Training Program
Our fellowship complies with the Houston Conference guidelines for postdoctoral training in clinical neuropsychology. Following these guidelines, our fellowship is a two-year full-time training period that consists of clinical and research experiences and coursework/didactics.
Clinical Training
The fellow will spend both years in Rehabilitation Services (main supervisors: Drs. Haines, Hall, Boyle).
70% of time is performed completing outpatient clinical work, mostly neuropsychological evaluations, although there are opportunities to provide individual psychotherapy. Patient populations for the neuropsychological evaluations include neurologically compromised individuals (e.g., dementia, Parkinson Disease , Multiple Sclerosis, Fetal Alcohol Syndrome) as well as rehabilitation individuals (e.g., TBI, CVA). Lifespan populations are served (ages 7 and older), with the split at about 70% adult and 30% pediatric. Occasional pre-surgical Wada evaluations are conducted at The Toledo Hospital, a community hospital about 15 minutes from UTMC.
The fellow spends another 10% of time at outside facilities. A portion of this will be performing inpatient clinical work at The Rehabilitation Hospital of Northwest Ohio. Mostly assessments are conducted, although there is the opportunity for individual psychotherapy. Supervisors for this work include Drs. Haines, Hall, Farrell, Suico, Wuescher and Schneider. The other portion of this is participation in a monthly interdisciplinary clinic for pediatric patients with Fetal Alcohol Syndrome at Ohio Guidestone, which is located in Perrysburg, Ohio (supervisors: Drs. Hall and Boyle). Once per month, the fellow will evaluate adolescents who are being treated at the Juvenile Residential Center; these are individuals who are in the judicial system, are receiving residential psychiatric care, and are referred with concerns about cognitive dysfunction (supervisor: Dr. Boyle).
Another 20% of time is split between didactics/coursework, research opportunities, and supervising others. Fellows have the opportunity to work on research projects with an extant database. Primary supervisor is Dr. Hall. There is a potential, if the fellow has interest, to participate in research with professors in the Department of Psychology on the Main Campus. The goal is for the fellow to have one publication or presentation upon graduation from the fellowship. With regard to supervising others, Clinical Psychology PhD students from two local universities (University of Toledo and Bowling Green State University) often participate in a neuropsychology externships at UTMC and the fellow provides supervision to these students. Fellows may have the opportunity to supervise Physician's Assistant students completing their clinicals as well as Psychiatry, Neurology, and PM&R residents. In addition, fellows will have the opportunity to supervise medical students who are completing their Neurology rotations.
Coursework and Didactics
The fellow will take the medical school course series in Neuroscience at UTMC during
their second year of fellowship. This is a major time commitment of 20-30 hours per
week for 8 weeks and the clinical/research work expectations are consequently reduced.
Our fellowship participates in a Clinical Neuropsychology inter-fellowship didactic
series presented online; these occur once per week. In addition to didactics on various
Neuropsychology topics, the fellow participates in mock fact finding and report defense
exercises with the goal of preparing for board certification by ABPP in Clinical Neuropsychology.
The fellow is also expected to attend a portion of the Neurology Resident Lecture
Series, which occur at a hospital about 15 minutes away from UTMC (Toledo Hospital),
but have been virtual over the past few years. The fellow can also attend didactic
training experiences such as Neurology grand rounds, Neuropathology conference, Neurovascular
case conference, Neuropsychology journal club, Neuropsychology peer supervision group,
observation of a neurosurgery, and other grand rounds/research seminars/journal clubs
as available.
Aims
The Neuropsychology Postdoctoral Program is designed to provide a solid foundation for general practice as a clinical neuropsychologist. The fellowship is two years, adheres to Houston Conference training guidelines, and is an APPCN and APPIC member program in good standing. The goals of training are aligned with a scientist-practitioner model. We believe that clinical practice is highly benefited from participation in scientific inquiry. In turn, programmatic research is made stronger and more relevant to the populations it aims to serve by clinical involvement. Training will be focused across the core domains identified by the Houston Conference: Assessment, Treatment and Intervention, Consultation, Research, and Teaching, and Supervision.
Competencies
As such, Fellows are expected to meet competencies in the Integration of Science and Practice, Ethical and Legal Standards/Policy, Individual and Cultural Diversity, Professional Identity and Relationship/Self-Reflective Practice, Assessment, Intervention, Research, Teaching/Supervision/Mentoring, Management/Administration, and Interdisciplinary Systems/Consultation (please confer https://doi.org/10.1080/13854046.2020.1829070)
Evaluation
The fellow is evaluated in each of the following core competency areas and their components, with an expectation of satisfactorily progressing: 1) psychological/neuropsychological assessment, 2) interventions, 3) supervision/teaching, 4) research and scholarly inquiry, 5) administration and professional development, and 6) ethics, law, and diversity issues. To successfully complete the fellowship, trainees are expected to demonstrate an appropriate level of professional psychological skills and competencies in the core areas as described above. Fellows receive a formal, written evaluation biannually.
More specifically, the fellow will complete three comprehensive neuropsychological evaluations per week along with RHNO consults/monthly FAS evaluations for fulfillment of the assessment competency (competency 1). The fellow will have opportunities to provide interventions, which can include brief, problem-focused therapy or feedback of neuropsychological results (competency 2). They will also assist in administrative work including billing, dictating reports, and attending rehabilitation staff meetings (competency 5). At least one research poster must be presented at a neuropsychological conference (INS, NAN, AACN) (competency 4). The fellow will provide two to three lectures per year to PM&R residents, PT/OT/nursing school, TBI support groups, etc. (competency 3). Lastly, the fellows will demonstrate ability to provide equal quality in the processes, procedures, and services being conducted to diverse populations. They will exercise reasonable judgment and take precautions to ensure that their potential biases, the boundaries of their competence, and the limitations of their expertise do not lead to or condone unjust practices (competency 6).
Due Process
As Fellows are admitted to the University of Toledo’s Neuropsychology Fellowship program, they are expected to progress appropriately and maintain good academic standing. However, should a Fellow display problematic behavior that is initially observed by the training faculty, the member of the staff will enact the due process procedures. At the outset of concern, the observing faculty member will approach the fellow in private and informally and provide oral notice to the fellow; to discuss the noted concern and offer suggestions to address the issue. It is the responsibility of the faculty member to facilitate an informal interaction to address initially observed deficiencies.
Following corrective informal feedback, should deficiencies remain (with appreciation for individual differences and accommodations made for disabilities), the Training Director will send a written notice of a remediation plan within 5 days of concern from the faculty member.
The faculty will assemble at their earliest convenience (no longer than 7 days after the Training Director’s written notice was sent) to develop the remediation plan. The plan will subsequently be reviewed at a hearing with the Fellow to collaboratively implement the formal plan. During the next faculty meeting (no more than 30 days), the training faculty will discuss with the fellow’s progress toward meeting goals for improving deficiencies.
Once determined appropriate progress has been made, the training faculty will meet with the fellow to formally remove the remediation plan (a formal letter will also be sent to the Fellow noting same). Should progress not be made an additional plan may be developed and will follow the same timelines; this information and the remediation plan will be shared with the fellow’s graduate school program. If the fellow is unable to be removed from the second remediation plan, the Fellow will formally be placed on probation. The goal of the probation process is to help Fellows identify and address difficulties that are hindering their success and progression through the Fellowship. The Training Faculty will convene to determine a written plan that outlines the specific steps that are needed for the Fellow to remain in the program. This document will be provided to the Fellow and reviewed weekly. Further, one of the training faculty members will be assigned to the Fellow to act as a mentor to provide close supervision and guidance during the probation period. The Fellow and the mentor will meet 3 times per week to discuss concerns and work collaboratively to improve deficient areas and to assess for progress toward being removed from the status of probation. The formal decision to remove the Fellow from probation will be made at the next monthly faculty meeting and communicated with the Fellow and the Fellow’s graduate program in writing.
In the unfortunate event that the Fellow is unable to be removed from probation, the Fellow may be formally terminated from the Fellowship. This decision is not taken lightly and is made collaboratively with the Training Faculty and the director of services. However, prior to dismissal, the Training Faculty will involve Human Resources to provide additional assistance to transitioning the Fellow back to normal status.
Appeals
At any point in the due process stage, the fellow has the right to formally appeal any decision made by the training committee (including the remediation plan, probation, or termination). Within 10 days of written receipt of a decision during the due process stage from the committee, the fellow is required to submit a written appeal. Appeals are discussed initially with the training faculty and then with the fellow. A formal reply will be offered to the Fellow within 30 days.
Grievance
The University of Toledo’s mission is to improve the human condition; to advance knowledge through excellence in learning, discovery and engagement; and to serve as a diverse, student-centered public metropolitan research university. Toward this end, we are committed to a learning environment that is professional and supportive. As the result, we have set forth the following policy if an instance arises during a fellow’s training wherein the fellow perceives unfair treatment by faculty, staff, or other fellow.
Definitions
Complaint: This is a verbal statement by the fellow to the Training Director or other faculty or staff member, expressing unfair treatment or dissatisfaction with any of the following: the program as a whole, a faculty member (including the Training Director), the other fellow, or a supervisee; the person making the complaint must perceive there to have been a negative impact to self.
Grievance: This is a written statement provided by a fellow to the Training Director, Department Chair, or Director of Services expressing unfair treatment or dissatisfaction with any of the following: the program as a whole, a faculty member (including the Training Director), the other fellow, or a supervisee; the person making the complaint must perceive there to have been a negative impact to self.
Attempts will be made by the faculty who receives the complaint or grievance to address and resolve the problem directly with the individual as soon as possible. If addressing the problem directly is not successful or the fellow prefers not to address the issue with the faculty member, then the fellow may consult with the Training Director or another member of the training faculty. At this point, the fellow will write out the grievance and submit within 30 days from the date of the complaint. The Training Director will respond in writing within 10 days following receipt of the grievance. The Training Director will assist by taking one or more of the following actions: Serving as a consultant to facilitate communication between the Fellow and the individual; bringing the issue to the faculty meeting for consultation and problem solving; requesting assistance from APPIC. Should a concern arise between the Fellow and the Training Director, the Fellow may submit the formal grievance to the training faculty at the monthly meeting and the faculty will serve as a liaison between the Fellow and Training Director. Within 15 days following the grievance meeting, the faculty will meet with the fellow to discuss the concern and reply with a formal letter. If the Fellow is not satisfied with the response from the Training Faculty, the Fellow may elect to involve Human Resources or APPIC directly to assist with the arbitration process. Any retaliation against those who file grievances or who are otherwise involved in the grievance process are strictly prohibited.