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Neuropsychology Fellowship

The University of Texas MD Anderson Cancer Center Postdoctoral Fellowship in Clinical Neuropsychology is a structured two year fellowship which provides competency-based postdoctoral training in Clinical Neuropsychology appropriate for those seeking to pursue ABPP Board specialization in Clinical Neuropsychology. The fellowship is accredited by the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN). As a member of APPCN, selection of candidates is conducted through the National Match hosted by NMS.

Goals and Objectives

In accordance with the Houston Conference Guidelines Policy Statement on Specialty Education and Training in Clinical Neuropsychology, the postdoctoral fellowship at MD Anderson is a residency education and training program designed to provide “the clinical, didactic and academic training to produce an advanced level of competence in the specialty of clinical neuropsychology and to complete the education and training necessary for independent practice in the specialty”. Our goals also include that fellows will become prepared for independent practice as clinical neuropsychologist with a variety of adult and geriatric patient populations, and that fellows will become prepared to pursue ABPP Board Specialization in Clinical Neuropsychology. Our training philosophy is also consistent with that set forth in the Houston Conference Guidelines, namely, clinical training in the specialty of clinical neuropsychology “through integrated education and training …predicated on the view that the training of the specialist in clinical neuropsychology must be scientist-practitioner based, and may lead to a combined, primarily practice, or primarily academic career”.

In keeping with the Houston Conference Guidelines, specific training goals include:

  • Advanced skill in the neuropsychological evaluation, treatment and consultation to patients and professionals sufficient to practice on an independent basis;
  • Advanced understanding of brain-behavior relationships;
  • Scholarly activity, e.g., submission of a study or literature review for publication, presentation, submission of a grant proposal or outcome assessment;
  • Eligibility for state or provincial licensure or certification for the independent practice of psychology;
  • Eligibility for board certification in clinical neuropsychology by the American Board of Professional Psychology.

In the MD Anderson Fellowship in Clinical Neuropsychology, these goals are accomplished through a structured two year program incorporating:

  1. Clinical experience with patients both at MD Anderson and in other area clinical neuropsychology settings supervised by ABPP certified (or board eligible) specialists in Clinical Neuropsychology
  2. A wide range of high quality didactic educational activities, including the opportunity to attend a prestigious medical school neuroanatomy and neurology course
  3. Scholarly activity
  4. Regularly scheduled evaluation of the fellow’s progress and competency

Clinical Training

Training at MD Anderson Cancer Center

Fellows receive advanced training in providing assessment and intervention in a diverse range of medically-complex adult patients. The MD Anderson Cancer Center is a large multidisciplinary academic medical institution, and the Section of Neuropsychology runs an active consultation-liaison service that receives consult requests from every clinical division in the institute, including Neuro-Oncology, Neurosurgery, Radiation Oncology, Psychiatry, Physical Medicine and Rehabilitation, Internal Medicine, Breast Medical Oncology, Head and Neck Surgery, Leukemia, Lymphoma Myeloma, and the Cancer Pain Service. MD Anderson has consistently been ranked as one of the top two Cancer Hospitals in the nation by U. S. News and World Report, and is one of the largest cancer centers in the world. Our program is the only APPCN neuropsychology fellowship that offers the opportunity to gain extensive clinical experience in medical neuropsychology in a primary cancer setting.  

Approximately 50% of the patients referred have a known structural brain lesion (e.g., primary or metastatic brain tumor) for which we perform preoperative fMRI, pre- and postoperative neuropsychological assessments, longitudinal evaluation of cognitive, behavioral, emotional and functional well-being, and offer management and intervention strategies; the other 50% of patients are referred for assessment of traditional adult neuro-medical disorders and provision of management and intervention strategies (e.g., dementia, seizure disorders, stroke, psychological and psychiatric comorbidities, cancer and cancer therapy neurotoxicities, discharge and return to work planning, driving evaluations, capacity evaluations, behavioral management, compensatory and restorative intervention approaches). During the first year, fellows typically evaluate one patient per day, four days per week. During the second year, fellows are expected to evaluate a minimum of one, and up to two, patients per day, four days per week, though this can be modified based on the fellow’s level of involvement in research. Read more information on the general structure of the fellowship.

All supervision at MD Anderson is provided by ABPP-certified clinical neuropsychologists. There are five neuropsychology staff members in the Section of Neuropsychology:

Read more regarding Structure, Supervision, and Evaluation.

Training In External Specialty Rotations

In addition to the clinical experience at MD Anderson, the fellow will also participate in an external rotation one day per week at a partnership institution to further enhance the diversity of their clinical training in adult neuropsychology. The typical duration of the external rotations is four months. A fellow may choose to rotate through a maximum of three different institutions per year. This training format provides opportunities for gaining additional specialized clinical experience with other patient populations in all major areas of neuropsychology, including dementia, stroke, movement disorders, epilepsy, TBI, acute, subacute and outpatient neurorehabilitation, cross-cultural neuropsychological evaluation, pediatric and developmental neuropsychology, and private practice neuropsychology. This format also allows the clinical training to be tailored to the fellow’s interests and specific training needs.  

All supervisors at external rotation sites are ABPP-CN certified, or board eligible. External specialty rotation sites are all within walking distance (or accessible by Metrorail) in the Texas Medical Center.

Partnership training sites include:

Didactic Opportunities

This fellowship offers didactic opportunities both within the institution, within a joint didactic partnership with other Houston neuropsychology fellowships, and within the Texas Medical Center. A minimum of 10% of the fellow’s time (4 hours per week) will be spent in educational pursuits, per APPCN requirements.  

At MD Anderson

Section of Neuropsychology

The purpose of didactic presentations within the Section of Neuropsychology is to provide both education in the neuropsychology of oncology, as well as preparation for ABPP board exams, including review of major neuropsychology topic areas covered on ABPP exam. Didactic presentations within the Section of Neuropsychology will generally be scheduled on a weekly basis. Although there will be a variety of didactic presentations relevant to all areas of clinical neuropsychology, year one didactics will include a greater focus on cognition in cancer, and year two didactics will have a greater focus on major neuropsychology topic areas covered on ABPP exam. Fellows are expected to play a significant role in initiating and managing didactics. Attendance is mandatory.  

Didactics within the Section  may be composed of a combination of formats including but not limited to:

  • Topics presented by neuropsychology faculty
  • Topics presented by other MDACC professionals as available
  • Topics presented by the fellow
  • Case presentations by neuropsychology faculty (primarily year one)
  • Case presentations by the fellow
  • Fact finding case presentations by neuropsychology faculty (primarily year two)
  • “Journal Club” format

Department of Neuro-Oncology

  • Neuro-Oncology M&M and patient rounds (mandatory) - a review of current neuro-oncology patients as well as occasional M&M presentations. This meeting is attended by faculty and staff every Monday at 8 a.m.
  • Neuro-Oncology Core Curriculum series (mandatory) - Mondays at 4 p.m. throughout most of the year
  • Neuro-Oncology Journal Club (optional, but encouraged)

Department of Neurosurgery

  • Tumor Board (optional, but encouraged)
  • Brain cutting (when available, optional, but encouraged)

Multidisciplinary campus-wide educational events (all optional)

  • Psychiatry Educational Lecture Series
  • Integrative Medicine Program 1) Lecture Series, and 2) Integrative Medicine Program’s Research Club
  • Palliative Care and Rehabilitation Medicine Grand Rounds
  • The Section of Integrated Ethics 1) Ethics Seminar and 2) Difficult Case Review Series
  • Pain Medicine Grand Rounds
  • Division of Cancer Prevention Grand Rounds, including the Section of Behavioral Science

Houston-Area Joint Neuropsychology Didactics (mandatory)

These are monthly rounds presented by neuropsychologists at several different clinical neuropsychology training sites within the Texas Medical Center, including TIRR, the Clinical Neuropsychology Fellowship at the Michael E. DeBakey VA Medical Center, Texas Children’s Hospital, The Memorial Hermann Hospital Epilepsy Monitoring Unit, Mentis Neurorehabilitation, and Baylor College of Medicine Cognitive Neuroscience Laboratory. These are offered approximately eight months per year.

Texas Medical Center Didactics

  • Behavior Neurology and Neuropsychiatry Conference offered by TIRR Memorial Hermann Hospital monthly at noon
  • The Texas Medical Center is the largest medical center in the world, and as such there are numerous other ongoing didactics and other educational events available. These are optional.

Baylor College of Medicine CNS I & II

Fellows who have not already met Houston Conference Guidelines for Foundations of Brain-Behavior relationships will attend this course in the spring of year one with medical students, and usually other Houston-area clinical neuropsychology fellows. This medical school course covers CNS anatomy, physiology, the neurological exam, neurological disorders, and basics of neuro-imaging through lecture, clinical presentations, and lab (with human brain dissection). Both lecture and lab are mandatory. For fellows requiring this course, both the external rotation and the Section of Neuropsychology didactics are suspended.

Summary of Didactics

When not attending Baylor College of Medicine medical school classes, fellows are required to spend a minimum of 4 hours per week in didactic activities. The following four didactics are mandatory: 

  1. MD Anderson Section of Neuropsychology Didactics
  2. MD Anderson Department of Neuro-Oncology Patient Rounds & M&M meeting
  3. MD Anderson Department of Neuro-Oncology Core Curriculum (approximately 9 months of the year)
  4. The Houston-Area Joint Neuropsychology Didactics (when offered)

The Department of Neuro-Oncology Core Curriculum and the Houston-Area Joint Neuropsychology Didactics are not year-round, leaving one open hour which the fellow must fill with the educational activity of their choice during those months when these didactics are not offered.

It is noted that didactic schedules may change, and this is beyond our control in some cases. Every attempt will be made to ensure that fellows receive the minimum required educational activities. Other didactic activities, including university courses, may be mandated if areas of significant weakness in foundation skills are identified.  

Scholarly Activity

The Houston Conference Guidelines specify that exit criteria for the fellowship include successful demonstration of scholarly activity. Our training philosophy is scientist-practitioner based, with the goal of producing a clinical neuropsychologist who will be able to utilize empirical findings to inform and guide their clinical activities, as well as to effectively evaluate the scientific merit of procedures and interventions. The fellow is expected to display motivation for scientific inquiry. This includes referring to the literature and integrating relevant theories into their patient-related activities.

Fellows are required to remain actively involved in research throughout their postdoctoral training term, and are expected to utilize protected research time effectively. As per APPCN guidelines, fellows will have at least 10%  protected time (4 hours per week), which can be dedicated to research. However, more research time will be available according to the fellow’s level of interest in research, and as approved by Neuropsychology faculty.

Fellows are expected to produce at least one scholarly project (e.g., submission of a study or literature review for publication, presentation, submission of a grant proposal or outcome assessment) during their two-year term.    

Extensive research opportunities are available within the context of an actively funded clinical research program involving both CNS and non-CNS cancer patients. Additionally, the Section manages the largest neuropsychological database of brain tumor patients affording unparalleled opportunities for retrospective research.  

Structure, Supervision and Evaluation

Structure

The fellowship at MD Anderson is a structured two-year program in which fellows are provided with an individualized training plan. This fellow will be provided with a recommended training calendar which is designed to facilitate the fellow’s professional goals, including identifying weaknesses in a fellow’s knowledge base, so that these may be remediated, thus preparing for state licensure and ABPP board exams. The individualized training plan for each fellow will be developed with specific objectives to meet these aims. At a minimum, this plan will be reviewed and modified as needed during each formal evaluation, which occurs approximately every six months, as described in the Evaluation section.  

Supervision

Fellows will receive a minimum of two-hours direct supervision by Neuropsychology faculty per week. One hour of supervision will occur in a dedicated weekly meeting with the training director. The other hour (at a minimum) of supervision will be provided in increments by the Neuropsychology faculty assigned to supervise the fellow for each patient.  

In addition to receiving supervision for clinical activities, fellows may receive extra guidance for identifying professional goals, planning for Texas licensure, preparing for Board examinations, etc., by Neuropsychology faculty on an ongoing basis, as needed. In addition, fellows will receive guidance for identifying and completing a minimum of one scholarly activity project, as noted in the Scholarly Activity section.

Evaluation

A goal of the MD Anderson Neuropsychology Fellowship is to provide competency-based training. To meet that goal, fellows are provided with formal evaluation at regular intervals.

In addition to receiving ongoing feedback regarding their performance during their supervision, fellows are formally evaluated approximately every six months by all Neuropsychology faculty (e.g., March, September, March, and exit criteria in August). In addition to evaluating the fellow’s clinical skills, knowledge base, and scholarly activity, fellows are also evaluated on their professional demeanor. If significant difficulties are identified by the first 6-month evaluation, a formal 3-month plan for remediation acceptable to the Neuropsychology faculty and the fellow will be developed. If the problem areas identified in the remediation plan are not satisfactorily corrected within three months, the fellow will not be reappointed for the following year. It is anticipated that this will be rare.  

Supervisors at external rotation sites submit a formal evaluation form regarding the fellow’s performance to the Training Director at the end of each rotation. However, supervisors at external rotation sites are encouraged to inform the Training Director of any observed difficulties at any point during the rotation. If problems are identified, the external rotation supervisor and Training Director will determine a plan for remediation.

A written APPCN First Year Resident Examination will be administered at the end of year one with the intention of evaluating the relative strength and weaknesses of the fellow’s knowledge base in order to better identify needs for continuing education in the final year of training.  

As defined by the Houston Conference Guidelines, exit criteria for the Residency includes a formal evaluation of competency in 1) advanced skill in the neuropsychological evaluation, treatment and consultation to patients and professionals sufficient to practice on an independent basis; and 2) advanced understanding of brain-behavior relationships. Formal evaluation of competency in these areas may include, but is not limited to, APPCN-based written examinations, successful performance on mock fact-finding cases, and successful demonstration of advanced clinical skills for one or more patients throughout an entire case, from initial case conceptualization through provision of feedback to the patient and referral source.  

Stipend and Benefits

The stipend is $43,000 per year plus $1500 per year for educational expenses (e.g., books, conference expenses, etc.), paid health insurance, optional vision and dental benefits, 15 days paid vacation, 5 educational days, and approximately 8 - 10 institutional holidays per year.  

The Section of Neuropsychology has four clinical exam rooms. Two rooms have video monitoring capabilities. The fellow has their own desk, computer with standard word processing and statistical software, access to digital medical records, and access to an in-house dictation service. MD Anderson provides a large, fully equipped fitness center attached to the hospital, which is free to employees.

Fellow Selection Criteria

The MD Anderson Postdoctoral Fellowship in Clinical Neuropsychology is a participating member of the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN). As a member of APPCN, selection of candidates is conducted through the National Match hosted by NMS (“the match”). Applicants may register online at www.natmatch.com/appcnmat.  

APPLICANTS MUST REGISTER FOR AND PARTICIPATE IN THE NMS APPCN MATCH TO BE CONSIDERED FOR THIS FELLOWSHIP.   

The MD Anderson Program Code Number is 8602.

  • Eligible applicants must be a graduate of an APA- or CPA- accredited clinical psychology program with specialty training in neuropsychology and a degree of Ph.D. or Psy.D., as per Houston Conference Guidelines. Candidates must have had foundation and higher-level graduate-level courses in neuropsychology. 
  • Doctorates in clinical psychology without prior neuropsychology experience are not accepted. Doctorates in experimental psychology, counseling psychology, school psychology, developmental psychology, behavioral medicine, health psychology, neuroscience, and neurobiology are not accepted.  
  • Candidates must have completed an APA- or CPA- accredited internship in clinical psychology. Internships including formal neuropsychological training are strongly preferred.
  • Candidates are expected to have had formal training and experience in neuropsychological assessment, interpretation, and report writing at either the graduate or internship level. Previous neuropsychological experience in a medical setting is strongly preferred.  
  • This fellowship is not suitable for those wishing to respecialize in Clinical Neuropsychology.

Houston, The Texas Medical Center and Neuropsychology

Houston

Houston, Texas is the fourth largest city in the nation. Houston is a very cosmopolitan city, where more than 90 languages are spoken and 92 countries have consular offices, the third highest in the nation. Houston offers an enormous range of cultural opportunities, with a 17-block downtown theater district, more than 500 cultural, visual and performing arts organizations (and one of only five US cities that offer year-round resident companies in all major performing arts), world-class museums, and professional football, soccer, basketball, baseball, and AHL hockey teams. Houston has a sensational and ethnically diverse restaurant scene, and has been on Esquire Magazine's list of America’s Top 10 Best Food Cities as well as  the Top 25 for Travel+Leisure America's Best Cities for Foodies. And despite our warm climate, Houston is ranked in the Top 5 for the 2014 Forbes' list of Coolest Cities to Live. It is well-known that Houston has one of the best economies in the country, with Forbes naming Houston as one of the Top 15 Best Places for Business and Careers. To top it all off, the C2ER Cost of Living Index 2013 Annual Average shows that Houston has the third lowest overall cost of living among the nation’s 20 most populous metropolitan areas. The same study also shows that Houston's overall after-taxes living costs are 5.6 percent below the average for all 308 urban areas participating in the survey, largely due to affordable housing costs.

See also:  

The Texas Medical Center and Neuropsychology

The Texas Medical Center is the largest in the world, with more than 50 clinical and research institutions, including two medical schools and 13 teaching hospitals. MD Anderson was the founding institution of the Texas Medical Center, and is the single largest institution within the TMC, with more than 18,000 employees. Houston has a long tradition as a major center for neuropsychology, largely due to the establishment of one of the earliest scientist-practitioner doctoral training programs in clinical neuropsychology at the University of Houston, as well as the concentration and proximity of professional neuropsychologists in the Texas Medical Center. The first model for training in Clinical Neuropsychology was established by The Houston Conference in 1997. We are proud to be the home of some of the most prestigious neuropsychologists in the world. Houston has enjoyed the camaraderie of large neuropsychology professional society for the past twenty years. The Houston Neuropsychological Society, with approximately 100 members, hosts an annual symposium and other events which feature prominent local, national and international neuropsychologists.

Application and Contact Information

For additional information and application instructions, see the APPCN website, and the NMS website. Please note that there is a deadline for registering with the National Match, which may be different from the MD Anderson application deadline listed below.   

After reviewing the information on the APPCN and NMS websites, provide the Training Director, Jennie L. Rexer, Ph.D., ABPP with the following by email (jrexer@mdanderson.org)  

  1. A one-page maximum personal statement summarizing neuropsychological and other relevant education and clinical training, areas of clinical and/or research interests, and general professional goals
  2. A one-page statement describing the candidate's adult medical neuropsychological experience, including specifying how much training has been spent working with dementia patients
  3. Curriculum vitae
  4. Copies of graduate transcripts listing courses, grades, and degrees. (Note that if the doctorate has not yet been awarded at the time of application, the applicant must provide an APPCN Doctoral Training Verification Form.)
  5. List of graduate school and/or medical courses related to neuropsychology
  6. List of familiar neuropsychological and psychological assessment procedures
  7. Two de-identified neuropsychological reports
  8. Three letters of recommendation. Please do NOT submit more than 3 letters of recommendation.
  9. Please let us know if you will be attending the North American meeting of the International Neuropsychological Society, including the dates you will be able to interview

Please note that, if selected, candidates will also be required to provide official transcripts, proof of eligibility to work in the US for the duration of the two-year fellowship, verification of immunizations, pass a pre-employment drug screening, and be screened for tobacco use. MD Anderson is a tobacco-free institution. 

Application Deadline:  Applications for the 9/01/2015 - 8/31/2017 fellowship will be accepted until January 16, 2015.  

Interview Policy: The program director or designee will be available to interview applicants at the February North American meeting of the International Neuropsychological Society. Policy regarding on-site interviews: We encourage visits from invited applicants for on-site interviews, although they are not required. Other interviews are acceptable (e.g., telephone, internet video conferencing, etc.). Interview location is not considered a factor in the selection process. 


© 2014 The University of Texas MD Anderson Cancer Center