Qualification in Clinical Neuropsychology

For me, primarily it was a way to structure my learning in a way that would have been almost impossible for me through un-assessed, un-structured study. The essays, exams and portfolio with their deadlines and the final viva exam are highly motivating, perhaps more extrinsic than intrinsic, and not without some trepidation but highly motivating nonetheless.

In my experience, the process rapidly accelerates your learning compared with routine CPD (although this is valuable too of course) due to the volume of material you need to cover, the breadth of the curriculum and the opportunity to assimilate it all. This assimilation afforded the opportunity to make conceptual links between different areas of the curriculum and better understand over-arching principles of neuropsychology rather than accumulate disconnected pieces of information.

Ultimately the benefit of all of this is that you become a better, safer, more competent clinician, supervisor and colleague in your area of work. In addition to this, you gain knowledge of conditions and approaches that you may not work with day-to-day which broadens your skillset for the benefit of your clients, team and organisation. It’s also true that adding these strings to your bow that may help you with moving on to new posts in the future either in the NHS or private sector.

Lastly, there is something satisfying and reassuring about achieving a set standard for competence in the field of neuropsychology. It’s not a cure for ‘imposter syndrome’ but it gives a little symptomatic relief! However, it’s important to remember that the QiCN marks sufficient competence for entry to the profession. It doesn’t mean you can retire your copy of Lezak and the learning and development is no doubt career long. While this may be deflating on the one hand, on the other hand it is helpful to hold in mind that at viva no one is expecting you to be Barbara Wilson and, in theory, two years of post-qualification neuropsychology experience could be enough.

There is a common theme in terms of challenges; resources. Finding the considerable time to write the essays, prepare for the exams, put the portfolio together and prepare for viva is challenging. When you consider that this is often happening at the same time as a full-time clinical job, child care and/or family commitments, home improvements, weddings etc, the time commitment is a big ask.

Furthermore, finding the funding to attend a taught programme and then register for the QiCN can be a significant financial challenge. Some candidates are lucky to secure some or all of the funding from their NHS trust, however, others are entirely self-funding and the total cost is not insignificant. Given that weddings, stamp duty and home improvements also don’t come cheap, candidates can feel caught between a rock and a hard place, wanting to progress their skills and careers but also needing to prioritise other aspects of life.

Re: The Knowledge Component

• Exams

  • Try to negotiate some study leave. Evenings and weekends are unlikely to be enough
  • Focus revision on exam questions as a base but be aware a new topic could and probably will arise so consider revising beyond past papers. However, be realistic. You cannot know ‘all of neuropsychology’. Use the competency framework and curriculum as a guide. Aim for good enough
  • If you can, get a ‘study buddy’ who is at the same stage for academic and emotional support. In my study group, we prepared sample answers and shared them as exam prep
  • The time goes extremely quickly in the exam hall. Divide your time equally between questions and be disciplined about moving on. An excellent answer won’t make up for a missing one

• Essays

  • There are four broad topics with two essay choices per topic. You are required to do two essays in total which must be chosen from two different topics. Overall, choosing two from eight gives a fair amount of choice
  • In choosing an essay, you can either choose something you know about already and can do relatively easily or choose a more challenging unfamiliar
  • topic that will develop your knowledge. This will depend on your overall capacity at time
  • If in doubt, choose something you are most interested in. The topic will be with you over many, many hours so choose wisely!
  • After submission, consider sharing essays amongst peers/study buddies afterwards as exam prep

Re: The Portfolio

• Logs
  • Keep contemporaneous logs (clinical & supervision). Doing these retrospectively is much more arduous
  • Consider backdating if this helps you include a better breadth of cases. For example, if you have moved jobs or changed roles can you sample across this experience?
  • Make up your own word document for the logs following the same layout. If you copy & paste from the handbook example you’ll waste hours struggling with idiosyncratic formatting
  • I restricted my clinical logs to one page per case with the sanity of the examiners in mind
  • For the clinical logs, include representative cases that show your skills not every case you had. You examiner probably doesn’t want to see dozens of similar assessment or intervention cases. When deciding what to include, consider the competency framework and how you are showing you meet it
  • I added ethnicity to my logs in addition to ‘age, gender, setting’ to give additional cultural context but it is not a requirement
  • Don’t leave it to the last minute to get supervisors’ signatures. They may be in the Bahamas when you need them. Check if they have an electronic signature. This could speed up the process.
  • Allow much more time than you think for formatting and tidying up before going to print
  • Back up everything!
• Case Studies
  • Make sure you are working from the most up-to-date handbook regarding case selection
  • Remember to ask for consent from your clients
  • Remember the case studies are your opportunity to show your skills, experience and abilities and how they map onto the competency framework. Choose a range of cases that show your breadth of assessment and intervention skills with a range of presenting problems and conditions. If you leave obvious gaps you may be examined more vigorously on them at viva to check your knowledge
  • The word count is very tight. Including appendices can help but remember the handbook states that you should not put things in the appendix that belong in the body of the case report
  • If you did several pieces of work with a client (e.g. cognitive assessment, behavioural intervention, family work, vocational rehabilitation etc) it is likely you will be unable to describe all of them fully in the case report. Perhaps choose a primary focus and maybe one secondary focus (but be prepared to discuss other related aspects of the clinical work you did at viva)
  • Back up everything! Then back it up again.
• Viva
  • Know your cases inside out
  • Be open about your developmental arch throughout the portfolio. Perhaps earlier cases had limitations but you can demonstrate how you learned, developed and improved over time. However, be careful not to rely too heavily on saying you would have done it all differently in hindsight. This will wear thin and make it a tense hour for all parties
  • Remind yourself of the fundamental psychometric properties of the tests you have commonly used. For example, are you confident you could described at least some strengths and limitations if asked? (I had a viva buddy and we divided up our most commonly used tests and drew up a brief psychometrics crib sheet for each and shared them)
  • Be ready to respond to some statistical questions. For example, if you said something was ‘significant’, can you described how you arrived at that conclusion? Are you ready with base rate information etc? However, overall I found the viva more clinically focused than psychometric (but I suspect this depends on the examiners)

For me, the benefit of the independent route for the knowledge component was that it offered an additional degree of flexibility. I didn’t have to work around teaching block dates or cover the travel or accommodation costs associated with the taught courses. It was also cheaper than a taught course and QiCN registration combined. I enjoyed the autonomy and it is very much an adult-learning model.

However, finding the relevant materials to cover the curriculum was challenging (there is no reading list) and digesting it all independently would have been very lonely without a study buddy. I was also aware that I missed out on networking opportunities associated with a taught programme and fully appreciate that sitting at home with Cicerrone’s back catalogue is not the same as being taught directly by Jon Evans, for example.

It was difficult working a full-time job and preparing for the QiCN but in both posts I was in during the QiCN I was able to negotiate study leave. Luckily, the departments I was working in valued the QiCN and were willing to support it as were the clinical teams I worked in. However, evenings, weekends and precious bank holidays did get eaten up.

I started with Lezak as a core text but citing Lezak a hundred times throughout your exams and essays is unlikely to ingratiate you with the examiners. In terms of other text books I found the following helpful;

• Neuropsychological Neurology, (Larner, 2013)
• Handbook of Clinical Neuropsychology (Marshall & Gurd, 2012)
• Clinical Neuropsychology: A practical guide to assessment and management for clinicians (Goldstein & McNeil, 2012)
• Psychological Management of Stroke (Lincoln, 2012)
• Traumatic Brain Injury: Rehabilitation for Everyday Adaptive Living (Ponsford, 2017)
• Mild Cognitive Impairment and Dementia: Definitions, diagnosis and treatment (Smith & Bondi, 2013)
• Cognitive Neurorehabilitation: Evidence and Application (Stuss & Wincour, 2010)

Beyond these texts, review papers, consensus papers and any paper from Neuropsychological Rehabilitation will be helpful. NHS Athens will be your friend here or if you have a trainee, they may be able to help you by accessing papers from their university library.
Last but not least, you will need understanding friends, families and partners while you become a (hopefully occasional) QiCN bore for a number of months or years. Remember to extract yourself from your revision/essay prep/viva prep from time to time to nurture you actual life. You will need it throughout and afterwards.

• Amount: £120 (£100 + VAT)
• When: upon submission of an enrolment application

This is a non-refundable fee which covers the processing and review of your enrolment application.

An invoice will be sent to you when we receive your enrolment application and this must be paid within 30 days of the date on the invoice.

We will not be able to confirm your enrolment until this fee has been paid.

• Amount: £5925.60 (£4938.00 + £987.60 VAT)
• When: upon confirmation of enrolment (either in full or by monthly direct debit)

This fee covers any support and expert advice you might need, as well as administration carried out during your enrolment by either the society’s staff or members of the Qualifications Board.

It also pays for one assessment of each element of the qualification.

If you are referred for further assessment on any element a re-submission fee will become due.

Should you withdraw from the qualification a refund may become due (please see the Terms and Conditions for further information).

• Amount: £385.20 (£321 + VAT)
• When: one month prior to submitting your amended work

The re-submission fee covers the cost of work carried out during the re-assessment of your portfolio.

We offer flexible payment plans via direct debit to spread the cost of a qualification over your period of study. These are monthly interest free payments and you can choose to pay over 12, 24, 36 or 48 months.

We only charge you for the cost of the qualification once. If you need longer to complete the qualification we won’t charge you extra.

Please be aware that if you complete your qualification before the payment term has been completed you will be required to pay the outstanding balance before your results can be released.

Please note that you may incur additional costs during your training which are not set by the society, may include, but are not limited to, supervision costs, travel and accommodation costs (for instance, for supervisory meetings, events and conferences) and professional indemnity insurance.

These fees are not set by the society so we are unable to advise on what rates will be charged.

A fee reduction of 20% is available to candidates who are in receipt of state benefits or a state pension.

Requests for reductions for other reasons will not be considered.

Formal requests for reductions must be submitted to the Professional Development Delivery Officer along with evidence of income and level of state benefits.

All fees charged by the society are reviewed annually and, therefore, are subject to change from 1 January each year

Some candidates undertake the society’s exams and essays to fulfil the knowledge dimension of the training.

Fees to undertake the knowledge dimension are separate to the practice dimension fees and are as follows:

• First sitting of all four written papers: £1585 (£1320.83 + VAT)
• Re-sit fee (per paper): £395.25 (£329.38 + VAT)
• First submission of two essays: £1113 (£927.50 + VAT)
• Re-submission fee (per essay): £556.50 (£463.75 + VAT)

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