I. Specific Objectives

Neuropsychology is a subspecialty within clinical psychology, and neuropsychologists are scientists-practitioners. Neuropsychologists must know their patients, the natural history of illness and injury, and individual variations in disease. Thus, we train residents as general clinical psychologists with broad knowledge of neuropsychology and psychopathology. Specifically, we prepare residents to be competent diagnosticians, therapists, and counselors; to be competent giving and interpreting the widest variety of tests and procedures; to understand and integrate medical and other data; to consult with other professionals, and to counsel patients and their families.

II. Structure

Residents consult on referrals from all medical services; in addition, psychotherapy is carried out on direct referrals to neuropsychology or from the Outpatient Psychotherapy Program. Inpatients are examined in their hospital rooms, and outpatients are seen in Department of Psychology offices.

III. Program Description

We consult on and contribute to diagnosis and management of a wide variety of patients referred by neurology, neurosurgery, psychiatry, internal medicine, surgery, allergy and other services. Patients may have later onset "cortical" and "subcortical" dementias (Alzheimer, Pick, vascular, stroke, etc.), movement disorders (Parkinson, Huntington, etc.), auto-immune and inflammatory disorders (multiple sclerosis, lupus, cerebritis, vasculitis, etc.), immunodeficiency and infectious disorders (HIV, encephalitides, etc.), organ transplants (heart, liver and kidney), and seizure disorders (pre- and post-neurosurgical evaluations, Landau-Kleffner syndrome, Wada, etc.). There is also an emphasis on neuropsychological and psychological evaluation of patients with behavioral and psychiatric disorders, such as the schizophrenia, delusional, major affective, anxiety, adult attention deficit, and substance abuse/dependency disorders.

We emphasize that the primary purpose of the residency is to develop clinical competence. Research involvement is possible, if the resident has completed and defended his or her dissertation; otherwise, the resident's first research priority is the completion of the dissertation. Given these priorities, we encourage research that is consonant with the resident's interest, or participation in on-going research. Present research concerns mood disorders in medical illnesses (multiple sclerosis, Parkinson's disease, sleep disorders, cancer and seizure disorders), ethical issues in forensic neuropsychology, and the untoward effects of infection (HIV-1 and hepatitis C) on cognition and brain white matter. Statistical consultation is available.

Residents are first introduced to clinical activities of staff neuropsychologists and accompany them during examinations. They are then responsible for their own patients, including the initial discussions with referral sources, chart review and gathering of collateral data, the examination itself, charting, oral and written reports to referral sources, and consultation with patient, family and external agencies.

IV. Seminars and Supervision

In addition to seminars required of and the various Medical Center activities open to all residents, there are required topical seminars/lectures and regularly scheduled meetings for neuropsychology staff and residents, and elective courses, seminars and lectures. The topical seminars and lectures include Report Writing, Walk Rounds (Neurology, First Week), Consultation Walk Rounds (Neurology, Second Week), Neurological Examination, Epilepsy/EEG, Wada, Movement Disorders/Neurology, Movement Disorders/ Neuropsychology, Alzheimer/Vascular Dementia, Multiple Sclerosis, Brain Mapping/Evoked Potentials, Dystrophies, EMG, Neuroradiology/ CT & MRI, and Projectives. The required lectures/seminars/rounds include Neuropsychology Case Conference (Weekly), Neuropsychology Journal Club (Weekly), Neurology Grand Rounds (Weekly) and neurology/radiology/pathology conference (Weekly). The elective courses/lectures/seminars/rounds include Neuroscience/ Neuroanatomy Course, Brain Cutting (Weekly), Stroke Center Grand Rounds (Monthly), Epilepsy Staffing (Weekly), Psychiatry Grand Rounds (Weekly), Pediatrics Grand Rounds (Weekly), Preventive Medicine Grand Rounds (Weekly), and Internal Medicine Grand Rounds (Weekly).

Supervision is generally rotated among the neuropsychology staff on a case by case basis. Supervision is intensive, individualized, and provided on all cases immediately and for as much time as needed rather than at pre-specified and limited times.