Mission

The mission of the WRNMMC Postdoctoral Fellowship in Clinical Neuropsychology is to produce an advanced level of competence in the specialty of clinical neuropsychology, to complete the education and training necessary for independent practice in the specialty, and to develop specific skills relating to the unique applications of clinical neuropsychology in the military environment.

Vision

 To be the premier training program for developing highly skilled and adaptable clinical neuropsychologists who excel in military and civilian healthcare settings. We aim to cultivate a cadre of experts dedicated to advancing neuropsychological science and practice, enhancing the well-being and resilience of military personnel, retirees, and their families. Through rigorous training and interdisciplinary collaboration, our program aspires to produce leaders who uphold the highest standards of excellence, integrity, and service in the field of clinical neuropsychology.

Aims

To provide clinical, didactic, and academic training in order to engender advanced competencies necessary for:

• Integrating the science of brain-behavior relationships with clinical practice
• Applying ethical and legal standards to neuropsychological practice
• Applying individual/cultural diversity issues in neuropsychological practice
• Applying neuropsychology to the military setting
• Professional values, attitudes, and behaviors in the clinical setting
• Communication and interpersonal skills in the clinical setting
• Neuropsychological consultation in multidisciplinary settings
• Neuropsychological assessment
• Neuropsychological intervention
• Neuropsychological research
• Teaching and supervision of junior neuropsychology trainees
• Administration within a neuropsychology clinic

Didactics are provided through the Neuropsychology Distance Learning Series, of which the WRNMMC Postdoctoral Fellowship in Clinical Neuropsychology is the host site. This is a 2-hour, weekly multisite video teleconference that provides didactic training, case conference, and board exam preparation. The objective of the series is for fellows to develop an up-to-date, research-based understanding of foundational concepts and contemporary issues in clinical and experimental neuropsychology. The didactic training includes discussions of required readings that are divided into four terms over a 2-year cycle, covering the following four themes: Psychometric properties of neuropsychological tests and procedures; Neuropsychological aspects of specific diseases; Neuroanatomy and neurobehavioral signs and symptoms; Conceptual foundations, advanced topics, and diversity in neuropsychology. Case conferences are assigned by week to participating fellows across sites. Board exam preparation involves fact-finding exercises, ethics vignette discussions, and practice sample defense of each fellow’s case presentation.

Outpatient Neuropsychological Assessment (2-year core training experience)

• Receive direct instruction in administering a wide range of neuropsychological tests
• Receive one-on-one instruction in fundamental and advanced neuropsychological concepts and techniques during weekly clinical supervision
• Conduct comprehensive neuropsychological evaluations in the WRNMMC Neuropsychology Assessment Service with adult and older adult patients from a variety of referral sources (including neurology, neurosurgery, geriatric medicine, primary care, behavioral health, flight medicine, and medical evaluation boards) with written report and feedback to patients and families
• Utilize psychometrist assistance for half of cases during year 1 and for all cases during year 2
• As a member of an interdisciplinary team, conduct Wada testing and intraoperative cortical mapping (if opportunities are available)

NICOE Outpatient Assessment Rotation (6 months)

• Conduct outpatient neuropsychological assessments with predominantly mild TBI patients (2 evaluations per month)
• Attend multidisciplinary clinic meetings
• Provide various psychological and/or neuropsychological treatment services as fellow’s training schedule permits (optional)

Inpatient Neuropsychological Assessment (12 months)

• Participate in Inpatient Neuropsychiatry Treatment Team meetings, advising the team on patient care needs from a neuropsychological perspective
• Conduct inpatient neuropsychological evaluations
• Prepare brief written reports and convey neuropsychological findings and recommendations in person to the interdisciplinary treatment team

Neuropsychological Interventions (3 months)

• Co-facilitate an outpatient cognitive rehabilitation group at the NICOE under the supervision of a speech-language pathologist

Training in Clinical Supervision (3 months)

• Provide case supervision to a psychology intern, including supervision of test administration, interpretation of neuropsychological test results, and documentation

There are no formal elective rotations during the fellowship.

Military unique topics in neuropsychology are integrated into the regular didactic curriculum, which includes readings and discussions about (e.g.) ethical practice in military settings, management of mild traumatic brain injury, combat-related posttraumatic stress disorder, etc. Military unique training is also obtained in the course of completing special evaluations such as military aviator evaluations, evaluations of service members undergoing Medical Evaluation Board review, and potentially consultation in forensic evaluations of service members being subject to the military criminal justice system. Fellows complete rotations at the National Intrepid Center of Excellence where they are involved in the evaluation and treatment of service members who have suffered traumatic brain injury. Finally, fellows complete a research project on a military-relevant topic.

Medical Neuroscience course at Georgetown University School of Medicine in the Fall during year 1. Audit only; not for credit.

Training activities include tiered supervision of junior trainees, providing lectures to trainees and professionals of other disciplines, and participation in the administration of a neuropsychology clinic.

Each fellow is required to serve as the primary investigator for a research project in clinical neuropsychology with a military relevant focus, to include analysis of data and presentation or publication. At the Fellowship Director’s discretion, a quality improvement project may also fulfill this requirement as long as it involves: 

1. Subject matter that could benefit healthcare provision outside of the setting in which the project is conducted
2. Data analysis to address a hypothesis, and
3. Presentation or publication.

Individual supervision in clinical research is available on an as needed basis, and monthly group supervision is provided. Opportunities to present research include annual professional conferences such as those held by the International Neuropsychological Society, American Psychological Association, American Academy of Clinical Neuropsychology, and the National Academy of Neuropsychology.

Completion of a program development project or process improvement project relevant to administration in neuropsychology (e.g., expand an underdeveloped product line in clinical neuropsychology, developing/implement a novel assessment or treatment protocol) is a required training experience.

Throughout the training cycle, fellows engage in mock trials of the board exam to prepare them for certification in Clinical Neuropsychology by the American Board of Professional Psychology.

The WRNMMC Neuropsychology Assessment Service and the National Intrepid Center of Excellence.

Applicants to the fellowship must possess an unrestricted license to practice psychology in one of the 50 states or the District of Columbia, must possess the 73B Specialty Skills Indicator. Traditionally, only active duty United States Army psychologists have been accepted to the program, but plans for opening the fellowship to Navy psychologists are underway.

United States Army 73B psychologists interested in applying for the fellowship can obtain instructions for application from the Long Term Health Education and Training (LTHET) program, Medical Service Corps, United States Army. There are internet links to this LTHET information through the Army Medical Service Corps web page and the Army Knowledge Online Clinical Psychology (73B) web page. Application deadlines vary from year to year, so applicants should consult the relevant Milper Message, usually available in December/January, for the most up to date information. The application materials required by the United States Army Human Resource Command (HRC) LTHET program include DA Form 3838 Application for Professional Training, Commanders Height/Weight/Body Fat Standards and Army Physical Fitness Test Memorandum, undergraduate and graduate transcripts, a Department of the Army photograph on-line, a Memorandum of Recommendation from the Psychology Consultant to the United States Army Surgeon General, and an up to date Officer Record Brief/Official Military Record File on-line.

In addition to the application materials required by LTHET, applicants must send the following materials to the Fellowship Director (preferably via email): a letter of interest, graduate and undergraduate transcripts, two letters of recommendation, a curriculum vita, and a de-identified sample report (preferably neuropsychological or one in which you address a neurocognitive issue). Telephonic interviews are scheduled with the Fellowship Director following receipt of application materials. Based on the interview and review of application materials, the Fellowship Director makes a determination as to whether the applicant meets qualifications for fellowship training in clinical neuropsychology and advises the Army HRC accordingly. A Selection Board comprised of senior United States Army Medical Service Corps officers (usually including one psychologist) selects fellows upon consideration of the various aspects of the qualified applicants’ backgrounds and military careers.

Telephonic interviews are scheduled with the Fellowship Director following receipt of application materials.

Fellows receive training in providing supervision through tiered supervision of junior psychology trainees as well as focused didactics. Fellows provide a lecture to the WRNMMC Psychiatric Nurse course and additional lectures to trainees and professionals of other disciplines as opportunities arise. Fellows also present two case conferences to their peers as part of the Neuropsychology Distance Learning Series, in which they supplement their presentation by presenting a brief literature review on a topic relevant to the case.

The core faculty consist of clinical and research neuropsychologists who have been trained in accordance with the Houston Conference Guidelines for specialty training in Clinical Neuropsychology. Adjunct faculty include speech-language pathologists (for training in cognitive rehabilitation), who are credentialed within their specialty. The Program Director is board-certified in Clinical Neuropsychology by the American Board of Professional Psychology.

Mentorship is embedded within the clinical supervision fellows receive from faculty neuropsychologists. If a fellow would prefer to have a non-faculty mentor, that can be arranged.

The work environment is collegial and supportive, and faculty inquire into trainees’ overall well-beings and work life balance. The trainee’s schedule is adjusted when needed to allow for personal matters and emergencies that might arise. Fellows receive information about wellness resources and behavioral health services available to them, both within WRNMMC and in the community.