Pediatric Psycho-Oncology Fellowship

The goal of the fellowship program is to advance the profession of psychology and improve behavioral health outcomes among children with cancer and cancer-related conditions through exemplary postdoctoral training that prepares early career psychologists to make important contributions to clinical practice, research/scholarship, and education within the subspecialty of Pediatric Psycho-oncology. 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

Specific training objectives include the development of:

• Advanced skills in the core functional competencies of clinical psycho-oncology assessment, intervention, consultation, and science base and application sufficient to practice on an independent basis.
  • Particular focus on patients from birth to young adulthood.
  • Optional training available with adults throughout the lifespan.
• Advanced understanding of clinical psychology and all foundational competencies that cut across the functional competencies identified above, including Interpersonal Interactions, Ethical and Legal Foundations, and Professional Identification.
• Scholarly training (didactic, experiential) and productivity (e.g., contributions to a research study, literature review, book chapter, or other scholarly product for publication or presentation)
• Eligibility for state or provincial licensure or certification for the independent practice of psychology.
• Eligibility for board certification in the specialty of American Board of Clinical Child and Adolescent Psychology (ABCCAP).

Supervised clinical training in pediatric psycho-oncology assessment, consultation, and intervention comprises the majority (70%) of the fellowship experience for this Program. Fellows receive advanced training and supervised experience in all aspects of clinical practice, including clinical interviewing, diagnosis, recommendations, referrals, interventions, and both oral and written communication of results with patients, caregivers, and referral sources.  The inpatient and ambulatory populations are equally represented in the overall service volume. 

Fellows receive advanced training in clinical psycho-oncology through their participation in core/mandatory training experiences as well as possible elective training experiences for interested fellows, as follows:

Core Training Experiences

Approximately 80-100% of the fellow’s clinical training time will occur within The MD Anderson Cancer Center, Division of Pediatrics, Section of Behavioral Pediatrics, Pediatric Clinical Psychology Service (see below for optional/elective experiences that could comprise up to 20% of clinical time based upon the training goals of the fellow). This is an active consultation-liaison service that receives referrals from all other medical and behavioral health services within the Division 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 neurofibromatosis. Patients present for evaluation at any point from diagnosis to long term survivorship. Advanced training in evaluating and addressing the psychological effects of these presenting conditions and their various treatments is a strong area of focus of this training experience. Significant opportunities exist for service provision throughout the trajectory of medical care, including survivorship and end of life.  This training experience extends throughout the entirety of the 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 fellowship. Supervisors for this training experience include Martha A. Askins, Ph.D., and Rhonda S. Robert, Ph.D., ABPP, both of whom have 20+ years of experience supervising and teaching psychology trainees at the pre-doctoral levels.

Elective Training Experiences/Rotations

Elective or optional rotations are provided so that fellows can receive advanced psychological training in providing assessment and intervention with adult patients, thereby contributing to their knowledge of cancer care across the lifespan. The following elective rotations are offered.

1.      The MD Anderson Cancer Center, Department of Palliative, Rehabilitation, and Integrative Medicine

• Division of Integrative Medicine
  The MD Anderson Integrative Medicine Program engages patients and their families to become active participants in improving their physical, psycho-spiritual, and social health. The ultimate goals are to optimize health, quality of life, and clinical outcomes through personalized, evidence-based clinical care. Psychologists play an important role in Integrative Medicine as experts in cognitive-behavioral strategies and expressive therapies that promote well-being. Participation in this optional rotation will allow fellows to gain in-depth knowledge on how psychologists, working alongside an interdisciplinary team, contribute to the wholistic care of the patient and his or her family members. The length of this optional rotation will be up to one day per week for three or four months. Supervisors for this rotation: Catherine Powers-James, Ph.D. and Aimee Christie, Ph.D.

• Division of Palliative and Supportive Care
  Patients commonly experience burdensome physical symptoms and/or psychological distress from their disease and/or the cancer treatment itself. Psychologists in Palliative and Supportive Care work primarily with inpatients to help ease the stress that can be associated with a family’s cancer journey. They provide evidence-based interventions that effectively treat adjustment reactions, depression, anxiety, and pain. Psychologists also provide essential support to patients, and their family members, who may be facing end-of-life. For example, psychologists provide specialized consultation to support children of adult patients. The length of this optional rotation will be up to two days per week for three or four months. Supervisors for this rotation: Cindy L. Carmack, Ph.D., Sujin Ann-Yi, Ph.D., and Monica Agosta, Ph.D.

2.       The MD Anderson Cancer Center, Department of Pain Medicine

Unfortunately, between 20% to 50% of cancer patients experience pain, and about 80% of people with advanced cancer endure moderate to severe pain, according to the National Cancer Institute.  The MD Anderson Pain Center plays an important role in helping patients maintain comfort and quality of life. Pain has both physical and psychological components and can be acute or chronic in nature. Assessment of pain is very specialized, and a wide range of psychological interventions are used to successfully help people cope with pain, including relaxation and cognitive-behavioral coping strategies. Sometimes used in combination with physical and drug treatment, psychological intervention has proven effective for pain sufferers across the lifespan. Participation in this optional rotation will allow fellows to learn about specialized, evidence-based pain assessment and treatment in adults with cancer and cancer survivors. The length of this optional rotation will be up to one day per week for three or four months. Supervisor for this rotation: Grace S. Kao, Ph.D., ABPP.

3.       The MD Anderson Cancer Center, Department of Behavioral Science Tobacco Treatment Program

The Tobacco Research and Treatment Program is preeminent in the world and offers tobacco-cessation services, including in-person behavioral counseling, telephone counseling, web-cam counseling and several tobacco-cessation medication treatments, at no cost to MD Anderson cancer patients who are current tobacco users or recent quitters. Psychological treatments are evidence-based and contribute greatly to positive treatment outcomes among cancer patients (e.g., greater survival, faster wound-healing, better pulmonary functioning and quality of life). Psychologists in the Department of Behavioral Science are leaders in this specialized area of healthcare. Fellows will have the opportunity to participate in either an in-depth, two days per week, nine-month experience, where they will provide supervised clinical treatment or a one day per week, three to four-month shadowing experience where they will have exposure to how patients are assessed, treated, and followed long-term. Supervisor for this rotation: Diane Beneventi, Ph.D., NCTTP.

The 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, 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. Research opportunities with Department of Pediatrics faculty are available within the context of funded and unfunded clinical research programs.

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 make substantial contributions to a research study, literature review, book chapter, or other scholarly product for publication or presentation during the course of fellowship.

A minimum of 10% of the fellow’s time (4 hours per week) will be spent in educational pursuits. Didactic offerings, either mandatory or optional, are described below.

The purpose of didactic offerings within the Section of Behavioral Pediatrics is to provide 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 as preparation for ABPP board exams. There will be a particular but not exclusive focus on development and application of these competencies within a pediatric hematology-oncology setting.

Didactic offerings will involve a combination of presentation/learning formats, including but not limited to:

• Topics in pediatric and lifespan psychology/neuropsychology and professional development presented by faculty or other professionals internal and external to MD Anderson
• 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)
• 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
• Mock oral board examinations (Examiner – MD Anderson psychology faculty; Examinee –fellow)
• 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
• 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 respond 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: 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.
• Other MD Anderson Didactic Forums:
  • 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

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

*additional optional didactic opportunities exist throughout the week

Supervision

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 consultation (intake) reports, assessment information, supervisory observation and review of case presentations, and review of progress notes 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 psychologist.

Research/scholarship mentoring will be regularly provided by the faculty member(s) overseeing each fellow’s research/scholarship activity. 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 and 9^th months 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.

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 Psycho-Oncology Training Faculty

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

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.

Our MD Anderson training faculty provide services within the MD Anderson 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 (if applicable).  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 position in the 2024-2025 training cycle. The planned start date is on or around September 3, 2024, and the planned end date is August 31, 2025, 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 a degree of Ph.D. or Psy.D.
• Candidates must have completed an APA- or CPA- accredited internship in clinical psychology. 
• International candidates are considered, provided they meet the above criteria and have authorization to work in the US for the one 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 must register through APPA CAS (https://appicpostdoc.liaisoncas.com).
• 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 MDACC policy.
• Preferred: Licensed Psychological Associate or Provisional Psychology License eligibility.

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 December 15, 2023.

A complete application requires all of the following:

1. A cover letter/letter of intent summarizing psychological 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. Copy of doctoral diploma OR a letter of attestation from your Director of Clinical Training confirming that the anticipated dates of degree conferral will occur prior to the planned start date of this fellowship
6. Response to additional question prompts in our APPA CAS program listing

Fellow selection is based upon factors deemed relevant to prospective fellows’ potential success in the profession of pediatric psychology. 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 Psycho-Oncology Fellowship: December 15, 2023

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 the Association of Psychology Postdoctoral and Internship Centers (APPIC) and current MD Anderson policy. 

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. 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