Surveying barriers to training: a call for change for international neuropsychology trainees in the U.S.

Abstract

Introduction: By 2050, the U.S. population is projected to become increasingly heterogeneous, requiring a culturally competent neuropsychology workforce equipped to serve this evolving demographic. International graduate trainees bring valuable cultural and linguistic assets to the field of clinical neuropsychology but face significant structural barriers involving restrictive immigration policies.

Methods: This paper explores structural and institutional challenges by presenting results from a survey of 118 training directors across doctoral (n = 40), internship (n = 50), and postdoctoral (n = 28) levels, alongside personal narratives from four international trainees.

Results: Results reveal low international trainee enrollment - particularly at the postdoctoral level - and widespread immigration-related challenges, such as limited visa sponsorship and duration, unawareness of visa-related training restrictions, and discomfort among directors in supporting visa issues. Despite the potential benefits of STEM designation for clinical and counseling psychology programs to ease visa barriers, few programs have attempted and succeeded in this process. Personal narratives also highlighted the burdensome STEM conversion process, and the role of trainee-led efforts in overcoming bureaucratic hurdles.

Conclusions: To urgently address these issues, we advocate for systemic reforms including national-level STEM reclassification of psychology programs, extended visa durations, enhanced national pipelines and institutional support for visa sponsorship, and improved education on immigration policies. These efforts align with the Multicultural Orientation (MCO) model and AACN's Relevance 2050 goals by fostering a culturally and linguistically responsive workforce equipped to meet evolving mental health needs and to ensure the continued relevance of clinical neuropsychology.