Neuropsychology Education Program Rains Professionals of Tomorrow in an Underserved Field

Neuropsychology remains an underappreciated and underserved field in the United States. There is a shortage of practitioners with the expertise needed to address unique and constantly evolving neuropsychological health care needs of patients recovering from life-altering brain injuries and illnesses. TIRR Memorial Hermann, in partnership with McGovern Medical School at UTHealth Houston, along with several hospitals and medical programs in the Texas Medical Center, has developed a structured, two-year postdoctoral fellowship in clinical neuropsychology.

The program positions TIRR Memorial Hermann at the forefront of education in the field nationally, with graduates practicing both within the Memorial Hermann Health System and in health care settings across the country. Over the course of its history, the program has produced more than 35 clinical neuropsychologists with specialty training in managing patients who have traumatic brain injury, traumatic spine injury, multiple sclerosis, and disorders of consciousness, as well as those recovering from a stroke, brain tumor, and/or limb loss.

“The role of the clinical neuropsychologist is really to support our colleagues in rehabilitative medicine by helping to address any emotional, cognitive and/or neurobehavioral concerns that may hinder patients’ rehabilitation and recovery,” explains Jacob M. Williams, PhD, the director of the Department of Rehabilitation Psychology/Neuropsychology at TIRR Memorial Hermann and a licensed psychologist.

However, despite the importance of this care, particularly for patients with neurobehavioral disorders that directly impact their recovery (e.g., agitation), “there are only a handful of training programs like ours across the country,” Dr. Williams adds.

The training programs at TIRR Memorial Hermann enroll one postdoctoral fellow affiliated with UTHealth Houston and one intern affiliated with the Baylor College of Medicine Menninger Department of Psychiatry and Behavioral Sciences program (similar to a medical residency, according to Dr. Williams) each year. A number of recent alumni have joined the clinical team, including Xuan Jesson, PhD, and Karina Loyo, PhD, both of whom are clinical neuropsychologists within the Brain Injury and Stroke Program at TIRR Memorial Hermann, and Lindsey Harik, PhD, a clinical neuropsychologist with the health system’s Neurobehavioral Brain Injury Program. Another is Zinat Taiwo, PhD, who works with the TIRR Memorial Hermann Challenge Program, which provides comprehensive services to assist brain injury and stroke survivors with community integration. The current postdoctoral fellows are Amanda Wisinger, PsyD, and Andrew DaCosta, PsyD, with Robiann Broomfield, MA, as the intern.

TIRR Memorial Hermann’s Neuropsychology Fellowship Program, led by Training Director Petya Demireva, PhD, is aligned with a scientist practitioner model and follows Houston Conference guidelines for specialty training in neuropsychology. The program leverages TIRR Memorial Hermann’s reputation for offering advanced training in brain injury rehabilitation, in both inpatient and outpatient settings.

Training includes advanced supervised clinical experiences, multiple specialty clinical rotation opportunities and a comprehensive didactics program (with a course in medical applied neuroscience and neuroanatomy, among other subjects). Across the two-year program, fellows complete four six-month major rotations three days per week, for a total of 24 hours weekly. The program also allows for three six-month minor rotation experiences as chosen by the fellow.

In addition, following an initial period of training and supervision, postdoctoral trainees and interns are quickly directly engaged in patient care, gaining valuable experience. Fellows in the program can customize their training by selecting experiences across settings, including inpatient and outpatient rehabilitation, neurology, and oncology.

“We’ve helped to train a good number of clinicians who have gone to work in a variety of settings, both within TIRR Memorial Hermann and other health systems all over the country,” Dr. Williams says. “Our graduates are comfortable working with a wide range of patients who have significant disabilities due to life-altering injuries and illnesses, and are able to help keep families informed about the next steps in recovery for their loved ones.”

The program is also designed to prepare fellows for American Board of Professional Psychology board certification in clinical neuropsychology, an achievement for neuropsychologists that recognizes individuals who have passed further vetting and examination by a group of their experienced colleagues.

Finally, because the program is based in one of the world’s largest medical centers, neuropsychology fellows have access to numerous research supervisors who are leaders in their respective fields and fellows are guided to choose projects in line with their individual goals.

“Being able to train the next generation of clinicians is really an essential part of what we do and our overall mission at TIRR Memorial Hermann,” Dr. Williams notes. “There aren’t many places that offer this kind of training program with this kind of focus, and ultimately our patients benefit through access to highly trained professionals, and our field does as well.”