neuropsychology in canada, and other neuropsych concerns

[Una]

HI! I was just wondering if anyone out there is considering practicing in Canada due to the tightening managed care issues in the US. In Canada, clinicians have much more freedom with insurance companies, in that they do not have to fight and justify treatment as much as here. So I'm guessing that a Canadian neuropsych would not have a problem making that 60-80K in private practice. I just wanted to get some healthy perspective on this from somebody else. Of course, there are not as many jobs in Canada, but neuropsych and child are still the best fields in terms of job availability in psychology.

To tell you a bit about myself, my long-term goal is to help diagnose (as neuropsychs deal with differential diagnosis) and plan treatments for children with developmental disorders (especially severe). I am considering doing part-time teaching or educational consulting or even scientific writing, as I think that a full time practice leads to burn-out for some people. I think that a position as clinic director would be very cool too. Entering a phd program in clinical psych this fall. Was originally on the track for med school, and I am a little afraid of all the negative rap that neuropsych is getting. In case of severe disillusionment I will probably defect to community psychology or occupational health.

However, I think that as neuropsych in private practice I will have much more autonomy than one working in a hospital (I am aware of how miserable psych students are when it comes to working with doctors - how they are not respected and laughed at). I believe that a neuropsychologist's work is just as challenging as that of a neuro. Neuropsychologists do not have as much clout in providing the actual diagnosis, cannot prescribe meds and cannot prevent the disorder - they are involved in secondary intervention. But sometimes for a kid with a developmental disorder there is not much one can do medically, the kids are over-medicated, and parents are grateful for the neuropsych's recommendations. The neuropsych spends a lot of time digging around in the details of a specific case, and really gets to know the patient neurologically and behaviorally - which is fascinating. An MD will never get as clear a picture of the patient as the neuropsych does. I think the work is less stressful because you see less patients?... Employing psychometrists to work for you eliminates the tedious work involved in testing.

I would be very happy if someone could comment on what I've said based on talking to neuropsychs and observation. I'd be happy to get some healthy perspective from students!

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[PublicHealth]

HI! I was just wondering if anyone out there is considering practicing in Canada due to the tightening managed care issues in the US. In Canada, clinicians have much more freedom with insurance companies, in that they do not have to fight and justify treatment as much as here. So I'm guessing that a Canadian neuropsych would not have a problem making that 60-80K in private practice. I just wanted to get some healthy perspective on this from somebody else. Of course, there are not as many jobs in Canada, but neuropsych and child are still the best fields in terms of job availability in psychology.

To tell you a bit about myself, my long-term goal is to help diagnose (as neuropsychs deal with differential diagnosis) and plan treatments for children with developmental disorders (especially severe). I am considering doing part-time teaching or educational consulting or even scientific writing, as I think that a full time practice leads to burn-out for some people. I think that a position as clinic director would be very cool too. Entering a phd program in clinical psych this fall. Was originally on the track for med school, and I am a little afraid of all the negative rap that neuropsych is getting. In case of severe disillusionment I will probably defect to community psychology or occupational health.

However, I think that as neuropsych in private practice I will have much more autonomy than one working in a hospital (I am aware of how miserable psych students are when it comes to working with doctors - how they are not respected and laughed at). I believe that a neuropsychologist's work is just as challenging as that of a neuro. Neuropsychologists do not have as much clout in providing the actual diagnosis, cannot prescribe meds and cannot prevent the disorder - they are involved in secondary intervention. But sometimes for a kid with a developmental disorder there is not much one can do medically, the kids are over-medicated, and parents are grateful for the neuropsych's recommendations. The neuropsych spends a lot of time digging around in the details of a specific case, and really gets to know the patient neurologically and behaviorally - which is fascinating. An MD will never get as clear a picture of the patient as the neuropsych does. I think the work is less stressful because you see less patients?... Employing psychometrists to work for you eliminates the tedious work involved in testing.

I would be very happy if someone could comment on what I've said based on talking to neuropsychs and observation. I'd be happy to get some healthy perspective from students!

I just wrote a long reply and it was deleted! You may want to check out these websites:

http://forums.studentdoctor.net/showthread.php?t=127454

http://www.div40.org/

http://www.nanonline.org/

http://info.med.yale.edu/chldstdy/

http://www.apa.org/science/ic-snyder.html

Neuropsychology is a diagnostic discipline. Neuropsychologists are often called upon to help diagnose complex cases of dementia, aphasia, brain injury, or developmental disorders. They are trained to make treatment recommendations and to use behavioral interventions. With the push to gain RxP, it'll be interesting to see how things change -- if they change at all -- in clinical psychology and neuropsychology. Based on the discussions I have had with neuropsychologists, they do NOT want RxP because they're endlessly fascinated by brain-behavior relationships, and find that neuropsychological assessment is enough work! The beauty of neuropsychology is that there are so many applications, including child, forensic, and even sports.

That being said, I know of several neuropsychologists who make $60-80K/year, and several others who make six figures. It's definitely possible, even with managed care.

With your interest in child neuropsychology, you should definitely seek out internships and post-docs in this area. Yale has a good program from what I have heard (see link above).

 

[Una]

That was a great post, PublicHealth. I'm sorry your first one got erased. Great links! Yes, I'm definitely thinking of doing an internship and post-doc in neuropsych, or at least in clinical psychology with a major focus on child neuro-developmental disorders. I hear they are quite competitive, but hopefully I can get one.

 

[Sanman]

Hey Una,
I'm actually in the process of applying to grad schools right now. I also originally intended on going to med. school, but became more interested in neuropsychology along the way. I'm also interested in developmental issues such as LD and ADD. Also, neurosurgical applications of neuropsychology. I have thought of practicing in Canada, just because I think Montreal or Toronto wouldn't be a bad place to live. But, even with managed care, you would probably make more in the US. This has a lot to do with the fact that a lot of testing is n't reimbursed by insurance and is out of pocket. Also, private practice here full time yields more like $80-120K in the most recent salary survey I have seen. However, that is still down about 15k from 1997. The 60-80k is more for institutional and academic positions. You certainly do have a lot of options in private practice neuropsych. I think working with physicians is easier in a community setting. My old pediatrician spoke highly of the neuropsychologists that he knew. He also said it was a smarter move than than therapy or pediatrics monetarily. Of course, this is in an upper middle class/wealthy suburb where just about everyone can afford to pay out of pocket. I believe that if you have a good business sense that neuropsychology can be both intellectually and financially satisfying. You just can't walk into it anymore, however that is just as true in medicine nowadays.

 

[PublicHealth]

Hey Una,
I'm actually in the process of applying to grad schools right now. I also originally intended on going to med. school, but became more interested in neuropsychology along the way. I'm also interested in developmental issues such as LD and ADD. Also, neurosurgical applications of neuropsychology. I have thought of practicing in Canada, just because I think Montreal or Toronto wouldn't be a bad place to live. But, even with managed care, you would probably make more in the US. This has a lot to do with the fact that a lot of testing is n't reimbursed by insurance and is out of pocket. Also, private practice here full time yields more like $80-120K in the most recent salary survey I have seen. However, that is still down about 15k from 1997. The 60-80k is more for institutional and academic positions. You certainly do have a lot of options in private practice neuropsych. I think working with physicians is easier in a community setting. My old pediatrician spoke highly of the neuropsychologists that he knew. He also said it was a smarter move than than therapy or pediatrics monetarily. Of course, this is in an upper middle class/wealthy suburb where just about everyone can afford to pay out of pocket. I believe that if you have a good business sense that neuropsychology can be both intellectually and financially satisfying. You just can't walk into it anymore, however that is just as true in medicine nowadays.

Great post, Sanman. Here's a 2001 article on neuropsychologist salaries:

http://www.centerforhealthyaging.com/NatPsychArticles/Sept_Oct_2001.htm

There's a more recent salary report in Archives of Clinical Neuropsychology or The Clinical Neuropsychologist. If I find the link, I'll be sure to post it. If anyone else has it, please post it!

Here's an interesting article that discusses the potential role of neuropsychologists in using fMRI for clinical purposes: http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12480491

Interesting career in neuropsychology: http://newsbureau.upmc.com/Bios/BioLovell.htm

 

[Sanman]

Great links Public!

There is an online powerpoint that quotes the Sweet et al. study:
http://people.uncw.edu/puente/IntroClinNeuro/Power/Clinical%20Neuropsychology%20in%20North%20America.ppt

Also, I've read about the neuropsychologist in the third link you posted. It's sparked a suggestion that possible work could be gotten by contracting with local schools to test for concussion and mild tbi in middle and highschool football,lacrosse, etc. players.

 

[PublicHealth]

Also, I've read about the neuropsychologist in the third link you posted. It's sparked a suggestion that possible work could be gotten by contracting with local schools to test for concussion and mild tbi in middle and highschool football,lacrosse, etc. players.

Good point, although it'll be interesting to see how much of a role neuropsychologists may play in this capacity, given that brief, computer-administered and scored neuropsychologic test batteries do most of the work. I would imagine that a neuropsychologist would be needed to interpret the results and make recommendations. Individual variability, especially in brain injury/concussions, may render computer-determined diagnoses and recommendations less sensitive and specific.

Another article:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=155420

 

[Una]

These are great links. Yes, definitely, neuropsychologists can expand their practice into forensic and sports areas. I don't know a lot about neuropsychs contracting in schools, but I suppose you could do that. Myself, I'm interested in educational consulting - helping develop computer programs and games for children with developmental disabilities. I think one could even go work as an enterpreneur and start a company making and testing therapy tools and study aids. Arnold Miller has done that (Creative Designs Inc.)

My main problem is that while my clinical interests are in neuropsych, and I am going to take neuropsych classes/practica, my research interestes fall more into the educational/health side of things. I will love doing research with my supervisor, but he's not a neuropsychologist. I don't know how fellowship programs will look at that. Maybe I can apply our ideas to a study on ADHD or Down's syndrome populations, and do my dissertation on that or something.

 

[Sanman]

I can relate to your problem because educational consulting because I've also considered doing this, being that I have a strong computer science background. My suggestion would try looking into neuropsychological populations. Perhaps AD/HD or people with brain injury as far as cognitive retraining. Also, you may want to look into the validity of computer administered tools as compared to paper counterparts. Just some suggestions. Una are in grad school already?

 

[Una]

I will be enrolling this fall - Syracuse University clinical psychology phD program. So Sanman, you are applying this year? It's not really not as bad as they make it look It is very, very important to select a single advisor at the schools you are applying to, and to contact this person directly. I think this is best done in September or October. You should read this person's research and a) tell the prof why you like his/her work b) ask questions about it. This is very useful because it will tell you whether you are actually interested in the profs work, and it will convey to the prof that you are a critical thinker. And, it massages the profs ego so sweetly!
You also need to track your application after you send it in - call the grad school and ask them if they received everything and when they're sending it on. It is amazing how often things get lost and apps end up incomplete! Try not to call the psych dept too often though, they do not like it.
I applied to 12 schools. The only schools I got into were the ones where I contacted my potential advisor and exchanged 2 or more emails. The rest were a waste of applications - and it's funny, because some of them really were not competitive!

 

[smeachen]

Hi,

As I am starting my grad program next month (Wayne State Univ, in Michigan), I thought I might weigh in on the topic of applying to neuropsych grad programs. Also, I'm Canadian (just finished my B.A. in Vancouver), so I have some sense of the neuropsych scene up here.

First of all, Una gave some very good advice. After hearing from all of the schools you apply to, you will inevitably feel that some were a "waste of time." I know I did. I was warned by my undergraduate supervisors that this would be the case. It's bound to happen if you apply broadly, as most neuropsycyhologists will recommend. However, taking the time to do a lot of research ahead of time will help to minimize the costs in wasted application fees. (Believe me, the whole process when you include the GRE test, application fees, courier costs, transcript orders, etc. will blow you away!)
For example, make sure your potential supervisor is actually accepting students the year you apply, check the profiles of past accepted applications to see if your GPA, GRE scores, etc really do make the grade (most schools won't even look at you if you don't).

I have to agree with Una that one should be careful about OVER-contacting a school. It tends to turn them off. I think the key is to make sure they know who you are, but make sure they're not groaning or rolling their eyes when they see your name pop up in their inbox. I would hazard a step one step further actually. Una suggests contacting the professors prior to making your application to introduce yourself and get them interested. Though this is indeed often a good idea (many of my peers gained acceptance to schools this way) it should not be done without caution. In fact, some of the schools I applied to specifically directed students to AVOID contacting professors, who tend to receive dozens and dozens of such emails every fall and grow to resent them.

There are a few alternative approaches for such schools/potential supervisors. For example, for some schools, I held off emailing professors until I was invited for an interview. Another great tip I received that worked wonders, was to take the time and effort to email your potential supervisor's grad students. They will give you the low-down, believe me. There is no better source of info on a given researcher than his/her underlings in the lab.

Good luck to Sanman with your application. If you have any questions at all, feel free to email me. I know I couldn't have gotten through the process without a lot of help.

Sarah