Adult Neuropsychology Fellowship
The residency is a member of the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN) and is structured to meet Houston Conference and APA Division 40 Guidelines for training in neuropsychology with a goal of preparing fellows for board certification. The program collaborates with the Departments of Psychiatry and Psychology at Hartford Hospital and the Institute of Living (IOL), as well as the Departments of Neurology and Neurosurgery at Hartford Hospital. The department has >80 psychologists and trainees, updated staff information is available on our website.
Hartford Hospital maintains the only Level 1 Trauma Center in the region and operates the state’s only air ambulance system, LIFE STAR. Our quality programs have continually been recognized for excellence by the Federal Government, US News and World Report, Blue Cross/Blue Shield and the National Cancer Institute.
Founded in 1822, the IOL is the third oldest psychiatric hospital in the nation, and the first hospital of its kind in Connecticut. It lies in the center of Hartford CT, across the street from Hartford Hospital and Connecticut Children’s Medical Center. The IOL has a rich history of treatment and research in psychiatry, neuropsychiatry and neuropsychology – in fact, much of Brenda Milner’s work with HM occurred on our floor! Today, the Institute houses state-of-the-art centers for neuropsychiatric research and care.
Overview
In accordance with Houston Conference guidelines, the fellow receives intensive training in the science and practice of clinical neuropsychology, including opportunities for assessment, intervention, and research. We carry two postdoctoral fellows, starting on alternate years. Training differs across the two years in content, population, autonomy and to a degree, complexity, though the training program will flex to meet each fellow’s individual training needs. Each fellow's training is individually designed to meet his or her specific interests and professional goals. All fellows gain experience providing services in both inpatient and outpatient settings. Fellows conduct a minimum of two full neuropsychological assessments per week.
Training
Year 1:
The fellow will generally complete 2 comprehensive adult outpatient evaluations weekly during the first year.
One outpatient evaluation will be seen as part of our Neuropsychology Outpatient Clinic on the Institute of Living campus. In our outpatient clinic, patients are referred from a variety of sources (both internal and external) and have varying presenting problems, some of which include pre-existing movement disorders, neurodegenerative disease, pre- and post-transplant, seizure disorder, head injury, and stroke. The fellow will be responsible for and receive supervision in battery selection, clinical interview, assessment, scoring, interpretation, report writing, and feedback with patient, family, and treatment.
The second outpatient evaluation will be seen in the Chase Family Movement Disorders Center (CFMDC). The CFMDC is part of our esteemed Ayer Neuroscience Institute within Hartford HealthCare. The CFMDC is a multidisciplinary specialty neurology clinic focusing on the diagnosis and management of various movement disorders, including Parkinson’s disease, Atypical Parkinsonism, Essential Tremor, Dystonia, Huntington’s, and secondary Parkinsonism (e.g., neuroleptic-induced, vascular, etc.). The CFMDC is very dedicated to the holistic care of each patient and also collaborates closely with various disciplines (e.g., integrative medicine, PT, OT, speech, gastroenterology, urology, etc.) throughout the Hartford Healthcare network. Neuropsychology plays an integral role in the care of the CFMDC patient population and is well respected and appreciated by the various members of the team. Neuropsychologists and neuropsychology fellows establish cognitive baselines, assist in differential diagnosis of neurocognitive disorders, provide serial evaluations for the purpose of tracking the progression of decline, and offer relevant treatment recommendations. In addition, neuropsychologists within the CFMDC also collaborate with the neurosurgical team to provide pre- and post- Deep Brain Stimulation (DBS) and High Intensity Focused Ultrasound (HIFU) evaluations and offer valuable insight into the appropriateness of surgical candidates on the basis of their cognitive status. Neuropsychology fellows will see patients at the Vernon location Vernon, CT (20-minute drive from the IOL campus) and will have an opportunity, if desired, to be involved in DBS/HIFU case conferences, clinical council meetings, and the movement neurology fellowship lecture series.
The first year of training also emphasizes inpatient medical work one day per week. This primarily occurs at Hartford Hospital, but our inpatient consultation service also provides coverage on an acute Inpatient Rehabilitation Unit. Referrals largely come from neurology and PM&R, including stroke, traumatic brain injury, and brain tumor. Referrals of medically complex patients from other hospital departments (e.g., internal medicine, cardiology) are also common. Neuropsychological consultative services provide baseline data and are used to generate appropriate treatment targets and recommendations. Patients seen during their rehab stay may be followed longitudinally. Inpatient referrals typically seek to clarify cognitive deficits, aid in treatment and disposition planning, ascertain capacity, and/or aid in differential diagnosis in complex cases, such as those involving altered mental status of unknown etiology. The fellow will consult to departments throughout the hospital, completing bedside evaluations, 1-2 page reports, and providing same-day feedback to providers, patients, and families.
Year 2:
In the second year, the fellow will see one outpatient case within our Memory Care Center (MCC) and continue to see one outpatient case in our Neuropsychology Outpatient Clinic.
Similar to the CFMDC, the MCC is also part of the Ayer Neuroscience Institute and is a multidisciplinary specialty neurology clinic specializing in the diagnoses of problems with thinking and memory as well as continuing care after diagnosis. There, they work collaboratively with an impressive multidisciplinary team, consisting of neuropsychology, neuropsychiatry, neurology, social work, nursing, and specialists in neuroimaging. Cases are complex and range from individuals with traditional amnestic disorders to those with AD variants, FTD, DLB, and neuropsychiatric deterioration due to medical and psychiatric causes. Case conferences occur once per week with the team and are rich, enjoyable, collaborative, and provide wonderful opportunities for learning and professional development. In addition, there are optional opportunities to be part of the MCC clinical council meetings as well as collaborate with other specialties across on HHC regarding the provision of monoclonal antibodies.
The fellow will also take on primary responsibility for neuropsychology referrals from our inpatient psychiatric hospital at the IOL, with questions related to differential diagnosis (often of dementia), ongoing impact from an established CNS insult (often TBI or CVA), or to acquire a cognitive profile in individuals who have serious mental illnesses such as schizophrenia or bipolar disorder. Trainees find this rotation to be surprisingly enjoyable, in large part due to the complexity of the clinical picture. Reports (1 to 2 brief evaluations per week) are similar in structure and length to the medical inpatient unit rotation during the first year.
As noted, the fellow continues to conduct one outpatient evaluation per week from our Neuropsychology Outpatient Clinic (described in Year 1). They may also use this time to pursue elective experiences as well.
Additional Clinical Experiences: Across the 2-year program, the fellow will have opportunities to be involved in pre- and post-surgical neuropsychological assessments and participate in intraoperative cortical mapping during awake craniotomies and WADA evaluations. They will also carry 1 or 2 therapy cases, generally focusing on individuals who are adjusting to a CNS insult.
Elective experiences are available with our thriving health psychology department, at Connecticut Children’s, Grace Webb School (a therapeutic school located on the IOL campus), and throughout the system. A strength of our program is our system – we are able to carve out unique opportunities based on fellows’ interests. This may include forensic exposure, testing and supervision in Spanish for bilingual applicants, tailored CBT or dynamic therapy, and work in schools including IEP meetings, among many other experiences.
Research
The fellow is expected to actively participate in supervised research (2-4 hours reserved/protected weekly). Fellows are expected to present their research at a national or international conference as well as at our department research day. Options for collaboration both within and outside are department are available. In the past, fellows have partnered with neurology and/or analyzed archival data. Beginning this year, the Neuropsychology Division will be actively collaborating with our nationally recognized Olin Neuropsychiatry Research Center. Fellows are welcome to participate in ongoing projects within this center.
Supervision
Supervision is a key component of training at HH/IOL. Fellows can expect detailed, developmentally appropriate supervision geared at increasing autonomy and competence while also emphasizing professional development and skill acquisition. Outpatient case work will generally involve a planning session before the patient arrives, check-ins (as needed) during the testing day, and an hour per case of direct supervision after testing is completed. Inpatient supervision involves case discussion at the start of the day, on-the-fly supervision between cases, face-to-face supervision regarding conceptualization and writing, and group supervision/case presentations weekly. The crux of supervision changes as the trainee develops, and supervisors regularly meet to ensure supervision is appropriate for stage of training and individual needs. Honing succinct and efficient report writing skills is an area of emphasis. Adapting report writing style to referral needs (i.e., inpatient medical, inpatient psychiatric, outpatient, consultation, etc.) is a key outcome. Successful trainees are comfortable working in multiple settings, with different (but overlapping) expectations. Feedback is another major area of emphasis for the program. Contingent on patient and referral source needs, feedback will be provided for the majority of cases. In addition to direct feedback to referral sources, thoughtful feedback sessions with patients and families are designed to improve understanding of the clinical picture, with a focus on recommendations and attention to removing barriers to ongoing treatment.
Didactics
Hartford Healthcare offers a rich spectrum of educational and academic activities including Psychiatry, Neurology, and Neurosurgery Grand Rounds, weekly Memory Care Center conferences, monthly Cognitive Council/Amyloid Therapy Board meetings, and monthly Brain Tumor Case Conferences. The fellow attends weekly Neuropsychology Seminar with staff, invited guests, and other trainees; focus is on key foundational principles as well as developing fact-finding skills. The Neuroanatomy Series is a 1 hour, bi-weekly seminar that runs for ~10 months. Neuropsychology Group Supervision is a weekly seminar in which the trainees practice concise case presentations and review challenging cases. Test Administration Workshop is a 1 hour bi-weekly seminar that focuses on standard administration and norms. Foundations in Neuropsychology is a 1 hour weekly individualized course that reviews foundational principles in depth. There is a weekly core training program seminar for all psychology departmental fellows, with topics including early career development, research, focal (psychodynamic) therapy and case consultation, and diversity, as well as an advanced case conference series. Psychology Department meetings are held twice monthly. Several other seminars are available as electives.
Teaching/Tiered Supervision Opportunities
The fellow will also have the opportunity to teach in the clinical psychology internship program, be involved in training neurology and psychiatry residents and fellows, and supervise doctoral-level practicum students.
Graduation Criteria
Successful completion of the training program is indicated by the following accomplishments:
- The fellow can provide neuropsychological services to patients on an independent basis.
- The fellow demonstrates research competence by completion of at least one research project.
- The fellow is eligible for licensure in the state/province in which he or she intends to practice.
- The fellow meets criteria for certification in Clinical Neuropsychology by the American Board of Professional Psychology.
Fellow Selection
This fellowship is recruiting one postdoctoral fellow for the 2024-2026 training year and we participate in the APPCN match process. The IOL agrees to abide by the APPCN policy that no person associated with our program will solicit, accept, or use any ranking-related information from any residency applicant. All applicants must register with National Matching Services to be ranked for the fellowship. Applications must be received by December 16, 2024. Interview are conducted in January and will be held over Zoom.
Qualified applicants will have successfully completed a PhD or PsyD in clinical psychology including an APA/CPA approved internship. If the internship does not have a concentration or emphasis in neuropsychology, it will be incumbent upon the applicant to demonstrate comparable pre-internship experiences and coursework.
Salary is competitive with full health benefits and paid time off (vacation/sick; conference release time) included. Some support is offered for dissemination of research and other conference participation.
We request the following materials from applicants, via APPA CAS:
- Cover letter or letter of interest
- A curriculum vitae
- 3 Letters of recommendation
- A graduate transcript
- 2 Sample reports demonstrating your skill sets in different settings
- APPCN Match Number (if available)
- Before starting the fellowship, we will need confirmation from your program (or via transcript) that you have completed all requirements for graduation
Questions about the fellowship are welcomed and can be addressed via email to Kristin Slyne, PsyD, ABPP-CN at kristin.slyne@hhchealth.org, or consultation with our Administrative Associate, Ms. Paula Snedeker (860) 545-7167.
Fellowship Faculty
- Jennifer Caruso, PsyD (Chase Family Movement Disorders Center)
- John O’Hara, PsyD (IOL Psychiatric Inpatient Rotation)
- Carolina Posada, PhD (Hartford Hospital Inpatient Medical; Neuropsychology Outpatient Clinic)
- Ashley Schoener, PhD (Memory Care Center)
- Kristin Slyne, PsyD, ABPP-CN (Neuropsychology Outpatient Clinic; Training Director)
Helpful Links
For information pertaining to APPCN member status: