more neuropsych advice

[medapple]

Hello,

I'm strongly considering a neuropsychology PhD in the US (I'm from Canada) and will be applying this year for Sept 2007 entrance.

I went through many of the posts here and in the archives of this forum. The truth is, after reading all those posts, I'm really disillusioned and it seems like clinical psychology is not a good choice. But I may have read some things out of context, and I was hoping I could test out some my assumptions. Here are my assumptions (from what I've read in this forum)

The application:
-It is better to apply to a general clinical psychology program (vs one with a subspecialization in neuropsych) but have a supervisor that is neuroscience or neuropsych
-At the time of application, I should have an idea of whether I want to be a researcher or a clinician (supposed to be a scientist-practitioner but posters have said it doesn't usually pan out 50/50)

Career Prospects
-Comparing clinical PhD neuropsychologist vs research PhD neuropsychologist (both of whom went to a clinical PhD program but then had different internships, etc), seems that a research neuropsychologist (who used the PhD to work in academia) is the best in terms of job security and salary-wise. This I gathered after reading all the posts that many PsychD were entering clinical neuropsychology because it'll pay off their heavy educational costs, thus diluting the field and the salary.
-Unless I am the lucky few, I will not get a good return for my 6 years and my PhD student debt (both financially and in professional autonomy).
-As a research neuropsychologist, I'd be churning research as a living.

The Field in General
-Reading from the posts, the field of clinical psychology seems to be eroding. In a hospital setting, the clinical psychologist (or neuropsychologist) is used for secondary intervention by the MD. And the lack of professional identity allows jobs to be taken by MAs.


Anyways, please let me know if any of this is wrong (it may be, and I'm sorry for spreading ugly assumptions if it is). Honestly, after reading some of the posts, I think I'd be better off going to law school or getting a Master's of Public Health.

(And of course there's medical school, but I don't know that I'll get in. But idealistically, if it weren't for all these practical concerns, medical school and a clinical psychology PhD sound like too equally interesting options).

I know some people will tell me to go for my dreams and whatnot, but if the future of the field is really like this, then for me the bad (practical career outlook) outweighs the good (my interest in the field).

Thanks in advance for your replies! Please let me know what you think.

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[Neuro-Dr]

I'm sorry to hear about your worries. As someone who has been practicing about 8 years and loves what they do, I'll give you my perspective on your questions....

The application:
-It is better to apply to a general clinical psychology program (vs one with a subspecialization in neuropsych) but have a supervisor that is neuroscience or neuropsych
-At the time of application, I should have an idea of whether I want to be a researcher or a clinician (supposed to be a scientist-practitioner but posters have said it doesn't usually pan out 50/50)

There really aren't many PhDs in NP left, so most of us went through a clinical program with a NP specialization. As long as the program hits the core domains list in the HCG or Div 40, your in good shape. People also chose based on reputation, but I'll keep this simple. You should know if you want NP earlier on. Again, I have stated previously, my sence from the boards (and I have been a part of this) is that the core curriculum is more important than a mentor.

Career Prospects
-Comparing clinical PhD neuropsychologist vs research PhD neuropsychologist (both of whom went to a clinical PhD program but then had different internships, etc), seems that a research neuropsychologist (who used the PhD to work in academia) is the best in terms of job security and salary-wise. This I gathered after reading all the posts that many PsychD were entering clinical neuropsychology because it'll pay off their heavy educational costs, thus diluting the field and the salary.

All NPs due the same internships (an APA one in clinical or NP). The practicing NPs make SUBSTANTIALLY more than the academicians. Please refer to Sweet et al 2003 in Archives of Clinical NP for a salary breakdown. Still averaging $104K-$114K depending on region, length of practice and area.

I assume you mean PsyD. I'm not sure how many are going into NP, the numbers I've seen are small. However, Rutgers, Nova and Wright State put out several great docs per year, so keep them in your consideration.

-Unless I am the lucky few, I will not get a good return for my 6 years and my PhD student debt (both financially and in professional autonomy).
-As a research neuropsychologist, I'd be churning research as a living.

See above.

The Field in General
-Reading from the posts, the field of clinical psychology seems to be eroding. In a hospital setting, the clinical psychologist (or neuropsychologist) is used for secondary intervention by the MD. And the lack of professional identity allows jobs to be taken by MAs.

I'm not even sure what you were reading. However (and I've said this elsewhere), I don't know anyone professionally who is struggle for patients or identity. However, the sky was falling a decade ago when I was in school according to my professors and fellow students as well, so it must be an academic thing.

Anyways, please let me know if any of this is wrong (it may be, and I'm sorry for spreading ugly assumptions if it is). Honestly, after reading some of the posts, I think I'd be better off going to law school or getting a Master's of Public Health.

(And of course there's medical school, but I don't know that I'll get in. But idealistically, if it weren't for all these practical concerns, medical school and a clinical psychology PhD sound like too equally interesting options).

PLEASE, PLEASE, PLEASE do not go into a degree based on this as a deciding factor. You will be miserable. I know several psychologists (mostly NPs) who really wanted to be an MD and they never get over it and drive everyone crazy with their pseudo-medical thinking. Do what you are passionate about.


I know some people will tell me to go for my dreams and whatnot, but if the future of the field is really like this, then for me the bad (practical career outlook) outweighs the good (my interest in the field).

Thanks in advance for your replies! Please let me know what you think.[/QUOTE]

 

[Logic Prevails]

I'm just going to throw this out there:

How in the hell can you KNOW that you want to be a neuropsychologist when you haven't even experienced giving a single test. You wont know what this is like until you do it - and it is a BIG part of being a clinical neuropsychologist. Very few do intervention work (i.e. rehab), and testing is not for everyone - make sure you know what you are getting into and have no illusions about it.

 

[Dr.JT]

I'm just going to throw this out there:

How in the hell can you KNOW that you want to be a neuropsychologist when you haven't even experienced giving a single test. You wont know what this is like until you do it - and it is a BIG part of being a clinical neuropsychologist. Very few do intervention work (i.e. rehab), and testing is not for everyone - make sure you know what you are getting into and have no illusions about it.

You research the career, talk to people in the filed, and see if it matches with what you believe you want to do. Some people still find out later that it isn't for them. This is another reason to look for a program with some specialized training in neuropsych within a general clinical training-boulder model based program. It gives you the most flexibility career wise.

 

[medapple]

I'm not even sure what you were reading. However (and I've said this elsewhere), I don't know anyone professionally who is struggle for patients or identity. However, the sky was falling a decade ago when I was in school according to my professors and fellow students as well, so it must be an academic thing.

-Thanks for the reply. I really did go through the archives, and the neuropsych posts sounded fatalistic. There was even one post http://forums.studentdoctor.net/archive/index.php/t-155969.html
that was especially negative.

There really aren't many PhDs in NP left, so most of us went through a clinical program with a NP specialization. As long as the program hits the core domains list in the HCG or Div 40, your in good shape. People also chose based on reputation, but I'll keep this simple. You should know if you want NP earlier on. Again, I have stated previously, my sence from the boards (and I have been a part of this) is that the core curriculum is more important than a mentor.

-If everyone is in a generalized clinical program, then how do they pick who gets to do a NP specialization? There is competition, isn't there. If I were do pick a HCG or Div 40 (I'll check into these later), would it matter if I had a neuropsych/neuroscience mentor; I thought the mentor was very important?

PLEASE, PLEASE, PLEASE do not go into a degree based on this as a deciding factor. You will be miserable. I know several psychologists (mostly NPs) who really wanted to be an MD and they never get over it and drive everyone crazy with their pseudo-medical thinking. Do what you are passionate about.

-I actually am applying to a wide variety of programs. I really do think that within reason, a person can find a niche (something aligned with their motivations, ideals, goals) within many professions.

-Also, this may be me being ignorant, but how is the profession of neuropsychologist much different than an MD who chooses to specialize in similar work. (I will be shadowing a neuropsychologist this year to find out more about the profession btw). What are the main differences? (so far, I know that MDs have prescriptive power, and NPs do neuropsych testing work). What is the average day like for a NP?


Thanks!

 

[medapple]

I'm just going to throw this out there:

How in the hell can you KNOW that you want to be a neuropsychologist when you haven't even experienced giving a single test. You wont know what this is like until you do it - and it is a BIG part of being a clinical neuropsychologist. Very few do intervention work (i.e. rehab), and testing is not for everyone - make sure you know what you are getting into and have no illusions about it.

There's really no need to take that tone, especially in a written medium because nobody can tell what you mean (ie. if you're a funny or hardheaded or this is your usual way of speaking). Yes, I don't know what it's like to be a NP, that's why I'm asking questions in this forum and reading posts. Before I invest time, energy, and money into the application and the if I get in, the education, I would like to know what I'm getting myself into. What is testing like, and why isn't it for everyone? How did you know you wanted to be a NP? Please explain your response. (And yes, I know I'm supposed to take responses with a grain of salt because one person's individual experience won't necessarily apply to me).

Also, my mistake. I didn't mean intervention, I meant a second opinion. I'm not demeaning NPs, but I have worked as a RA in a hospital, and doctors seem to have the broadest set of responsibilities (and power, but that's in Canada, where MDs are paid under public health-care. Not sure how NPs are paid, I'll have to find out).

Actually, I'd like to ask, how are NPs paid in the US. I know the majority of US citizens have a private health care plan, whereas the elderly and extreme poor have medicare/medicaid, and the self-employed usually have none. How does your education factor into this?

 

[Psyclops]

medapple, I think Brad had the best intentions with his post. I think he just wanted you to think about it a little. Often times, younger students of psychology don't know much about testing and assessment, which are the NPs bread and butter. It seems all they do is teach about therapy in undergrad these days. So I think that is what he was responding to. But I'm sure he'll tell you himself in a couple of days.

Anyway, NPs in the US tend to get paid through third paty funds, such as insurance or the big Ms. Rarely do they have "clients" come see them to pay out of pocket. depending on the type of assessment, psychologists can be paid handsomely for it. This is the one thing that psychologists and not psychiatrists, therapists, etc. can do.

 

[Dr.JT]

-Thanks for the reply. I really did go through the archives, and the neuropsych posts sounded fatalistic. There was even one post http://forums.studentdoctor.net/archive/index.php/t-155969.html
that was especially negative.


-If everyone is in a generalized clinical program, then how do they pick who gets to do a NP specialization? There is competition, isn't there. If I were do pick a HCG or Div 40 (I'll check into these later), would it matter if I had a neuropsych/neuroscience mentor; I thought the mentor was very important?


-I actually am applying to a wide variety of programs. I really do think that within reason, a person can find a niche (something aligned with their motivations, ideals, goals) within many professions.

-Also, this may be me being ignorant, but how is the profession of neuropsychologist much different than an MD who chooses to specialize in similar work. (I will be shadowing a neuropsychologist this year to find out more about the profession btw). What are the main differences? (so far, I know that MDs have prescriptive power, and NPs do neuropsych testing work). What is the average day like for a NP?

Thanks!

What you would want would be a boulder model clinical psych program with strong biopsych coursework including courses in neuropsychology and neuropsych assessment. Also practicum experience in neuropsych assessment is a must. Having an advisor who is a known neuropsychologist, and conducting research with them, would make you highly competitive.

What a neuropsychologist does and an MD does is completely different. We assess and quantify cognitive functioning and provide differential diagnosis, often times for MD's (this is the simplified explanation of NP, it is obviously more complicated than this). We also develop tests for such purposes. All of my referrals come from MD's including neurologists, physiatrists, and psychiatrists (in that order). I think shadowing a NP is a great idea. Good Luck!

 

[Logic Prevails]

There's really no need to take that tone, especially in a written medium because nobody can tell what you mean (ie. if you're a funny or hardheaded or this is your usual way of speaking). Yes, I don't know what it's like to be a NP, that's why I'm asking questions in this forum and reading posts. Before I invest time, energy, and money into the application and the if I get in, the education, I would like to know what I'm getting myself into. What is testing like, and why isn't it for everyone? How did you know you wanted to be a NP? Please explain your response. (And yes, I know I'm supposed to take responses with a grain of salt because one person's individual experience won't necessarily apply to me).

Thanks Psyclops for filling medapple in on my intentions - I merely stuck something out there for you to think about and meant no offense or disrespect.

The reason for me asking this question is because I had some misguided ideas of what a neuropsychologist did prior to myself entering graduate school. For some reason, I had the idea that neuropsychologists were a more medicalized version of a psychologist and had more training in brain structure and function. In my opinion, the 'job title' is a bit of a misnomer (though others will likely disagree). I was surprised to discover that a neuro program can offer as little as one course in brain structure/function and focuses almost entirely on testing. When you think of 'testing' you can think about IQ, memory, attention, etc. if it keeps things conctrete for you. A neuropsychologist will be fluent in your typical 'test-batteries' but will also have greater ability to assess areas such as 'executive functioning' and fine-motor skills. The 'bread and butter' (as Psyclops has mentioned) of what a neuropsychologist does, is give these sorts of tests (not doing therapy). It is also worth noting that a neuropsychologist's clients are of a different lot, often individuals who have experienced 'Traumatic Brain Injury' (TBI) or are suspected of being compromised neurologically (i.e. FASD patients).

Testing itself has it's pros and cons and depends on the personality of the tester. Some people view this as a 'sherlock holmes' type job, and enjoy the challange of finding the right tests to give a particular patient given their symptoms and the challange that often presents itself when testing. The interpretation of these tests also requires a great deal of knowledge and skill. Others may see testing as tedious and boring, sitting in a room, often giving oral or pencil-and-paper tests for hours on end. I personally lean toward the former, but it is up to you to decide for yourself if it fits.

I am sure others (currently working in the field) will step in and tell me how my views are not entirely correct, and that their scope of practice is different - this is a good thing because we need various perspectives as students to create an opinion of our own - this is mine as a graduate student. Good luck with your decision and getting into a program.

 

[Dr.JT]

The reason for me asking this question is because I had some misguided ideas of what a neuropsychologist did prior to myself entering graduate school. For some reason, I had the idea that neuropsychologists were a more medicalized version of a psychologist and had more training in brain structure and function. In my opinion, the 'job title' is a bit of a misnomer (though others will likely disagree). I was surprised to discover that a neuro program can offer as little as one course in brain structure/function and focuses almost entirely on testing. When you think of 'testing' you can think about IQ, memory, attention, etc. if it keeps things conctrete for you. A neuropsychologist will be fluent in your typical 'test-batteries' but will also have greater ability to assess areas such as 'executive functioning' and fine-motor skills. The 'bread and butter' (as Psyclops has mentioned) of what a neuropsychologist does, is give these sorts of tests (not doing therapy). It is also worth noting that a neuropsychologist's clients are of a different lot, often individuals who have experienced 'Traumatic Brain Injury' (TBI) or are suspected of being compromised neurologically (i.e. FASD patients).
QUOTE]

As a NP I have to disagree with your post. You cannot be a NP with one course in brain structure. I have taken many psychophys courses, neuroanatomy, and neuroscience. In addition, weekly didactics and brain cuttings were required on post doc. This is far beyond what the average clinical psychologist has done. As for testing, that is what NP do. We assess cognitive functions in the context of our knowledge of both neurological and psychological functions. This is why we are valuable to MD's, we do something they do not do and add to their understanding of the patient.

 

[Logic Prevails]

As a NP I have to disagree with your post. You cannot be a NP with one course in brain structure.

I don't disagree with you that you SHOULD NOT be able to call yourself a neuropsychologist with one course in brain structure... but I am not so sure there is a liscensing board for the title 'Neuropsychologist', or (if one exists) that it states clearly that you can not call yourself one unless you have taken course X, Y, and Z.

I would think that a title including the prefix 'neuro' would be representative of an individual with thourough knowledge of the brain (more than a course or two at the graduate level in structure/function)... but I'm just calling it as I see it

 

[Psyclops]

Alright fellas/ladies, some have mentioned on this post and others that if one were interested in becoming a NP one might be best served by going to a general clinical program, but one that offers the right coursework and mentoring. Would you who feel this way, or anyway really, be willing to put up a list of schools that you feel exemplify good programs in this or other models? This doesn't have to be endorse your own school hour, but some more concrete examples would be nice. Thanks.

 

[Dr.JT]

I don't disagree with you that you SHOULD NOT be able to call yourself a neuropsychologist with one course in brain structure... but I am not so sure there is a liscensing board for the title 'Neuropsychologist', or (if one exists) that it states clearly that you can not call yourself one unless you have taken course X, Y, and Z.

I would think that a title including the prefix 'neuro' would be representative of an individual with thourough knowledge of the brain (more than a course or two at the graduate level in structure/function)... but I'm just calling it as I see it

You can call yourself whatever you want. I could call myself a child psychologist; however, this would be unethical and would open me up to action from the licensing board when they got wind of it. Furthermore, NP end up in court frequently. If you don't have the proper training you A- get shredded in court, and B- never establish a good reputation that leads to a solid referral base.

 

[Dr.JT]

Alright fellas/ladies, some have mentioned on this post and others that if one were interested in becoming a NP one might be best served by going to a general clinical program, but one that offers the right coursework and mentoring. Would you who feel this way, or anyway really, be willing to put up a list of schools that you feel exemplify good programs in this or other models? This doesn't have to be endorse your own school hour, but some more concrete examples would be nice. Thanks.

Off the top of my head, Wayne State University (its not my program, so no bias here) is a good example. Although I think it is technically a specialization, it is within the context of a general clinical program.

As a side note, I believe they have produced the largest number of board certified neuropsychologists.

 

[Dr.JT]

Alright fellas/ladies, some have mentioned on this post and others that if one were interested in becoming a NP one might be best served by going to a general clinical program, but one that offers the right coursework and mentoring. Would you who feel this way, or anyway really, be willing to put up a list of schools that you feel exemplify good programs in this or other models? This doesn't have to be endorse your own school hour, but some more concrete examples would be nice. Thanks.

Just spoke to a NP (board certified) colleague. He went to U of Georgia. Graduated about 7 years ago. He offered them as an example of no specialization, but all the requirements to be competitive in NP internships and postdocs. Keep in mind, things have become way more stringent since he graduated.

 

[Psyclops]

Thanks guys, that's a good start. Any other programs that you have heard of, attended, etc. that might be good to point our young collegues towards?

 

[Dr.JT]

Thanks guys, that's a good start. Any other programs that you have heard of, attended, etc. that might be good to point our young collegues towards?

I mentioned somewhere else the website neuropsychologycentral.com. Under their links section is a training subsection that includes links to programs with a NP concentration or that at least have a reputation for NP. I don't think it has been updated in a long time, but its probably still relevant.

 

[LM02]

Thanks guys, that's a good start. Any other programs that you have heard of, attended, etc. that might be good to point our young collegues towards?

I'm not a neuropsychologist, and I can't think of any recent graduates of my own graduate program that have pursued a career in neuropsychology.

Nevertheless, I have neuropsych friends from internship and postdoc, and they had gone to schools such as:

University of Florida-Gainesville
University of Iowa
UCSD/SDSU
Rosalind Franklin
Northwestern Med School
Penn State
UVA

I don't know anything specific about neuropsych at these schools, but you may want to check out their websites.

 

[medapple]

Thanks again for your replies (Brad too for clearing up your response), I'm understanding this profession much more. Actually, cognitive testing sounds like something I would really like doing; I've always been interested in cognition, memory, consciousness, learning, sleep functioning etc.

Regarding the application process, how competitive is it to get a neuropsych supervisor? I've looked at a few schools, and it seems that (for example) when there are 5 supervisors in a clinical program, only 1 is a neuropsych.

I'm asking because I don't have a major in psych (I majored in a pre-med like program). I have only a minor, and have taken only a few psych courses relating to biopsych/neuropsych, although I've taken bio, chem, etc. I have a good GPA, I can do well on the GRE. But I hear the big thing is the "fit" with the prof, in which case I'm guessing research related to theirs is a big deal. I've had a number of RA positions related to something in healthcare/ medicine, and have 1 RA position in a psychiatric clinic (which turned me off of psychiatry).

I know that since I'm not a psych major, I've lessened my chance of getting a NP to be my supervisor. My plan was that this year, I'd do the following:
i) take more psych courses
ii) shadow a NP
iii) try to do research with a neuropsychologist/neuroscientist

My questions are:

i) Is there anything else I should do?

ii) Will it hurt my chances that I haven't always been geared for neuropsych for my undergrad (ie. How will supervisors look at the fact that I published an abstract about gastroenterology)?

iii) Do I still have a good chance of being a NP (becoming certified) if I go into a boulder model clinical psych program with strong biopsych coursework and a neuropsych assessment practicum BUT I DON"T have a neuropsych supervisor (For example, I thought that developmental psych sounds interesting and related to NP somewhat. I'm asking this because I'm not sure how competitive I am for a NP supervisor since no psych major, but I may be able to get another type of psych supervisor).

iv) How does it look if I apply to 2 supervisors in the same grad program, one a NP and one a developmental psychologist (intuition tells me this is a bad idea, and I will appear to be a uninterested hedging-their-bets candidate)?

v) Dr.JT, you mentioned, "I know several psychologists (mostly NPs) who really wanted to be an MD and they never get over it and drive everyone crazy with their pseudo-medical thinking." Do you mind explaining what you meant by pseudo-medical. Do you mean psychosomatic? I just wanted to test whether I have pseudo-medical thinking.

Thanks again. Honestly, your responses about NP are so much valuable than going through career-service type texts.

 

[Dr.JT]

Dr.JT, you mentioned, "I know several psychologists (mostly NPs) who really wanted to be an MD and they never get over it and drive everyone crazy with their pseudo-medical thinking." Do you mind explaining what you meant by pseudo-medical. Do you mean psychosomatic? I just wanted to test whether I have pseudo-medical thinking.
QUOTE]

It was Neuro-Dr who made that post. But I to have experienced some NP's who would have rather been an MD. The point is that what neuropsychologists do is very different from what MD's do. Some NP's try to act more like neurologists, which is inappropriate. We offer something unique that MD's don't have expertise in. This is what should draw someone to being a NP rather than wanting to be a second rate neurologist who can't prescribe meds.

 

[Psyclops]

It sounds like you are on the right track, you certainly haven't done anything to hurt your chances in my opinion. It sounds like you have most of the components of a successful applicant mainly good gpa, good GRE (over 600 on both is what you will need), a good ammount of research experience, and a minor in psych. If I were you I would focus on taking a broad range of undergrad psych courses. The admissons comittee will like this. They don't neccessarily have to be neuro related. The pre-med major will evidence your ability to handle academic rigor, and that you have experience with bio oriented thnking. You wnat to continue your work in research. Preferably as close as possible to what you ultimately want to do, i.e., neuropsychrelated. If you could shadow someone that would be ideal, that would demonstrate that your intereest in the field developed organically, or at least in seeing the practical side it did not deter you.

It will not hurt you that you weren't "always geared towards NP" as you say. As for choosing whom you want to work with in any given program, there is an art to that. I put down in my SOP the person (2 at the most) that I wanted to work with at each program I applied to. This is a double edged sword of course, it's putting all of your eggs in one basket, but you show how focused you are.

Its time for you to get moving if you plan to apply this fall. Get your list of programs and professor ready, and come October or so start sending them some e-mails telling them how much you love them, how amazing you are, and what a delight it would be to work with them, and then confirm they are taking new sudents.

 

[Neuro-Dr]

As a sort of summation, please be aware all who read these NP posts, that ALL members of Div 40 Board and all DOTs at APPCN sites are from ABCN. In addition, if you read Div 40s website on requirements it pretty much covers the 4 domains listed in HCG (although there is no policing of this). Upon reflection from Dr.JTs comments and others, I think your safest search in today's waters are to ensure that your program covers these domains and that you have a good advisor. If you can only accomplish one, I still say go with the coursework. I have never (over 50 applications) seen someone rejected who had the coursework, but I have seen them rejected or advise to update their coursework even coming from a big name advisor. There are always a good deal of politics involved with any board, so all the facts are not clear. However, you (medapple) now have several opinions with slightly different spins by which to formulate your thoughts.

 

[psychick]

There really aren't many PhDs in NP left, so most of us went through a clinical program with a NP specialization.

[/quote]

Sorry to sound ignorant, but does this mean that you entered a clinical program and took as many neuro courses as you could? Or is there another separate program that you enroll in to get that NP specialization? Or does it mean you initially got your clinical PhD degree, and then focused on a NP postdoc fellowship?

 

[Therapist4Chnge]

Sorry to sound ignorant, but does this mean that you entered a clinical program and took as many neuro courses as you could? Or is there another separate program that you enroll in to get that NP specialization? Or does it mean you initially got your clinical PhD degree, and then focused on a NP postdoc fellowship?

I believe he means there aren't many programs that have specific neuro concentrations/specializations, but they offer a number of electives in the area (neuroanatomy, nuerophysiology, nuero-assessment, etc).

To get an approved div 40 post-doc fellowship in neuro (correct me if I'm wrong Neuro-Dr. / Dr. JT) you need to go to an internship site that was at least 50% nuero. Typically to get a neuro site for internship you need to have a background in it (which is where the specialization and/or large # of classes in the area comes in). Neuro seems to be one of the areas where people know they want to do it going in. Is it fair to people who don't know they want to do it....No, that often people gear their apps with a neuro slant so they can get matched with a neuro person and start their training early on, and not rely on internship to get it.

 

[erg923]

1.)University of Houston's clinical program has a great reputation in neuropsych circles. University of Georgia, University of Kentucky (my home state), Wayne State, University of Florida, as well. All very competitive programs though. I've heard the Pacific Graduate School of Psychology and Nova Southeastern are the best for neuropsych amongst the less competitive professional schools.

2) I am very much a neuropsych person myself....more into aging and cognitive issues associated with age though, rather than all of neuropsych in general. Everyone who I talk to in the field agrees that the neuropsych is coming to a crossroads soon, in the sense that there are increasing financial restrictions in reimbursement rates, and the field's struggle to advance and keep up with advances in neuroscience. If anyone on here belongs the n-psych listserve you can really see how divided the field is. While often interesting and helpful, you quickly see the differences of opinions on key issues in the field (ie., SVTs, test use and selection, approach to assessment etc..). And it is very interesting to see the differences in opinion regarding what scores really mean or represent in a particular case. I recall a heated exchange sometime ago about what percentiles were really average, low average, impaired, etc. Assuming normal distribution, something I thought for sure would have been settled unequivocally a long time ago in the field.

 

[Lunabin]

My two cents - and keep in mind I'm merely a postdoc...

The VAST majority of us in NP attended Clinical PhD programs (though PsyD's are not uncommon - Joel Kramer anyone...) and focused on NP and Health psych as there is a lot of overlap.

I personally don't know that there are many NP programs left, but the one's mentioned previously are notorious - you can easily research the rest.

As for getting certification, you can look up the guidelines in Div. 40 of APA, and probably at NAN, INS, AACN, or elsewhere. I would recommend (1) doing all the coursework you can, (2) getting clinical experience in practica, internships, and of course postdoc, and (3) do research in NP for your thesis and/or dissertation, along with anywhere else you can during grad school.

It seems, Medapple, that you're realizing the competitive nature of the field already. That really doesn't change once you do finally get in. There will be competition for the best practicum sites, internships, and certainly postdocs. Unfortunately, things aren't getting any easier and match rates are getting worse and worse (see Natmatch.org for the internship and NP postdoc match info).

Some mis-info above - it is recommended you do 50% clinical NP on internship, though this is (I believe) still only a recommendation and not always possible. The overall point is to get in as much as possible! When the time comes, you may choose to simply get an APA internship, and may have to go to a generalist program (that does both NP and clinical intervention) just to get it done... That is another bridge to cross and shouldn't be too much of a concern for you right now.

Sounds like you are on the right path - I'm personally impressed that you're following a NP at your level, and do hope that this person will be writing one of your rec letters?!?

Good luck!

 

[nala56]

1.)University of Houston's clinical program has a great reputation in neuropsych circles. University of Georgia, University of Kentucky (my home state), Wayne State, University of Florida, as well. All very competitive programs though. I've heard the Pacific Graduate School of Psychology and Nova Southeastern are the best for neuropsych amongst the less competitive professional schools.

2) I am very much a neuropsych person myself....more into aging and cognitive issues associated with age though, rather than all of neuropsych in general. Everyone who I talk to in the field agrees that the neuropsych is coming to a crossroads soon, in the sense that there are increasing financial restrictions in reimbursement rates, and the field's struggle to advance and keep up with advances in neuroscience. If anyone on here belongs the n-psych listserve you can really see how divided the field is. While often interesting and helpful, you quickly see the differences of opinions on key issues in the field (ie., SVTs, test use and selection, approach to assessment etc..). And it is very interesting to see the differences in opinion regarding what scores really mean or represent in a particular case. I recall a heated exchange sometime ago about what percentiles were really average, low average, impaired, etc. Assuming normal distribution, something I thought for sure would have been settled unequivocally a long time ago in the field.

Do you think that neuropsychologists will no longer be needed in the medical field and in the legal system? Do you think that neuropsychologists will have jobs in the future that does not involve working with academia?

 

[erg923]

Q.Do you think that neuropsychologists will no longer be needed in the medical field and in the legal system?

A. No of course not. We are not going anywhere anytime soon. I do think its important to keep up with advances in neuroscience and imaging though. Create new and better tests etc...

Q. Do you think that neuropsychologists will have jobs in the future that does not involve working with academia?

A.Well yes of course, and we have plenty in private practice now. But we of course need both. We need neuropsychologists in academia in order to continue research in the field, and you of course need the people in clinical service settings (hospitals, rehab centers), and private practice to provide sevices

 

[Student3107]

I am currently a senior undergraduate major in psychology and took a neuropsychology class and loved it. Can anyone clear up for me exactly what a clinical neuropsychologist does? I talked to the chair of my department, who is not a NP, who told me that they can work in hispital settings to administer tests on patients with brain damage and do therapy with them? Is this mostly what they do? I want to be sure I am making the right decision of not changing to premed and doing psychiatry instead.

 

[erg923]

This depends on the setting you work in. This is broad and simplistic version, but......A neuropsychologist in a service at a hospital or academic med center is likely to be used primarily as a consulting service for differential diagnosis. They primarily just do diagnostic assessment (psychometric testing), and report writing of those evals. Everything from brain injury, to dementia evals, to differentiating psych factors from organic brain dysfunction, to other neurological disease with potential cognitive complications. In a rehab hospital setting, one likely will see mostly brain injured clients for evals and possibly, supportive therapy. In private practice, one can chose to do only evals, or both evals and have therapy clients. Obviously one need to be well versed in psychology, neuroanatomy, behavioral neurology, and neuroscience to be a competent neuropsychologist.

Psychiatrists really will not deal with any of these issues. Neuropsychiatrists primarily deal with psychiatric complications that result from neurologic disease or injury. However, they typically are most interested in the psychiatric complications rather than the cognitive ones, and do not do (and aren't trained in) any in-depth cognitive testing as neuropsychologists do. Neurolology probably has the most overlapping interests with neuropsychology, but in general, they are more interested in cells, neurochemistry, and neurologic disease as a whole. Neuropsychologists really care about functional neuroanatomy (i.e., memory, attention, language), how it influences behavior and cognition, and how we can measure it and quantify it.

 

[Student3107]

Thank you for your reply. So they mostly do testing more than therapy? I don't know if i would be happy simply testing patients rather than actually getting to work with them and help them. That is why I am beginning to shy away from psychiatry-- the chair of my department said many psychiatrists simply write prescriptions and don't get the time to actually work with their patients. I really liked my neuropsych class though and would really like to pursue something with neuropscyhology where I could work with people who have experienced brain damage. Is this possible?

 

[erg923]

Yes of course. Brain injury and dementia evals are probably the biggest referral qestions you will see in clinical neuropsychology practice. All neuropsychologists are trained in general clinical psychology, including therapy. Neuropsych tends to attract psychologists who do not like therapy though, because alot of it is assessment and diagnostics. However, there are certainly opportunities for it depending on where you work. A rehab hospital would likely offer the most opportunities for psychotherapy in conjunction with diagnostic evals.

I would take issue with the fact that doing assessments isn't helping people though. After the process is over, and you have figured out what is going on with this person, that is a valuable contribution to both the patient and the physician treating them. Think of it has being the "House" character, except with appropriate social skills. haha. And you'd be surprised the rapport you can develop with someone during an 8 hour testing session.

Psychiatry is not just writing scripts, although that is the popular image and it certainly does happen. This is purely by choice of a psychiatrists though, based mostly on financial issues and the strong biologic training model of psychiatry. Regardless, if you like brain injury and therapy, neuropsych is the area that will deal with that, not psychaitry.

 

[sweetrelief]

I have been accepted at a clinical neuropsych program and am a really great fit with the prof I would get to work with. However, it is not currently APA accredited. They are trying to obtain accreditation (waiting to hear results from site visit), but this is my main reason for not accepting immediately. Any feedback as to how attending a non-APA accredited program will influence internship acceptance, post-doc positions, etc. (assuming that it is not obtained in the years I'm there)?

 

[Therapist4Chnge]

I have been accepted at a clinical neuropsych program and am a really great fit with the prof I would get to work with. However, it is not currently APA accredited. They are trying to obtain accreditation (waiting to hear results from site visit), but this is my main reason for not accepting immediately. Any feedback as to how attending a non-APA accredited program will influence internship acceptance, post-doc positions, etc. (assuming that it is not obtained in the years I'm there)?

Be very careful, as this can be a tough road. I'm not saying people aren't successful, but it can follow you for a bit (internship, post-doc, first job out, competitive positions, etc). It is already a competitive marketplace out there, the last think you need is to start 2 steps back.

 

[sweetrelief]

Be very careful, as this can be a tough road. I'm not saying people aren't successful, but it can follow you for a bit (internship, post-doc, first job out, competitive positions, etc). It is already a competitive marketplace out there, the last think you need is to start 2 steps back.

That's what I'm afraid of... I'm waitlisted at an accredited program, but the fit just isn't as good. In terms of research, I would be much more productive at the non-accredited program. I keep vacillating between thinking it will get accredited within the next 5 years, and thinking that I am setting myself up to be disappointed with the limited range of opportunities I will have.