processing speed results? Must be persisting effects from some remote mild TBI or exotic and unknown toxin exposure; couldn't just be that the person ridiculously anxious while testing). If all you have is a hammer...

Which can cause significant problems in its own right, especially if you already have someone with somatically-focused anxieties (iatrogenic effects, anyone?). Sort of like those times I'll have patients tell me they met with a doc in the past after their concussion who told them, "you're never going to be the same."

 

[Therapist4Chnge]

Which can cause significant problems in its own right, especially if you already have someone with somatically-focused anxieties (iatrogenic effects, anyone?). Sort of like those times I'll have patients tell me they met with a doc in the past after their concussion who told them, "you're never going to be the same."

Welcome to my yesterday. One patient told me her Internal Medicine doc told her they'd need to "wait and see" if she had brain damage from her concussion.

Another patient swore she had PTSD bc "some doctor" told her she did, following her accident. She has since gone to an EMDR therapist, chiropractor, and a Reiki / energy healer. None have helped, but she KNOWS she has brain damage. She also knows her lawyer believes her and all the doctors at our AMC are quacks.

 

[psych844]

Really? I don't have any neuropsych training, but I'd think that fatigue alone (physical/mental) from dealing with such stress/trauma would basically guarantee that processing speed was lowered (let alone all the other factors..ie anxiety).

 

[smalltownpsych]

I always thought that certain types of head trauma can cause significant processing speed deficits by shearing some of the neural tracts that connect the various regions of the brain. Isn't that also part of the problem with emotional regulation and the connections between the frontal cortex and limbic system. Of course, run of the mill concussions wouldn't cause that type of damage. When I have seen these types of patients with serious head trauma from car accidents, some of their neurological impairments are pretty obvious just in an interview. I haven't had the opportunity to work with the mild concussion, seeking disability types yet. I'm sure they will start showing up though.

 

[AcronymAllergy]

I always thought that certain types of head trauma can cause significant processing speed deficits by shearing some of the neural tracts that connect the various regions of the brain. Isn't that also part of the problem with emotional regulation and the connections between the frontal cortex and limbic system. Of course, run of the mill concussions wouldn't cause that type of damage. When I have seen these types of patients with serious head trauma from car accidents, some of their neurological impairments are pretty obvious just in an interview. I haven't had the opportunity to work with the mild concussion, seeking disability types yet. I'm sure they will start showing up though.

With moderate to severe (or perhaps even complicated mild) injuries, you can certainly have axonal shearing, sure. With mild TBI/concussion, after a few months, not so much. Persisting problems at that point are much more likely than not due to extra-injury factors.

 

[Pragma]

With mild TBI/concussion, after a few months, not so much. Persisting problems at that point are much more likely than not due to extra-injury factors.

+1, I wish that PCPs would get some training on this rather than watching the news. So many iatrogenic effects of bad information when these occur.

 

[smalltownpsych]

+1, I wish that PCPs would get some training on this rather than watching the news. So many iatrogenic effects of bad information when these occur.

The PCPs don't really know the difference between mild, moderate, and severe for most mental health issues and tend to overestimate severity. I have also seen this with psychologists who have not had good exposure to more severe forms of disorders, as well. That is one of the main reasons that I sought out inpatient experience during my training.

 

[psych844]

Sorry, unrelated to this thread but was watching a British show called "24 hours in the A @ E" and saw a patient who got into a fight, his head was punched, and he had a temporary change in his personality. Made me think of the neuropsych people here.

 

[smalltownpsych]

Sorry, unrelated to this thread but was watching a British show called "24 hours in the A @ E" and saw a patient who got into a fight, his head was punched, and he had a temporary change in his personality. Made me think of the neuropsych people here.

Yup, they have been punched in the head too many times too! I think you hit the nail on the head.

 

[psych844]

Yup, they have been punched in the head too many times too! I think you hit the nail on the head.

haha

 

[bcliff]

posted in the wrong thread, whoops