Clinical Neuropsychology Fellowship Tracks and Sites

There are three fellowship tracks available:

All fellowship tracks provide the opportunity to work with a wide array of patient populations and considerable resources within which the fellow can advance their specific interests while gaining a broad spectrum of experience. Supervised direct service delivery responsibilities include interviewing, test administration, report writing, consultation with various departments and medical personnel, and provision of feedback to patients, families, and referral sources. 

Dartmouth Hitchcock Medical Center (DHMC) in Lebanon, New Hampshire

The Neuropsychology Service at DHMC serves as the primary training site for all fellows. Outpatients make up the bulk of referrals, though inpatients are occasionally seen. Referrals come from a wide variety of sources such as Neurology (e.g., epilepsy, movement disorders, stroke, MCI, dementia), Neurosurgery (e.g., presurgical evaluations for epilepsy and movement disorders), Psychiatry (including geropsychiatry), Pediatrics, Genetics, Transplant Program, Hematology/Oncology, and Internal Medicine, as well as other medical units at DHMC.  Referrals also come from sources in the regional communities including school systems, health care providers, and community mental health centers.

New Hampshire Hospital (NHH) in Concord, New Hampshire

NHH is the state's primary psychiatric inpatient facility, and is a teaching hospital staffed largely by Dartmouth Psychiatry faculty. As such, it represents a unique example of public sector-academic liaison. Neuropsychological consultation is provided for patients from admissions and longer-term units, including Adult Psychiatry and Geriatric units. While at NNH, fellows conduct brief and comprehensive neuropsychological evaluations and work extensively with an interdisciplinary team that includes psychiatry, social work, nursing, occupational therapy, forensic psychology, and general psychology, among others.

Adult Fellowship

The Adult Neuropsychology Fellowship involves a variety of experiences, taking place at the Neuropsychology Service at DHMC in Lebanon, New Hampshire, and the Neuropsychology Service at NHH in Concord, New Hampshire.

Fellows on the Adult Fellowship DHMC, Embedded Neurology, and Inpatient Psychiatry track:

  • Year 1: (a) Six-months full time on general outpatient neuropsychological service at DHMC; (b) Six-months, three-days per week on the general outpatient neuropsychological service at DHMC and two-days per week at NHH.
  • Year 2: (a) Six-months full time on general outpatient neuropsychological service at DHMC; (b) Six-months full-time on the embedded neurology rotation at DHMC. The embedded neurology rotation emphasizes evaluation and intervention with adults living with epilepsy, as well as evaluation of other patients referred through the Department of Neurology, conducting Wada Tests, provision of a self-management program for people with epilepsy and cognitive concerns (HOBSCOTCH), and presenting at epilepsy surgical case conference
     

Fellows on the Adult Fellowship DHMC and Inpatient Psychiatry track:

  • Year 1: Full-time on general outpatient neuropsychological service at DHMC.
  • Year 2: (a) Six-months full time on general outpatient neuropsychological service at DHMC; (b) Six-months, three-days per week on the general outpatient neuropsychological service at DHMC and two-days per week at NHH.
  • Fellows on this track can also participate in Wada Tests, obtain training in HOBSCOTCH, as well as have opportunities to present at the weekly Multidisciplinary Epilepsy Surgery Case Conference.
     

All adult fellows participate in specialty clinics during either their first or second year:

  • Cognition in Older Adults (COA) Clinic: This clinic involves clinicians from geropsychiatry, neurology, radiology, and neuropsychology. Fellows conduct neuropsychological evaluations, attend COA team meetings, and have the opportunity to shadow COA team members.
  • Adult Interdisciplinary Developmental Disabilities Clinic (AIDD): This interdisciplinary consultation model includes Dartmouth Health clinicians from psychiatry, neurology, internal medicine, occupational therapy, and neuropsychology, meeting alongside patients with intellectual/developmental disabilities (IDD), their families, and their community team members.

Typical Caseload

All fellows provide consultation to referral sources, feedback with patients and families, and participate in intervention planning and monitoring as part of their duties. Adult fellows’ typical neuropsychological evaluation caseload includes 3-4 cases per week, with psychometrist support for some cases at DHMC.  

Pediatric Fellowship

The Pediatric Neuropsychology Postdoctoral Fellowship Program at Dartmouth involves numerous activities designed to provide a well-rounded training and learning experience. In addition to the outpatient Pediatric Neuropsychology Clinic  (PNC) at DHMC that evaluates children with various neurological, metabolic, genetic, developmental, and cognitive disorders, we participate in five multi- and inter-disciplinary clinics with developmental pediatrics, neurology, speech-language pathology, occupational therapy, and psychiatry:

  • Autism and Communications Disorders Clinic (ACDC) evaluating children ages 0-5 years old: answering referral questions pertaining to development, speech-language disorders, and ASD.
  • Neuropsychology and Developmental Psychiatry Clinic (NDPC) for children and adolescents with complex medical presentations ages 6-17: answering referral questions for children with complex medical histories, cognitive and academic struggles, and mental health comorbidities.
  • Autism Spectrum Disorders Diagnostic Clinic: answering referral questions focused on the diagnosis of ASD, utilizing ADOS-2 and standardized developmental interviewing.
  • Interdisciplinary Developmental Disabilities Clinic (IDD): in this unique clinic, the patient, their family, and their entire community-based team are present for evaluation, assessment, and the creation of treatment recommendations from a multi-disciplinary team of providers.
  • Transitional and Long-term Care Clinic (TLC): follow-up clinic for babies and toddlers who were in the NICU; working collaboratively with neonatology to provide developmental assessments.

Sports neuropsychology is also a major element of the training experience. Fellows are engaged in extensive participation within school-based concussion management intervention programs. There are also many consultation opportunities, including work with concussion management return-to-play programs at regional high schools, middle schools, and colleges. Fellows also rotate within several clinics devoted to patients who have experienced brain injury:

  • Concussion Consultation Clinic: Seeing patients for consultation via telehealth and in-person in the acute/post-acute phase of recovery to provide education and design treatment planning early in the process.
  • Sports Neuropsychology Clinic: Seeing patients with persisting symptoms after concussion (PSaC), providing targeted neuropsychological evaluations to guide diagnostic decisions and treatment.

Pediatric fellows are provided the opportunity to participate in Wada Tests and attend the weekly epilepsy surgical planning conference. As part of their training in hematology/oncology, attendance at the Pediatric Tumor Board is also available.

Typical Caseload

The typical caseload of pediatric fellows is two to three clinics per week, depending on their mix of clinical activities. We take a developmental approach to training; thus, clinical volume begins modestly and increases as skill and efficiency grow. All fellows provide consultation to referral sources, feedback with patients and families, and participate in intervention planning and monitoring as part of their duties. The mix of activities is somewhat flexible and can be tailored to the fellow’s interest when possible. Dedicated writing and research time is provided across both years of training.