Adult Neuropsychology Postdoctoral Fellowship

Setting and Program Description

The primary focus of the Adult Neuropsychology Postdoctoral Fellowship at University Hospitals Cleveland Medical Center is to provide advanced training and education in the competencies necessary for the specialized practice of clinical neuropsychology. At the completion of the program, fellows should be capable of independent patient care, research and teaching in a range of settings including academic medical centers, hospitals and private practice.

The program is housed within the Department of Neurology at UH Cleveland Medical Center. UH Cleveland Medical Center is a 1,032 bed, nonprofit medical center in the University Circle neighborhood of Cleveland, Ohio, and is one of the primary teaching hospitals of Case Western Reserve University School of Medicine. UH Cleveland Medical Center is the anchor hospital of the University Hospitals Health System, which includes an integrated network of 18 hospitals, more than 40 outpatient health centers, 4,700 medical providers and more than 26,000 employees. The Department of Neurology is included within the Neurological Institute of University Hospitals and comprises 55 faculty across nine sites. Neurology houses multiple Centers of Excellence including Brain Health and Memory; Epilepsy; Movement Disorders; Stroke and Cerebrovascular Disorders; Critical Care Neurology; Community Neurology; and others. The Department of Neurology supports a large residency training program (12 per year for a total of 48 residents) and fellowship programs in Adult Neuropsychology, Pediatric Neurology, Neuromuscular Medicine, Vascular Neurology, Epilepsy, Clinical Neurophysiology (EEG) and Neurologic Intensive Care. UH Cleveland Medical Center is a thriving academic center. It houses an active clinical trials unit in neurology and has been ranked among the top 20 programs in the country for National Institutes of Health funding several consecutive years.

UH Cleveland Medical Center is consistently recognized as one of the nation's best hospitals by U.S. News & World Report. In 2016 – 2017, UH Cleveland Medical Center was named among the country’s Top 50 in eight methodology-ranked specialties including neurology and neurosurgery. These results place UH Cleveland Medical Center in the top 1 percent of the nation’s 5,000 hospitals eligible for ranking every year. In addition to the exceptional care provided to patients, resident and fellowship training is included among the primary initiatives of University Hospitals, aligning with its mission: To Heal. To Teach. To Discover.

The primary site for training in the Adult Neuropsychology Postdoctoral Fellowship Program is the UH Cleveland Medical Center Department of Neurology. However, patients are also seen at several satellite clinics around the Greater Cleveland area. Many of the services that the Neuropsychology Program provides involve a multidisciplinary, team-based approach and include frequent interactions with other specialist providers, both informally and in formal case conference formats. Fellows will also have opportunities for multidisciplinary team participation in the areas of dementia/memory loss, deep brain stimulation, epilepsy, normal pressure hydrocephalus, sports-related concussion and mild traumatic brain injury, among others.

Offices for faculty and fellows are located on the campus of UH Cleveland Medical Center. Each fellow is provided with a personal work space and his or her own computer/laptop. Fellows also have access to the medical library and online journals through UH Cleveland Medical Center.

The client populations served by the Department of Neurology are quite diverse in age, socioeconomic status and cultural background. The fellow will develop experience with clinical populations that include all forms of dementia and memory loss; deep brain stimulation and movement disorders; epilepsy and epilepsy surgery; normal pressure hydrocephalus; attention deficit hyperactivity disorder; learning disabilities; concussion and mild traumatic brain injury; traumatic brain injury; cerebrovascular disease and stroke; multiple sclerosis; neuro-oncology; and other conditions/syndromes. The fellow’s primary responsibilities will be diagnostic interviewing, neuropsychological assessment, and report writing; however, a substantial portion of the fellow’s schedule is blocked for didactics and research activities.

Although fellows will gain experience with a wide range of neurological conditions and patient populations, the Adult Neuropsychology Postdoctoral Fellowship at UH Cleveland Medical Center has four primary clinical service emphases: behavioral neurology, concussion management, general neurology and pre-surgical evaluation.

Behavioral Neurology

The Brain Health and Memory Center services at UH Foley ElderHealth Center provides care for the older adult patient. As part of a multidisciplinary team that also includes neurologists, geriatricians, nurse practitioners, nurses and social workers, neuropsychology plays an essential role in providing comprehensive outpatient care for this patient population. Neuropsychology fellows will have the opportunity to participate in UH Foley ElderHealth Center’s integrated patient care model and gain experience with diverse patient populations. Referral questions/differential diagnosis often includes, but is not limited to, mild cognitive impairment and mild neurocognitive disorder; Alzheimer’s disease (including early onset); frontotemporal dementia; vascular dementia; lewy body dementia; posterior cortical atrophy; primary progressive aphasia; rapidly progressing conditions such as prion disease; Parkinson’s disease; Huntington’s disease; multiple sclerosis; traumatic brain injury; stroke; and other medical, psychiatric and substance use disorders. Fellows will participate in individual feedback sessions with patients and their families and may also participate in summary visits alongside the referring neurologist/geriatrician and social worker on a case-by-case basis.

Fellows will also have the opportunity to engage in clinical didactic training experiences with UH’s nationally recognized expert behavioral neurologists, Brian Appleby, MD, and Alan Lerner, MD. Opportunities for education and involvement in clinical research programs will be available including projects to examine prion diseases such as Creutzfeldt-Jakob disease and young-onset dementias in collaboration with the National Prion Disease Pathology Surveillance Center at Case Western Reserve University School of Medicine. Opportunities for involvement in multiple ongoing clinical trials through UH Foley ElderHealth Center will also be provided. These clinical trials are to explore new treatments for neurodegenerative conditions as well as caregiver education, methods and resources. For additional information about our behavioral neurology services, visit the Brain Health and Memory Center website.

Concussion Management

The UH Concussion Management Program is a neuropsychologist-led, multidisciplinary, collaborative effort that provides comprehensive concussion care in order to safely return both sports and non-sports patient populations back to sports, school and work. UH Sports Medicine covers a large population of athletes in Northeast Ohio at all levels of athleticism including numerous youth leagues, 47 high schools and seven colleges/universities. We are also affiliated with several professional organizations including the Cleveland Browns (National Football League). In 2014, UH became one of only two Level I trauma centers in the Cleveland area, providing opportunities to work with patients who have sustained a wide range of neurological injuries of varying severity, including head trauma. Neuropsychological evaluation is an integral part of the concussion management process, with referrals coming at all phases of recovery depending on patient needs and concussion protocols.

Neuropsychological fellows will gain invaluable experience with multidisciplinary concussion management teams, concussion at all levels of sport, diverse populations and multiple contexts of injury. Our neuropsychology faculty are nationally recognized experts in the field of sports neuropsychology and have been active in establishing sports concussion legislation in Ohio as well as providing education regionally and nationally on concussion-related topics. Opportunities for concussion research are also be available for fellows, with our neuropsychology faculty currently acting as PI on multiple research investigations on concussion-related topics such as evaluating the use of subthreshold exercise in post-concussion syndrome; evaluating the effectiveness of youth concussion testing; evaluating new and leading-edge technologies for the diagnosis and management of concussion; and more. For further information, visit the UH Concussion Management Program website.

General Neurology

The Neuropsychology Program at University Hospitals receives referrals for comprehensive evaluation primarily from Centers of Excellence within UH Neurological Institute. However, additional referrals are received from other UH institutes and from outside institutions. UH Neurological Institute comprises a team of nationally recognized experts delivering comprehensive, coordinated care for disorders of the brain and nervous system. Recognized by U.S. News & World Report as one of the finest neurology and neurosurgery programs in the country, UH Neurological Institute includes 14 Centers of Excellence that provide individualized treatment, innovative techniques and access to some of the most innovative research designed to advance the science of neurological medicine.

For the Neuropsychology Program, the most common referral questions include differential diagnosis of neurodegenerative disorders and documentation of deficits associated with neurological diseases including stroke, head injury, neuro-oncology diseases, neurodegenerative diseases and many others. Neuropsychology fellows have the opportunity to complete outpatient neuropsychological evaluations of patients with a wide variety of referral questions and neurological diagnoses as well as opportunities to participate in integrated treatment teams. For more information, visit UH Neurological Institute’s website.

Pre-Surgical Evaluation

Neuropsychology is a fully integrated and critical component of the deep brain stimulation (DBS), epilepsy surgery and normal pressure hydrocephalus (NPH) programs at University Hospitals. Neuropsychological evaluation is required at a patient’s pre-surgical evaluation and as part of post-surgical outcome monitoring for each service. Neuropsychology fellows and faculty meet weekly or biweekly with our surgical treatment teams to review neurocognitive findings in conjunction with other sources of data including the neurological and neurosurgical exam, EEG and neuroimaging results, levodopa response testing, and others. The team collaboratively determines appropriate interventions and plans for patients, with fellows obtaining invaluable experience in working with multidisciplinary treatment teams, presenting neuropsychological data to providers in related fields and working with diverse neurological populations.

Each of these programs is nationally recognized and led by faculty who are renowned as leaders in their respective fields.

For additional information on the UH Parkinson’s & Movement Disorders Center, including the DBS program, visit our website.

For more information about the UH Epilepsy Center, including the epilepsy surgery program, visit our website.

For further information on NPH and other related services, visit our Brain Health & Memory Center website.

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