NP Question

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roryportman

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Following NP post-doc, how difficult would it be to find a job that focused on racial/ethnic minorities? Are most jobs categorized by peds / older adults/ TBI / cancer domains, as opposed to cultural/race/SES variables? Thanks!

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Following NP post-doc, how difficult would it be to find a job that focused on racial/ethnic minorities? Are most jobs categorized by peds / older adults/ TBI / cancer domains, as opposed to cultural/race/SES variables? Thanks!

Institutional jobs? Probably pretty difficult, though there may be some in certain niche areas. Most jobs are either generalist positions or a specific area (neuroonc, TBI, etc). However, you could pretty easily carve out a niche if you had expertise in a certain area. For example, there is one neuropsych in the area that is a bilingual Spanish speaker, and I forward that person every single referral that comes my way that needs a Spanish interpreter otherwise. If someone spoke Hmong or Russian, they could also easily fill a caseload in my area. I'd gladly stop doing my Russian interpreter-assisted evals if someone in the area could do a better job.

In short, finding a job at institution that pays well solely focusing on this, will be hard to find. You could probably easily find a job with an org that caters to those populations, but it likely won't pay well. But, make a name for yourself with some expertise in an area with need, and you can easily carve out some dedicated slots for the work. But, once you are out of postdoc, you get to enter the wonderful world of billing and payor mix. Another factor that will likely limit your ability to solely focus on certain populations. If you want to get paid well, anyway.
 
Neuro is very much based on the medical model. Like all of medicine, the jobs are described by what they treat, not who they treat. Lifespan neuropsych is one of the most difficult things to do. It requires one to keep up on the literature children and adult to include: development, school laws and techniques, cultural considerations including what’s hip with the kids and new relevant parenting ideas, neuropathology, adult resources such as nursing homes, pharmacology, etc. How one would spend that much time in that specific endeavor and then say, “but I only want to see patients from X group” is beyond my understanding.

Legally, there are likely problems with racial restrictions on who someone sees.

Pragmatically, you’re talking about finding X number of people with relatively rare neurological illnesses, who have insurance, who are seeking care, etc. Exclusively seeing ethnic minorities of lower SES is probably going to represent a challenge to the financial viability of a practice. Most practitioners lose money on Medicaid.

This things being said: the one loophole I can imagine would be if you spoke a foreign language and lived in an area where that population was huge (e.g., there’s a strangely large population of Somalis in Maine. If you speak Somali and lived there and took whatever insurance they have, then I would guess you’d be full.). Even with that, I would highly doubt one could be competent in every type of exam.
 
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Second/third everything said above. Your best bet would be to work in an area where there's a large population of the racial/ethnic group(s) you'd like to work with, and go from there.

And agreed 100% with PsyDr's comments regarding lifespan neuropsychology. I work in a generalist neuropsych role, and just keeping up with all of the adult stuff is borderline overwhelming; I have no idea how folks could stay on top of that and kiddos/adolescents.
 
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All of your responses make a lot of sense. Thank you for taking the time to write!
 
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