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Internship Program
Submitter Name:*required
          Email Address:*required
Program Title:*required
Program City/State:*required


Please fill out the questions below as relates to your program:
Please identify the degree of exposure to neuropsychology: General clinical track
Rotation in neuropsychology
Separate full time track in neuropsychology
Other
Department: Psychiatry
Neurology
Psychology
Rehabilitation
Free Standing
Pediatrics
Other
Program Director:
  Email:
  Phone:
  Fax:
  Address:
Program website:
Number of completed applications in the preceding year:
Number of applicants accepted into the program in the preceding year:
Number of positions anticipated for the upcoming year:
Is there a separate application process for neuropsychology: Yes No
Application Deadline:
Program Setting(s):
University Clinic
Hospital Other
VA Hospital  
Program Accredited by APA or CPA in:
Clinical Counseling None
School Other  
Member of the Association for Internship Training in Clinical Neuropsychology (AITCN) Yes No
Number of neuropsychology interns accepted into program each year
Is there a separate selection process for neuropsychology interns? Yes No
List specific doctoral coursework and training required for selection:
Number of neuropsychology faculty: Full-time
Part-time (20 hrs.+)
Part-time (< 20 hrs. )
Other consulting faculty: Discipline
 Specialty
  Discipline
Specialty
  Discipline
Specialty
Number of faculty board certified in clinical neuropsychology
Certifying Board(s)
Stipend ($)/annum
Month/Day program begins:
Time in neuropsychology rotation or track:
Percent time in neuropsychology activities:
Percent time/week in neuropsychological assessment (testing; scoring; supervision; report)
Is there specialty coursework for neuropsychology interns?  Please specify: List all types: (please put frequency in parenthesis after each)
Please list the rounds/seminars/conferences the neuropsychology intern is required to attend: List all types: (please put frequency in parenthesis after each)
Please specify other didactic training: List all types: (please put frequency in parenthesis after each)
Is additional training available in:
          Neuroanatomy
Yes No
          Neurodiagnostics Yes No
          Behavioral Neurology Yes No
Patient population
Please name the primary disorder(s) in your patient population.
Are there opportunities for socialization with:
          psychology faculty
Yes No
          other faculty Yes No
          other medical trainees Yes No
Are research activities     
Are there specific exit criteria for students completing the clinical neuropsychology internship? Yes No
If Yes, please indicate criteria
Please add additional information to be included in your listing: