PhD/PsyD Is neuropsych a lost cause for me?

[imaginarysonicscape]

Hi all,

I've posted on here before with questions revolving around this topic, but I wanted to go ahead and post again now that I'm a year into my program and am more knowledgeable about what is available to me in my program. I went into this program with some interest in neuropsych, but I did not know enough about neuropsych or psych assessment at the time to realize how much I would love it. I am very enthusiastic about testing and neuropsych appeals to me more than ever before. A job involving lots of assessment and little to no therapy is my dream. Assessment-related classes are the only classes where I am actually excited to do the readings, attend lecture, etc.

My program provides a very solid generalist training and plenty of opportunities for assessment experience, but unfortunately very few opportunities for neuropsych assessment. We have a neuropsych research lab, but I was accepted to another unrelated lab and I think it is possible but unlikely that my PI would be willing to have me do a neuropsych-related dissertation. There is one practicum site that I initially believed was a neuropsych site, but is actually more of a health psych site with some opportunity for neuropsych assessment experiences sprinkled in. Further, we have a set curriculum with no flexibility for electives, and the only related classes we have are a basic clinical neuropsychology course taught by a non-faculty neuropsychologist and a neuropharmacology course taught by a professor in the neuroscience department.

I met with the director of my program to express my interest in assessment (as they are enthusiastic about assessment themselves). While they were very excited to talk to me about non-neuropsych career options involving assessment, they told me that it is unlikely neuropsych boarding would be in the cards for me in this program. I also heard from an applicant to my program that they were told the same thing during their interview with the director (I didn't ask; they just happened to mention it in conversation).

I am wondering if I should even bother trying to pursue neuropsych at this point. I am also feeling very regretful. In hindsight I would have applied to programs with more neuropsych-related opportunities if I had known what I know now, but I just did not realize how much it would appeal to me at the time. Transferring programs seems far too risky and would also cause me a lot of financial burden. Do I still have chance at neuropsych in my program, or should I crush all hope and focus my efforts elsewhere? What do you think of my situation? Thank you!

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[jdawg2017]

From what you said, it does not sound like there are any neuro pracs in the area, and your program doesn't really do neuro clinical work (even if you have a "neuro" lab).

I think the more experienced people on here will have more knowledge, but as a neuro PhD student in a big city with lots of in-house and out-of-house neuro opportunities, I can say that is what drew me to where I am today. Boarding will be difficult, not to mention landing neuro internships and post-docs, if you simply cannot get the hours and experiences you need where you are.

 

[WisNeuro]

From what you said, it does not sound like there are any neuro pracs in the area, and your program doesn't really do neuro clinical work (even if you have a "neuro" lab).

I think the more experienced people on here will have more knowledge, but as a neuro PhD student in a big city with lots of in-house and out-of-house neuro opportunities, I can say that is what drew me to where I am today. Boarding will be difficult, not to mention landing neuro internships and post-docs, if you simply cannot get the hours and experiences you need where you are.

Boarding will not be difficult, as long as a few things are true. One, it has to be an accredited program, and they will need an accredited internship. The OP should definitely be looking at that health psych rotation, as it will at least give them some assessment experience. If there is a VA nearby, that may have some opportunities as well. After that, the OP will need a more neuro intensive internship, getting ~50% of their time doing assessment would be needed to start making up for the lack of foundation as well as set themselves up for a neuro postdoc. Additionally, if they can find some way to include some neuro aspect into their dissertation, that will improve their chances. It will be an uphill climb, but it is not out of the question. Depending on their program.

 

[imaginarysonicscape]

Boarding will not be difficult, as long as a few things are true. One, it has to be an accredited program, and they will need an accredited internship. The OP should definitely be looking at that health psych rotation, as it will at least give them some assessment experience. If there is a VA nearby, that may have some opportunities as well. After that, the OP will need a more neuro intensive internship, getting ~50% of their time doing assessment would be needed to start making up for the lack of foundation as well as set themselves up for a neuro postdoc. Additionally, if they can find some way to include some neuro aspect into their dissertation, that will improve their chances. It will be an uphill climb, but it is not out of the question. Depending on their program.

It is accredited with good accredited internship match rates, and the program's reputation is pretty good. I am doing a therapy practicum right now but will be doing assessments at the on-site clinic throughout the program, and I am fairly confident I can get into one of the assessment-heavy practica for my 3rd year placement (we have a few, but only the health psych one involves neuropsych as far I am aware). We have a VA nearby, but the program dropped the practicum site there a few years ago since it is no longer funded by the VA.

 

[AbnormalPsych]

It sounds like being boarded is the goal, but I also want to throw out that you do not have to be boarded to be a neuropsychologist. Not to say that you shouldn't be, but just a reminder.

There are many successful and respected non-boarded neuropsychs in my region in private and group practice.

 

[WisNeuro]

It sounds like being boarded is the goal, but I also want to throw out that you do not have to be boarded to be a neuropsychologist. Not to say that you shouldn't be, but just a reminder.

There are many successful and respected non-boarded neuropsychs in my region in private and group practice.

As the years go by, it is harder and harder to be one without boarding. Some state run plans in my area will not let you bill without it.

 

[psych.meout]

As the years go by, it is harder and harder to be one without boarding. Some state run plans in my area will not let you bill without it.

And I'm betting that, as boarding becomes the norm, not being boarded will negatively affect referrals from other providers and other important parts of private practice.

 

[EmotRegulation]

For what it's worth, I know someone who ultimately matched to a neuro internship and got the 2 year postdoc neuropsych experienced required to get boarded. This was with one year of an intensive and highly regarded neuro practicum/externship, but ZERO neuropsych coursework (other than our required psychopharmacology course which was half about neurotransmitters but not about neuroanatomy or brain functions) or research focus. Mind you, this is an anecdote for sure, but still something.

Can you collaborate on a side project with the neuropsych lab? Definitely focus on assessment practicum training, even if not pure neuropsych (as there's plenty of overlap in many measures; neuropsychologists give standard cognitive assessments and personality assessments too).

 

[WisNeuro]

And I'm betting that, as boarding becomes the norm, not being boarded will negatively affect referrals from other providers and other important parts of private practice.

I won't refer to non-boarded individuals in other states when asked for recommendations. And, in the few cases where I need to refer out of my system, I will only refer to boarded people. Luckily, my area is flush with ABPPd people.

 

[mbneuro124]

I didn't know I wanted to go into neuropsychology until I started my program. Luckily, I was able to get some good neuro practica experience and also did a neuro-related dissertation. I matched at a non-neuro internship site, but did get a neuro post-doc. What I've learned through speaking with mentors is there are various paths one can take to become a neuropsychologist. It certainly does not have to be as clear cut as you may think. I'd say it is not a lost cause at this point.

 

[PsyDr]

1) as unfair as it is: Sometimes it is who you know. I am aware of an individual who got a prestigious neuro post doc due to connections between faculty.

2) there is always rehab psych, neuros up and coming treatment heavy sibling.

 

[NeuroTrope]

You should be fine. I concur WisNeuro's advice. Try to match at an internship that provides at least 50% opportunities for neuropsychology assessment. VAs are probably your best bet. Obtain as much experience as possible now and at least get quite a bit of assessment experience. Being fluent in the WAIS/WMS/MMPI-2/PAI/WRAT/etc. will improve your chances of a good match at a site that does lots of assessment. At the end of the day it is the post doc fellowship that is most important for getting boarded. You can even try to "grow" a post-doc in neuropsychology if you can network with folks in private practice.

The path may not be as obvious if you don't come from a neuropsychology program but it is one you can still find. I came from a neuropsychology lab but several colleagues in non-neuro labs went on to be board certified/eligible by going the above route.

 

[WisNeuro]

You can even try to "grow" a post-doc in neuropsychology if you can network with folks in private practice.

For this particular OP, I would caution against this route. They will likely have limited didactic experiences in neuro at the grad level, which will lead to a shaky foundation in the fundamentals. They should do their best to find an established, APPCN site with solid didactics to supplement that. If they can't do that, the "grown" postdoc should be a last resort. Not being able to show you've had appropriate didactics can significantly affect the boarding process.

 

[futureapppsy2]

1) as unfair as it is: Sometimes it is who you know. I am aware of an individual who got a prestigious neuro post doc due to connections between faculty.

2) there is always rehab psych, neuros up and coming treatment heavy sibling.

Rehab psych is strongly in favor of boarding, too, though--see the recent Baltimore conference on this. Despite the strong overlap between rehab and neuro (I'm the rare rehab person with very minimal interest in neuro), rehab tends to have a somewhat different take on things.

 

[Kadhir]

These things may have been suggested above but tl;dr. Ignore if so.

I'd reach out to the PI of that neuropsych lab. See what they recommend in terms of getting neuropsych practica/coursework. How do his/her students do it? Also talk to the outside neuropsychologist who teaches your graduate course. Maybe they can hook you up somehow. Also, you might be able to switch out some classes for others in your program.

I realized early on that the neuropsych training in my program wouldn't cut it, so I moved for a year to do a neuropsychology practicum in a different city. Also switched out a very basic biopsych class for neuroanatomy in a different department. Sought out some other random opportunities (worked with an outside supervisor, took on some supervised consultation work related to npsych) as well. I realize these things aren't feasible for everybody, but you have to be as proactive as possible. The director is probably giving you those answers in part because it's the easiest thing for them to do.

 

[imaginarysonicscape]

These things may have been suggested above but tl;dr. Ignore if so.

I'd reach out to the PI of that neuropsych lab. See what they recommend in terms of getting neuropsych practica/coursework. How do his/her students do it? Also talk to the outside neuropsychologist who teaches your graduate course. Maybe they can hook you up somehow. Also, you might be able to switch out some classes for others in your program.

I realized early on that the neuropsych training in my program wouldn't cut it, so I moved for a year to do a neuropsychology practicum in a different city. Also switched out a very basic biopsych class for neuroanatomy in a different department. Sought out some other random opportunities (worked with an outside supervisor, took on some supervised consultation work related to npsych) as well. I realize these things aren't feasible for everybody, but you have to be as proactive as possible. The director is probably giving you those answers in part because it's the easiest thing for them to do.

Oops, forgot to mention the PI of the neuropsych lab is the program director. The students in their lab just do neuropsych-related research but don't actually go into neuropsych practice. We're not allowed to take any elective classes outside of those listed in the curriculum, and the program uses a match process for practica so we cannot apply for practicum sites outside of that system. Everything extra we want to do has to be pre-approved by the program director. I could maybe take some didactic courses outside of the program with pre-approval, but for me to take any formal classes or practica I would have to ask the director to change the rules for me.

 

[Kadhir]

Oops, forgot to mention the PI of the neuropsych lab is the program director. The students in their lab just do neuropsych-related research but don't actually go into neuropsych practice. We're not allowed to take any elective classes outside of those listed in the curriculum, and the program uses a match process for practica so we cannot apply for practicum sites outside of that system. Everything extra we want to do has to be pre-approved by the program director. I could maybe take some didactic courses outside of the program with pre-approval, but for me to take any formal classes or practica I would have to ask the director to change the rules for me.

It sounds like they're being rather rigid, and I'm wondering if the director is deliberately holding back exploring opportunities for you their students don't readily have. But those are dark places and I'll stay away from them. Anyways, practica may be tricky if liability is an issue but coursework should not be. I also had to petition my program to substitute classes and definitely to leave for a year. But it had to change with someone at some point, and luckily these things have since made their way into the clinical manual for future students. If the director's response is firm, then I think you've already received the best advice above.