For best practices, I would follow the guidelines mentioned above for a given specialty. If you want to work in a major medical center or academic medicine, not doing so may come back to bite you. If you only plan to work in private practice or other smaller settings, it honestly may not matter one bit. As I have said, I know people, even in NYC, that practice neuropsych with little to no formal training. I considered a post-doc in geriatrics/behavioral medicine, but having to move halfway across the country for a lower paying position is just not something I could stomach. Instead, I took a job with similar opportunities as the post-doc in the city I was currently living in. Post-docs are great if you can get them, but the lack of post-docs (especially with the current funding issues) do make them a necessity in my opinion. That said, if you want to work in s certain area, I would look for a job in that area. Some colleagues and mentors (clinicians mind you) stated that they grabbed the first available job, got their license, and then worried about about getting the position they really wanted. While I feel that such advice is a little extreme, it has not seemed to hurt them (they all worked at a VA hospital I trained at).