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[00:00:00]Dr. Sharp: Hello, everyone. Welcome to the Testing Psychologist podcast, the podcast where we talk all about the business and practice of psychological and neuropsychological assessment. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner, and private practice coach.

This episode is brought to you by PAR. PAR offers the RIAS-2 and RIST-2 remote to remotely assess or screen clients for intelligence, and in-person e-stimulus books for these two tests for in-person administration. Learn more at parinc.com.

All right, y’all, welcome back. I am so glad to be here with you today. And I am so glad to be talking to my guests today, Dr. Ryan Van Patten and Dr. John Bellone from the Navigating Neuropsychology podcast. If you haven’t heard Navigating Neuropsychology, in Ryan and John’s words, it is a voyage into the depths of the brain and behavior. It’s a podcast all about the clinical [00:01:00] aspects of pediatric and adult neuropsychology, and they are just knocking it out of the park with content and guests each time. There’s a link in the show notes to navneuro.com. Definitely encourage you to check out their podcast if you’re interested in neuropsychology.

They also have just written a brand new book called Becoming a Neuropsychologist that’s available now for pre-order on Amazon. There will be a link to that in the show notes as well. And that book provides a lot of the framework for our conversation today. So we talk about the path to becoming a neuropsychologist. First, defining neuropsychology and neuropsychologist, and then talking about the ways to get there, the Houston conference guidelines, the difference between a neuropsychologist or a clinical neuropsychologist and a “regular testing psychologist” or [00:02:00] school psychologist, for example.

So we have a great conversation. Very open. And we touched on a lot of topics that I think many of you will find helpful if you’re early in your career or if you are later in your career or mid-career, even like myself. So we spent some time talking about what folks might need, who want to go back and re-specialize in neuro-psychology, what that would look like, and how to do it. So there’s a lot in this episode for everybody really across the career span.

Let me tell you a little bit more about John and Ryan and then we will get to the episode.

John graduated with his Ph.D. from Loma Linda University. He did his doctoral internship at Yale and then his postdoc fellowship at Brown University. He’s board-certified through the ABPP. He currently works in a group practice in Southern California [00:03:00]in both outpatient and inpatient rehab settings. He’s also the backup neuropsychology consultant for the Anaheim Ducks NHL team.

His career goals are to provide excellent neuropsychology services to adults and older adults with a variety of conditions and concerns. He has broad clinical interests, but he’s particularly passionate about reducing the risk for cognitive decline and improving overall health through lifestyle. He’s lectured extensively on the power of exercise, healthy diet, quality sleep, psychological wellbeing, and staying cognitively and socially active have on maintaining and improving cognitive functioning now, and as we age.

Now, Ryan got his Ph.D. in Clinical Psychology from St. Louis University in St. Louis, Missouri. He completed his doctoral internship at Brown University and then a postdoc fellowship in neuropsychology at the University of California in San Diego. He is currently a neuropsychologist at Massachusetts General Hospital, Spaulding Rehabilitation Hospital, and Harvard Medical School in Boston, MA.

His career goals include working as a clinical scientist, writing grants, and carrying out large-scale research projects in a variety of topic areas related to neuropsychology and geriatrics. Ryan also plans to spend a significant portion of his time teaching and completing clinical neuropsychological evaluations.

So these guys know their stuff. Like I said, they have literally written the book on what we’re talking about today. So without further ado, here’s my conversation with Dr. Ryan van Patten and Dr. John Bellone.

Ryan, John, welcome to the podcast.

Dr. Ryan: Thanks so much for having us. This is great.

Dr. John: Yeah, I’m really happy to be here. I’m a [00:05:00] longtime listener, first-time caller.

Dr. Sharp:  I see. Yeah, I love it. I know we’ve had these circling orbits for several months now, and I’m just grateful and excited to be able to talk with you all in person and do some overlapping here. It’s really exciting.

Dr. Ryan: It’s impressive that you’re this one-man show Jeremy, it takes two of us, me and Bellone.

Dr. Sharp: It’s wild. I couldn’t live without my VAs and support from other people for sure. But it’s funny on the other side though, I’m like, oh my gosh. If I had to run all these decisions by somebody else, we’d never get anything done.

Dr. Ryan: There’s plenty of that on our end. You have no idea how many headaches I’ve had running things by John.

Dr. Sharp: I can only imagine my God.

Dr. John: Mistakes that I have averted because of that now.

Dr. Sharp: Thank goodness, right. And yet, despite all of that, you have managed to write a book together as well.

Dr. John: Yes. [00:06:00] We were masochistic enough to take on that challenge.

Dr. Sharp: Yeah, that’s pretty incredible. That’s a big part of the interview today and as a framework for what we’re going to be talking about as y’all have this book coming out, which I think needed addition to the field. And I know you said this in the introduction to the book, but something that I wish had been around when I was going through grad school because I think my trajectory would probably have been quite different if I’d come upon a resource like this. So, I’m excited to talk with you all about it. It’s a great piece and there’s a lot of good info in there. So we’re ready to dive in.

Just right off the bat, I mean you all are, I think early safe to say early career at this point?

Dr. Ryan: Yes.

Dr. John: Very much.

Dr. Sharp: Tell me, how do [00:07:00] you start to undertake something like this at this point in your lives?

Dr. John: Right. Well, we had been doing the podcast Navigating Neuropsychology for two years now. And we had been getting lots of emails and questions from student listeners of the podcast asking us about how they could pursue a career in neuropsychology. And we just got tired of saying, well, there’s really no comprehensive resource that really describes the process from the ground up. So after, I don’t know how many emails we got, we decided, you know what, let’s just write the book on it, Ryan, and solve the problem ourselves. We wanted to provide a north star, so to speak, to guide students through the process.

In terms of finding time for this at the time, neither of us had families or children. So we had a little bit more time. I don’t really have a [00:08:00] good answer. We just saw the niche that needed to be filled. And like you had said, we had wanted this resource when we were going through… we would have wanted something like this when we had gone through the process. So we just wanted to provide this to students. And we took on nights and weekends of writing as usual. I don’t know Ryan, what’s your thought?

Dr. Ryan: Well, I think we have a mixture of interest in nerdiness and stupidity in order to do something like this.

Dr. John: Perfect combination, true.

Dr. Ryan: Yeah. But more seriously, I think neuropsychology is a fairly well-delineated field with professional organizations, journals or certification and APA division 40 of neuropsychology. So we’re very proud of that. But to become a neuropsychologist and to get into the field is not so well delineated. John [00:09:00] and me or everyone we know that we talked to, they all say, well, I just got lucky. I took the right course. I took a biopsychology course. I happened to learn about it through indirect means. I was in the right place at the right time.

And that’s concerning because that means we’re missing people who otherwise would be very interested in neuropsychology, but just an undergraduate in particular, don’t learn about the field because it’s not in the […]. It’s just not talked about the way psychiatry- people know the term psychiatry or psychology more broadly. So we’re hoping that this book can make it easier for people who are interested and motivated, no matter their demographic background or socioeconomic status that they can have the chance to pursue neuropsychology. We both love the field and find it fascinating and interesting. So we want for people [00:10:00] to have the chance to become a neuropsychologist.

Dr. Sharp: Yeah.

Dr. John: And I’ll add that we’re particularly missing people who are less privileged and underrepresented like Ryan alluded to. So, we hope that this will also help diversify the field which is much needed.

Dr. Sharp: Yeah, I’m glad that you brought that up. I was going to touch on that as we went along, but here we are. So we can dive into that.  As far as the content of the book and maybe more of the marketing of the book, if you’ve gotten that far, how are you planning to widen the net and find more folks who might not otherwise be exposed to neuropsychology?

Dr. John: A lot of this is on our editor and the publishing company. One of the reasons why we went with a well-known publishing company is so that they could adequately market and get it where it needs to be. We’re hoping it will be in all university libraries and public libraries and widely [00:11:00] distributed. It’ll be available hopefully on Amazon and everywhere you can buy books. And in terms of getting the word out, we’re active on social media, some of us more than others, right? We’re also planning on trying to get the word out to students there. We know a lot of students are in Facebook groups and on Twitter and Instagram, things like that.

Dr. Ryan: Yeah. I think it would be really beneficial if we can get this into universities so that undergraduates can learn that. Certainly graduate school in neuropsychology, I hope it would be helpful to grad students. But even earlier on, for me as a senior in high school, as a first-year in college, a freshman, that’s when it would have been most beneficial. Hopefully, we can promote the book in those settings.

Dr. Sharp: Right.

Dr. John: And it’s also a way for people to know if they don’t want to choose the field. We laid out all the pros and cons as [00:12:00] I’m sure we’ll get into the reasons to choose it and some challenges to working in this profession. So that freshman in college let’s say, who stumbled across the book, they can have an educated opinion of whether or not they think that this will be a good path to pursue before they take on the student loans and things like that, get too far into it and realize maybe later that it’s not the best fit.

Dr. Ryan: In addition to that, our primary audience potentially would be undergraduates, graduate students, but we’re very appreciative of the chance to come on your podcast, Jeremy in great part because we think that it’s not just college students who would benefit. Psychologists, people who are already established who might want to retread, who might find that they’re very interested in neuropsychology even if their specialty training was not in neuro-psychology, I think could really benefit. It’s never too late either.

[00:13:00]Dr. Sharp: Right. I’m excited to get into that portion of it. And I’m glad that y’all are happy to talk through that. I get a lot of questions about that in our Facebook group, just how do you go back? How do you basically rewind time which is impossible? So, in lieu of doing that, what can we do?

But yeah, I think about going into undergraduate myself, I knew that I wanted to be a psychologist. I really didn’t have any idea what that meant though. And I didn’t know that assessment was even a possibility until I got to grad school. And even then, even though we have advisors, they’re not advisors in the sense of like high school or even college where they’re like, here’s how you pick a career path exactly. And here’s how you go about doing that. You get locked into whatever your advisor does. And if that’s not a person who isn’t a neuropsychologist, then you might be out of luck. And then it’s almost too late if you get to the end of grad school. So [00:14:00] yeah, I think it’s going to be super valuable.

You talked about your target audience for the book. It is an undergraduate and graduate student, right? And then there is quite a bit of material for folks who are already psychologists just to wade through in terms of the state of the field of neuropsychology and what it is.

Dr. John: True. Right. If I could just add to that. So we broke it up into two parts. The first part is more of a background on the field. What is neuro-psychology? What cognitive domains do we test? What patients do we see? What settings do we practice in? So, it’s really just an overview of the field for someone who maybe is interested in it and doesn’t know much about it.

And then the second part is really the roadmap or the blueprint for how to get from undergraduate all the way through advanced training, postdoc, and beyond. So even for people who don’t want to pursue this [00:15:00] field necessarily, I think part one could be helpful just in laying out all the ins and outs of the field.

Dr. Sharp: Absolutely. I’m curious just about y’all’s personal story. For each of you, how did you find your way into neuropsychology and why do it?

Dr. John: Ryan was a produce boy before he went into neuropsychology. So he has an interesting story.

Dr. Sharp: Produced like at a grocery store?

Dr. Ryan: Yes.

Dr. Sharp: Okay. So solid foundation.

Dr. Ryan: Right. Got another difference between the sweet potatoes and the red potatoes. A very good life skill. So, I can go first. I think my story is similar to a lot of people in neuropsychology. In undergraduate, I was a psychology major. I was also pre-med. [00:16:00] My plan was to go into neurology. I was very interested in the brain and also behavior, but I had no idea that neuropsychology existed for the most part of my undergraduate.

And then I just so happened to take a course in bio-psychology and my wonderful professor was, I was fortunate enough that he spent about 15 minutes during one class period talking about careers that use neuroscience and biopsychology and he happened to mention neuropsychology. He showed one of our tests, the Wisconsin Card Sorting Test on a slide. And I was immediately so fascinated. It was the perfect blend of my interests that I had no idea was even available. So from there, I really pursued it. Even though there weren’t neuropsychologists at my undergrad institution, I got lucky enough to get into a graduate program that had a neuropsychology concentration.

Dr. John: Those 15 minutes were enough for you, Ryan?

Dr. Ryan: That [00:17:00] was it. Yeah, I’m really glad I went to class that day.

Dr. John: The one class you went to.

Dr. Sharp: That’s great.

Dr. John: And I guess mine is similar to Ryan’s into the traditional route. So early on I was really interested in both philosophy and neuroscience, which is a whole another story. I’ll give you the short version of my path. I was interested in philosophy and neuroscience and then I took a biopsychology course in college, and I found that it was the perfect blend of those two fields. My professor really focused on the philosophical aspects of neuroscience like, consciousness and whether or not we have free will and at the end Graham, and I just love that. It was such a good blend of my two interests. And that class coupled with a research lab that I had gotten involved with led me to apply to psychology Ph.D. programs that had a neuropsychology emphasis.

And then grad school just [00:18:00] further solidified my passion for the field. And the fact that I could continue to study the brain, contribute to scientific knowledge, make a profound direct impact in people’s lives, and then make a pretty good salary while doing all that, I just couldn’t beat it.

Dr. Sharp: Right. Yeah, it’s amazing when you find that perfect overlap of all the Venn diagram circles. That’s super cool. And both of you at this point are doing some research and some practice, if am I remembering, right?

Dr. John: Ryan is doing both.

Dr. Sharp: Yeah. Okay.

Dr. Ryan: I am more research-focused and John is more clinically focused. We’re both interested in both, but right now in our professional lives, I would say I’m on the research side and John is on the clinical side more so.

Dr. Sharp: I see.Well, that’s one of the benefits of this degree. I think it is the flexibility and that you can work in a variety of settings. So, can y’all run down some of the common places that neuropsychologists might end [00:19:00] up?

Dr. Ryan: Yeah. Great question. So we have a chapter on where you might find neuropsychologists out there in the world? I would say, there are many answers to this question, but there are probably three settings that are most common: universities, private practice or group practice settings, and hospitals.

And then within hospitals, there are a lot of specific types of hospitals that end up being very important for what the job of a neuropsychologist looks like. There are academic medical centers, the hospitals that are affiliated with the university, there are VA hospitals where we’re obviously working with veterans, rehabilitation hospitals where neuropsychologists are part of interdisciplinary teams and work with patients with brain injuries such as traumatic brain injury and stroke. A lot of cognitive training as well as assessment, psychiatric [00:20:00] hospitals where obviously we’re working with people who have a pretty severe mental illness.

And so each one of those individual settings can look very different. Our job looks different. And we discussed in the book how neuropsychology is an amalgam of many different things. There are different pieces to the training. Depending on where you work, you might capitalize on one aspect of training more so than another. If you’re at a psychiatric hospital, then you’re really drawing on that training and psychopathology, mental illness, those types of things. If you’re at our rehabilitation hospital, you’re drawing on training that you received in cognitive rehabilitation, how to help people recover as best as they can. So I think it’s helpful to get a lay of the landscape in terms of all these different types of places where we can end up.

[00:21:00] Dr. Sharp: Yeah. The variety of hospitals is striking. I mean, you never think there are that many hospitals, but there’s a lot of hospitals out there that we can end up in, right?

Dr. John: That’s true.

Dr. Sharp: So, I think it suffices to say that there are any number of situations that we might find ourselves in. My question, we switch back and forth with the Facebook group. It’s like this Royal I guess as a field, but there are a lot of questions about how did you research in private practice?

I’m curious if you all have run across any folks who have managed to bridge the gap between those two? Aand if not, that’s okay. But that’s just something that popped into my mind. It’s a topic that’s come up before and I’ve never had a great answer or a great model for how to do that.

Dr. Ryan: Yeah. Great question. I think the first idea that comes to mind is if a clinician in private practice can also affiliate with a nearby [00:22:00] university, that’s a great way to then become involved in what’s going on at that university or a large hospital might be running a randomized clinical trial. So in your community, if you have an institution to affiliate with, that’s a great option. If not, I’ve seen people in private practice, exclusively who develop very large clinical data sets based on all the patients they see. It takes a long time. It takes years. But imagine you’ve been at this in a setting for 10 years, and if you are methodically tracking the patients you see, you could start to develop a large neuropsychology dataset with lots of demographic cognitive data that could be really useful for research.

Dr. John: Yeah, that’s actually something that I planned to do. I track every patient that comes in. I have a spreadsheet that’s de-identified and [00:23:00] just has the diagnosis, the etiology, and some other relevant factors. I’m pretty early in my career, but I plan on using that data set eventually as part of my informed consent. Each patient that I see, I have them sign something to say that I can use their data in aggregate in a future research endeavor if I wanted to. So, I’m planning ahead for that, but the data sets just are not developed sufficiently at this point.

Dr. Ryan: Independent testing psychologists could even collaborate together. If John develops this dataset, Jeremy, if you had your own testing data set, if I had one, theoretically, we could go the route of big data and put them together if we gave similar measures. And multi-institution research is always preferred if possible  for better generalizability, larger sample sizes. So that’s something I [00:24:00] would encourage people to think about.

Dr. Sharp: That’s a great point. Yeah, I wouldn’t be surprised if some folks started to get on board with that, or if you got some outreach around them because I know that there are a lot of folks who miss that research component. When you go into private practice, I feel like a lot of us just say goodbye to research. And that’s a shame. I know that there are ways to do it, but there may be more hurdles when you’re in private practice than if you’re embedded in a hospital or academic institution.

Well, these are good ideas. Well, I wanted to talk with you all and really get into some of the nuts and bolts. One of the pieces that you all tackle in the book is not just how you define neuropsychology, but then you also make the distinction and go further with the definition of a clinical neuropsychologist. So I wonder if you could talk through both of those, and then I would love to lead into how [00:25:00] those differ from just a “normal testing psychologist ” and see where that takes us.

Dr. John: Yeah. And maybe we should put two disclaimers before we start this, where Ryan and I, we’re not representing any larger organization here. Certainly not all neuropsychologists, we’ll give you our opinion. And this is based on talking with many of our colleagues and really thoroughly reviewing the literature and the relevance to organizations. But we do not represent anyone else. Also, the information that we’re going to give, it’s specific to the US because the training and requirements for becoming a neuropsychologist really vary drastically from country to country. Jeremy, I know that you recently did a few episodes in international testing psychology, which I thought really interesting, but it’s clear that there are differences in training.

[00:26:00] If there are any international listeners, Jeremy or your episodes are great. We also have a resource specific to neuropsychology training in different countries. They can go to navneuro.com/global. And we broke it down by country. We have different articles and links to organizations.

Dr. Sharp: That’s great. I’ll put that and all other links and resources we talk about in the show notes just for people to check out.

Dr. John: Excellent. Ran, do you want to talk about the definition of neuropsychology first and then we can talk about clinical neuropsychologists?

Dr. Ryan: Sure. Yeah. So there are different definitions of neuropsychology out there, but the one we use for the book that’s pretty simple and a good place to start would be, the scientific study of how the brain produces behavior and then how behavior is altered. If something atypical happens to the brain, this is often called the brain-behavior [00:27:00] relationships. When you think neuropsychology, think the brain behavior relationship. And then there’s the science of that and the clinical practice of that. I would say that’s neuropsychology. John, you want to tackle clinical neuropsychology?

Dr. John: Yeah, so that’s obviously the field. So the fields will be broken up really into broadly two arms; research and clinical. And they overlap a lot. But there are neuropsychologists who practice solely in clinical settings. And there are some that do just research. And most of us do some combination of the two as we alluded to before, Jeremy, your question.

But in terms of the definition of a clinical neuropsychologist, it’s important to know that not only does this vary from country to country, but even within the US, the term neuropsychologist is not unanimously agreed [00:28:00] upon. And it’s not protected either. So as far as I know, in all states and provinces in Canada, you must hold a license in order to call yourself a clinical psychologist to protect a term clinical psychologist. The neuropsychologist is not protected in the same way. There’s no license associated with it.

And Jeremy, when you talked with Dr. Debbie Anderson and her conversation about Australia, she alluded to how this is contentious and can be a thorny topic. And I think that’s the case everywhere in my understanding.

Dr. Sharp: Right. Yeah. So the clinical part just designates those who focus and actually practice versus doing research?

Dr. Ryan: Right. So our conservative approach to defining a clinical neuropsychologist in the US would be, this is someone who is eligible for board certification in the field. [00:29:00] There are a lot of organizations to become familiar with and acronyms related to board certification neuropsychology, but the American Academy of Clinical Neuropsychology or AACN is an advocacy organization that really pushes the sponsors’ board certification. And then the American board of professional psychology or APAP is the larger board that provides board certification in psychology. and the American board of clinical neuropsychology ABCM is the specialty board for our field.

Dr. John: Alphabet soup here.

Dr. Sharp: Oh, absolutely. Yeah, it wouldn’t be our field without a bunch of acronyms.

Dr. Ryan: Right. So to reiterate, we consider a clinical neuropsychologist as someone who is eligible for board certification. Then there are a lot of rules and hurdles that must be crossed in order to be eligible as menial reports certified [00:30:00] yet, but you can be board certified and we can get into that if that’s helpful.

Dr. John: Well, my hunch is that in the next 10 or 20 years, it will be the case where only people who are board-certified in clinical neuropsychology are going to be able to call themselves a clinical neuropsychologist. But it seems as though we’re inching that way towards protecting the term which I fully support, but we’re definitely not there yet.

But from our perspective, at present, at least like Ryan mentioned, we feel that the only people that are very likely to pass that credential review process. And that’s the threshold that we set in our books. So we can jump right into discussing what it takes to pass the credential review, Jeremy, or we can take it however you want?

Dr. Sharp: Yeah. I think that’d be helpful just to define that. I mean, I would guess that people are familiar with the Houston conference guidelines for the most part, but I’m sure there are some folks [00:31:00] out there who aren’t and would really benefit from knowing about that. So let’s talk through that a bit. What are those eligibility guidelines?

Dr. Ryan: John, can I jump in real quick? Just a caveat before we get into the Houston conference is that we defined a clinical neuropsychologist, but that would be different from a research neuropsychologist. So I think there are a lot of clinical scientists or research neuropsychologists out there who may not be eligible for board certification because their interest is primarily or solely a research career and they’re doing work relevant to neuropsychology.

So in my opinion, it’s very valid for them to call themselves research neuropsychologists or just neuropsychologists, which is separate from board certification, which is a clinical credential.

Dr. John: Yeah, we’re very clear. The term is clinical neuropsychologist to [00:32:00] distinguish between the two. Jeremy, to go back to your question. So the Houston conference guidelines are drawn on heavily by the credentialing boards to determine eligibility for board certification.

In 1997, prominent members of the profession held a conference in order to determine a model of integrated education and training in the specialty of clinical neuropsychology. The resulting policy statement, which is commonly referred to as the Houston conference guidelines, laid out what’s expected at different levels of training in neuropsychology. And the most concrete recommendation was that a two-year structured postdoctoral fellowship in clinical neuropsychology is really necessary in order to practice clinical neuropsychology.

And this two-year formal postdoc would include mostly clinical work pertinent to neuropsychology but [00:33:00] also formal didactics and also research training as well. The guidelines also recommended that graduate students begin developing the foundation of brain-behavior training in their words and the guidelines to a considerable degree. So already in doctoral training, we expect people to get neuropsychological training and then to further really specialize the capstone experiences that two year postdoc at the end.

The documents are really easy to read, so we would highly encourage any listeners who are interested in these guidelines in the fields to read the full five pages. It’s easy to just Google Houston conference guidelines. We also have a direct link at navneuro.com/hcg. So we can include that in the reference list or if you have your own link, Jeremy.

Dr. Sharp: Sure. I can put that in there. I feel like the Houston conference guidelines have been pretty well known, but then you also talked about it in your [00:34:00] book the taxonomy for education and training and clinical neuropsychology, which was new to me. So I would love to hear more about that.

Dr. John: Yeah. Ryan, do you want to take that or I can talk through it?

Dr. Ryan: Go ahead.

Dr. John: The Houston conference was in 1997, then the guidelines were published in 1998. So the fields really didn’t do much in terms of advancing training, laying down on paper at least until very recently when several different bodies in neuro-psychology came together. I’ll back up a second. So it was APA, the American Psychological Association that’s made it I think mandatory to layout for each of their specialties within psychology or at least the [00:35:00] ones that offer board certification in my understanding, layout a taxonomy that could help clarify to prospective students what training a graduate Program and internship and postdoc offers.

And so they laid out different levels of specialty training. This is the taxonomy. And they are in different degrees of intensity from the major area of study that is the heaviest in terms of that specialty. And the next level would be an emphasis, then just experience and then just exposure.

And so major areas really mean that the program is focused in neuropsychology, for example. And there are other specialties that have this taxonomy. And then it just exposure means maybe you have a class in neuropsychology or there are certain criteria, but it’s just very small amounts of training. And this is not [00:36:00] caught on just yet because it’s so new. The paper was 2019. It was pumped in 2019 by Glenn Smith and the clinical neuropsychologist Snarky, which we can include in the show notes. And this really laid out the taxonomy in detail and some competency areas and other things in the fields.

And this was going off of another article by Sperling and colleagues in 2017. So we can include these in the show notes, but it’s really just a way for students to know exactly what they’re getting in terms of what programs will program can say in their materials, in their brochure. We offer a major area of study in neuropsychology. And then students know, okay, I’m getting at least 50% neuropsychological training, and this is really lining me up versus programs just saying they have a concentration or that they offer neuropsychology training, which is a little vague and not uniform across programs.

Dr. Sharp: I see. 

Dr. Ryan: So, [00:37:00] the Houston conference guidelines are the framework, the skeleton. The taxonomy is very consistent with the guidelines and adds to them. I think flushes them out more, provides more specifications, like John said, more training programs to use in order to implement the guidelines.

Dr. Sharp: I see. So it’s not like the taxonomy is not going to replace the guidelines by any means. It’s more an elaborating or filling in the gaps and defining what’s laid out in the guidelines. Is that a good way to understand it?

Dr. Ryan: Very much so.

Dr. John: Now, there are other guidelines in addition to the Houston conference guidelines, which are set out by ABC and the American board of clinical neuropsychology. So that’s the board that operates the board certification exam in neuropsychology, ABC. They have some other requirements in addition to the Houston conference guidelines, which [00:38:00] I can run through pretty quickly if you want me to, Jeremy.

Dr. Sharp: Yeah, I think that’d be helpful. Go ahead.

Dr. John: So the fellowship must reflect… in order for someone to be board eligible, …the fellowship must reflect a structured and sequenced set of clinical and didactic experiences. That’s the language that they use. And the fellowship has to provide onsite supervision of all clinical cases. They have to put the learning needs of the postdoc ahead of the operational needs of the program.

So it’s not just something that you can do while working at your normal practice and say, oh yeah, I was getting supervision. You have to demonstrate to the board that this was a formal structured program and that you were doing more than just someone would do in doing Private practice or group practice.

Dr. Sharp: Can I jump in, sorry, just for a second. I think that’s an important question. Because I know there’s a lot… I don’t know, maybe I’m making assumptions, but my perception [00:39:00] is that there’s a lack of formal postdocs and fellowships. And a lot of folks do end up in a private practice setting even if they are headed in the direction of getting boarded. So, do you all have thoughts or ideas about how they can vet private practices and what they might need to ask for if they’re going that route to make sure that it’s as structured and formalized as possible?

Dr. John: Yeah, I do. In the book, we mentioned that it is possible. Many people do end up stitching together their own fellowship so to speak. They are kind of creating their own fellowship that provides the requisite training. And that’s fine as long as you meet all the criteria. It is very important.

The onus is really on you in these situations. So, if you go to a formally established program, like the one that’s an APPCN member, or if it’s APA [00:40:00] accredited in neuropsychology, or even there are many programs that are not APPCN or APA that are still very well-established in terms of a neuropsychology fellowship.

So really if you do those programs, it’s obvious to the board. Okay., we’ve seen so many people come through this review process and that program is already embedded in good. There’s an extra burden so to speak on the person who does create their own fellowship because the board wants to know if you’re really following the guidelines or if you’re just giving them lip service.

And so the most common approach I would say is to find an open position at a local group practice. And you would be under the guidance of the staff neuropsychologist at the practice. And so it’s really important that you get the requisite didactics, you get some scholarly activity, you get interdisciplinary [00:41:00] interactions with nearby universities or at the practice itself.

And I’ll say two other things. So if you want to go that route, we really strongly recommend that you document all of your training in case the board asks for it, or you document your didactics, you keep syllabic or email exchanges from professors or people who you got didactics from getting in writing upfront from your supervisor that they’re going to adhere to all aspects of the Houston conference and ABCN on guidelines and criteria.

We think that’s really important because the supervisor might say, oh yeah, we ascribed to the Houston conference guidelines and then it becomes obvious that they’re actually not following them to a T. So getting that in writing, I think is important. People that are interested in this can also consider emailing the ABCN [00:42:00] credential review committee chair directly. And we’ll give you the link to that email in case questions remain after they look through the guidelines and the ABCN application and other website materials, but this is definitely an option.

As you said, Jeremy, there are not many neuropsychology Postdocs. It might be hard for people to find, especially if they’re geographically restricted. I will say it’s a little bit easier to create your own fellowship if you are in a metropolitan area where there are lots of neuropsychologists and universities that you can do didactics at and things like that.

Dr. Ryan: That was a good answer, John. I would maybe boil it down to say that if someone’s this considering fellowship at a private practice where it’s not so clear that this is an easy path or a straightforward path to board certification, the two [00:43:00] resources I would start with would be the Houston conference guidelines and the webpage of ABCN- the American Board of Clinical Neuropsychology. That is where you can find the criteria that will specify what your fellowship needs to have in order for you to be eligible for its certification.

Dr. Sharp: Sure. That’s helpful. I think there’s some embedded advice there for any boarded folks who are maybe trying to create or run a postdoc in private practice as well. I know there are those listeners out there too.

Dr. John: Yeah. There’s nothing inherently wrong with that. As long as you’re getting all the training and you’re meeting these criteria, nothing wrong with that.

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All right, let’s get back to the podcast.

So we’ve been talking a lot about the training and the boarding process. I’m not going to get into the whole exam process and what’s involved there. I think some great info and your book and there are [00:45:00] books independently about how to do that. But I do want to try to tackle this question that I hear so much, which is, how are clinical neuropsychologists different from someone who just does a lot of testing and as an assessment specialized psychologist? So y’all can take that in any direction you want and we’ll see where it goes.

Dr. Ryan: That’s a really good question. I imagine you get that a lot Jeremy given your podcasts, The Testing Psychologist, right? So I think I would first differentiate between psychological tests and neuropsychological tests on the one hand, and psychologists and neuropsychologists on the other hand.

So in my mind, neuropsychological tests, that term is typically used to describe tests of cognition, attention, processing speed, working memory, et cetera. [00:46:00] Psychological tests are often used by neuropsychologists, but these also might be called broadband inventories of personality and psychopathology, something like the MMPI or the PAI. So these tests are often self-report, there are some projective tests like the Rorschach, but they’re typically measuring what I call psychological symptoms more so depression, resilience, anxiety, stuff like that whereas neuropsychological tests, again, definitions are never ubiquitous, but neuropsychological tests are often synonymous with cognitive tests.

Then there are psychologists and neuropsychologists. Neuropsychologists are all psychologists, neuropsychology is a specialty or subspecialty underneath psychology. And we’ve talked about how we think about defining and clarifying who would be a clinical neuropsychologist, that someone who [00:47:00] is eligible for board certification in clinical neuropsychology or who is board certified.

So to get to the part of your question, Jeremy. You could have psychologists who are not yet eligible for neuropsychology, who are doing a fair amount of testing and that can look different depending on the setting. They might do psychoeducational testing like for ADHD and learning disabilities, testing those academic skills. They may do psychological testing to inform treatment in which case it may be more of psychological tests that I mentioned like MMPI and PAI. They also might do at least screening some more cognitive testing. So I would say both psychologists and neuropsychologists can do both types of testing.

If a testing psychologist is very [00:48:00] interested in being assessment-focused and especially doing a cognitive assessment heavily, then in my opinion, I would recommend that they work toward board certification because the training that neuropsychologists get in the cognitive tests, psychometrics underlying them, brain-behavior relationships like functional neuroanatomy, psychopharmacology, all those areas are really helpful if someone is doing a fair amount of cognitive and neuropsychological testing.

Dr. John: Yeah. And I can add to that, Jeremy, if you want me to.

Dr. Sharp: Of course. Yeah.

Dr. John: I would say that all neuropsychologists are testing psychologists but not all testing psychologists are neuropsychologists necessarily. And the difference really lies in the degree of training in behavior relationships as Ryan just laid out. Both coursework and clinical experience [00:49:00] and really the formal two-year postdoc that followed the criteria that I mentioned before.

And I liken this to the difference between a primary care physician and a neurologist where the PCP will have some degree of familiarity with brain pathology. They probably conduct aspects of the neurological examination. They often incorporate that into their wellness visits, but this is the area that the neurologist specializes in and has completed a formal residency and fellowship. So it’s really the fellowship that specializes in the neurologist relative to the PCP.

And I know it’s really a fine line. I’m sure there are many people who have received a general assessment heavy training that might be able to pass the ABCN and credential review potentially and would be just as good as a neuropsychologist at the clinical work. [00:50:00] But really if we’re going to lay down definitions and to protect the quality of the fields, on average at least, I think we really need to… this is what the field has distinguished as meeting criteria is really that formal postdoc in neuropsychology. And you have to have 50% of your integrative neuropsychological evaluation and services, the clinical neuropsychology on fellowship. That’s one of the other criteria with ABCN.

Dr. Sharp: Sure. I appreciate y’all diving into this. It’s a tricky topic. I’m like, what word describes this? I said, a little tricky, but it’s fraught like there’s a lot of discussions. I don’t know. Maybe y’all are a little bit protected from some of this because you are clinical neuropsychologists.

In my world, [00:51:00] I think there’s a lot more diversity in terms of neuropsychologists, there are testing psychologists. There are school psychologists who do a lot of testing. There are school neuropsychologists. So there’s a lot of discussions like, what exactly is different?

I wonder if we could drill down a little bit into the training because that’s the piece that seems to really distinguish the fields or the specialties? I know that this is going to vary depending on the setting and supervisor and any number of variables. But I wonder if you can talk at all about what is happening in that fellowship that is different than others, let’s just say assessment heavy training settings where someone might be administering the same tests, making the same diagnosis. Is there any way to describe what is different than the fellowship? 

Dr. John: There’s [00:52:00] neuropsychology dust in the water that we drink.

Dr. Sharp: Are you selling that?

Dr. John: Yeah, we should bottle that up.

Dr. Sharp: We’ll put it right in the show notes.

Dr. John: And like you alluded to, it’s going to vary so much based on the setting and the supervisors. I’ll say two things then Ryan you can add. We can speak to our own experiences on fellowship. And then what we know about our colleagues, which we’ve talked to many of them for the podcast and for the book as well about this. But I mentioned the degree of neuropsychology-specific training is really important. So that 50% is very important. I don’t think that by definition people who don’t get that neuropsychology at 50%, neuro-psychology-specific training on fellowship would be eligible. So there’s that.

And part of that means that the patient populations that you’re seeing are [00:53:00] usually more neurologically oriented. So we see a lot of stroke or epilepsy, brain injury, multiple sclerosis, things that affect the CNS primarily. We do see broad psychopathology as well, and the gamut of emotional and behavioral disorders and disturbances, but really we are seeing mostly neurological types of diseases and injuries. I’ll say that for most people.

There’s also, I mentioned the structured didactics specific to neuropsychology. That’s one distinguishing aspect that general psychologists don’t typically get. We have a seminar series in neuropsychology. We often have opportunities for grant rounds in neurology and neuroradiology. I had that on my [00:54:00] fellowship. I had the opportunity to shadow a neuropathologist and do brain cuttings all throughout my training, actually from my doctoral training internship, and beyond. So those are just a couple of ideas that I have. There’s also typically a neuropsychology-related research component to a fellowship which also just helps solidify the neuropsychology aspect.

Dr. Sharp: Sure.

Dr. Ryan: To add to that, I would emphasize what you said, John, about brain disorders. I think that is such a large part of neuropsychology training. We spend so much time, of course, on our assessment measures, the psychometrics standardization, what it means to test someone’s thinking memory, emotional functioning, but then becoming very familiar with Alzheimer’s disease, [00:55:00] epilepsy, the symptom profiles, the way they look cognitively, what’s going on in the brain and neuropathology, neuroanatomy, there’s the neuro of neuropsychology certainly comes out a lot during the fellowship.

One other thing that I’ll add in terms of clinical psychologists broadly and then neuropsychologists is that I think neuropsychologists have a lot to offer. Clinical psychologists, like someone who specializes in treating depression or trauma, we have a lot to offer them in terms of assessment as we’ve been saying. And clinical psychologists broadly often do a lot of intervention and they have a lot to offer us in terms of us becoming more intervention oriented. More neuropsychologists are becoming interested in addition to assessment, also cognitive training, any treatment we can provide to these patient populations.

[00:56:00] And we draw a lot from certainly cognitive behavioral therapy, motivational interviewing, these other psychological interventions that are pioneered by clinical psychologists of other specialties. So, I think there’s a great back and forth. We work well together and inform each other.

And then getting back to your specific question, Jeremy, to be honest, I’m not aware of what an assessment-heavy fellowship might look like. That’s not a neuropsychology fellowship. Do you have experience with that or do you know people who are in assessment-heavy fellowships that aren’t neuropsychology?

Dr. Sharp: That’s a good question. I think about maybe like certain VA postdocs that I’ve heard of. I have heard of folks going through where it’s not necessarily marketed as a neuropsychology fellowship [00:57:00] or neuropsychology post-doctoral, but they’re doing a lot of testing. They’re doing a lot of assessments. And maybe that’s just a semantic issue. Maybe it is the same and there’s just not calling it that or describing it that way.

Dr. John: Sorry, I just want to jump in because maybe those people would be quite like I mentioned before, maybe they would be eligible for board certification. Just because the fellowship didn’t call itself a neuropsychology fellowship, it doesn’t mean that the board won’t pass you through. You can look at the HoustonConference Guidelines, the other criteria and see if maybe your fellowship did meet that.

I think it’s a very fine line that we’re drawing between assessment heavy and neuropsychology. Typically, the distinction that we see is between a general psychologist- someone who got a little… by definition, every psychologist has had some exposure to assessment, but usually it’s just in grad school, and then they just [00:58:00] focus on therapy, and that’s what they specialize in. And so that’s a much more clear distinction between a general psychologist who mainly practices psychotherapy versus a neuropsychologist. So it’s a harder line to draw.

Dr. Sharp: It is. Yeah.

Dr. Ryan: When I think of an assessment-heavy fellowship that’s not neuro-psych, for some reason, I just imagined someone administering like 150 Rorschach all the time, but…

Dr. John: That would be a personal nightmare. That’s the 12th ring of hell that I’m just skipping rocks all day. I will also say Jeremy though just to further solidify the difference between if there is an assessment, general versus neuropsychology distinction, it’s a little bit indirect in terms of the postdoc, but I think the other thing that postdoc gives you is the eligibility to go through the board certification process, and going through the [00:59:00] ABCN certification process itself makes you a better neuropsychologist. I can speak personally to that.

I know we don’t want to get into the ins and outs of the board certification process, but after the credential review, once you pass that, then you have a written exam where it’s specific to neuropsychology. There is some psychopathology- it’s just generally on the exam, but that was quite a process to study and pass that exam. And then you submit practice samples. You submit two sample reports to neuropsychologists to vet which is also a process to go through that. I just passed that recently. And now personally, I’m preparing for the oral examination.

Going through all the diseases, again, all the symptomatology and all the pathogenic features of each disease process, the underlying neuropathology, the functional neuroanatomy, [01:00:00] it’s just further solidifying my knowledge in neuropsychology. And I think that process in itself of going through the board certification process has already made me a better neuropsychologist. And when I’m finished, it will have made me a much better neuropsychologist than I could have been otherwise.

And that’s why I said earlier that I think eventually, we’re going to have a protected term of clinical neuropsychologists where it’s going to mean that you have to have gone through a board certification process.

Dr. Sharp: Yeah, it just makes sense. It seems like we’re headed in that direction, certainly. So can you all speak at all to how that training informs say interpretation and intervention recommendations when you’re testing because I hear that a lot too? This idea of like, we’re giving the same tests, [01:01:00] we’re making the same recommendations, where’s the distinction here?

And it seems like a lot of it rests in this background knowledge and training that isn’t necessarily right in the forefront of a report. Does that make sense? And so I think it’d be helpful for people. I’m really trying to help you validate this because people are like, “I think I’m a neuropsychologist” and I’m like, I don’t know.

So, I’m just trying to really drill down into how this training is different and then how it shows up in your interpretation or report writing or recommendations.

Dr. Ryan: Well, that’s a great question, Jeremy. And like John has said, I think some of those people might be eligible or very close to being eligible if they have a lot of assessment experience. So we’re not here to say that they are not eligible. I would definitely encourage those people to check [01:02:00] out the ABCN and Houston Conference Guidelines to see where they’re at.

I think one thing thus far we have underrepresented is neuro-psych report writing. John just mentioned it. And it’s right to your question, Jeremy. That’s something that we’re doing extensively in fellowship and learning even before fellowship is all the steps to this process, the testing interview, the behavioral observations, that’s a skill in itself. And then really importantly, is putting this all together in a package that our medical colleagues or the referral source, whoever that may be, can really digest. So I would say learning report writing is a huge skill that comes along in neuropsychology. And a big part of that as you mentioned is recommendations.

So a lot goes into recommendations. I think everything we have touched on this far, [01:03:00] knowledge of brain diseases, the specific brain disease that this person may have, interpreting neuropsychology data, and then going from your conclusions, your interpretations to how can we use this to help this person as best as possible, being aware of resources in your local community, and then larger national resources- something like the Alzheimer’s association. This is just all stuff that we spend a lot of time working on, thinking about, talking about, going to lectures on.

And so there’s nothing that I’m saying that your listeners may not already have. That’s why we say that we’re not here to exclude people. But we know from experience that if you go through the process of [01:04:00] neuropsychology training, you will get a lot of exposure to this stuff. You’ll talk and hear and learn so much about providing recommendations that could be as helpful as possible to the individual patient you have that I would say that’s a huge part of neuropsychology.

Dr. John: Yeah. And I can add. And just to further hammer in, we are not the gatekeepers. We’re just the messengers of the guidelines and criteria that have been laid out by the heads of our field and the organizations.

But I’ll just add to what Ryan said that it’s not just the report writing process. We lend our specialty neurocognitive knowledge to that process, but maybe even more so, it’s in the feedback sessions that I find myself really tapping into the functional [01:05:00] neuroanatomy. And whether it’s talking about Alzheimer’s disease and sometimes patients don’t have any interest in understanding the underlying etiology and neuropathology.

But every so often I get patients who are really interested in their families. They have an adult child who’s really interested in the brain disease process, the prognosis for how quickly this disease is going to progress, what distinguishes Alzheimer’s disease from Lewy body dementia or Frontotemporal dementia, or maybe they’ve done a Google search and they’ve looked into it, or maybe they’re considering a particular medication.

And although we don’t prescribe and it’s not our specialty, we have knowledge in the medications that are specific to cognition. I’m thinking of the Acetylcholinesterase inhibitors (AChEIs) and an NDA, [01:06:00] antagonists, things like that. So I find that my knowledge not only applies to the report writing process and talking with referral sources but also in the feedback session themselves quite frequently.

Dr. Sharp: Right. Yeah, I think it’s good to have some of these examples. I want to pause and I just want to say that I really appreciate y’all’s willingness to talk through this because I think it’s hard to set it up without it becoming a us versus them conversation. And that’s not my intent by any means. And I know it’s not y’all’s intent, but these are questions that come up. And I think it is important to really illustrate what is different here because it is different.

Dr. John: Right. And we’re not establishing a hierarchy. There’s no valence here. We’re saying there are different [01:07:00] specialties within psychology, neuropsychology is one of them. And in order to be a specialty, you have to have some definition of your field and some training criteria. And so we’re just laying them out here.

Dr. Sharp: Of course. Yeah. I think I’ve interviewed a woman named Stephanie Nelson who y’all may know of or not. She’s a pediatric neuropsychologist with the pediatric sub-specialty. She goes on my podcast and she posts often in our Facebook group. And there are those moments when I catch myself thinking, this is pretty comparable. Like I have a pretty similar skillset. And then she in particular and others, but she in particular, will offer some explanation of a question, and I’m like, “Oh goodness, this is way different.” Like she is coming at this from a totally different place. And we have to honor that. There’s some pretty extensive knowledge going on there.

Dr. Ryan: Yeah, thanks. I have that experience with [01:08:00] so many other experts and professionals like trauma psychologists. I’m interested in PTSD and have some rudimentary knowledge of treatment and such, but I could sit down and have a conversation with a friend of mine who works primarily treating people with PTSD and just be blown away by their knowledge and the connections they make but I wouldn’t. So, I understand where you’re coming from.

Dr. Sharp: Yeah, it’s nice to see all these. We all have our specialties, right?

So I wanted to maybe close or start to close with this question of, okay, so we’ve walked through a traditional path for boarding. That is fantastic. Now, what about those of us who totally missed the boat? And this is very personal for me as well. I mean, I did not do even a neuropsych-heavy internship or post-doc, but [01:09:00] came to it in post-grad training. And now I’m left in this weird gray space. So, is there a path to board if you miss the boat on those two things initially?

Dr. John: Yes, there definitely is. And it’s encouraged by the board. I mean, we would fully support people who wanted to re-specialize and retread. So if someone listening wanting to go that path, the steps that they would take really depend on what specific degree they have, whether it’s even in psychology, or if it’s experimental psychology versus clinical psychology, the first degree, and then what training they have already received and what experience they have. And obviously the closer to neuropsychology and to clinical work, those experiences are the easier that the process would potentially be.

And there are different ways to think about it at each level. [01:10:00] There are different ways to re-specialize, but I guess maybe first I’ll answer based on assuming that most people listening are licensed psychologists.

Dr. Sharp: I think that’s true. And I would say, most people if they have an interest in this podcast, I would imagine they are like me where Ph.D. in a Clinical Psych program probably had maybe a neuropsychology practicum or two or three, but didn’t do the formal fellowship, but they do a lot of testing and have testing knowledge. So yeah, maybe we could confine it to that subset because I’m imagining that’s what our listeners primarily are.

Dr. John: Yeah. And in our book, we list the different levels. So if anyone, maybe a psychiatrist is listening to this and they’re interested in pursuing the field, we lay it out in the book. But so for someone who’s a licensed [01:11:00] psychologist, you’ve already done the vast majority of the work and training. And if you have proper training, you would easily pass the ABAP general reviews of the ADPP general review process, which is the first thing you have to do for any of the specialties in psychology.

And that would be an easy process, supposedly. Not super easy but everyone who is a licensed psychologist should be eligible for ABAP generally. Once it passes that, then it gets kicked down to the specific specialty board for neuropsychology, that’s ABCN. And so someone who doesn’t have a postdoc in neuro-psychology would not pass that ABCN credential review process. And so that would take a formal neuropsychology post-doc two years. You [01:12:00] can do it half time if that was easier for somebody, but it would have to meet the criteria that we had already talked about.

And so just to make it super clear, ABCN and other organizations haven’t said explicitly that just doing continuing education workshops and occasionally consulting or getting supervision on the side, that is not sufficient. The boards are very clear on that. So it really it’s that postdoc experience. Before someone did that though, I would encourage them to look at the guidelines and the criteria to see if they feel like they might make a case that they meet those criteria. And if so, then email the board and see, or maybe even submit your application before you go through the whole process of another postdoc. It wouldn’t hurt to just submit to the board I would think.

Dr. Sharp: I like that. Does that seem like a viable [01:13:00] question to ask? Are there folks who will actually answer that question for you? Like if I were to get off our podcast and go email someone and say, Hey, here’s what my training looks like, should I go back? Is there someone who will answer that question somewhere?

Dr. John: Yeah. So we actually had the current chair of the ABCN credential review committee review our book, Kathleen Fuchs. She’s the incoming president. At the end of this year, I think she takes over. So, she reviewed our book and she gave us the… we actually had the wrong email address. She said, no, no, it’s this one. Make sure you put this one in the book this week. It’s specifically for the committee chair to answer emails. And Ryan, I know when you were going through your post-doc, you had a question about whether some of your research experience would apply to your eligibility and she answered you right away, right?

Dr. Ryan: Right. Yeah. I didn’t know her at the time, but Kathleen is great. [01:14:00] And everyone who I’ve interacted with who’s part of the ABCN board has been very helpful, generous with their time. To answer your question, Jeremy, I would say yes, definitely. If you looked at the Houston conference guidelines and the ABCN website, and you think based on my fellowship and my training record, I think I have a case. I’m not sure. Definitely, I would say, reach out to them and lay out your case, your training, your position, ask questions. And our experience has been that they are incredibly helpful.

Dr. Sharp: That’s great.

Dr. John: I hope us as neuropsychologist don’t come off as a snobby group or off-putting. My experience with my colleagues and even with the people who were very high up in the organizations, they’ve been so kind and generous like Ryan said.

Dr. Ryan: Yeah. I mean, we are clinical psychologists, right? I am incredibly proud and happy to be that and the generalist training that we received. [01:15:00] So everyone has their general training or specialty or subspecialty. So we share so much of our training with other clinical psychologists, I appreciated your question, Jeremy, about is this an us versus them? It can feel like that. But I think all three of us agree that it is definitely not.

Dr. John: I should also say that I know we’re talking about postdocs as if it’s oh yes, just go to a postdoc and it’s super easy. I just wanted to say that we completely understand that it would be difficult mentally, emotionally, financially, potentially to pivot to another career path. And people listening, if they wanted to pursue that, they might consider uprooting themselves from a good job that they’re at and their family potentially, they might have to move across the country to find training.

They might be going to be serving as a trainee and a supervisee [01:16:00] for maybe longer than they expected. It would be hard to go back into that trainee role after practicing for a while and then you might be waiting years to get back into the practice. So, we completely acknowledge that it’s not an easy thing to do. But I think if neuropsychology is the career that is calling to you as a listener and there’s going to lead to a more fulfilling work-life, then in my mind, the cost is almost certainly worth it.

Dr. Sharp: Well, I think you raise a really important point that a lot of us have to consider. If you’re thinking about re-specializing, the real question is why. Why would you want to do this? Is it just for personal gratification? Is it for pride? Is it for clinical as a financial? I mean, there are a lot of components to really think through because it’s a huge choice for those of us [01:17:00] who are set, right? I mean, established practice, things are going well. As you said, it’s a big sacrifice in many ways to go back emotionally, financially, and logistically. So really thinking through that question of why you might want to do this is very important.

Dr. John: I agree. And we included a whole chapter in our book of why choose neuropsychology. And we lay out all the different reasons why our colleagues have told us that they have chosen this field and our own. So, if anyone’s not quite sure they can look at that chapter.

Dr. Sharp: That’s great. Well, I appreciate y’all talking through everything that we’ve talked about. A lot of our discussion has mirrored your book, which is either out or going to be out by the time this releases. So we’ll make sure to have it accessible in some way. That’s very obvious to folks who want to pick it [01:18:00] up.

And I will say, I was fortunate enough to be able to look through the draft or advanced copy and I wish I had had it. That’s the highest praise I could give. It’s really valuable. And I think will help a lot of folks along their journey here.

Dr. John: Thank you. That was the reason why we wrote it. So we’re really happy to hear that.

Dr. Sharp: Yes.

Dr. Ryan: Thank you, Jeremy, for the time speaking with us. It’s been great.

Dr. Sharp: Yeah. Likewise. Thanks, y’all.

All right y’all, thanks so much for tuning in to this episode with John and Ryan from Navigating Neuropsychology. If you haven’t checked out their podcast, I would definitely suggest you do so. There’s a link in the show notes to navneuro.com. And you can pre-order their book on Amazon right now. I will say that I got an advanced copy and got to look through it and it is really good. It’s really good for anybody out there pondering [01:19:00] your career and trajectory as a neuropsychologist or to becoming a neuropsychologist. So check that out. The link to that is in the show notes as well.

As always, thank you for listening. If you haven’t subscribed or rated the podcast, I would be so grateful for you to do those things. Subscribing is easy in iTunes and Spotify it’s, follow. So take a moment. And if you enjoy the content, make sure to subscribe so you don’t miss future episodes.

Okay. I hope all of you are doing well, hanging in there, and looking forward to some rest and relaxation over the holiday season. All right. Take care.

[01:20:00] The information contained in this podcast and on The Testing Psychologists website are intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for professional, psychological, psychiatric, or medical advice, diagnosis, or treatment. Please note that no doctor-patient relationship is formed here, and similarly, no supervisory or consultative relationship is formed between the host or guests of this podcast and listeners of this podcast. If you need the qualified advice of any mental health practitioner or medical provider, please seek one in your area. Similarly, if you need supervision on clinical matters, please find a supervisor with expertise that fits your needs.

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