Hi Sanman,
Thanks for your interest. Feel free to e-mail me if you have more specific questions. I would be more than happy to answer them. I address some of your concerns below.
I have heard opinions from both sides -- psychiatry (MD/DO) and clinical neuropsychology (PhD) -- and have come to the conclusion that it all depends on which profession suits YOU the best.
Behavioral Neurology and Neuropsychiatry both require the MD or DO degree in addition to 4-5 years of residency and anywhere between 1-3 years of fellowship training. This varies depending on your desire for subspecialization.
Clinical Neuropsychology requires the PhD degree. These programs are typically PhD programs in Clinical Psychology, which include a predoctoral internship in a clinical setting and may include courses in and applied training in clinical neuropsychology. Nearly all graduates from such programs go on to do fellowships in their area of specialization -- e.g., child clinical neuropsychology.
A major difference between medical training and graduate training is that graduate training in neuropsychology requires you to complete a dissertation which is usually based on original research. Such research is typically in some area of clinical psychology or clinical neuropsychology -- e.g., "attentional deficits in obsessive-compulsive disorder." Neuropsychologists are particularly interested in the relationship between brain and behavior and spend a good part of their time conducting neuropsychological evaluations of patients to assess cognitive capacities such as memory, executive function, attention, and language. Some also work in rehabilitation hospitals where they conduct evaluations of brain-injured patients and some may work in neurosurgical settings in which they perform cortical mapping.
As far as salary is concerned, behavioral neurologists and neuropsychiatrists can make anywhere between $120,000-$200,000/year, although the median tends to hang around $140,000/year. Clinical neuropsychologists can make anywhere between $50,000 and $75,000/year with the median around $60,000/year. All of these estimates are based on statistics from the U.S. Dept of Labor and from my many interactions among such professionals.
Regarding the future of neuropsychology, here's an e-mail I recently received from Dr. Michael Westerveld, a clinical neuropsychologist in the Dept. of Neurosurgery at the Yale University School of Medicine:
"The challenges that face the profession are not scientific,
but economic. Unfortunately, the reality is that reimbursement for clinical neuropsychological services are declining, as they are in every other medical and mental health specialty. The profession will, in my opinion, continue to flourish as a science, but as a clinical specialty I think the gravity of the danger is real. I would truly like to believe that in ten years these issues
will be largely resolved, but as the economic pressures on the Medicare system increases with the aging of the population, neuropsychology will be hard hit. The sad reality is that private insurance companies are leading the decline, whereas they used to provide a respite from the lower government reimbursement
systems. This is a somewhat pessimistic view, to be sure, but one that, if ignored, will become reality.
As far as the biological basis of behavior, I think that it depends more on the area you are interested in. If you are interested in Psychiatric disorders and pharmacalogical interventions, Psychiatry is a more logical discipline although Psychologists are gaining a foothold in this area and have successfully gained
prescription priveleges in some domains (New Mexico, and the DOD, with more poised to follow). However if you are more interested in the neurological basis of normal behavior and the impact of neurological injury or disease, then I would pursue either Clinical Neuropsychology or Behavioral Neurology."
Hope this helps!
neuropsych
and I'll argue it out with you till dawn...!
