Neuropsychology Fellowship

With an aging population and a corresponding expected increase in cancer diagnoses, it is inevitable that clinical neuropsychologists will require an understanding of the cognitive impact of cancer and cancer therapy. Our goal is to prepare neuropsychology fellows for independent practice, providing broad-based neuropsychology competencies with a variety of adult and geriatric patients (e.g., dementia, stroke, movement disorders, epilepsy, TBI), as well as the specialty education and training relevant to the neuropsychology of oncology.

In keeping with the Houston Conference Guidelines, specific training goals include:

• Advanced skill in neuropsychological evaluation and treatment, as well as consultation to patients and professionals;
• Advanced understanding of brain-behavior relationships;
• Scholarly activity;
• Eligibility for state or provincial licensure or certification for the independent practice of psychology;
• Eligibility for board certification in clinical neuropsychology by the American Board of Professional Psychology.

In the MD Anderson Fellowship in Clinical Neuropsychology, these goals are accomplished through a structured two year program incorporating:

1. Clinical experience, primarily outpatient based with some inpatient consultation at MD Anderson Cancer Center. Additionally, fellows will participate in clinical rotations within Texas Medical Center clinical neuropsychology programs supervised by ABPP certified (or board eligible) specialists in Clinical Neuropsychology.
   
2. A wide range of high quality didactic educational activities, including participation in Baylor College of Medicine’s neuroanatomy and neurology courses.
   
3. A novel research project or literature review, to be completed by the fellow and submitted for presentation or publication, emanating from the multiple grant, industry, and philanthropy funded faculty research programs.
    

Fellows receive advanced training in providing assessment and intervention with a diverse range of medically complex adult patients. MD Anderson is a large, multidisciplinary academic medical institution, and the Section of Neuropsychology runs an active consultation-liaison service that receives consult requests from every clinical division in the institute, including Neuro-Oncology, Neurosurgery, Radiation Oncology, Psychiatry, Physical Medicine and Rehabilitation, Internal Medicine, Breast Medical Oncology, Head and Neck Surgery, Leukemia, Lymphoma Myeloma, Geriatrics, and the Cancer Pain Service. MD Anderson has consistently been ranked as one of the top two cancer hospitals in the nation by U. S. News and World Report, and is one of the largest cancer centers in the world. Our program is the only APPCN neuropsychology fellowship that offers the opportunity to gain extensive clinical experience in adult medical neuropsychology in a primary cancer setting.  

Approximately 50% of the patients referred have a known structural brain lesion (e.g., primary or metastatic brain tumor) for which we perform preoperative fMRI, pre- and postoperative neuropsychological assessments, and longitudinal evaluation of cognitive, behavioral, emotional and functional well-being, and offer management and intervention strategies. The other 50% of patients are referred for assessment of traditional adult neuro-medical disorders and provision of management and intervention strategies (e.g., dementia, seizure disorders, stroke, psychological and psychiatric comorbidities, cancer and cancer therapy neurotoxicities, discharge and return to work planning, capacity evaluations, behavioral management, compensatory and restorative intervention approaches).

Supervised clinical training comprises the majority of the fellowship experience. Fellows receive advanced training and supervised experience in all aspects of the neuropsychological evaluation, including clinical interviewing, test selection, scoring, interpretation, and synthesis of test results, provision of recommendations for interventions, and communication of results with patients, caregivers, and referral sources. The number of patients seen per clinic day will vary depending on a number of factors, including fellow readiness and involvement in research. Typically, fellows begin by evaluating one patient per clinic day, and increase clinic involvement to a minimum of one, and up to two, patients per clinic day. The majority of evaluations occur in our outpatient clinic, but fellows will have the opportunity to participate in inpatient evaluations throughout their experience and engage in elective rotations throughout the Texas Medical Center. Fellows are also encouraged to participate in multidisciplinary fMRI.  

All supervision at MD Anderson is provided by ABPP-certified or ABPP-eligible clinical neuropsychologists. There are four neuropsychology faculty in the Section of Neuropsychology:

• Jeffrey S. Wefel, Ph.D., ABPP, Professor, Section Chief
• Mariana E. Bradshaw, Ph.D., ABPP, Associate Professor, Director of Training 
  
• Jennie L. Rexer, Ph.D., ABPP, Associate Professor
• Kyle R. Noll, Ph.D., ABPP, Associate Professor 

Read more about structure, supervision and evaluation below.

Training In External Specialty Rotations

In addition to the clinical experience at MD Anderson, the fellow will also participate in an external elective rotation one day per week at a partnership institution to further enhance the diversity of their clinical training in adult neuropsychology. The typical duration of the external rotations is four months. A fellow may choose to rotate through a maximum of three different institutions per year. This training format allows the clinical training to be tailored to the fellow’s interests and specific training needs and provides opportunities for gaining additional specialized clinical experience with other patient populations in all major areas of neuropsychology, including dementia, stroke, movement disorders, epilepsy, TBI, acute, subacute and outpatient neurorehabilitation, cross-cultural neuropsychological evaluation, pediatric and developmental neuropsychology, and private practice neuropsychology.  

All supervisors at external rotation sites are ABPP-CN certified, or board eligible.

Partnership training sites include:

• The Institute of Research and Rehabilitation (TIRR)
• Baylor College of Medicine Department of Neurology
• Houston Neuropsychology Group
  
• The University of Texas Health Science Center at Houston (UTHealth)

This fellowship offers didactic opportunities within the institution as well as a joint didactic partnership with other Houston neuropsychology fellowships. A minimum of 10% of the fellow’s time will be spent in educational pursuits.

Neuropsychology

The purpose of didactic presentations within the Section of Neuropsychology is to provide both education in the neuropsychology of oncology, as well as preparation for ABPP board exams, including review of major neuropsychology topic areas covered on ABPP exam. Although there will be a variety of didactic presentations relevant to all areas of clinical neuropsychology, year one didactics will include a greater focus on cognition in cancer, and year two didactics will have a greater focus on major neuropsychology topic areas covered on ABPP exam. Additional neuropsychology didactics occur jointly with other neuropsychology trainees within the TMC; fellows will participate in a weekly neuropsychology grand rounds series as well as a monthly series focused on diversity issues hosted by Baylor College of Medicine.

Didactics within the section may be composed of a combination of formats including lectures, case presentations, fact finding exercises, and journal club.

Neuro-Oncology/Neurosurgery

• Neuro-Oncology Core Curriculum series
  
• Neuro-Oncology Journal Club
• Neuro-Oncology M&M and patient rounds
• Clinical Neurosciences Lecture Conference

Multidisciplinary campus-wide educational events

• MD Anderson Grand Rounds
• Psychosocial Oncology Grand Rounds
• Psychiatry Educational Lecture Series
• Integrative Medicine Program Lecture Series
• Palliative, Rehabilitation and Integrative Medicine Grand Rounds
• Integrated Ethics 1) Ethics Seminar and 2) Difficult Case Review Series

Baylor College of Medicine Nervous System Course

Fellows will enroll in this course in the spring of year one with medical students other Houston-area clinical neuropsychology fellows. This medical school course covers CNS anatomy, physiology, the neurological exam, neurological disorders and basics of neuro-imaging through lecture, clinical presentations, and lab. Both lecture and lab are mandatory. Both the external rotation and the Neuropsychology section didactics are suspended during this 6-week, intensive course, and clinic responsibilities are adjusted accordingly to ensure ample protected time to complete requirements.

Our training philosophy is scientist-practitioner based, with the goal of producing a clinical neuropsychologist who will be able to utilize empirical findings to inform and guide their clinical activities, as well as to effectively evaluate the scientific merit of procedures and interventions. The fellow is expected to display motivation for scientific inquiry. This includes referring to the literature and integrating relevant theories into their patient-related activities.

Fellows are required to remain actively involved in scholarly activity throughout their postdoctoral training term, and are expected to utilize protected research time effectively. Fellows will have at least 10% protected time which can be dedicated to research. However, more research time may be available according to the fellow’s level of interest in research, and as approved by Neuropsychology faculty.

Fellows are expected to produce at least one scholarly project during their two-year term and will receive supervision and assistance to find a project that meets their interests. The section manages the largest neuropsychological database of brain tumor patients, affording unparalleled opportunities for retrospective research. Fellows may engage in a new “investigator initiated” research project or participate in the extensive research opportunities available within the context of our faculty’s actively funded clinical research programs in the following areas:

1. Characterizing the neuropsychological and neuroimaging phenotype of brain injury (e.g brain tumor, neurotoxicity of therapy/“chemobrain”) in cancer patients; 
2. Identifying predictive and prognostic biomarkers of treatment-related cognitive decline (e.g., pharmacogenetic risk/protective factors, imaging signatures of risk/resilience); 
3. Developing and testing pharmacologic and behavioral interventions for neuroprotection or restoration of brain health and cognitive function in CNS and non-CNS cancer patients; 
4. Identifying cancer therapies that provide maximal disease control with maximal clinical benefit (e.g., integrating cognition as an endpoint in clinical trials); 
5. Developing brain mapping tools to minimize surgical morbidities (e.g., fMRI techniques and intraoperative monitoring of cognitive function during awake craniotomies)

Recent publications from the Section of Neuropsychology include: 

• Impact of Apolipoprotein E Genotype on Neurocognitive Function in Patients With Brain Metastases: An Analysis of NRG Oncology's RTOG 0614. Wefel JS, Deshmukh S, Brown PD, Grosshans DR, Sulman EP, Cerhan JH, Mehta MP, Khuntia D, Shi W, Mishra MV, Suh JH, Laack NN, Chen Y, Curtis AA, Laba JM, Elsayed A, Thakrar A, Pugh SL, Bruner DW. Int J Radiat Oncol Biol Phys. 2023 Dec 13:S0360-3016(23)08238-X. doi: 10.1016/j.ijrobp.2023.12.004. Epub ahead of print. PMID: 38101486
• Validation of Non-invasive Language Mapping Modalities for Eloquent Tumor Resection: A Pilot Study. Muir M, Patel R, Traylor J, de Almeida Bastos DC, Prinsloo S, Liu HL, Noll K, Wefel J, Tummala S, Kumar V, Prabhu S. Front Neurosci 16:833073, 2022. e-Pub 3/2022. PMCID: PMC8923233
• Neurocognition and Health-Related Quality of Life Among Patients with Brain Tumors. Noll K, King AL, Dirven L, Armstrong TS, Taphoorn MJB, Wefel JS. Hematol Oncol Clin North Am. 2022 Feb;36(1):269-282. doi: 10.1016/j.hoc.2021.08.011. Epub 2021 Oct 25. PMID: 34711455.
• Neurocognitive, symptom, and health-related quality of life outcomes of a randomized trial of bevacizumab for newly diagnosed glioblastoma (NRG/RTOG 0825). Wefel JS, Armstrong TS, Pugh SL, Gilbert MR, Wendland MM, Brachman DG, Roof KS, Brown PD, Crocker IR, Robins HI, Hunter G, Won M, Mehta MP. Neuro Oncol. 2021 Jul 1; 23(7): 1125-1138. doi: 10.1093/neuonc/noab011.PMID: 33515019
• Alterations in Functional Connectomics Associated with Neurocognitive Changes Following Glioma Resection. Noll KR, Chen HS, Wefel JS, Kumar VA, Hou P, Ferguson SD, Rao G, Johnson JM, Schomer DF, Suki D, Prabhu SS, Liu HL. Neurosurgery. 2021 Feb 16; 88(3):544-551. doi: 10.1093/neuros/nyaa453.PMID: 33080024 
  
• Hippocampal Avoidance during Whole-Brain Radiotherapy plus Memantine for Patients with Brain Metastases: Phase III Trial NRG Oncology CC001. Brown PD, Gondi V, Pugh S, Tome WA, Wefel JS, Armstrong TS, Bovi JA, Robinson C, Konski A, Khuntia D, Grosshans D, Benzinger TLS, Bruner D, Gilbert MR, Roberge D, Kundapur V, Devisetty K, Shah S, Usuki K, Anderson BM, Stea B, Yoon H, Li J, Laaack NN, Kruser TJ, Chmura SJ, Shi W, Deshmukh S, Mehta MP, Kachnic LA. J Clin Oncol. 2020 Apri 1; 38(10): 1019-1029. doi: 10.1200/JCO.19.02767
• Neuropsychological Practice in the Oncology Setting. Noll KR, Bradshaw ME, Rexer J, Wefel JS. Arch Clin Neuropsychol. 2018 May 1;33(3):344-353. doi: 10.1093/arclin/acx131.
• Neurocognitive functioning is associated with functional independence in newly diagnosed patients with temporal lobe glioma. Noll KR, Bradshaw ME, Weinberg JS, Wefel JS. Neurooncol Pract. 2018 Aug;5(3):184-193. doi: 10.1093/nop/npx028. Epub 2017 Nov 19.
• Neurocognitive function varies by IDH1 genetic mutation status in patients with malignant glioma prior to surgical resection. Wefel JS, Noll KR, Rao G, Cahill DP. Neuro Oncol. 2016 Aug 30. pii: now165. [Epub ahead of print]

Structure

The fellowship at MD Anderson is a structured two-year program in which fellows are assisted in preparing for state licensure and ABPP board exams.

Supervision

Fellows will receive a face-to face clinical supervision on every case by Neuropsychology faculty. In addition, research mentoring and professional development will be provided throughout the fellowship, and fellows will meet regularly with the training director to ensure that needs are being met.

Evaluation

Fellows are provided with formal evaluation at regular intervals.

In addition to receiving ongoing feedback regarding their performance during their supervision, fellows are formally evaluated approximately at six months, one year, and prior to completion of training by all Neuropsychology faculty. The training director will solicit input from supervisors at external rotation sites regarding the fellow’s performance. Fellows will also be asked to provide feedback regarding their experience. Any areas that are identified as needing improvement will be addressed collaboratively to ensure that goals are being achieved. As defined by the Houston Conference Guidelines, exit criteria for the fellowship includes a formal evaluation of competency in 1) advanced skill in the neuropsychological evaluation, treatment and consultation to patients and professionals sufficient to practice on an independent basis; and 2) advanced understanding of brain-behavior relationships. Formal evaluation of competency in these areas may include, but is not limited to, APPCN-based written examinations, successful performance on mock fact-finding cases and successful demonstration of advanced clinical skills from initial case conceptualization through provision of feedback to the patient and referral source.

Stipend and benefits are competitive. First-year fellows receive a stipend of $57,789; this is increased to $58,945 for the second year. In addition, fellows receive up to $1,500 per year for approved educational expenses (e.g. conference expenses), along with paid health insurance and optional vision and dental benefits. 

Neuropsychology fellows are required to complete 2 years of full-time, supervised training. Fellows receive 160 hours (4 weeks)/year of paid vacation leave and 100 hours (2.5 weeks)/year of paid sick leave, as well as institutional holidays (typically 9-10 days per calendar year). After six months of employment, fellows are also eligible for up to four weeks of paid parental leave, provided all program requirements are still met.

Neuropsychology has ample clinical space with video monitoring capabilities. The fellow has their own desk, phone, and computer with standard word processing and statistical software and access to electronic medical records. 

The MD Anderson Postdoctoral Fellowship in Clinical Neuropsychology is a participating member of the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN). As a member of APPCN, selection of candidates is conducted through the National Match hosted by NMS (“the match”). Our program code number is 8601. Applicants may register online at www.natmatch.com/appcnmat.

Applicants must register for and participate in the NMS Match to be considered for this fellowship. 

• Eligible applicants must be a graduate of an APA- or CPA-accredited clinical psychology program with specialty training in neuropsychology and a degree of Ph.D. or Psy.D., per Houston Conference Guidelines. Candidates must have had foundation and higher-level graduate-level courses in neuropsychology.
• Doctorates in clinical psychology without prior neuropsychology experience are not accepted. Doctorates in experimental psychology, counseling psychology, school psychology, developmental psychology, behavioral medicine, health psychology, neuroscience and neurobiology are not accepted.
• Candidates must have completed an APA- or CPA-accredited internship in clinical psychology. Internships should include formal neuropsychological training.
• Candidates are expected to have had formal training and experience in neuropsychological assessment, interpretation and report writing at the graduate and internship level. 

MD Anderson is located in Houston, Texas, within the world's largest medical center, the Texas Medical Center. This area boasts:

• A vibrant metro area
• The finest in medical education and treatment
• Numerous parks and green spaces
• A thriving arts and cultural scene
• Moderate cost of living

Read our "Why Houston" brochure for more insights about the city.

For more information, learn more about training at MD Anderson or go to Visit Houston. 

Houston has a long tradition as a major center for neuropsychology, largely due to the establishment of one of the earliest scientist-practitioner doctoral training programs in clinical neuropsychology at the University of Houston, as well as the concentration and proximity of professional neuropsychologists in the Texas Medical Center. The first model for training in Clinical Neuropsychology was established by The Houston Conference in 1997. We are proud to be the home of some of the most prestigious neuropsychologists in the world. Houston has enjoyed the camaraderie of large neuropsychology professional society for the past twenty years. The Houston Neuropsychological Society, with approximately 100 members, hosts an annual symposium and other events which feature prominent local, national and international neuropsychologists.

For additional information and application instructions, see the APPCN website and the NMS website. Please note that there is a deadline for registering with the National Match, which may be different from the MD Anderson application deadline listed below.

After reviewing the information on the APPCN and NMS websites, gather the items listed below for application. The following application materials can be submitted electronically via email to mebradshaw@mdanderson.org: 

1. A one-page personal statement summarizing experience, goals and interests
2. Curriculum vitae
3. Copies of graduate transcripts listing courses, grades and degrees. (Note that if the doctorate has not yet been awarded at the time of application, the applicant must provide an APPCN Doctoral Training Verification Form.)
4. List of familiar neuropsychological and psychological assessment procedures
5. One de-identified neuropsychological report
6. Three letters of recommendation. 

Please note that, if selected, candidates will also be required to provide official transcripts, proof of eligibility to work in the U.S. for the duration of the two-year fellowship, verification of immunizations, pass a pre-employment drug screening and be screened for tobacco use. MD Anderson is a tobacco-free institution.

Application Deadline: January 6, 2025

Interview Policy: Interviews will be conducted virtually in January 2025.