Preparing for Internship, Residency and Board Certification in Clinical Neuropsychology INS Meeting, Portland: Thursday,

1. Preparing for Internship, Residency and Board Certification in Clinical NeuropsychologyINS Meeting, Portland:Thursday, February 8, 2007 APA Division 40’s Association of Neuropsychology Students in Training (ANST), Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN), and American Academy of Clinical Neuropsychology (AACN)

2. Doctoral Training and Internship/Postdoc Preparation: Paula Shear, PhD and Desiree A. Byrd, PhD Postdoctoral Training and the APPCN Match: Brad L. Roper, PhD and Robin Hanks, PhD Board Certification:Linas A. Bieliauskas, PhD Topics and Presenters

3. Doctoral Training and Internship/Postdoc Preparation: Paula Shear, PhD and Desiree A. Byrd, PhD

4. Doctoral Programs: Houston Conference Guidelines • Doctoral training level: • Specialization in CN begins at this level. • Generic psychology and generic clinical cores should be completed. • Foundation of brain-behavior relationships should be developed to a considerable degree. • However, variability may occur between doctoral programs in the degree to which of brain-behavior relationships and practice of CN are emphasized. • ENTRY and EXIT CRITERIA: Those specified by the doctoral program • IMPLICATIONS: You may have relatively few opportunities for specialization in CN at the doctoral level, depending on your program. If so, you will benefit greatly from being proactive in finding ways around this in your community to make you competitive for CN internships and residencies.

5. Internship Programs: Houston Conference Guidelines • Internship training level: • Complete training in general practice of professional psychology. • Extend specialty preparation in science and professional practice of CN • % time in CN should be determined by the training needs of the individual intern. • Internships MUST be completed in an APA or CPA approved professional psychology program. • ENTRY criteria: Completion of all graduate education requirements including doctoral dissertation. • EXIT criteria: None specified in policy statement.

6. Competitive Postdoctoral Preparation • Doctoral and internship APA/CPA accreditation. • Make sure your doctoral and internship programs together cover all ‘core’ generic bases as well as the preparatory neuroscience foundations. • If something was lacking, supplement it with additional supervised practicum, accredited continuing education, etc.

7. A Word About Licensure • If you know what state(s) you want to be licensed in following your training, check out the coursework requirements while you are still in graduate school. Even an excellent general graduate curriculum will not prepare you fully for licensure in all 50 states. It is much easier and cheaper to take any additional required coursework while you are still a doctoral student.

8. Competitive Postdoctoral Preparation • Involvement in national organizations (e.g., APA, INS, NAN). Publications and conference presentations are a plus, particularly in the year you are interviewing for residencies. • If your dissertation is not already defended, have a realistic plan for dissertation completion. • Internship: Round-out general clinical activities: An all-neuropsych internship is not always helpful. Try for a mix that addresses any weaknesses. • Make sure to talk to your mentors about where you want to apply.

9. Alternative Routes into Clinical Neuropsychology • Your doctorate is not in clinical psychology • You come from a small doctoral program with limited opportunities in neuropsychology • You decided late in your graduate or internship career to focus your training in neuropsychology • You need to remain in a limited geographic area for internship or residency

10. Postdocs: Judging Programs • Residency conforms to the Houston Conference. • At least 50% clinical service delivery and 2 hrs of supervision per week. • Quality supervision and fair evaluation. • Opportunities for education and research. • Sufficient range of patient types. • Diversity issues are addressed. • Not a “sweat shop.”

11. Postdocs: Judging Programs • Evidence of staff expertise. • Staff are professionally active. • Adequate financial, clerical, and physical resources. • APA accreditation: still “in process” at the postdoc level. • Past residents have good jobs!

12. Postdoctoral Training and the APPCN Match: Brad L. Roper, PhD and Robin Hanks, PhD

13. Postdocs: Application • Application procedures differ across programs (but simpler than internship) • List specific goals in cover letter. • Attend INS for interviews. • Ask to speak with former/current fellows. • Most important: Apply to as many. programs as you can.

14. Postdoctoral Training:Houston Conference Guidelines • Goal is to complete the education and training necessary for independent practice of clinical neuropsychology (CN) • Residency is a REQUIRED component in specialty education in CN • The equivalent of 2 years of full-time education and training • Residency MUST occur on at least a half-time basis

15. Postdoctoral Training:Houston Conference Guidelines ENTRY criteria: 1. Entrance SHOULD be based upon completion an APA/CPA- accredited doctoral program. 2. Residents WILL have successfully completed an APA/CPA- accredited internship which includes SOME training in CN.

16. Postdoctoral Training:Houston Conference Guidelines EXIT criteria: 1. Faculty includes a board-certified clinical neuropsychologist and other psychologists. 2. Training at a fixed site or affiliated local sites with primarily on-site supervision. 3. Access to clinical services and training in medical specialties and allied professions. 4. Interactions with residents in medical and allied specialties. 5. Eligibility for state or provincial licensure for independent practice. 6. Eligibility for board certification by ABCN.

17. APPCN-Member Programs: Criteria • Duration of 2 years of postdoctoral training, or equivalent on at least a half-time basis. • Activity at least 50% clinical, 10% research, and 10% didactics. • Program director is board-certified in clinical neuropsychology by ABCN/ABPP

18. Deadline Applicant Program Register with NMS Mid Jan. 2007 Interviews Submit ranks 03/02/07 Clearing-house Match 03/12/07 APPCN Matching Program

19. APPCN Matching Program • Computerized matching process, run by NMS on behalf of APPCN • Non-APPCN programs that meet Houston guidelines may also participate. • Decision rules are applied based on the applicants’ and programs’ rankings. • Fees for programs and applicants.

20. APPCN Matching Program • Programs can tell you only whether or not you are competitive. • Premature offers are not allowed. • If a program does not plan to rank you, they are supposed to tell you so. • Match is binding. • Clearinghouse is available.

21. APPCN Matching Program Participation

22. Success in match (%) APPCN Matching Program

23. APPCN Matching Program Average # of rankings in 2006

24. APPCN Matching Program: Advantages to Applicants • Access to most quality programs that meet training standards for ABCN board certification • Ability to apply to many programs using the same process • Minimize travel by interviewing at INS • Match outcome is binding • Most fair system for applicants • Clearinghouse

25. APPCN and the ABPP/ABCN Exam: • APPCN has developed a practice written exam that residents take after their first year • Results are tabulated yearly, and residents receive feedback on their relative standing • The exam is not meant for formal evaluation • Many sites also conduct mock oral exams and use ethics vignettes that are standardized for APPCN programs. Standardized fact finding cases are also in preparation.

26. APPCN Matching Program Contact Information: APPCN: http://www.appcn.org NMS: http://www.natmatch.com

27. American Board of Clinical Neuropsychology (ABCN) Linas A. Bieliauskas, PhD

28. Why Board Certification? • Protection of the patient is paramount! • During earlier periods, multiple routes to clinical practice were followed. Multiple claims to competence still prevail. • Even with formal training, level of training cannot be guaranteed, either by program or by student. • Self-designation is not acceptable. Certificates of training are no better. • Certification by examination by peers is the only appropriate method of assuring competence.

29. Psychology Boards Analogous to Medical Boards • State licensure is not appropriate for specialty regulation. • Problems with generic licensure abound, including: • Understanding of specialty criteria difficult for legislators • Multiple claims to competence without appropriate exam • Sunsetting • Board certification is voluntary and regulated by the field. • Medical specialties also not regulated at state level • AMA directory lists “self-designated” specialists

30. Officers and Appointees 2005-2007 • President: Glenn Smith • Vice President: Michael Westerveld • Secretary: Karen Wills • Treasurer: Rich Naugle • ABPP Representative: Sandra Koffler • Executive Director: Linas Bieliauskas • Exam Committee Chair: Bernice Marcopulos • Local Arrangements Chair: Chris Grote

31. Current Status of Board Certification • As of October, 2006, there are 581 board certified Clinical Neuropsychologists, from 48 states, the District of Columbia, and 4 provinces. • Since its inception, ABCN has awarded board certification to 591 individuals. • In 2005, 61 took the written exam and 36 took the oral exam. • In 2006, 83 took the written exam and 47 took the oral.

32. Application and Examination 1. Application and Credentials Review 2. Written Exam 3. Work Sample Evaluation 4. Oral Exam

33. AACN Resources • Available at www.theaacn.org • AACN Study Guide for board certification: A very detailed resource regarding each step in the process. • AACN Mentorship Program: • Available to candidates who have passed the Credentials Review • Meant for support and consultation • Participation is optional, although advisable

34. BRAIN Listserver • “Be Ready for ABPP in Neuropsychology” • New members are accepted upon referral from a member of AACN or an already existing member of BRAIN who may or may not have completed the ABPP/CN process (this person is considered the new member's "sponsor"). • If a supervisor is not a member of AACN or Brain, they should contact someone who is. • The only other criterion to join BRAIN is that the new member be a licensed psychologist.

35. Application and Examination • Application and Credentials Review • Written Exam • Work Sample Evaluation • Oral Exam

36. BRAIN Listserver (continued): • If an AACN or BRAIN member would like to add someone to the study group listserver,contact Michael Kirkwood (kirkwood.michael@tchden.org) with the name, email address, and a brief narrative biosketch of the potential member. • After receiving this information, Dr. Kirkwood will send an email to the new member and the sponsor, which will include an introductory welcome letter and listserv registration information. Dr. Kirkwood will subsequently post the biosketches of new members to the BRAIN listserv as a means of introducing them to the group.

37. Questions?