Clinical Neuropsychology

 

Dominic A. Carone, Ph.D., ABPP-CN

Clinical Neuropsychology

 

Q. What is your practice like?

I coordinate the Neuropsychology Assessment Program at SUNY Upstate Medical University. My practice is in an academic medical center. Seventy percent of my practice is with adults (no upper age limit) and thirty percent is with children (down to age five). Referral diagnoses are diverse and include (but are not limited to) traumatic brain injuries of all severity, cerebrovascular disease, neoplasms, demyelinating diseases, toxic encepaholpathies, dementia, and developmental disorders. Although my salaried position is only for clinical work, I also maintain a large research database and perform research projects when possible. Leading and attending didactic seminars are another important part of my practice. Another important aspect is training student neuropsychology interns.

Q. What did you learn about yourself and your practice while doing board certification?

Preparing for board certification allows one to focus on areas of strength and display that knowledge during the process but it also allows one the opportunity to improve their knowledge based in areas of relative weakness. I learned an enormous amount about the tests I use (and even those I do not use), in terms of psychometrics and clinical applications based on evidence-based research. The process reinforced the need to use evidence-based research in clinical decision making, which I believe I am more focused on since going through the board certification process. The focus on ethics was also important because it allowed me to examine my practice and determine specific areas where I could better meet aspirational ethical guidelines. For example, I now include a written informed consent with all patients prior to the evaluation and provide feedback to virtually all patients and/or family members.  Essentially, the board certification process allows you to challenge yourself in all aspects of your professional work so that you can maximize your potential. I learned through this process that I was able to take on that challenge and meet it, which was enormously gratifying on both a personal and professional level. Too often, I believe that people fall into a daily routine after they are licensed such that they do not refresh their knowledge base to keep current with current research and professional standards. Board certification preparation helps prevent this from happening.

 

Q. What might you consider doing differently based on what you learned?

As noted above, one of the things I do differently in my practice is include a written informed consent with all patients prior to the evaluation and provide feedback to virtually all patients and/or family members. I am also more prone to integrate evidence-based research into my clinical work.

Q. Do you see yourself in a different light for having completed the board certification process?

Absolutely. Having a credential from your peers that attests to your competency in advanced specialty practice is very gratifying on a personal and professional level because you know that you have met the highest standards of your profession.

Q. What motivated you to seek board certification in neuropsychology?

I was focused on making sure that my training was consistent with board certification guidelines from the day I entered graduate school. The reason is because I believe that professional standards are important to ensure competency in one’s profession. Without some way to designate who has received specialized training in a particular area and is competent to offer those services, the public can be misled into believing that they are being rendered services by such an individual when this will not always be the case. Board certification provides a standard that the public can use to identify competent practitioners in a specialty area. Thus, one reason I sought board certification is because I believe that the process is important from a public healthcare perspective. The other reason I sought board certification was for external validation (from people other than my supervisors) that I had the requisite training and skills to offer specialized services in clinical neuropsychology. Board certification was also important to me as someone who trains students because the credential attracts the best applicants and it is also very important for them to say that received training from someone who is board certified. I believe this played a role in my first student intern getting accepted into a clinical neuropsychology graduate program this year.

Q. Having attained board certification, looking back, what was your greatest misconception about the ABPP or the credentialing process?

I did not have any significant misconceptions because I came into the process at a time where I believe ABPP has done an excellent job clarifying that the examiners want you to pass and are not looking for reasons to fail you. This message has gotten out through listserves, the BRAIN website, and the new ABCN book offered through Oxford University Press. I think that the greatest misconception is that the examiners will be unfair, look for reasons to fail you, and ask questions that are almost impossible to answer. I found the exact opposite to be the case. The examiners (and the entire process) were fair and supportive, albeit challenging.

Q. What was the most challenging/interesting/surprising aspect of the board certification process?

The most challenging aspect was finding the time in my professional and personal life to prepare for the exam. Too often, I hear this given as an excuse as to why people delay applying for board certification. However, it certainly is possible provided that the applicant makes some temporary personal sacrifices. The sheer amount of information I learned and consolidated from my many years of training was the most interesting aspect of the process. The most surprising aspect was learning how organized and supportive everyone was during the process (including the administration office, my ABCN mentor, my BRAIN study group, and the ABCN examiners).

Q. What advice would you give to a candidate for board certification in neuropsychology?

My advice is to apply for board certification as soon as possible after licensure because the longer you delay, the less likely you will apply. I advise that people give themselves plenty of time to prepare for each aspect of the examination and not to feel rushed. I advise getting an ABCN mentor who can guide you through the process, especially for the work sample submissions and the oral examination. Mock oral examinations are highly suggested, particularly with someone you do not know. I suggest doing several mock examinations prior to the actual examination. I also suggest purchasing the book by Armstrong et al (2008) entitled “Board Certification in Clinical Neuropsychology: A Guide to Becoming ABPP/ABCN Certified Without Sacrificing Your Sanity.” I also highly suggest reading Blumenfeld’s “Neuroanatomy through Clinical Cases.”

Q. What have you found most valuable or rewarding about board certification (e.g., salary increase, referrals, colleagues, increased self esteem, learning, something else)?

I believe that both a sense of pride and a sense that I have provided a service to the public by allowing myself to be identified as someone competent to provide a specialty services are the two most rewarding aspects about board certification. I also met some great new colleagues and friends in the preparation process (e.g., mento, study partners) who I would not have met otherwise. I will have these friends forever and have many fond memories.

Q. What would readers be most surprised to learn about you?

That I am six foot six and 250 pounds.

Q. How has your professional life changed since attaining board certification?

I think that the main change is that your colleagues and co-workers will look at you with greater admiration and respect, which always feels nice, and adds to the increased sense of pride you have after attaining board certification. More people contact me to do independent medical examinations and forensic work, although I limit myself purely to clinical referrals. Otherwise, my professional life is largely unchanged.

Q. What is the most interesting/challenging/rewarding/fulfilling aspect of your work as a psychologist?

The most interesting, challenging, rewarding, and fulfilling aspect of my job is disentangling the complexity of a patient’s clinical presentation such that I can understand the many different aspects contributing to that presentation. I greatly enjoy integrating interview data, medical records, research, and objective test results together to conceptualize a case. Helping patients understand the reasons why they are likely having the problems they do, providing education to them and their families, and guiding them towards more efficient care and treatment is highly rewarding because you feel like you have made a positive impact in someone’s life.

 

 

 

Follow ABPP on Facebook