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that students are expected to have met at the doctoral level need to
interface with the entrance requirements for internships in clinical neuropsychology.
It was agreed that the present discussion should focus on the ideal model
before alternative methods of obtaining the necessary training were considered.
The group next considered the issue of entrance criteria for
doctoral training programs in clinical neuropsychology. There was some
discussion as to whether the standard entrance criteria for individual
doctoral programs needed to be modified by specifying a bachelor s level
degree in psychology or a related discipline, or by specifying a required
core of undergraduate courses. It was agreed that the entrance requirements
for doctoral programs in clinical neuropsychology should be those specified
by the individual graduate program. The group agreed that ordinarily, each
student would have a bachelor s level degree in psychology.
Discussion of the exit criteria for doctoral training programs
in clinical neuropsychology began with consideration of the need to interface
with APA accreditation guidelines (American Psychological Association,
1996a). It was agreed that the exit criteria should include completion
of the requirements for APA accredited training programs. The question
of how specifically these requirements need to be addressed in the integrated
model was considered in light of the revised Guidelines for APA accreditation.
The new guidelines appear to be less specific and to allow for more flexibility
in individual programs. Programs are expected to clearly delineate their
individual training, goals and then are evaluated based on whether or not
they are able to meet these goals. The nature of the exit criteria for
doctoral training programs in clinical neuropsychology was then considered.
Specifically, it was stated that we are attempting to establish the minimum
criteria for such programs. The question of how much training within each
of the domains of knowledge (Generic Psychology Core, Clinical Psychology
Core, Basic and Clinical Neurosciences, Specific Clinical Neuropsychological
Training) should be accomplished at the doctoral level was discussed. Concerns
were also raised as to how such exit criteria could be measured. The possibility
of stating that students should be able to pass a proficiency exam in each
specific area was considered. Group members raised the points that the
proficiency criteria are determined by the individual training programs
and that the integrated training model needs to allow for diversity in
such programs.
It was agreed that a majority of the Generic Psychology and Clinical
Psychology Core requirements should be completed at the doctoral level.
Several group members added that they are looking for students to have
completed a fair amount of the training requirements in the Basic and Clinical
Neurosciences and Specific Clinical Neuropsychological Training areas when
they are evaluating intern applicants. Group members also felt that focusing
on establishing requirements for training in the Basic and Clinical Neurosciences
and Specific Clinical Neuropsychological Training areas would be a service
to future students by encouraging doctoral training programs to offer these
opportunities. The group agreed that it was important for students to have
exposure to these areas prior to internship, where these skills could then
be built upon. The group next considered the level of knowledge/skill that
they felt was required at the doctoral level for all of the identified
knowledge areas. There was some discussion as to whether or not proficiency
in knowledge and proficiency in skills should be separated, with the opinion
raised that the doctoral level is where knowledge is obtained and the internship
is where skill is obtained.
The group considered the desirability of having the doctoral
dissertation completed prior to internship. Group members affiliated with
internship programs made the point that the pressure to complete a dissertation
while a student is on internship detracts from their ability to maximally
benefit from the training and research opportunities available to them.
The group agreed to make the statement that the doctoral dissertation is
to be completed prior to internship, while acknowledging that this may
be more of an inspirational goal in the present educational environment.
Group members reacted to the chairs' presentation of their document
on integrated education and training in clinical neuropsychology. Several
group members were upset that the chairs' document included alternative
training models in addition to the training model previously approved by
the conference delegates. The group chair clarified the position of the
chairs, reporting that they felt that a competency-based model of education
and training needs to address other possible pathways of training and that
they were reluctant to label other fields/routes as "less desirable." The
chairs did not discard the previously approved training model, but they
felt that they must include other possible models of education and training
in their document. Members of the group recognized the chairs' desire to
leave alternative training pathways open, but felt that such pathways should
be limited.
Several group members raised concerns as to whether or not students
from such alternative training pathways would be qualified at the internship
level. The group chair reported that in the viewpoint of the chairs, it
does not matter when training is received in a competency-based model,
so long as it is received. The chairs felt that generic doctoral training
would be adequate and that specialized neuropsychology training could take
place at the internship level. The group members disagreed, stating that
this would place an undue burden on internship programs, essentially making
them responsible for training students in the specialty of clinical neuropsychology.
The group next addressed the implication of the chairs' position
that clinical training is the focus of doctoral programs and that specialized
neuropsychological training can take place later. Discussion focused on
whether or not training in neuropsychology should be required at the doctoral
level. The group chair reported that the chairs wanted to be inclusionary
rather than exclusionary, and thus did not even wish to indicate a preference
for specialized doctoral training programs in neuropsychology. Group members
again expressed concern about students receiving no training in neuropsychology
before the internship level. It was noted that explicitly acknowledging
such a possible training pathway runs counter to training guidelines already
approved by the delegates and violates the spirit of the proposed integrated
model of education and training in clinical neuropsychology. Group members
raised the possibility of developing retraining guidelines similar to those
in place in clinical psychology programs for students from other fields
interested in specializing in neuropsychology.
It was the group's position that the conference should produce an aspirational,
integrated model for training in clinical neuropsychology. The group felt
that all aspects of general, neuropsychological, and professional education
and training should be integrated across all levels of training. Furthermore,
the group felt that neuropsychological education and training should be
required at the doctoral, internship, and residency levels. The group objected
to any proposed models specifying a temporal order to training programs
(i.e., generic preceding professional preceding neuropsychological training).
However, the group did acknowledge that within a competency based integrated
model, some degree of diversity should be expected and permitted among
individual programs. 41
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