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Neuropsychology Internship Training Program - Clinical Experiences

Each intern participates in two rotations simultaneously during the training year.

Pediatric and Adult Outpatient Service, Neuropsychological Assessment

Rosemarie Basile, PhD. - Primary Surpervisor

The Outpatient Neuropsychology service treats the lifespan, from geriatric populations to infants presenting with a broad range of behavioral, developmental, learning and neurocognitive disabilities. Referrals to Outpatient Neuropsychology are received from a variety of sources including: the Rehabilitation Medicine Department, Adult and Pediatric Emergency Medicine Trauma Services, Adult Neurology, Developmental Pediatrics, Pediatric Neurology, Psychiatry, Oncology, Neurosurgery, and professionals in the community.

Based on one’s training needs and specific interests, an Intern can choose to focus primarily on either adult or pediatric cases. Because of the breadth of our referrals, it is not feasible to develop expertise in all the populations we serve. Thus, cases are clustered so that the intern can develop a thorough understanding of several conditions of interest [eg. Chari malformations, Traumatic Brain Injury, subcortical dementias, Autism etc].

This rotation will primarily consist of neuropsychology evaluations. In addition to neuropsychological assessment and report writing, the provision of feedback to physicians, patients, and families will be an integral part of the supervised experience. Diagnostic exposure will include patients with traumatic brain injury, tumors, blood borne cancer, sickle-cell disease, stroke, degenerative diseases, toxic and metabolic conditions, attention deficit/hyperactivity disorder, autism, learning disabilities, various neurologic conditions, chronic pain, psychiatric illness, and somatoform disorders.

In addition to the assessment component, this rotation will also allow for training and experience in health and behavior interventions and more general psychotherapy in a time limited, problem focused setting. Interns may follow a given patient during the patient’s inpatient and outpatient course in order to view progress over several months. This provides continuity of care for the patient as well as the opportunity to achieve longer term treatment and psychotherapy goals and better understand the evolving nature of neurological insult.

Inpartient Clinical Rotation, Traumatic Brain Injury/Neurorehabilitation

Rashmi Rastoi, PhD. - Primary Supervisor

During this rotation, Interns will evaluate inpatients admitted with brain injury or other neurologic injury requiring comprehensive multidisciplinary inpatient rehabilitation. Diagnostic exposure will include traumatic brain injury (TBI), stroke, tumors, dementia, and related neurologic disorders with cognitive sequelae. Interns will learn to perform a patient’s initial neurobehavioral assessment, including evaluation of neurocognitive abilities as well as personal adjustment and emotional status. Assessment will include clinical interviewing, mood assessment, and measures of coma, orientation, agitated behavior, and neurocognitive abilities including memory, verbal and nonverbal reasoning, and executive function.

Interns will gain experience in test administration, scoring, interpretation, and feedback reporting. Interns will also learn the consultant role played by a rehabilitation neuropsychologist on a multidisciplinary team. They will learn to work in a close, ongoing relationship with physical medicine and rehabilitation physicians, rehabilitation nurses, social workers, case managers, and physical, occupational, recreational, and speech therapists along with other allied health providers.

In addition to assessment and consultation, Interns will learn neurocognitive, health/behavioral, and psychotherapy interventions appropriate for neurologically injured patients and their families. As well as individual therapy interventions, Interns will learn to lead group interventions, including structured orientation groups, support groups, psychoeducational groups, and problem-focused groups designed for patients and families beginning the process of neurocognitive rehabilitation.

Training Supervisors

Each intern will have a primary training supervisor on the Inpatient unit and in the Outpatient clinic. Based on the learning needs and specialty of staff, interns may change supervisors mid-year to enhance their learning. Interns typically receuve 3-4 hours of supervision weekly.

Didactics

Didactic experiences in the Neuropsychology track are both formal and informal. The intern will be expected to complete readings in clinical neuropsychology, especially as they pertain to clinical cases. Readings will be chosen in consultation with clinical supervisors. The Neuropsychology interns will participate in weekly Neuropsychology Didactics, Psychiatry Rounds, Journal Club and Neuroradiology Rounds. Neuropsychology Didactics cover topics in neuroanatomy, cognitive neuroscience, neurological disorders and professional and ethical topics. Neuroradiology Rounds are led by a neuroradiologist where clinical aspects and neuroradiology findings of cases are discussed.

Many additional educational opportunities exist including Medical Grand Rounds, Pediatric Grand Rounds, Clinical Research Seminars, Neurology Rounds, and several Brown Bag Lunch Series.

Research

The Neuropsychology intern will be expected to collaborate on research or quality improvement projects during their training year.

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