PhD/PsyD How do neuropsychologists' responsibilities differ?

[bcliff]

Hi all,

I’m pretty sure we’ve had posts like this in the past, but I think it’s been a little while. Right now, I’m an extern in a relatively high-stress neuropsychology placement (purposefully vague description), where I enjoy working. Thinking about internship, postdoc, and beyond, I’m admittedly a little worried about how sustainable this specific niche of neuropsychology is for me personally (burnout). It’s also a new setting for me, so I imagine that as I become more fluent in this type of work, my level of exhaustion will decrease? I think a big source of my own stress is being simultaneously split between so many responsibilities at this point in my training (e.g., classes, program milestones, lab/research responsibilities, multiple practicum sites), and I often have the thought that if I was “just at this one site full time" I’d be able to better manage the stress and responsibilities it demands -- It kind of feels like a never ending set-shifting task? Have others had similar thoughts or experiences in externship positions, and/or is this feeling of being particularly stressed at this level of training shared by others?

Right now, I’m interested in seeing what neuropsychologists are doing at different sites (e.g., VA, AMC, etc.) -- I always think day-by-day breakdowns are a nice way to articulate the true gist of a position. A theme I’m interested in, right now at least, is the ease with which life and work can be balanced in different settings.

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[WisNeuro]

Training is always busy. I can only speak for myself, but my current responsibilities are easily manageable. It's mostly my clinical work, with intermittent training responsibilities. I probably work 35ish hours a week. I think the set-shifting is still there, but just less to worry about in the work setting. I no longer have classes and a dissertation over my head, but I do still have CE credits, admin work, etc. I think you just get more used to it and the stuff you deal with is cyclical and generally the same, so while you're set-shifting, you're shifting into and out of familiar tasks for the most part.

My externship was pretty hectic. I did 2.5 days a week technically and I was always working in different specialty clinics (e.g., TBI, Neuroonc, Dementia, inpatient units) so it was a lot to take in being at that point in my training. Throw on dissertation, classes, and internship apps, and it's a lot to handle. It will get better. Or at least you will have more opportunities to make it better as you will have choices as to where you want to work, to some extent.

 

[PsyDr]

1) IME, a great deal of the stress of training is that you are gaining skills while you're doing the work. It's an added layer which is sometimes ignored. For example, I can write a report in no time right now. In training it took hours and hours. It's not that I have any more ability, I just have a LOT more practice. Likewise, I've had enough experience in strange patient interactions, that it is unusual for me to be stressed out by something happening. This was not always true. The first patient I had that did some psychotic behavior scared me. Now I forget to mention stuff like that when talking about my day.

2) As one gets more fluent, things gets easier. Boring even. If you read enough reports, you'll eventually see other practitioners change their battery. What the profession often doesn't admit is that some of this is because of boredom.

3) You will never have a position where all you have to do is clinical neuropsych. Even if that's what is advertised. There will be meetings, phone calls, emails about things about things important and so banal that you'd swear you're in junior high school, etc. In PP, you'll have business stuff thrown in as well.

4) day to day, most people are testing about 3-5 patients/week. Some have psychometricians, some don't. The trade off is that if you use them, you spend more time dictating. Most find an upper limit where you can't dictate more than X reports/day. Dictation does get lonely if you do too much of it. Unless you like sitting in a room alone, talking to yourself. If you're in an AMC, there are case conferences to discuss patients. If you're in PP, referrals are calling you nonstop about when a report will be done, because they want it within 15 min of the testing being done. If you're wise, you'll schedule some professional development time (i.e., reading). Some people do some psychotherapy on the side, but arguably that's more of a rehab psych thing.

5) IME, the exhaustion comes from not doing stuff when you are off. If you come home and sit in front of the TV or work, you get physically deconditioned and mentally drained. Yes, I see the irony in me saying this.

 

[Gepetto]

I am very interested in having a better understanding of this as well-- as a prac student, it's hard to know the job duties of a neuropsychologist the 80% of the time that I'm not there.

I am attempting to decide the best training between hospital setting versus VA setting for neuropsych internship. Could any neuropsychologists tell me more of a breakdown day-to-day what sorts of things you do when you are not actively testing a patient or report writing?

Any other advice or considerations you can impart regarding hospital versus VA internship? I've never been in a VA system, so I cannot say whether it is a future career goal.