Neuropsychology Residents

[PublicHealth]

Do any of the neurology residents in this forum work with neuropsychology residents? I'm curious to know more about the interrelationship between these two fields (e.g., types of patients seen, common referral questions, etc.) at the residency level.

---

Members don't see this ad.

 

[MacGyver]

Do any of the neurology residents in this forum work with neuropsychology residents? I'm curious to know more about the interrelationship between these two fields (e.g., types of patients seen, common referral questions, etc.) at the residency level.

there is no interaction. Unlike psychology, neurology is a real science.

I know you like to blend the roles together. I'm sure you fantasize about wearing a white coat that says "Dr." on it. You'll be one of those fools like the chiropractors or naturopaths who puts "Dr. Smith" on their coat so they can pretend to be a real doc, instead of revealing their little charade by truthfully printing "Sam Smith, PhD" on it instead.

 

[Old MD]

To the OP, what is a neuropsycology residency?? 😕 There are neurology residencies, neurosurgery residencies, psychiatry residencies and neuroradiology fellowships.

Neurologists who subspecialize in the cognitive/memory disorders of their field do a Behavioral neurology fellowship after residency. I'm not sure if there's some sort of subspecialty fellowship that psyciatry residents can do if they are interested in bridging the fields the other way, but I don't think so.

 

[Pinky]

what is a neuropsycology residency??

i would assume it's the post-grad clinical training that psychology PhDs who have chosen to specialize in neuropsychology undergo to prepare him/herself for clinical work, similar to the post-grad training that we endure to prepare ourselves for our chosen specialties.

in the past, i worked closely with two neuropsych specialists. one was a neurologist with a psychology degree. the other was a psychology PhD without a medical degree. both were very good.

 

[Pinky]

Do any of the neurology residents in this forum work with neuropsychology residents? I'm curious to know more about the interrelationship between these two fields (e.g., types of patients seen, common referral questions, etc.) at the residency level.

Types of patients seen:
We would regularly consult for questions of competency in patients who were borderline demented vs. crazy.

We would also consult for many of the dementias to get another piece of information. Alzheimers vs. FTDs, mixed, etc. We would have a working diagnosis and see if neuropsych testing confirmed it.

In other neurology patients, we would often consult to see if the behavior or mood disorder that we were seeing was a part of a pre-existing psych condition or due to the new neurologic condition.

As each day passes, the boundaries between psychiatry and neurology will continue to blur.

 

[Old MD]

i would assume it's the post-grad clinical training that psychology PhDs who have chosen to specialize in neuropsychology undergo to prepare him/herself for clinical work, similar to the post-grad training that we endure to prepare ourselves for our chosen specialties.

Oh, I see. So they are called residencies, are they? 🙄

 

[PublicHealth]

Oh, I see. So they are called residencies, are they? 🙄

Old MD,

Sorry to say, but you're living up to your name ... OLD MD. Postdoctoral residencies in neuropsychology have been around for decades. I'm sorry that you have not heard of them. How long ago did you train?

They're actually more often called "postdoctoral residencies" or "postdocs."

Here's are some examples:

http://www.mgh-psychology.org/PostDoc/neuropsychology.html

http://www.hopkinsmedicine.org/jhhpsychiatry/medpsych_fellow.htm

http://psychiatry.bsd.uchicago.edu/education/ed_postdoc.html


Pinky,

Thank you for infusing some objectivity into this thread. 👍

 

[PublicHealth]

there is no interaction. Unlike psychology, neurology is a real science.

I know you like to blend the roles together. I'm sure you fantasize about wearing a white coat that says "Dr." on it. You'll be one of those fools like the chiropractors or naturopaths who puts "Dr. Smith" on their coat so they can pretend to be a real doc, instead of revealing their little charade by truthfully printing "Sam Smith, PhD" on it instead.

I'm a first-year medical student. I asked the original question because I am interested in pursuing behavioral neurology and was curious to know if/how clinical neuropsychology residents interact with neurology residents and what types of cases are typically referred for neuropsychologic testing.

So what year of college are you in?

 

[JMD]

Publichealth,

I don't know a whole lot of specifics, but I can tell you that there is a good deal of collaboration between neuropsych and some of the MD's (neurology, neurosurgery, radiology) here in Buffalo. We have a neuroimaging center that focuses most of its work on multiple sclerosis, and I know the neuropsychologists there work on neuroimaging of cognitive and personality changes in MS and developing neuropsych tests related to the disease. Some of the others' interests/work involves sleep disorders, epilepsy, and Parkinson's.

These neuropsychologists are actually listed as faculty in the "Department of Neurology" of the medical school (not that they need that to justify their pursuits).

So, as for there being "no interaction" between neurologists and neuropsychs, I have just provided an example that shows otherwise.

Old MD, because you are unaware of what a neuropsychology residency does not mean that they do not exist. Next post lay off the ignorance and try to write something that pertains to the OP's question.

It's a shame that there are people out-of-touch enough to believe that you need an MD to practice science and help others.

 

[Old MD]

Old MD, because you are unaware of what a neuropsychology residency does not mean that they do not exist. Next post lay off the ignorance and try to write something that pertains to the OP's question.

It's a shame that there are people out-of-touch enough to believe that you need an MD to practice science and help others.

Hi there dufus: Very rich of you to speak of "laying off the ignorance". You are in serious need of some elementary lessons on how to hold a discussion.

The most important rule is: Pay attention to what your discussant/opponent is saying.

1. Where did I claim neuropsychiatric "residencies" do not exist? I have little knowledge of them, so I told the OP what I knew existed and ASKED him what these things were. I did not CLAIM they didn't exist.

2. Write something that pertains to the OPs question? How, dufus, is asking him exactly what he's talking about unrelated to what he's talking about?

3. I said you need an MD to practice science???? That is *****ically untrue on so many levels I'm just going to leave it there.

 

[Old MD]

Old MD,

Sorry to say, but you're living up to your name ... OLD MD.

Oh wow, thats impressive, little tot. Resort to Ad hominems when someone asks you a question. Thats right - its a sure fire way of gaining respect. And more importantly, its the best way to persuade someone of your views. You must have learnt the technique in your Psychology classes. Youre a psychology grad aren't you? I can see youve been well educated.

I suppose the only thing you could take issue with is my amusement at the use of the term residency for such programs. I stand by that opinion, because I really do find it amusing. The term residency is a coinage of William Halsted, the first Professor of Surgery at Hopkins, who instituted the rigorous post graduate medical training that we have today. He revolutionized medical education.

As midlevel practitioners and other "wannabes" (to use a not inappropriate term) developed, they started to appropriate the systems, habits, dress and language of doctors. So now you have NPs who wouldn't mind calling themselves doctors, optometrists claiming they can perform surgery in the eye, and midlevels talking about their "residency" training.

I do not object to the use of the word, after all it is probably the closest practical descriptor. But you have to admit that from a doctors perspective its amusing.

 

[JMD]

OldMD,

It seemed to me that you're posts were mocking the OP, as if he did not know what he was talking about when referring to Neuropsychology residencies. My point was simply that there is no reason to mock him because this is actually what neuropsych postdocs are referred to. I apologize if I took your posts a bit too seriously.

As for the "need an MD to practice science" thing, that was directed toward Macgyver's post:

"there is no interaction.
Unlike psychology, neurology is a real science.
I know you like to blend the roles together. I'm sure you fantasize about wearing a white coat that says "Dr." on it. You'll be one of those fools like the chiropractors or naturopaths who puts "Dr. Smith" on their coat so they can pretend to be a real doc, instead of revealing their little charade by truthfully printing "Sam Smith, PhD" on it instead."

 

[PublicHealth]

Hi there dufus: Very rich of you to speak of "laying off the ignorance". You are in serious need of some elementary lessons on how to hold a discussion.

Name calling. Very impressive! Take your own advice and "resort to ad hominems when someone asks you a question."

1. Where did I claim neuropsychiatric "residencies" do not exist? I have little knowledge of them, so I told the OP what I knew existed and ASKED him what these things were. I did not CLAIM they didn't exist.

I never asked about neuropsychiatric residencies. It was neuropsychology residencies.

JMD,

Thank you for your reply. It's a shame that some people are so belligerent in these internet forums. I hope it speaks more to the lackluster personalities of these people than it does to the state of interprofessional relationships in the healthcare system.

 

[neurologist]

Do any of the neurology residents in this forum work with neuropsychology residents? I'm curious to know more about the interrelationship between these two fields (e.g., types of patients seen, common referral questions, etc.) at the residency level.

Ahem, well, to get away from all the name calling and return to the question at hand:
One of the big roles that neuropsychologists fill is in regional epilepsy centers. They are closely involved in pre- and postoperative assessment of epilepsy surgical candidates, performing very extensive test batteries to localize language and memory function (including Wada testing), and assessing for psychiatric comorbidity prior to the surgeon whacking out part of the patient's brain. They also do a lot of psychological assessment for patients suspected of having "pseudoseizures." Very interesting stuff.

Traumatic brain injury is also a big field for neuropsychologists, because they do a lot of work in identifying, localizing and quantifying cognitive deficits and disabilities to guide TBI rehab plans (and generating disability ratings, etc).

They will, of course, also get involved in assessing patients with suspected dementia.

 

[neurologist]

Types of patients seen:
As each day passes, the boundaries between psychiatry and neurology will continue to blur.

Absolutely.
Unless it's very clearly a purely peripheral nerve problem, any patient seen by a neurologist should be suspected of having psychiatric comorbidity until proven otherwise

Neurology = Psychiatry with physical findings
Psychiatry = Neurology without physical findings

 

[Kazema]

Kind of a related question: how common is it for a doctor to complete residencies in both psychiatry and neurology?

 

[PublicHealth]

Ahem, well, to get away from all the name calling and return to the question at hand:
One of the big roles that neuropsychologists fill is in regional epilepsy centers. They are closely involved in pre- and postoperative assessment of epilepsy surgical candidates, performing very extensive test batteries to localize language and memory function (including Wada testing), and assessing for psychiatric comorbidity prior to the surgeon whacking out part of the patient's brain. They also do a lot of psychological assessment for patients suspected of having "pseudoseizures." Very interesting stuff.

Traumatic brain injury is also a big field for neuropsychologists, because they do a lot of work in identifying, localizing and quantifying cognitive deficits and disabilities to guide TBI rehab plans (and generating disability ratings, etc).

They will, of course, also get involved in assessing patients with suspected dementia.

Thanks, neurologist! We need more people like you in these forums. Would you care to share any of your personal experiences, perhaps even a unique case, in which neurologic and behavioral neurologic/neuropsychologic expertise was required?

 

[scm]

hey, thought i'd add my experience... i've done a bunch of neuro rotations/electives at my hospital in variuos capacities, I don't recall neuropsych ever being mentioned.

However, while in geriatrics clinic (we have one of the strongest geri programs in the country top 5 usnews/blah, im saying this cause we got much exposure no to brag or that i care), i often saw patients who had been referred to Neuropsych for dementia dx etc. in fact, i hadn't thought of asking at the time, but I'm not sure if these patients had seen Neurologists..but thats another discussion.

We also have a strong TBI program, and indeed when talking with the rehab folks in charge, I've heard reference to the neuropsych folks being involved there as well, but I'm not familiar with specifics...so, nothing new reallly to contribute other than confirm yes, neuropsych role in dementia and TBI. As for the behavioral neurologists, I'm sure there is some overlap and difference in terms of approaches..and depends to some degree who is available where you practice.

scm

 

[Old MD]

I never asked about neuropsychiatric residencies. It was neuropsychology residencies.

Doh! That was a typo. And you know it. the thing we've been discussing from the start was neuropsychology, not psychiatry. Good attempt at weasling out of a gentlemanly apology though. Not at all surprised.

PS. I only returned to JMD what he gave me in kind ("ignorant").

Neurologist, I of course defer to you as a neurologist, but it seems to me that split between neurology and psychiatry is not quite how you put it. As psychiatry becomes more reductionist, it approaches neurology. I think it is psychiatry that is changing (moving toward neurology). I believe in 50-60 years, there will mostly only be neurology (when we can explain the psychiatric diseases at a molecular level) and of course the surgical and radiological specialists who will deal with the procedural aspects of things.

Similar to the evolution of the hard sciences and philosophy. 500 years ago all sciences were just one field - Natural Philosophy. As the study of physical, chemical, and biological phenomena began to advance through empirical investigation, they gained their own identity. Each breakway leaves whatever that is not "investigateable" as a science in the realm of philosophy.

I predict in a few decades chemistry will be subsumed into physics, and gradually (much more difficult) biology too.

 

[Old MD]

OldMD,


As for the "need an MD to practice science" thing, that was directed toward Macgyver's post:

Oh sorry. I thought you were referring to me.

 

[Old MD]

(including Wada testing)

is that still done? hasn't it been replaced by some other procedure? I seem to remember hearing that you guys are moving away from the Wada.

 

[PublicHealth]

Doh! That was a typo. And you know it. the thing we've been discussing from the start was neuropsychology, not psychiatry. Good attempt at weasling out of a gentlemanly apology though. Not at all surprised.

PS. I only returned to JMD what he gave me in kind ("ignorant").

Neurologist, I of course defer to you as a neurologist, but it seems to me that split between neurology and psychiatry is not quite how you put it. As psychiatry becomes more reductionist, it approaches neurology. I think it is psychiatry that is changing (moving toward neurology). I believe in 50-60 years, there will mostly only be neurology (when we can explain the psychiatric diseases at a molecular level) and of course the surgical and radiological specialists who will deal with the procedural aspects of things.

Similar to the evolution of the hard sciences and philosophy. 500 years ago all sciences were just one field - Natural Philosophy. As the study of physical, chemical, and biological phenomena began to advance through empirical investigation, they gained their own identity. Each breakway leaves whatever that is not "investigateable" as a science in the realm of philosophy.

I predict in a few decades chemistry will be subsumed into physics, and gradually (much more difficult) biology too.

Thanks for the metaphysical tangent.