There are two primary fellowship tracks available:
Both fellowship tracks provide the opportunity to work with a wide array of patient populations and considerable resources within which the fellow can advance his or her 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 NH
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, Neurosurgery, Psychiatry, Pediatrics, Genetics, 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 NH
NHH is the state's primary psychiatric inpatient facility, and is a teaching hospital staffed by Dartmouth Psychiatry faculty. As such, it represents a unique example of public sector-academic liaison. The Neuropsychology Laboratory is housed in the Acute Psychiatric Services facility. Neuropsychological consultation is provided for patients from admissions and longer-term units, including Adult Psychiatry and Geriatric units.
Adult fellowship track
The Adult Neuropsychology Fellowship involves a variety of experiences, taking place at the Neuropsychology Service at DHMC in Lebanon, NH and the Neuropsychology Laboratory at NHH in Concord, NH. Typically, first year fellows spend three days per week providing clinical neuropsychological services at DHMC, and two days per week providing such services at NHH.
Second year fellows have the opportunity to participate in specialty clinics. In the Cognition in Older Adults (COA) Clinic they conduct brief cognitive assessments, may sit in on patient interviews with the physicians, and provide feedback to the multidisciplinary team. Second year fellows participate in the Adult Interdisciplinary Developmental Disability Clinic (AIDD) that involves clinicians from psychiatry, neurology, internal medicine, occupational therapy, and neuropsychology in the evaluation of adults with developmental disability and/or autism with challenging behaviors.
Second year fellows participate in the embedded Neurology rotation, specializing in evaluation and intervention with adults living with epilepsy.
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.
Adult fellows participate in the Wada test and other multidisciplinary clinics (COA, AIDD). Pediatric fellows also have the opportunity to gain Wada experience. Required didactics mainly take place on Fridays.
Pediatric fellowship track
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 DHMC clinical outpatient service that evaluates children with various neurological, metabolic, genetic, developmental, and cognitive disorders, we participate in four interdisciplinary 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.
- Neuropsychological 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.
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. Work within the hospital’s sports concussion program is also part of this experience.
While mostly conducted with the adult population, pediatric fellows are provided the opportunity to participate in WADA procedures. As part of their training in epilepsy, attendance at the weekly surgical planning conferences is also available.
Fellows also rotate within several clinics devoted to brain injury patients:
- Concussion Care and Consultation Clinic (C3): multidisciplinary clinic between Pediatric Neuropsychology and Pediatric Neurosurgery, seeing patients for consultation and brief evaluations in the acute/post-acute phase of recovery.
- Sports Neuropsychology Clinic: seeing patients in the post-acute phase of recovery, providing abbreviated neuropsychological evaluations to guide diagnostic decisions and treatment.
Pediatric fellows are provided the opportunity to participate in WADA procedures 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.
The typical caseload of pediatric fellows is 2-3 clinics per week, depending on their mix of clinical activities. Effort is made to keep caseload equivalent across years, although it may vary slightly. 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. Clinical cases are typically seen from Monday to Thursday, while required didactics take place on Fridays.