PhD/PsyD Post-doc w/ emphasis on Concussions

[InYourHead]

Hi,

I just recently got some exposure to concussions and was told that some fellowships offer specialized training in this area. I was told the University of Pittsburgh Medical Center is the best, and Children's National Medical Center in DC is also solid.

Is anyone familiar with other programs that offer concussion training?

Thanks!

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[LMK]

I'm not 100% certain about exposure to concussed patients, but the U of FL has a trauma psychology postdoc in Jacksonville. Definitely TBI, maybe not concussions. I think Jackson Memorial in Miami has similar.

 

[mcvcm92]

http://www.childrens.com/specialtie...toral-fellowship-in-clinical-neuropsychology/

 

[erg923]

University of Pittsburgh medical center sports concussion program.

You realize this is a subspecialization within neuropsychology, right? It will require hx of npsych work and experience.

 

[WisNeuro]

I would recommend a broader TBI experience where you will get exposure to a wide range of TBI (mild-severe). Merely seeing concussions will get old as you learn that 99% will completely resolve within weeks, months at most. Unless they are involved in litigation or secondary gain circumstances. Then they will fail effort tests and give you a profile that looks like an advanced dementia patient

 

[AcronymAllergy]

I agree that, if at all possible, widening the scope of your post-doc training would be a good idea. It's fine if you'd like to specialize in concussion, particularly in the very acute setting, but a postdoc in neuropsych should prepare you for general neuropsychological practice as well. This means getting at least a little bit of experience with a wide variety of conditions, including neurodegenerative conditions, movement disorders, moderate and severe TBI, seizure disorders, etc.

As erg mentioned, Univ. of Pitt. is the first program that jumps to mind when I think of concussion training, probably because I've seen their recruitment posts for the post-doc on various list serves.

Also, most any VA with a polytrauma clinic should get you plenty of exposure to folks with a h/o possible mild TBI, although few to none will be in the acute phase, as those folks would most likely present to the ER (if at all) and then be sent on their way.

 

[IT514]

Agree with the recommendation for broader experience. I'd recommend looking for sites that are at Level 1 trauma center and are actively involved with the trauma surgery and neurotrauma teams. For example, I meet with the trauma team weekly to discuss the TBI cases they refer to us and often see these folks for follow-up and occasionally for cog rehab/therapy. Some sites might focus on one level of severity more than others.

 

[Therapist4Chnge]

Definitely go broader for fellowship, as you don't want to pigeon hole yourself too early. It is much easier to start broad and hone in than do it the other way around.

 

[AcronymAllergy]

Definitely go broader for fellowship, as you don't want to pigeon hole yourself too early. It is much easier to start broad and hone in than do it the other way around.

+1. Case in point, a position near me had recently opened up that would've entailed significant concussion-related work, and my experiences in polytrauma and general neurology made me quite competitive despite no prior work specifically in a "concussion clinic," so to speak.

Because concussion is such a specialized area, I feel that (as has been said) it'd be easier to lay the in-depth general neuropsychological foundation first and then to develop concussion-related expertise rather than the other way around. This being because most/all general neuropsychological principles apply to concussion, but the opposite isn't really true.

I haven't looked at UPitt's program, but I'd have to imagine they'd get you some general neurology experience as well.

 

[PsyDr]

Another vote for: Get a fellowship with TBI. IME, People without exposure to severe TBIs, SMI, etc tend to over interpret because they have never really seen what severe is.

Like SMI, once you have seen real severe cognitive disturbances you will never forget it. See real aphasias, dyspraxias, neglect, etc. You will never forget how someone with a severely impaired memory score presented as.

Also mTBI is an awful patient population. Lots of litigation, they will drive to their appointment, complain of severe memory disturbances, repeatedly score 0 on any memory test, drive home, then argue with you about how they performed with examples about how they missed something. Then you get a call from an attorney.

 

[Therapist4Chnge]

mTBI….Lots of litigation, they will drive to their appointment, complain of severe memory disturbances, repeatedly score 0 on any memory test, drive home, then argue with you about how they performed with examples about how they missed something. Then you get a call from an attorney.

This is 100% accurate for a good portion of cases, which is why it is paramount that the clinician stays on top of the research and utilizes the best assessment tools for each evaluation. The nice thing about mTBI cases is that the vast majority of them have an opportunity to improve, though it is up to the pt if they want to commit to making changes.

The litigation component scares a lot of clinicians, but it usually isn't too bad. If you do IME work it can get a bit more complicated, but you are choosing to go down that road by taking the case. If you stick to clinical work it really shouldn't come up that often. I welcome contact and requests from law firms (as a clinical provider) because it is all billable if done correctly.