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Introduction and Background
Rush University Medical Center (RUMC) has been offering formal training in Clinical Neuropsychology since 1967, the year our internship in clinical psychology was first accredited by the American Psychological Association. Neuropsychology training at the internship level has continued since that time, and over 30 individuals who trained in or supervised clinical neuropsychology at Rush have earned board certification through the American Board of Clinical Neuropsychology (ABPP-CN). Rush's commitment to the highest standards of training in clinical neuropsychology is in part demonstrated by our hosting the ABCN oral examinations for over 20 years, and in current and former neuropsychology faculty serving as examiners or on the AACN Board of Directors.
RUMC also was one of the first programs to offer fellowship training in clinical neuropsychology, beginning in the 1960 and continued for approximately 20 years until changes in departmental organization and funding led to a cessation of the fellowship. However, in 2007, funding for this position was re-established.
RUMC articulates a four-fold mission of patient care, teaching, research and service. The central tenet of the RUMC mission is to provide the very best care for its patients. While providing outstanding patient care is a core mission, the institution simultaneously embraces the missions of teaching, research, and service. Because the training and educational departments are integrated within the university and medical center, RUMC is uniquely positioned to prepare outstanding health care professionals, researchers, and leaders.
Established in 1837, RUMC has been serving the city of Chicago longer than any other health care institution in the city. The medical center is comprised of a 613-bed hospital serving adults and children, the 61-bed Johnston R. Bowman Rehabilitation Center, and dozens of outpatient clinics, all of which provide an abundance of opportunities for training health psychologists, neuropsychologists, and child psychologists. In FY 2007, RUMC totaled over 30,000 hospital admissions and 169,000 patient days. The inpatient and outpatient services serve the health care needs of over 600,000 patients annually. This is an exciting time at Rush as the largest expansion of our campus is underway. Our $1.2 billion building campaign culminated in January 2012 with the opening of our new 14-story inpatient hospital.
Geographically, RUMC is positioned in the Medical District on Chicago's west side, adjacent and accessible to some of the most underserved and ethnically diverse communities in the city. This location, as well as its status as a Medicare and Medicaid provider, confers a great degree of cultural, ethnic, and economic diversity among the patients served by the medical center.
The Department of Behavioral Sciences at RUMC was established more than 40 years ago as the Psychology and Social Sciences Department. Distinctive among medical center-based psychology departments, it is a free-standing, independent, and separately budgeted unit in the medical center under the chairmanship of a widely published, internationally recognized academic clinical psychologist. Clinical psychologists play integral roles in the medical center as practitioners, researchers and behavioral science instructors in the medical college. Each member of the faculty holds an appointment in the Department of Behavioral Sciences and provides services in medical specialty departments such as gerontology, hematology/oncology, neurology, pediatrics, psychiatry, pulmonology, and surgery.
The Department of Behavioral Sciences is organized into 6 sections: Neuropsychology, Outpatient Psychotherapy, Sleep Medicine, Circadian Rhythms Research, Geriatric Rehabilitation Psychology and Psychosocial Oncology. Departmental faculty consists of more than 20 PhDs and 3 MDs. There are currently 7 post-doctoral fellows in the department, including one in Clinical Neuropsychology. In addition, there are 9 pre-doctoral interns in our APA-accredited program, including 3 neuropsychology interns, 4 health psychology interns and 2 pediatric psychology interns.
Departmental faculty are leaders in their respective fields. Several members of the faculty are principal investigators on currently held RO1 and other NIH grants. All faculty are engaged in ongoing basic or translational research, as evidenced by first authored journal articles, reviews, chapters and abstracts. All psychology faculty are involved in the education of medical students and/or trainees.
Neuropsychology is a subspecialty within clinical psychology. Neuropsychologists must know their patients, the natural history of illness and injury, and individual variations in disease, as well as the context of patients' culture, family and psychological make-up. Thus, we prepare residents to be competent diagnosticians and communicators; to be competent giving and interpreting the widest variety of tests and procedures; to understand and integrate medical and other data; to consult with other professionals, and to counsel patients and their families.
The mission of the Postdoctoral Residency is to provide comprehensive training to individuals wishing to specialize in the practice of neuropsychology. Upon completion of the training program, individuals will be prepared to start the process of board certification and to be independent scientist-practitioners.
Residents consult on referrals from all medical services. Residents rotate between inpatient and outpatient weeks. They typically see two outpatients each week on an "outpatient" week, with these evaluations typically lasting the better part of a day. They typically see between two and eight inpatients on an inpatient week, with these evaluations typically being more brief than those conducted on an outpatient basis. Residents work side-by-side with faculty, interns and our psychometrician in a "team" model where all are expected to participate in decision-making about the program, and in doing the work that needs to be done. A great emphasis is placed on the development of skills related collegiality and teamwork. Residents are supported, encouraged and taught how to develop supervisory skills and are asked to "pre-supervise" interns and the psychometrician's work on some cases. Residents are formally rated at the 3, 6, 12, 18 and 24 month marks, or more frequently if there is a need. Residents are given a certificate at the end of their training. Grievance procedures have never had to be utilized by any neuropsychology trainees but are available.
Clinical Training and Populations Served
The neuropsychology service consults on and contributes to diagnosis and management of a wide variety of patients referred by neurology, neurosurgery, psychiatry, internal medicine, surgery, cardiology and other services. Patients may have dementia (Alzheimer, frontal-temporal, vascular, stroke, etc.), movement disorders (Parkinson, Huntington, etc.), auto-immune and inflammatory disorders (multiple sclerosis, lupus, etc.), immunodeficiency and infectious disorders (HIV, encephalitis, etc.), organ transplants (heart, liver and kidney), and seizure disorders (requiring pre- and post-neurosurgical evaluations, Wada procedure, etc.). There is also an emphasis on neuropsychological and psychological evaluation of patients with behavioral and psychiatric disorders, such as schizophrenia, delusional, major affective, anxiety, adult attention deficit, and substance abuse/dependency disorders.
Approximately 80% of referred patients are between the ages of 18 and 90-something. Nearly all referrals between the ages of 4 and 17 are cases where seizures are present or suspected. Our service typically refers out pediatric referrals where the question is primarily centered on Attention Deficit Disorder or Learning Disability. Residents are expected to increase the breadth of their training through exposure to a variety of populations and presenting complaints. However, there are opportunities to request certain types of training cases to increase competency or enhance specialization with certain populations.
Residents are first introduced to clinical activities of staff neuropsychologists and accompany them during examinations. They are later responsible for their own patients, including the initial discussions with referral sources, chart review and gathering of collateral data, the examination itself, charting, oral and written reports to referral sources, and consultation with patient, family and external agencies. All of this is done with the support of their assigned supervisor. Residents will spend approximately 60% of their time engaging in clinical evaluations including diagnostic interviewing, test selection, test administration/scoring, report writing, and supervision.
Supervision and Didactic Learning Experiences
Supervision is generally rotated among the neuropsychology staff on a case by case basis. Generally, residents can expect to receive between 2-5 hours of individual supervision per week, depending on the case load and a resident's training needs. Supervision is intensive, individualized, and provided on all cases immediately and for as much time as needed rather than at pre-specified and limited times. Although there are variations between supervisors, and between types of patients and circumstances, reports typically are 2 to 3 pages in length. Inpatient reports typically are completed before patient discharge. Outpatient reports typically are completed with 5 to 7 business days of last patient contact. An emphasis is placed on the residents developing the ability to give oral and written feedback that the referral source will find to be clear, precise, meaningful and helpful.
Neuropsychology residents attend case conference and journal club throughout the year, along with the four faculty, three residents, and psychometrician. Others also often attend these meetings. For example, these meetings recently have been attended by a psychiatry resident who has a special interest in neuropsychology. Last year, the meetings were attended by a neuropsychologist from Spain who came to Rush to shadow our service for three months. Pediatric interns and other trainees often are in attendance as well.
Neuropsychology case conference occurs on Mondays at 12pm. A faculty member or trainee will present a recently-seen case. In some cases the presenter will blind the audience as to the presenting/final diagnosis or imaging/EEG results so as to encourage members to think aloud (akin to the ABCN oral exam) as to what might be "going on" with this patient. In other cases, especially those where the final report has yet to be written, the presenter will disclose all known information so as to solicit a group appraisal of the most appropriate way to diagnose the case and to arrive at appropriate treatment recommendations. In all cases, trainees are expected to be active participants whose ability to think aloud and communicate their findings is both challenged and supported.
Neuropsychology journal club occurs on Fridays at 12pm. A faculty member or trainee presents on a topic of interest to clinical and research-based neuropsychologists. Over the course of a year, presentations will occur on newly-published tests, ethics, professionalism and all manner of topics specific to neuropsychology ranging from A(phasia) to Z(-score and other methods of transforming raw data).
In addition to individual supervision and neuropsychology meetings, residents at Rush have a wealth of other didactic experiences available to choose from. Some of these are mandatory (e.g. weekly Neurology and Epilepsy grand rounds), and others are optional (Psychiatry Grand rounds, as well as rounds in other academic departments such as Pediatrics, Internal Medicine, Physical Medicine and Rehabilitation, etc.).
Residents are expected to spend about 20 to 30% time devoted to research efforts which may include coordination and data collection for an ongoing project with a RUMC faculty member, or initiation of an independent research project. A half-day each week is blocked out for research activity, but residents' schedules are open enough for them to typically use another 6 to 8 hours each week for research projects. Nearly all neuropsychology interns and residents over the last 5 years have been successful in completing a research project while at RUMC, be it grant applications, journal articles, chapters or an abstract. Current and future residents are expected to show evidence of scholarship as a result of their research efforts, including peer-reviewed publications, and/or a grant application for extramural funding.
Inpatients are examined in their hospital rooms, and outpatients are seen in the Department of Behavioral Sciences' designated testing rooms. The Department recently relocated to newly renovated space that is much larger and nicer than had been the case. The neuropsychology resident has his/her own private office with a networked computer. Library access is available online or at the Rush University Library on campus. Residents can audit, for no charge, classes at Rush University, including the neurobiology and neuroscience classes taught at the medical college. Rush is also near other hospitals and universities, including the University of Illinois-Chicago, Stroger and the West Side VA and can attend lectures at these facilities.
Residents earn approximately $39,000 for the first year, with a slight cost-of-living increase for the second year. Residents are full-time employees of RUMC and receive health, vision, and dental insurance benefits. Residents are allotted 20 days of paid-vacation time with additional professional leave time available for attendance at professional meetings or job interviews.
Please send a letter of intent, curriculum vitae, graduate school transcript, one sample report, and three letters of recommendation to Christopher Grote, PhD, Director of the Neuropsychology Service, at:
Christopher Grote, PhD, ABPP-CN
Director of Neuropsychology
Department of Behavioral Sciences
Rush University Medical Center
1645 W Jackson Blvd., Suite 400
Chicago, IL 60612
Applicants invited for interview can do so at Rush in January 2015, or at the INS meeting in Denver in February, 2015.
Please feel free to contact Dr. Grote, or any of the neuropsychology faculty and staff, with questions. Dr. Grote can be reached at (312) 942-5523 or email@example.com
Dr. Anthony Odland, the current fellow in Clinical Neuropsychology, can be reached at (312) 942-5935 or at firstname.lastname@example.org.
Rush's APPCN match code is 8181.
Our program 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.
Christopher Grote, PhD, ABPP-CN
Phone: (312) 942-5523