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SUMMARY OF BREAKOUT GROUP ONE
Question III A and B
Residency Emphasis
Melissa Wright and Stanley Berent
Members: Stanley Berent (Chair), Melissa Wright (Recorder), Cynthia R. Cimino, Robert J. Ivnik, Brick Johnstone, Christina A. Meyers, Robert D. Jones, and Keith Owen Yeates.
The group decided unanimously that specialty training in clinical neuropsychology
should not be accomplished at a single level, and that specialization should
not begin at the postdoctoral level. Beyond this, there were considerable
differences of opinion regarding specific aspects of the training requirements.
For example, discussion focused on the skills and knowledge that should
be acquired at the residency level. Some members argued that requirements
for residency training in terms of duration, research, and clinical training
should be flexible to accommodate individual differences in residents'
doctoral and internship experience. In response, several individuals emphasized
that residency training provides breadth of experience and exposure to
legal issues, ethical problems, and a wide variety of clinical populations.
These members felt that 2 years of such training should be required in
order to ensure that an individual is prepared to function independently
as a clinical neuropsychologist upon completion of residency. A compromise
model was proposed that would stipulate 2 years as a standard length of
residency, with allowance for 1 year duration as an exception, given demonstration
of competency and clinical maturity.
It was suggested that the establishment of exit criteria as opposed
to a time-based requirement for postdoctoral residency might accommodate
individuals who had already obtained extensive training, in clinical neuropsychology.
Several members responded to this with the argument that demonstration
of proficiency for a checklist of skills is insufficient because one year
would not provide adequate professional seasoning and maturity.
Despite some different viewpoints the group agreed upon the following
standards for residency training in clinical neuropsychology:
1. Residency programs could be freestanding or exist as a specialty
area within the context of a generic clinical program.
2. Guidelines for residency training should incorporate APA and APPCN
standards as presented in the draft of postdoctoral residency standards
(Association of Postdoctoral Programs in Clinical Neuropsychology, 1997),
and as published in the proceedings from the Ann Arbor Conference (Belar
et at., 1993).
3. Residency in clinical neuropsychology is mandatory, and 2 years
of residency training will be the standard, with a rare exception of a
one year residency, provided that there is demonstration of proficiency
upon completion.
4. Time allocated for activities such as clinical work, research and
didactic experiences should be balanced.
5. Licensing requirements for the state in which residency training
occurs should be met by experiences provided.
6. Postdoctoral residency training should provide breadth of professional
experiences, including exposure to ethical issues, a variety of clinical
populations, and legal consultation.
7. A didactic component in the form of seminars and course work should
be included.
Group discussion then turned to the question of how residency training
in clinical neuropsychology should be integrated with education and practicum
training at the doctoral and internship levels. It was decided that entrance
criteria for postdoctoral residency should complement exit criteria for
internships specialized in clinical neuropsychology. The question then
arose as to whether residency entrance requirements can be established
so that individuals who have completed doctoral work in related fields
such as physiological psychology or linguistics could be accommodated.
Group members concluded that the Houston Conference should establish entrance
criteria, and that the issue of re-specialization would need to be addressed
further at a later date. The majority felt that an APA accredited internship
should be required.
In a discussion of exit criteria for specialized residency in clinical
neuropsychology, the issue of competency evaluation for residents was addressed.
Several members emphasized that the validity of such evaluation should
be considered, and it was suggested that residents complete the written
examination for board certification or another nationally standardized
exam. Some opposition to the proposal for a written exam as part of exit
criteria was expressed. Reference was made to the Division 40 Petition
(Meier et al., 1995) to CRSPPP for specialty recognition as a source for
criteria that differentiate clinical neuropsychology from other specialties
in terms of (1) populations, (2) problems, and (3) procedures and technologies.
Further reference was made to the APPCN specific training requirements
for residency programs in clinical neuropsychology, especially items 13A
and 13B (Association of Postdoctoral Programs in Clinical Neuropsychology,
1996). Group support was offered for requirements involving submission
of publishable material or scholarly work, which might force residency
programs to allocate time for research.
The group agreed upon the following requirements for entry into a residency
program specialized in clinical neuropsychology:
1. Doctoral degree from APA or CPA accredited program in professional
psychology (clinically oriented)
2. Completed clinical internship [with a focus in clinical neuropsychology]
3. Major rotation in clinical neuropsychology that meets specific criteria
4. Exposure to child and adult neuropsychology from internship
Additionally, planning for the content of training in the residency
training program should consider:
1. Licensing requirements.
2. Board certification requirements.
3. Competency examinations at critical points in training and as criteria
for completion.
4. Accreditation criteria.
Exit criteria were adopted from the postdoctoral residency standards
(Association of Postdoctoral Programs in Clinical Neuropsychology, 1996).
A substantial majority of residents completing the training program should
meet the following exit criteria on completion of the training program:
1. Ability to undertake consultation to patients and professionals
on an independent basis
2. Demonstrated research competence by submission of a study or literature
review for publication or presentation or by submission of a grant
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