MD Anderson's Postdoctoral Fellowship in Clinical Neuropsychology is a structured two-year fellowship that provides 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.
With an aging population and a corresponding expected increase in cancer diagnoses, it is inevitable that clinical neuropsychologists will require an understanding of the cognitive impact of cancer and cancer therapy. Our goal is to prepare neuropsychology fellows for independent practice, providing broad-based neuropsychology competencies with a variety of adult and geriatric patients (e.g., dementia, stroke, movement disorders, epilepsy, TBI), as well as the specialty education and training relevant to the neuropsychology of oncology.
In keeping with the Houston Conference Guidelines, specific training goals include:
- Advanced skill in neuropsychological evaluation and treatment, as well as consultation to patients and professionals;
- Advanced understanding of brain-behavior relationships;
- Scholarly activity;
- 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:
- Clinical experience, primarily outpatient based with some inpatient consultation at MD Anderson Cancer Center. Additionally, fellows will participate in clinical rotations within Texas Medical Center clinical neuropsychology programs supervised by ABPP certified (or board eligible) specialists in Clinical Neuropsychology.
- A wide range of high quality didactic educational activities, including participation in Baylor College of Medicine’s neuroanatomy and neurology courses.
- A novel, investigator-initiated research proposal or a research project, to be completed by the fellow, emanating from the multiple grant, industry, and philanthropy funded faculty research programs
Fellows receive advanced training in providing assessment and intervention in a diverse range of medically complex adult patients. MD Anderson 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, Geriatrics, 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).
Supervised clinical training comprises the majority of the fellowship experience. Fellows receive advanced training and supervised experience in all aspects of the neuropsychological evaluation, including clinical interviewing, test selection, scoring, interpretation, and synthesis of test results, provision of recommendations for interventions, and communication of results with patients, caregivers, and referral sources. The number of patients seen per clinic day will vary depending on a number of factors, including fellow readiness, and involvement in research. Typically, fellows begin by evaluating one patient per clinic day, and increase clinic involvement to a minimum of one, and up to two, patients per clinic day. The majority of evaluations occur in our outpatient clinic, but fellows will have the opportunity to participate in inpatient evaluations throughout their experience and engage in elective rotations throughout the Texas Medical Center. Fellows are also encouraged to participate in multidisciplinary fMRI assessment and research programs involving navigated transcranial magnetic stimulation and intraoperative awake craniotomy with direct cortical stimulation.
All supervision at MD Anderson is provided by ABPP-certified or ABPP-eligible clinical neuropsychologists. There are five neuropsychology staff members in the Section of Neuropsychology:
- Jeffrey S. Wefel, Ph.D., ABPP, Associate Professor, Section Chief
- Shelli R. Kesler, Ph.D., Associate Professor
- Mariana E. Bradshaw, Ph.D., ABPP, Assistant Professor, Director of Training
- Jennie L. Rexer, Ph.D., ABPP, Assistant Professor
- Kyle R. Noll, Ph.D., Assistant Professor
Read more about structure, supervision and evaluation below.
Training In External Specialty Rotations
In addition to the clinical experience at MD Anderson, the fellow will also participate in an external elective 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:
This fellowship offers didactic opportunities within the institution, a joint didactic partnership with other Houston neuropsychology fellowships, and within the Texas Medical Center. A minimum of 10% of the fellow’s time will be spent in educational pursuits.
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 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 will be given the opportunity to initiate and manage 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 MD Anderson professionals
- Topics presented by the fellow
- Case presentations by neuropsychology faculty
- Case presentations by the fellow
- Fact finding case presentations by neuropsychology faculty
- “Journal Club” format
- 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.
- Neuro-Oncology Journal Club (optional, but encouraged)
- Tumor Board (optional, but encouraged)
- Brain cutting (optional, but encouraged)
Multidisciplinary campus-wide educational events (all optional)
- MD Anderson Grand Rounds
- Psychosocial Oncology Grand Rounds
- Psychiatry Educational Lecture Series
- Integrative Medicine Program Lecture Series
- Palliative, Rehabilitation and Integrative Medicine Grand Rounds
- Integrated Ethics 1) Ethics Seminar and 2) Difficult Case Review Series
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.
- 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 enroll in 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 Neuropsychology section didactics are suspended.
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. Fellows will have at least 10% protected time, 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 during their two-year term and will receive supervision and assistance to find a project that meets their interests. Fellows may engage in a new “investigator initiated” research project or participate in the extensive research opportunities available within the context of our faculty’s actively funded clinical research programs in the following areas:
- Characterizing the neuropsychological and neuroimaging phenotype of brain injury (e.g brain tumor, neurotoxicity of therapy/“chemobrain”) in cancer patients;
- Identifying predictive and prognostic biomarkers of treatment-related cognitive decline (e.g., pharmacogenetic risk/protective factors, imaging signatures of risk/resilience);
- Developing and testing pharmacologic and behavioral interventions for neuroprotection or restoration of brain health and cognitive function in CNS and non-CNS cancer patients;
- Identifying cancer therapies that provide maximal disease control with maximal clinical benefit (e.g., integrating cognition as an endpoint in clinical trials);
- Developing brain mapping tools to minimize surgical morbidities (e.g., fMRI techniques, nTMS tasks, and intraoperative monitoring of cognitive function during awake craniotomies); and
- Advanced neuroimaging analysis approaches including the application of graph theory and machine learning. Additionally, the section manages the largest neuropsychological database of brain tumor patients affording unparalleled opportunities for retrospective research.
Recent publications from the Section of Neuropsychology include:
- Neurocognitive function varies by IDH1 genetic mutation status in patients with malignant glioma prior to surgical resection. Wefel JS, Noll KR, Rao G, Cahill DP. Neuro Oncol. 2016 Aug 30. pii: now165. [Epub ahead of print]
- Neurocognitive functioning and genetic variation in patients with primary brain tumours. Wefel JS, Noll KR, Scheurer ME. Lancet Oncol. 2016 Mar;17(3):e97-e108. doi: 10.1016/S1470-2045(15)00380-0. Epub 2016 Mar 2. Review.
- Verbal Learning Processes in Patients with Glioma of the Left and Right Temporal Lobes. Noll KR, Weinberg JS, Ziu M, Wefel JS. Arch Clin Neuropsychol. 2016 Feb;31(1):37-46. doi: 10.1093/arclin/acv064. Epub 2015 Nov 3.
- Neurotoxic Effects of Anthracycline- vs Nonanthracycline-Based Chemotherapy on Cognition in Breast Cancer Survivors. Kesler SR, Blayney DW.
JAMA Oncol. 2016 Feb;2(2):185-92. doi: 10.1001/jamaoncol.2015.4333.
- Clinical characteristics, pathophysiology, and management of noncentral nervous system cancer-related cognitive impairment in adults. Wefel JS, Kesler SR, Noll KR, Schagen SB. CA Cancer J Clin. 2015 Mar;65(2):123-38. doi: 10.3322/caac.21258. Epub 2014 Dec 5. Review.
- Brain network alterations and vulnerability to simulated neurodegeneration in breast cancer. Kesler SR, Watson CL, Blayney DW. Neurobiol Aging. 2015 Aug;36(8):2429-42. doi: 10.1016/j.neurobiolaging.2015.04.015.
- Relationships between neurocognitive functioning, mood, and quality of life in patients with temporal lobe glioma. Noll KR, Bradshaw ME, Weinberg JS, Wefel JS.Psychooncology. 2015 Dec 17. doi: 10.1002/pon.4046.
- A randomized trial of bevacizumab for newly diagnosed glioblastoma. Gilbert MR, Dignam JJ, Armstrong TS, Wefel JS, Blumenthal DT, Vogelbaum MA, Colman H, Chakravarti A, Pugh S, Won M, Jeraj R, Brown PD, Jaeckle KA, Schiff D, Stieber VW, Brachman DG, Werner-Wasik M, Tremont-Lukats IW, Sulman EP, Aldape KD, Curran WJ Jr, Mehta MP. N Engl J Med. 2014 Feb 20;370(8):699-708. doi: 10.1056/NEJMoa1308573.
- Memantine for the prevention of cognitive dysfunction in patients receiving whole-brain radiotherapy: a randomized, double-blind, placebo-controlled trial.
Brown PD, Pugh S, Laack NN, Wefel JS, Khuntia D, Meyers C, Choucair A, Fox S, Suh JH, Roberge D, Kavadi V, Bentzen SM, Mehta MP, Watkins-Bruner D; Radiation Therapy Oncology Group (RTOG). Neuro Oncol. 2013 Oct;15(10):1429-37. doi: 10.1093/neuonc/not114. Epub 2013 Aug 16.
- Default mode network connectivity distinguishes chemotherapy-treated breast cancer survivors from controls. Kesler SR, Wefel JS, Hosseini SM, Cheung M, Watson CL, Hoeft F. Proc Natl Acad Sci U S A. 2013 Jul 9;110(28):11600-5. doi: 10.1073/pnas.1214551110. Epub 2013 Jun 24.
The fellowship at MD Anderson is a structured two-year program in which fellows are assisted in preparing for state licensure and ABPP board exams.
Fellows will receive a face-to face clinical supervision on every case by Neuropsychology faculty. In addition, research mentoring and professional development will be provided throughout the fellowship, and fellows will meet regularly with the training director to ensure that needs are being met.
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. The training director will solicit input from supervisors at external rotation sites regarding the fellow’s performance. Fellows will also be asked to provide feedback regarding their experience. Any areas that are identified as needing improvement will be addressed collaboratively to ensure that goals are being achieved. As defined by the Houston Conference Guidelines, exit criteria for the fellowship 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.
Fellows receive a competitive stipend of $47,476 per year, plus $1,500 per year for educational expenses (e.g., books, conference expenses, licensing fees, etc.), paid health insurance, optional vision and dental benefits, 15 days paid vacation, five educational days and approximately eight to 10 institutional holidays per year.
Neuropsychology has ample clinical space. Two rooms have video monitoring capabilities. The fellow has their own desk, computer with standard word processing and statistical software and access to electronic medical records. MD Anderson provides a large, fully equipped fitness center attached to the hospital, which is free to employees.
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 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., 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.
MD Anderson is located in Houston, Texas, within the world's largest medical center, the Texas Medical Center, with 8 million patient visits per year. This area boasts:
- The finest in medical education and treatment
- Numerous parks, including Hermann Park which has an outdoor theater and large zoo
- An academic and cultural arena that includes Baylor College of Medicine, Rice and St. Thomas Universities, the Museum of Fine Arts and the Museum of Contemporary Arts
- Close proximity to Houston's noted symphony orchestra, opera, theater and ballet.
Other sites of various activities available within a few minutes' drive include Moody Gardens, Sam Houston Race Park, Cynthia Woods Mitchell Pavilion, SplashTown Waterpark, Downtown Aquarium, Space Center Houston, Lone Star Flight Museum, San Jacinto Battlefield, NRG Stadium, Minute Maid Park, Toyota Center and the George R. Brown Convention Center. The cost of living is moderate and housing is very reasonable. For more information, watch this video or go to Visit Houston.
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.
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, gather the items listed below for application. The following application materials can be submitted electronically via email to firstname.lastname@example.org:
- A one-page personal statement summarizing patient populations with whom you have experience, as well as areas of clinical and research interest
- Curriculum vitae
- 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.)
- List of familiar neuropsychological and psychological assessment procedures
- Two de-identified neuropsychological reports
- Three letters of recommendation. Please do not submit more than three letters of recommendation.
- 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 U.S. 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 2017-2019 fellowship will be accepted until Jan. 9, 2017. The fellowship begins Sept. 1, 2017 and ends Aug. 31, 2019.
Interview Policy: The program director or designee will be available to interview applicants at the 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.