Pediatric Neuropsychology Fellowship

This fellowship program advances the profession of psychology and improve behavioral health outcomes among children with chronic health conditions through exemplary postdoctoral training that prepares early career psychologists to make important contributions to clinical practice, research/scholarship, and education within the subspecialty field of pediatric neuropsychology. We will achieve this through direct teaching and supervision of advanced competencies, professional development opportunities, a commitment to a scientist-practitioner model, and a mutually-informative collaboration between multidisciplinary researchers and clinicians.

Consistent with Houston Conference Guidelines, our goal is to provide advanced subspecialty training in pediatric neuropsychology for psychology trainees who plan to pursue independent practice and go on to earn specialty certification through the American Board of Clinical Neuropsychology (ABCN), a member board of the American Board of Professional Psychology (ABPP).  Specific training goals include:

• Advanced skill in the core functional competencies of neuropsychological evaluation, intervention, and consultation sufficient to practice on an independent basis
  • Particular focus on the understanding and practice of neuropsychology with patients from birth to young adulthood (not a Houston Conference goal, but specific to our training site)
  • Particular focus on the understanding of the neuropsychology of oncology, though training across a wide range of pediatric (mandatory) and adult (elective) conditions will be made available through external rotations within and external to MD Anderson.
• Advanced understanding of brain-behavior relationships and all foundational competencies that cut across the functional competencies identified above, including Scientific Knowledge and Methods, Evidence Based Practice, Ethical Legal Standards, and Policy, Interdisciplinary Systems, and Professionalism.
• Scholarly training (didactic, experiential) and productivity (e.g., submission of an original research study, literature review, chapter, or other scholarly product for publication or presentation)
• Eligibility for state or provincial licensure or certification for the independent practice of psychology
• Eligibility and preparation for board certification in the specialty of clinical neuropsychology and subspecialty of pediatric neuropsychology by the American Board of Professional Psychology

Supervised clinical training in pediatric neuropsychological assessment, consultation, and intervention comprises the majority (70%) 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 both oral and written communication of results with patients, caregivers, and referral sources. Most evaluations occur in the outpatient setting, but fellows will have the opportunity to participate in inpatient evaluations throughout their training. Patient volume will vary in a developmental approach based upon the experience and skill set of each fellow, but total time spent in clinical work (inclusive of patient encounters, patient preparation and documentation, patient-related communications, team meetings, and supervision) will not exceed their allocated .70 Clinical FTE. Patient volumes and patient selection for fellows is based upon the training needs of each individual fellow rather than Department patient care coverage or billing requirements. Trainee clinic responsibility is significantly less than that of a full-time clinical psychologist or neuropsychologist, allowing ample time for participation in supervision, didactics, and scholarly activity.  Responsibilities are progressively increased for full-time post-doctoral fellows over the course of the fellowship; this is done with consideration of the fellow’ s individual capability and needs.  It is anticipated that by the end of the fellowship term, the fellow should be well-prepared to transition to independent practice.   

While there is a strong focus on pediatric cancer and related conditions,  the clinical training for this fellowship occurs across a diverse range of medically-complex, pediatric patient populations through participation in the following, core training experiences. With fellow interest, however, additional elective training experiences with other, Houston-area training programs (adult or pediatric) may be available.

Core Training Experiences:

1.      The MD Anderson Cancer Center,  Department of Pediatrics, Section of Behavioral Pediatrics, Pediatric Neuropsychology Service

Approximately 80% of the fellow’s clinical training time will occur within The MD Anderson Cancer Center,  Department of Pediatrics, Section of Behavioral Pediatrics, Pediatric Neuropsychology Service. This is  an active consultation-liaison service that receives referrals from all other medical and behavioral health services within the Department of Pediatrics, including the Adolescent and Young Adult program serving patients ages 15 through 39+ to support substantial experience with young adults in addition to the large complement of pediatric patients.  Primary referral conditions include brain and spinal cord tumors, leukemias and lymphomas, solid tumors, sickle cell disease and other hematologic disorders, and neurofibromatosis. Patients present for evaluation at any point from diagnosis to long term survivorship. Advanced training in evaluating and addressing the neuropsychological effects of these presenting conditions and their various treatments is a strong area of focus of this training experience. There exist significant opportunities for conducting evaluations pre/post various cancer treatments as well as for longitudinal evaluation of cognitive, behavioral, emotional, and functional well-being over time. In addition to training in assessment, fellows will also be trained in the provision of management and intervention strategies (e.g., return to school/work planning, behavioral management, compensatory approaches) as well as interdisciplinary consultation. Patients typically range from age 3 years to young adulthood, but infant assessment experience is available on a less frequent basis. This rotation extends throughout the full 2 years of fellowship training. A developmental training approach is adopted, such that fellows will be afforded opportunities to practice at a level of supervised practice that matches their demonstrated knowledge and clinical competencies at each stage of their two-year fellowship. Supervisors for this training experience include Marsha N. Gragert, Ph.D., ABPP and Peter L. Stavinoha, Ph.D., ABPP, both of whom are board certified in clinical neuropsychology through the American Board of Professional Psychology and both of whom have 20+ years of experience supervising and teaching psychology trainees at the pre- and post-doctoral levels.

2.      The University of Texas Health Science Center, McGovern Medical School/UT Health Houston Department of Pediatrics, Division of Neurology

Approximately 20% of the fellow’s clinical training time will take place within The University of Texas Health Science Center, McGovern Medical School Department of Pediatrics, Division of Neurology. The fellow will attend this training experience one day per week to further enhance the diversity of their clinical training in pediatric neuropsychology. This training format provides experience with common pediatric patient populations that are not available within MD Anderson Cancer Center yet are important to sufficiently train fellows in all foundational competencies in the field of pediatric neuropsychology. Referral conditions in this training experience include pre/post-surgical epilepsy evaluations in addition to referrals from general neurology (non-surgical epilepsy, traumatic brain injury, various neurogenetic conditions, prematurity/intraventricular hemorrhage, autism, complex trauma, and others) and occasionally other referral sources (pediatrics, endocrine, spina bifida, physical medicine and rehabilitation). Patients typically range from 4 to 18 years of age. The supervisor for this external, training experience is Amanda Child, Ph.D.

The Houston Conference Guidelines as well as criteria for APPCN-member programs specify that exit criteria for the fellowship include successful demonstration of scholarly activity. Our training philosophy is scientist-practitioner based, with the goal of producing  clinical subspecialists who will be able to utilize empirical findings to inform and guide their clinical activities, effectively evaluate the scientific merit of procedures and interventions, and contribute to the field through clinical research and dissemination of findings. 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. Research opportunities with Department of Pediatrics faculty are available within the context of funded and unfunded clinical research programs. Additionally, the pediatric neuropsychology service manages a large neuropsychological database, affording a range of opportunities for retrospective research.  

Fellows are required to remain actively involved in research throughout their postdoctoral training term and are expected to utilize protected research time effectively. Full-time fellows will have at least 10% protected time (4 hours per week) dedicated to research, with an additional 10% time dedicated to professional development activities (e.g., licensing exam preparation, conference attendance, job application and interviewing) that can be used for research during timepoints in the fellowship that involve less intensive professional development needs. Additional research time can be made available for interested fellows depending on the fellow’s training and career goals and past research background/preparation.

Fellows are expected to produce at least one scholarly project (e.g., submission of a study or literature review for publication, presentation, submission of a grant proposal or outcome assessment) during their two-year term.  

In compliance with requirements for APPCN-member programs, a minimum of 10% of the fellow’s time (4 hours per week) will be spent in educational pursuits. The purpose of the didactic programming is to provide both education in the neuropsychology of pediatric oncology as well as preparation for ABPP board exams, including review of major neuropsychology (adult and pediatric) topic areas covered on the ABCN examinations. Didactic offerings, either mandatory or optional, include those listed below. In addition, other didactic activities may be mandated or encouraged if areas of significant weakness in foundational skills/knowledge are identified or if special offerings of significant educational value to the fellows arise.  

Division of Pediatrics, Pediatric Neuropsychology Lectures and Directed Readings (mandatory, 3-4 times per month plus self-study)

• Directed readings according to established 2 year syllabus in preparation for the American Board of Professional Psychology, Clinical Neuropsychology written examination (self-study accompanied by monthly review of readings with faculty)
• Pediatric Neuropsychology topics presented by MD Anderson and non-MD  Anderson faculty through collaboration with UT McGovern Medical School faculty, APPCN-member recorded and live didactics, and invited lectures from MD Anderson, Houston-area programs, and other programs from across the nation
• Mock fact finding examinations (Examiner – MD Anderson neuropsychology faculty; Examinee – NP fellow)
• Case and didactic presentations by fellow

Baylor College of Medicine Neuropsychology Grand Rounds (mandatory, weekly)

This weekly lecture series presented by neuropsychologists from several different clinical neuropsychology training sites within the Texas Medical Center (including MD Anderson) offers an opportunity to join with other Texas Medical Center neuropsychology postdoctoral fellows in learning topics pertinent to the foundational and functional competencies of lifespan neuropsychology in preparation for specialty certification through ABCN.

Cross-Cultural Neuropsychology Didactic (Taquitos de Sesos, mandatory, monthly)

Taquitos de Sesos (Brain Tacos) is an international didactic program founded by Dr. Adriana Macias Strutt at Baylor College of Medicine, Department of Neurology, Neuropsychology Section. This program will focus on cross-cultural/Hispanic neuropsychology in clinical and research settings. Presentations by nationally and internationally recognized experts will be held on a monthly basis via a virtual meeting platform.

Division of Pediatrics, Section of Behavioral Pediatrics Fellowship Seminar (mandatory, weekly)

• Direct instruction in functional competencies (particularly assessment, intervention, consultation, teaching, and clinical supervision) and foundational competencies (particularly evidence-based practice, individual and cultural diversity, ethical and legal foundations, interdisciplinary systems, reflective practice, and professionalism) that span pediatric psychology and neuropsychology, presented by faculty or other professionals internal and external to MD Anderson, with a particular focus on pediatric hematology-oncology
• Topics presented by the fellows to develop their teaching and presentation skills while deepening content knowledge
• Case presentations by faculty and fellows
•  “Journal Club” review of relevant literature
• Research librarian training on conducting systematic literature reviews (half day/full day training)

Division of Pediatrics, Pediatric Grand Rounds OR The Section of Integrated Ethics Seminar and  Difficult Case Review Series  (mandatory, weekly - didactic forum attended each week determined by training faculty based upon relevance of scheduled topics)

• Pediatric Grand Rounds features a range of faculty speakers from within or outside of MD  Anderson covering current developments in hematology-oncology, including but not limited to psychosocial and supportive care. The audience includes fellows and faculty from within and outside of the Division of Pediatrics.
• Ethics Seminar is a regularly occurring event designed to both educate and stimulate discussion on topics of ethical concern focused on interdisciplinary patient care and research. Ethics Seminars responds to needs identified through proactive questions of perceived need from attendees and evaluation questions at current ethics education offerings.
• The Difficult Case Series is a regularly occurring presentation of an ethically challenging case by the attending medical team followed by an ethicist-facilitated discussion of the pertinent issues raised in the presented scenario.

Division of Pediatrics, Hematology/Oncology Fellowship Seminar (mandatory year 1, weekly when deemed relevant by training faculty)

This forum involves a one-year syllabus developed to provide a solid foundation a wide range of pediatric hematology-oncology conditions, their treatments, and associated complications (psychosocial, reproductive issues, pain management, etc.). This is an interdisciplinary forum attended by both medical and psychology fellows.

Division of Pediatrics, Pediatric Psycho-Oncology Lectures and Directed Readings (optional for relevant topics, self-study plus monthly seminars/faculty instruction sessions)

• Directed readings according to established 1 year syllabus, in preparation for advanced subspecialty practice in pediatric psycho-oncology and for certification through the American Board of Professional Psychology (Clinical Child and Adolescent Psychology specialty)
• Pediatric and Lifespan Psycho-oncology topics presented by MD Anderson and non-MD Anderson faculty
• Case presentations  given by faculty and fellows for group discussions and education.
• Palliative Care Lectures
  • Understanding Psychological Pain
  • Pain Management at End-of-Life
  • Vital Talk (2-day intensive training option)
  • Palliative Care
  • AYA Oncology Lectures - Fertility Preservation; Survivorship; Overview of Cancer Rehabilitation

Other Optional Didactic Forums

• Formal neuroscience/nervous system medical school course through the Baylor College of Medicine or UTHealth Houston McGovern Medical School
• Tumor Board
• Brain cutting (when available)
• Psychiatry Educational Lecture Series (monthly)
• Integrative Medicine Program Lecture Series
• Palliative Care and Rehabilitation Medicine Grand Rounds
• Pain Medicine Grand Rounds
• Division of Cancer Prevention Grand Rounds, including the Section of Behavioral Science
• UTHealth Houston McGovern Medical School Neuroscience Research Center – Neurofax

Sample Schedule (Full-Time Clinical Post-Doctoral Fellow)

*additional optional didactic opportunities exist throughout the week

Full-time fellows will receive a minimum of two-hours of direct supervision by training faculty per week. Supervision will be provided by the faculty assigned to supervise the fellow for each patient, and group supervision meetings will also be employed when deemed to be the best learning environment. Supervision will involve a combination of direct/in-vivo supervision during patient care and interdisciplinary meetings, scheduled supervisory meetings to plan and guide patient care with the attending supervisor(s), unscheduled supervisory contacts when deemed needed by fellow or supervisor, review of standardized assessment materials/raw test data, supervisory observation and review of case presentations, and review of assessment reports and other written documentation. The amount of direct/in-vivo supervision is generally greater for less experienced fellows, decreasing over time in a developmental approach as the fellow demonstrates a greater degree of independence in the clinical competencies required in different aspects of patient care. In some cases, supervisory review of audiotaped and videotaped patient care sessions may be utilized, with appropriate consent from the patient(s).  All trainee-patient encounters at MD Anderson are documented in Epic, with co-signature by the attending neuropsychologist.

Research/scholarship mentoring will be regularly provided by the faculty member(s) overseeing each fellow’s research/scholarship project. The amount of time spent in direct research mentoring will depend on the fellow’s role(s) for the project, their research skills and mentoring needs, and the stage of the project. However, fellows will obtain this mentoring on all aspects of research, from project conceptualization, planning, literature review, data collection and analysis, and manuscript preparation.

In addition to receiving supervision for clinical and research activities, fellows receive extra supervision by faculty for professional development, including identifying and preparing for professional goals, planning for Texas/out-of-state licensure, preparing for Board examinations, etc. This occurs through formal didactic presentations, regularly scheduled mentoring meetings with the Training Director and other training faculty as desired, and unscheduled mentoring contacts, when needed (e.g., job interview season).

Evaluation and Exit Criteria

A goal of this fellowship program is to provide competency-based training, and evaluations are similarly competency-based. Such competency-based evaluations will comprise an important exit criterion at the completion of fellowship. In addition to ongoing feedback to fellows regarding their performance during their supervision sessions, formal fellow evaluations are conducted at regular intervals, including 1) a complete, competency based written evaluation every 6 months and 2) a briefer, midterm, competency-based evaluation after the 3^rd, 9^th, 15^th, and 21^st month of fellowship.  These formal evaluations involve both self- and supervisor competency ratings in order to facilitate constructive discussion of strengths and areas of needed growth.

The written APPCN First Year Examination will be administered at the end of fellowship year one with the intention of evaluating the relative strength and weaknesses of the fellow’s knowledge base in order to better identify needs for continuing education in the final year of training.  

Fellows complete an evaluation of their supervisor(s) and the overall program at 6 month intervals. This information is used to guide goal-setting and supervisor/program improvement for the remainder of the fellow’s experience.  

Pediatric Neuropsychology  Training Faculty

• Marsha Nortz Gragert, Ph.D., ABPP (Pediatric Neuropsychology Fellowship Training Director)
• Peter L. Stavinoha, Ph.D., ABPP
• Amanda Child, Ph.D.

Pediatric Psycho-Oncology Training Faculty

• Martha A. Askins, Ph.D. (Pediatric Psycho-Oncology Fellowship Training Director)
• Rhonda S. Robert, Ph.D., ABPP

Our MD Anderson training faculty provide services within the Children’s Cancer Hospital.  Faculty and fellow offices and clinical treatment space are co-located with that of the physician faculty in the Division of Pediatrics. There is significant clinical, didactic, and research integration with the medical teams, including faculty, advance practice providers, nursing, and supportive care professionals. View a full listing of all faculty. View a listing of support programs.

The annual stipend for full-time fellows is currently $56,105.69 in fellowship year 1 and $57,228.13 in fellowship year 2.  An additional $2500 per year is provided for educational expenses (e.g., books, conference expenses, etc.). Fellows are also provided paid health insurance, optional vision and dental benefits, 160 hours (4 weeks) per year paid vacation leave, 100 hours (2.5 weeks) per year sick leave, 5 educational days, and approximately 8 to 10 institutional holidays per 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.

Fellows have office space, their own computer with access to a suite of office and statistical software, a private telephone line, institutional mobile phones, access to the internet and a large number of research/library databases, offsite access to MD Anderson’s medical record system and software, and dictation software provided by the institution. Fellows benefit from the administrative support provided by the departmental administrative assistants, appointment/referral/clinic coordinators, and business manager as well as the hospital’s information services, scheduling, admissions, and billing department personnel.

MD Anderson and the Division of Pediatrics is committed to the wellness of our faculty, staff, and trainees, providing access to a host of resources ranging from nutritional and financial wellness, stress management, and physical fitness resources. The latter includes access to an onsite fitness center.

We are recruiting for 1 anticipated position in the 2024-2026 training cycle. The planned start date is on or around September 3, 2024, and the planned end date is August 31, 2026, though dates are subject to minor adjustments by the program, if necessary.

Applicant Qualifications/Eligibility

• Eligible applicants must be a graduate of an APA- or CPA- accredited clinical, counseling, or school psychology program with specialty training in neuropsychology and a degree of Ph.D. or Psy.D., as per Houston Conference Guidelines. Candidates must have had foundation and higher-level graduate-level courses in neuropsychology;  candidates with a doctoral degree in clinical psychology without prior neuropsychology experience are not accepted.
• Candidates must have completed an APA- or CPA- accredited internship in clinical psychology. Internships including formal neuropsychological training are strongly preferred.
• Candidates are expected to have had formal training and experience in pediatric neuropsychological assessment, interpretation, and report writing at either the graduate and/or internship level. Strong preference is given to candidates with consistent experience in these areas across both the graduate and internship levels.
• Previous neuropsychological experience in a medical setting is strongly preferred, as is lifespan neuropsychology experience to supplement a focus on pediatric neuropsychology training.
• This fellowship is not suitable for those wishing to re-specialize in Clinical Neuropsychology.
• International candidates are considered, provided they meet the above criteria and have authorization to work in the US for the two year fellowship duration. Although international candidates (other than psychologists trained in Canadian graduate programs) may be considered for research postdoctoral or predoctoral training, they often do not have qualifications that would allow them to see patients under supervision, though review of qualifications can be conducted on a case-by-case basis.
• Applicants will be asked to provide the APPCN Verification of Completion of Doctorate form, which provides attestation from their Director of Clinical Training that the anticipated dates of dissertation defense and of degree conferral will occur prior to the planned start date of the fellowship. Applicants must have conferral of their doctoral degree or other equivalent confirmation of their doctorate prior to their start date for this fellowship.
• Applicants must register for and participate in the National Matching Service (NMS) APPCN match to be considered for this fellowship at www.natmatch.com/appcnmat.  
• Final appointment is contingent on criminal background check, proof of eligibility to work in the US for the duration of the two-year fellowship, verification of immunizations, passing a pre-employment drug screening, and screening for tobacco use according to MD Anderson policy.

Application and Interview Process

Applications will be accepted through APPA CAS (https://appicpostdoc.liaisoncas.com). The deadline for the receipt of all application materials for our program within the APPA-CAS system is January 2, 2024. Our Program ID is 414146.

A complete application requires all of the following:

1. A cover letter/letter of intent summarizing neuropsychological and other relevant education and clinical training, areas of clinical and/or research interests, and general training and professional goals
2. Curriculum vitae
3. Official graduate transcripts listing courses, grades, and degrees
4. Three letters of recommendation
5. Two de-identified neuropsychological reports
6. Signed APPCN Verification of Completion of Doctoral Form
7. Response to additional question prompts in our APPA CAS program listing

This residency site agrees to abide by the APPCN policy that no person at this facility will solicit, accept, or use any ranking-related information from any residency applicant. Fellow selection is based upon factors deemed relevant to prospective fellows’ potential success in the profession of pediatric neuropsychology. Particularly relevant factors include: clinical/research experiences; education; references from past supervisors as they relate to past training/work performance; fellowship training objectives; and long-term professional goals (including an interest in pediatric oncology). 

Application deadline for the Pediatric Neuropsychology Fellowship: January 2, 2024

Interviews will be arranged by invitation following review of applications. Applicants are extended interviews by direct communication from the fellowship program, including phone call and/or emailed letter. Interviews will be conducted virtually according to the recommended guidelines communicated by Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN), Association of Psychology Postdoctoral and Internship Centers (APPIC), and current MD Anderson policy.

Applicants should take note that our program will participate in the APPCN match system. Applicants should be sure to register with the National Matching Services, Inc. (416-977-3431; www.natmatch.com/appcnmat) in order to participate in the match. Our NMS Program Code is 9241.

This fellowship program is housed within the Children’s Cancer Hospital of the Division of Pediatrics at MD Anderson Cancer Center. MD Anderson has been named the nation’s top hospital for cancer care in U.S. News and World Report’s “Best Hospitals” rankings, and it has been named one of the nation’s top two hospitals for cancer care every year since the survey began in 1990.

MD Anderson is located within the world’s largest medical center, the Texas Medical Center, in Houston, Texas,. The Texas Medical Center’s 49 member institutions work together to promote the highest standards of patient care, research, and education.

Houston is the 4th largest U.S. city, with a population of more than 7.3 million in the greater metro area. Houston is a leader in the arts, education, and health care. Unlike most big cities, Houston offers a very low cost of living and very affordable housing – and there is no state income tax!

For more information about what MD Anderson and Houston have to offer:

• Learn more about training at MD Anderson and watch this video
• Go to Visit Houston, read about Houston, and watch this video,
• Watch this video and view this site for more information about the Children’s Cancer Hospital