Neuropsych Re-specialization

[CriminalPsych]

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So I was talking to a friend of mine, a few years ahead of me just starting in the field. He has his PsyD in clinical psych (university based) but he is looking into trying to specialize in neuro. This got me thinking. Normally, to the best of my knowledge, training in neuro consists of exposure during grad training, neuro related internship, then 2 year neuro post doc. So for those who have completed a more generalist internship, what do they need to do to become competitive for a neuro post doc? Or are quality neuro internships just to competitive to grab one late in the game?

 

[AcronymAllergy]

I know of at least a few people who matched to neuro fellowships, yet didn't know until internship that neuro was in the cards for them. While getting strong experiences (in addition to strong generalist training) at the grad school level is helpful, it isn't necessary. The Houston guidelines essentially say that your internship neuro intensity level should be reflective of your remaining needs as a trainee--if you have solid neuro grad school experience, then your internship can be fairly general (although you'll want at least some neuro work). Conversely, if you had little to no neuro experience in grad school, you'll want to spend 50+% of your time in neuro-related activities.

I honestly don't know of anyone who had limited neuro experience in grad school AND limited neuro experience on internship, and who then subsequently matched to a solid neuro fellowship. However, there are fellowships in the APPCN match that go unfilled each year (only a handful, but still), so I'm sure it's possible. I'd imagine it would make for a VERY intense postdoc experience, though. Neuro fellowships already tend to fall on the higher end of that intensity spectrum, and when you combine that with having to play catch-up, it'd be rough.

If that's what ends up happening, be SURE that your fellowship will allow you to have formal didactic experiences in all necessary areas (e.g., neuroanatomy, general neuropsych assessment principles). Otherwise, board certification could be even tougher to secure than the postdoc.

 

[paramour]

I'm confused. If you go to ABCN's site, there is an Association for Internship Training for Clinical Neuropsych. Are the member programs listed (http://www.uthsc.edu/AITCN/index_files/Page341.htm) the only internship sites that follow the Houston Guidelines? Or is this something completely different (for postdoc, or something else, or could I just go elsewhere to any ole' internship site that offers neuropsych training? 😕

 

[AcronymAllergy]

No, the AITCN sites aren't the only ones that adhere to the Houston guidelines and/or offer quality neuropsych training (UF, UAB and Methodist Rehab in Jackson, MS aren't on the list, for example). I honestly don't know what would make a program join vs. not join. My guess is that neuropsych programs that aren't in AITCN are probably already fed up with APA-related paperwork, and may not see the advantage of yet another administrative responsibility.

So long as you're receiving neuropsych training with quality supervision, you should be ok.

As for postdoc, the APPCN match makes things somewhat less hectic by at least partially centralizing the process, and its member programs are essentially guaranteed to offer the training necessary to be board-eligible. However, there are still some non-APPCN and/or non-match sites that do offer good training (one of the Johns Hopkins postdocs, Scott & White hospital in TX, and Cambridge Health Alliance, for example, are all non-match programs).

 

[paramour]

Good to know, thanks! It seemed like there were really few programs on that list and that I had heard of others who provided quality training not on that list, so it had me a bit stumped.

I recall hearing about some of the issues with postdoc, but that's still a bit ahead of my time ... for the time being. Maybe I'll get there one of these moons.

 

[AcronymAllergy]

Haha yeah, it can certainly get to be confusing. The Division 40 website has a slightly longer list of programs, although it isn't entirely exhaustive, either.

In the end, I simply selected MAJOR for "Neuropsych-Adult" as my only option from the drop-down menus on the APPIC directory and went from there. Based on my other critiera (e.g., APA-accredited, takes Ph.D. students from APA programs, is full-time), it returned somewhere around 120 "hits" for me.

 

[Therapist4Chnge]

I'm confused. If you go to ABCN's site, there is an Association for Internship Training for Clinical Neuropsych. Are the member programs listed (http://www.uthsc.edu/AITCN/index_files/Page341.htm) the only internship sites that follow the Houston Guidelines?

There are different paths that "qualify" for HG. There is a bar graph that was made to demonstrate the different combination of pre-doc/internship/post-doc trainings that are recognized.

...However, there are still some non-APPCN and/or non-match sites that do offer good training (one of the Johns Hopkins postdocs, Scott & White hospital in TX, and Cambridge Health Alliance, for example, are all non-match programs).

One of the JHU programs (an original member of the APPCN Match) dropped out 2-3 years ago. UCLA did also (also an original member). From my understanding some of the recent programs that dropped out want to have more control over who matches to their site. If you are a place like JHU or UCLA, you get your pick of great applicants, and you can secure them before the match deadline. It makes sense, particularly for sites with a larger research component. I looked at all of the above programs, and I can indeed confirm they are quite good. 😀 Neuro/Rehab programs have been poaching for years, so it is hard to argue against opting out.

 

[AcronymAllergy]

One of the JHU programs (an original member of the APPCN Match) dropped out 2-3 years ago. UCLA did also (also an original member). From my understanding some of the recent programs that dropped out want to have more control over who matches to their site. If you are a place like JHU or UCLA, you get your pick of great applicants, and you can secure them before the match deadline. It makes sense, particularly for sites with a larger research component. I looked at all of the above programs, and I can indeed confirm they are quite good. 😀 Neuro/Rehab programs have been poaching for years, so it is hard to argue against opting out.

Yep, I believe it's JHU Psychiatry (as opposed to PM&R) that is no longer a match program, and the main reason I've heard for sites leaving the match is as you've said--to have better control over who they end up with, and to be able to select from the top applicants prior to their participation in the match. If you've got the reputation for it, unless your director believes in the match and what it's trying to accomplish, there's nothing stopping you from withdrawing.

And even without the reputation, if you're in a geographically-desirable area, the odds are probably in your favor. There's a SLEW of sites in California (I'd venture to say perhaps the majority) that are non-match, and my guess is largely because even if the site isn't the strongest, it's in CA, and there's an overabundance of people either wanting to live there or who are already there and don't want to leave. Boston also has many non-match sites, and I'd imagine it's for the same reason.