Gender and ethnic/racial diversity in clinical neuropsychology: Updates from the AACN, NAN, SCN 2020 practice and “salary survey”

Abstract

Objective

Examination of gender and diversity issues within clinical neuropsychology, using data from the 2020 professional practice and “salary survey.”

Methods

Clinical neuropsychologists in the U.S. and Canada were invited to participate in an online survey. The final sample consisted of 1677 doctoral-level practitioners.

Results

Approximately, 60% of responding neuropsychologists are women and 53.8% of those women identify as early career psychologists (ECPs). Conversely, a majority of men in the sample are advanced career psychologists (ACPs). Both genders work predominantly in institutions, but more men than women work in private practice. ACP men produce a greater number of peer-reviewed publications and conference presentations. Across all work settings, women earn significantly less than men, and are less satisfied with their incomes. Establishing and maintaining family life is the biggest obstacle to attaining greater income and job satisfaction for both genders. Ethnic/racial minority status was identified in 12.9% of respondents, with 59.2% being ECPs. Job satisfaction and hostility in the workplace vary across ethnic/racial minority groups. Hispanic/Latino(a) and White neuropsychologists report higher incomes, but there were no statistically significant differences between any of the groups.

Conclusions

Income and select practice differences persist between female and male neuropsychologists. There is a slow rate of increased ethnic/racial diversity over time, which is much more apparent among early career practitioners. Trajectories and demographics suggest that the gender income gap is unlikely to be improved by the next survey iteration in 2025, whereas it is very likely that ethnic/racial diversity will continue to increase gradually.

Keywords:

• Gender
• diversity
• salary
• professional practice
• neuropsychology

Introduction

As the specialty of clinical neuropsychology has continued to grow in number of professionals engaged in active practice, there has been increasing interest in self-examination regarding practitioner characteristics, activities, beliefs, and incomes. This increased interest has been evident in frequent surveying of practitioners, to the extent that Marcopulos et al. (2020) provided a systematic review of surveys pertaining to clinical neuropsychology, and Guterbock and Marcopulos (2020) have provided a critique of relevant surveys, as well as guidance regarding best practices of surveying our specialty. Simultaneously, recent societal events, such as harsh pandemic-related job disruption, disproportionate job loss for women, violence directed against persons of color, and related social justice issues, have heightened the need to study characteristics and attainments of members within various professions. Within the specialty of clinical neuropsychology, such self-study includes a desire to understand the current status and trajectories associated with important sociodemographic variables, such as gender and ethnic/racial diversity.

This investigation explores data generated by the most recent large-scale professional practice survey in clinical neuropsychology, specifically as they relate to gender and ethnic/racial diversity. Of these two topics, gender has received the greater amount of attention from research investigators, primarily as gender relates to income disparities (Sweet et al., 2018) and leadership roles (Sachs et al., 2018; Rohling et al., 2022).

Readers should note that common parlance referring to the “gender pay gap” is synonymous with “gender wage gap.” Both are commonly used to refer to comparisons of remuneration between women and men for work-related activities. Considering that the terms “pay” and “wage” sometimes refer to work positions with assigned hourly or annual payment for services, broader and more inclusive conceptual terminology from a financial perspective would be “gender earnings gap” or “gender income gap,” terms that acknowledge real world work scenarios in which monetary differences can extend beyond assigned hourly and annual remuneration for work-related activities (e.g. the possibility that hours worked beyond minimum expectations can allow greater proportional hourly or bonus earnings). For this reason, we have chosen to use “gender income gap” when referring to differences in remuneration between women and men for work-related activities.

By comparison to the topic of gender, research related to ethnic/racial diversity in clinical neuropsychology has received less attention. Historically, the reason appears to reflect the relative lack of ethnic/racial diversity that has existed among clinical neuropsychology practitioners in the United States, though there is encouraging evidence that diversity trends are slowly increasing across time (Sweet et al., 2021b). In general, when subsets of survey respondents are under-represented, detailed analyses may be limited or even precluded. For this reason, important questions related to ethnicity and race have in the past been statistically difficult to address, a scenario that is only relatively better in the 2020 survey dataset. Notwithstanding continued limitations imposed by under-represented samples, the present investigation is intended to more thoroughly investigate ethnic/racial diversity, primarily using the latest 2020 professional practice survey data.

We acknowledge that gender and ethnic/racial identification are complex and multifaceted topics. Both have received increased attention in the last few years. As one of the primary goals of this article was to make comparisons across time, we elected to keep terminology synonymous with legacy terminology from prior iterations of the practice and “salary survey” when there was less emphasis placed on distinguishing between biological sex and gender, and different terminology was used for ethnic/racial groupings. Looking ahead to the next version of this survey, it will be imperative to include categories for gender diverse/gender non-conforming neuropsychologists, as well as to offer more specific categories for ethnicity/race that are consistent with government agencies and researchers in 2025.

Method

Original survey data in the present article were collected as part of a larger professional practice survey project. Preparation for the overall survey project began in 2018, with the development of the final survey instrument completed in the fall of 2019 (see also Sweet et al., 2021a, 2021b for a summary of the current survey methods). The Institutional Review Board (IRB) of NorthShore University HealthSystem approved the study in July 2019. The survey instrument was sent via electronic means (e.g. professional listserv announcements and e-mail blasts) to clinical neuropsychologists and postdoctoral trainees who practiced within the United States and Canada. Whereas previous articles summarize results of the overall survey findings among clinical neuropsychologists who practice in the U.S. (Sweet et al., 2021b) and Canada (Nelson et al., 2021), as well as postdoctoral residents (Sweet et al., 2021a), this study provides a more elaborate focus on gender and ethnic/racial diversity factors, using only the largest dataset of U.S. practitioners. New items addressing gender and diversity issues in greater detail were added in this iteration of the practice survey, including items related to aspects of career satisfaction, various career obstacles, and reasons for changing jobs, such as perceived unfairness/mistreatment. The full survey is available as an online supplement at The Clinical Neuropsychologist website (https://www.tandfonline.com/doi/suppl/10.1080/13854046.2020.1849803).

As was the case with the professional practice and income surveys conducted in 2005, 2010, and 2015, the current survey was administered through PsychData (https://www.psychdata.com/default.asp), an online platform developed by psychologists for internet-based research in the social sciences. The anonymous survey was opened online on 17 January 2020, at 9:00 a.m. Central Time, which corresponded with the sending of electronic invitations through professional listserv announcements and email blasts (see Acknowledgements for specifics), as well as mailing of postcards to neuropsychologists in the United States (see Sweet et al., 2021b for a detailed description of how mailing addresses were attained). A second wave of postcards was mailed in March 2020. The survey portal closed on 2 April 2020, at 10:00 a.m. Central Time, and all data were examined for usability (see Sweet et al., 2021b for a detailed description of the number of times the survey was accessed, data cleaning procedures, and computation of the usable final sample of 1677 U.S. practitioners).

Sample sizes vary across tables and sometimes within tables, as respondents used discretion as to the survey items they wanted to complete and those they elected to skip. Statistical analyses have been carried out within most tables, in an attempt to identify statistically significant differences between genders and between various ethnic/racial groups. The statistical analyses used to compare means and frequencies among the various groups include: a) chi-square analyses when examining differences between two categorical variables; b) independent samples t-tests to examine differences in means between women and men; c) one-way analysis of variance to determine whether there are statistically significant differences between the means of three or more independent groups (e.g. when comparing the means of the three career stages and when comparing the means of the different ethnic/racial groups); and d) two-way analysis of variance to test the effect of two independent variables on a dependent variable (e.g. when comparing the combined effects of gender and career stage on a dependent variable). Readers should note that in some tables, means will not evenly divide the reported minimum–maximum values, and at times there are large discrepancies between means and medians. Generally, in these instances of non-normal distributions, medians will provide more useful information. Non-normal distributions can also indicate the presence of outliers, which may disproportionately influence central tendency indicators.

Before analyses were completed, we identified and corrected for different types of extreme data points. Obvious data entry errors (e.g. annual full-time income of 0.00) were removed (n = 40). When numerical entries were required, but non-numerical words were entered, these responses were removed (n = 70). Numerical entries of extremely discrepant values on a statistical basis, which in most instances also appeared grossly unreasonable relative to available and historic survey data (e.g. a forensic hourly fee of $20,000), were removed first, and then the tails of the distribution were trimmed at the 5th and 95th percentiles. Statistical trimming of the tails occurred for the variables of annual income, clinical hourly fees, forensic hourly fees, and weekly forensic work hours.

In keeping with our previous work (cf., Sweet et al., 2006, 2011, 2015), and the 2020 parent survey database and publication from which the current results were derived (cf., Sweet et al., 2021b), we adopted a criterion of .01 for statistical significance as a strategy of guarding against false discovery (type I error). We also present effect size comparisons to assess the relative meaningfulness of demonstrated statistical test findings.

Related to the two topics of interest in this article, respondents were asked to select their “sex” from the following three answer choices: 1) female, 2) male, and 3) I prefer not to answer. They were also asked, “What is your ethnic/racial heritage” and selected from seven answer choices: 1) African American/Black, 2) American Indian or Alaskan Native, 3) Asian or Pacific Islander, 4) Biracial/Multiethnic/Multiracial, 5) White, 6) Hispanic/Latino(a), and 7) I choose not to disclose this information. Importantly, regarding gender, a majority of respondents identified as either female or male, and only 10 respondents selected “I prefer not to answer.” Given the small number in the latter group, only those who identified as female or male were included in the final analyses of this article. Similarly, with regard to self-assigned ethnic/racial identity, only two individuals identified as “American Indian or Alaskan Native.” Given such a small number, these individuals were only included in select analyses related to ethnic/racial differences between subgroups of respondents. Readers should be aware that whether related to being under-represented in the survey sample, under-represented in the larger population base, or due to small sample size data in the larger population base, when data are limited to being provided by very few individuals, some variables of interest may be unreliable.

In an attempt to more thoroughly explore gender and ethnic/racial differences relative to our previous work, a career stage variable (e.g. early career, middle career, and advanced career) was created to facilitate examination of possible age and experience cohort effects. According to the American Board of Professional Psychology, an Early Career Psychologist (ECP) is a licensed, doctoral-level clinician who earned her/his doctoral degree no more than ten years ago (see: https://www.abpp.org/Applicant-Information/5-Types-of-applications/Early-Career-Psychologist.aspx). For present purposes, clinicians who reported earning their doctoral degrees between 2009 and 2019 were considered ECPs. Psychologists who earned their doctoral degrees between 2000 and 2008 were considered “middle career psychologists” (MCPs), and those who earned their doctoral degrees during or before 1999 were considered “advanced career psychologists” (ACPs).

Results

Given the numerous statistical analyses conducted in this article, not all findings will be discussed in this section and will instead be listed under the appropriate table notes below. To aid reader navigation of the numerous detailed findings reported below, the following sequence of topics is presented under major headings:

1. Response rate

2. Part 1: Gender results

   1. general characteristics in 2020;

   2. sample characteristics across time;

   3. academic rank and position titles in institutions;

   4. board certification;

   5. scholarly activities;

   6. income;

   7. hourly fees;

   8. forensic activities;

   9. number of positions and perceived unfairness/mistreatment;

   10. career satisfaction; and

   11. personal/family and work environment obstacles by work setting and by professional identity to career satisfaction.

3. Part 2: Ethnic/racial diversity results

   1. general characteristics in 2020;

   2. scholarly activities;

   3. income;

   4. perceived unfairness/mistreatment;

   5. career satisfaction; and

   6. personal/family and work environment obstacles to career satisfaction.

Response rate

Every attempt was made to reach all U.S. doctoral-level neuropsychologists of the sponsoring organizations, as well as all doctoral-level practitioners within the broader U.S. community of neuropsychologists who may not belong to one of these organizations through electronic communication, including professional listserv announcements and e-mail blasts, and by U.S. mail. Assuming that the 5359 unique names and mailing addresses that were identified in 2020 are representative of all neuropsychologists, the final sample of 1677 respondents yields a response rate of 31.3%, which is a 6.2% increase compared to the 2015 survey, and is the largest sample surveyed within the specialty of clinical neuropsychology to date (see Sweet et al., 2021b for additional details related to the response rate).

Because the onset of the COVID-19 pandemic occurred during the survey data collection process, the possibility of effects on survey results can be raised. When examining potential differences between pre-pandemic and pandemic-era respondents, we found no significant findings. Of those who opted to disclose their gender, 82.6% of both women and men, as well as 90% of those in the chose not to disclose gender group, completed the survey prior to the official start of the pandemic. Seventy-six percent of African Americans/Blacks, 50% (i.e. one participant) of American Indians or Alaskan Natives, 84.8% of Asians or Pacific Islanders, 88.6% of Biracial/Multiethnic/Multiracial individuals, 84% of Hispanics/Latino(a)s, 82.4% of Whites, and 88.4% of those in the Chose not to disclose ethnicity/race completed the survey prior to the pandemic. Related to practice, there were no significant differences between the number of women and men who performed telehealth services prior to the start of the pandemic and those who provided such services after the start of the pandemic. Income values were not affected, as responses reflected 2019 attainments.

Part 1: gender results

General characteristics of 2020 survey respondents with regard to gender

Figure 1 shows a breakdown of respondents by gender, career stage, professional identity, and work setting. Of the 1677 respondents who completed the survey, 1383 of those respondents indicated active professional licensure and current practice of full-time or more (e.g. full-time plus part-time positions). Sixty percent of the licensed and currently practicing clinicians in the sample are women and 39.5% are men. The remaining 0.5% was assigned to a group labeled Chose not to disclose gender.

Figure 1. Breakdown of survey participants by gender, career stage, professional identity, and work setting. Priv. Prac. = private practice; Inst. + PP = institution plus private practice. Some percentages do not total 100% due to rounding.

General characteristics of 2020 survey respondents with regard to gender and career stage

When examining women’s career stages, Figure 1 shows that the overwhelming majority are ECPs (53.8%), followed by MCPs and ACPs, at 27.2 and 19%, respectively. In contrast, men are more likely to be advanced in their careers (44.6%), with only 31.4% identified as ECPs and 24% identified as MCPs. Directly compared to men within each career stage, women constitute 72.3% of ECPs, 63.4% of MCPs, and 39.4% of ACPs. In the Chose not to disclose gender group, there were two ECPs, four MCPs, and four ACPs.

General characteristics of 2020 survey respondents with regard to gender, career stage, professional identity, and work setting

Regardless of career stage, as shown in Figure 1, both women and men are more likely to identify as adult neuropsychologists, and most work in institutions exclusively, though advanced career men do so less frequently. Across all three career stages, many more women than men identify as pediatric neuropsychologists (percentages for women range from 22.7 to 29.6%; percentages for men range from 6.4 to 14.3%). Regarding work setting, ECPs work primarily in institutions. As one advances across the three career stages, a larger portion of time is spent working in private practice, and less time is spent working in institutions. In the work setting category of institution plus private practice, MCPs and ACPs spend approximately equal time (women: 18.2 and 18.8%, respectively; men: 39.5 and 37.6%, respectively).

Sample characteristics across time by gender

Table 1 shows a comparison of the overall sample characteristics from 2005 to 2020. The presence of women in the field has steadily grown over the last 15 years, whereas the presence of men has steadily declined from 2010 to 2020. Regardless of gender, most respondents work full-time. Compared to women, men are more likely to hold both a full-time and a part-time job, and from 2005 to 2015, were less likely to be employed on a part-time basis. Women and men are most often employed in institutions, rather than private practice. Figure 2 shows professional identity by gender across time, with men increasingly identifying as adult neuropsychologists from 2005 to 2015, and stable identifications as adult providers in 2020. Women, by comparison, increasingly identify as pediatric neuropsychologists. The percentage of lifespan neuropsychologists, for both genders, is decreasing across time as younger neuropsychologists identify with either adult or pediatric practice.

Figure 2. Professional identity across time by gender.

Table 1. Comparison of overall sample characteristics from 2005 through 2020.

	2005						2010						2015						2020
Gender^a	Women			Men			Women			Men			Women			Men			Women			Men
	Freq.		%	Freq.		%	Freq.		%	Freq.		%	Freq.		%	Freq.		%	Freq.		%	Freq.		%
Work status^b	(n= 375)			(n= 422)			(n = 771)			(n = 724)			(n = 843)			(n = 672)			(n = 932)			(n = 607)
Full-time	301	80.3		371	87.9		619	80.3		596	82.3		688	81.6		577	85.9		813	87.2		488	80.4
Part-time	42	11.2		10	2.4		104	13.5		32	4.4		92	10.9		32	4.8		72	7.7		47	7.7
Combined^c	29	7.7		38	9.0		38	4.9		90	12.4		57	6.8		58	8.6		47	5.0		66	10.9
General work setting	(n = 340)			(n = 393)			(n = 650)			(n = 641)			(n = 733)			(n = 600)			(n = 801)			(n = 522)
Institution only	174	51.2		160	40.7		325	50.0		230	35.9		428	58.4		274	45.7		509	63.5		219	42.0
Private practice only	74	21.8		118	30.0		193	29.7		183	28.5		151	20.6		146	24.3		178	22.2		139	26.6
Institution + PP	92	27.1		115	29.3		132	20.3		228	35.6		154	21.0		180	30.0		114	14.2		164	31.4
Professional identity	(n = 347)			(n = 405)			(n = 655)			(n = 642)			(n = 738)			(n = 606)			(n = 804)			(n = 525)
Adult neuropsychologist	175	50.4		209	51.6		333	50.8		373	58.1		407	55.1		381	62.9		449	55.8		326	62.1
Pediatric neuropsychologist	64	18.4		38	9.4		143	21.8		57	8.9		173	23.4		48	7.9		208	25.9		52	9.9
Lifespan neuropsychologist	91	26.2		129	31.9		148	22.6		181	28.2		139	18.8		166	27.4		140	17.4		139	26.5
Not a neuropsychologist^d	17	4.9		29	7.2		31	4.7		31	4.8		19	2.6		11	1.8		7	0.9		8	1.5

Note. Includes all licensed clinicians. Some percentages do not total 100% due to rounding. Freq. = frequency; Institution + PP = institution plus private practice.

a Regarding gender, no individuals selected “other” as an option, and only 10 selected “I prefer not to answer.” Given the small number of respondents who selected an option other than “female” or “male,” they were excluded from all analyses.

b Due to small numbers, individuals who reported being retired; disabled, not working; or unemployed are not included in the table and are instead listed here.

In 2005, women: 0 retired, 0 disabled, 3 (0.8%) unemployed; men: 3 (0.7%) retired, 0 disabled, 0 unemployed.

In 2010, women: 3 (0.4%) retired, 0 disabled, 7 (0.9%) unemployed; men: 6 (0.8%) retired, 0 disabled, 0 unemployed.

In 2015, women: 3 (0.4%) retired, 1 (0.1%) disabled, 2 (0.2%) unemployed; men: 4 (0.6%) retired, 0 disabled, 1 (0.1%) unemployed.

In 2020, women: 0 retired, 0 disabled, 0 unemployed; men: 5 (0.8%) retired, 1 (0.2%) disabled, 0 unemployed.

c Combined includes full-time plus part-time work.

d A self-designation indicating identity as a psychologist, but not as a neuropsychologist.

Academic rank and position titles in institutions by gender

Table 2 shows gender comparisons in academic rank and position titles within institutional settings in 2015 and 2020. At both time points, women have been more likely than men to be assistant professors, whereas men have been more likely to hold the academic rank of professor compared to women. No matter the gender, a majority of respondents hold the clinical position title of staff neuropsychologist/psychologist. From 2015 to 2020, clinical position titles have remained largely consistent for both women and men.

Table 2. Gender comparisons in academic rank and position titles within institutional settings from 2015 through 2020.

	2015				2020
	Women		Men		Women		Men
	Frequency	%	Frequency	%	Frequency	%	Frequency	%
Institutional academic rank	(n = 459)		(n = 393)		(n = 510)		(n = 331)
Lecturer/instructor/educator	40	8.7	27	6.9	42	8.2	21	6.3
Assistant professor	176	38.3	98	24.9	213	41.8	99	29.9
Associate professor	66	14.4	89	22.6	91	17.8	56	16.9
Professor	26	5.7	82	20.9	27	5.3	61	18.4
Emeritus	1	0.2	3	0.8	0	0.0	3	0.9
Other	85	18.5	48	12.2	37	7.3	19	5.7
Not applicable	65	14.2	46	11.7	100	19.6	72	21.8
Institutional position title	(n = 552)		(n = 444)		(n = 600)		(n = 373)
Staff neuropsychologist/psychologist	399	72.3	243	54.7	431	71.8	228	61.1
Clinical program director	49	8.9	58	13.1	48	8.0	38	10.2
Research program director	14	2.5	21	4.7	15	2.5	15	4.0
Clinical training director	24	4.4	15	3.4	29	4.8	12	3.2
Division head	18	3.3	45	10.1	29	4.8	40	10.7
Vice/associate/assistant chair	0	0.0	9	2.0	4	0.7	9	2.4
Department chair	8	1.4	12	2.7	8	1.3	11	2.9
Other	40	7.2	41	9.2	36	6.0	20	5.4

Note. Includes all licensed and non-licensed respondents who work in institutions and institutions plus private practices. Some percentages do not total 100% due to rounding.

Board certification by gender

Table 3 shows the differences between women and men in each of the three career stages with regard to ABCN board certification, as well as interest in becoming board certified. There were no significant differences between women and men regarding career stage. Interestingly, the earlier women are in their careers, the more likely they are to be board certified, whereas the opposite is true for men (i.e. ACP men are more likely to be board certified than those in their early and middle careers). Among individuals who are not board certified, interest in ABCN board certification is significantly greater for women than men, χ²[1]=46.1, p<.001; there are no significant differences between the genders when examining career stage. Interest in board certification is the highest for ECP women and ECP men and steadily declines over time.

Table 3. Obstacles to pursuing American Board of Clinical Neuropsychology (ABCN) board certification.

	Women		Men
	Freq.	% Yes	Freq.	% Yes
Are you board certified by ABPP? (n = 1546)	(n = 937)		(n = 609)
	387	41.3	289^a	47.5
Early career psychologists	(n = 499)	38.8	(n = 174)	22.3
	150/499	30.1	64/174	36.8
Middle career psychologists	(n = 252)	37.7	(n = 136)	24.0
	146/252	57.9	69/136	50.7
Advanced career psychologists	(n = 184)	23.5	(n = 296)	53.7
	91/184	49.5	154/296	52.0
	Total =	100.0	Total =	100.0
Are you interested in becoming board certified by ABCN? (n = 863)	(n = 547)		(n = 316)
	393	71.8	154	48.7
Early career psychologists	(n = 347)	80.4	(n = 109)	64.9
	316/347	91.1	100/109	91.7
Middle career psychologists	(n = 106)	15.0	(n = 65)	19.5
	59/106	55.7	30/65	46.2
Advanced career psychologists	(n = 93)	4.6	(n = 141)	15.6
	18/93	19.4	24/141	17.0
	Total =	100.0	Total =	100.0
Obstacles to becoming board certified^b	(n = 548)		(n = 317)
Prohibitive time commitment (e.g. insufficient time to prepare)	344	62.8	161	50.8
Limited incentive (e.g. lack of employer support)	187	34.1	107	33.8
Prohibitive cost (i.e. examination expense)	99	18.1	33	10.4
Lack of mentorship opportunities	52	9.5	21	6.6
Lack of mobility (e.g. unable to move to training sites)	11	2.0	5	1.6
Lack of access (e.g. unable to match with a training site)	3	0.5	7	2.2
Other	191	34.9	140	44.2

Note. Includes all licensed and non-licensed respondents. Freq. = frequency. Some percentages do not total 100% due to rounding.

a Only 287 of these men provided enough information to be classified into a career stage.

b Only asked of non-ABPP respondents; they could select all obstacles that applied.

Obstacles to pursuing ABCN board certification by gender

Also included in Table 3 are potential obstacles that respondents may face when pursuing board certification. Significantly more women than men indicated that prohibitive time commitment and prohibitive cost are barriers to pursuing ABCN board certification, χ²[1]=11.9, p=.001; χ²[1]=9.1, p=.003, respectively. Significantly more men than women indicated that the obstacles that compose the “other” group create barriers to pursuing ABCN board certification, χ²[1]=7.4, p=.007. There were no significant differences between women and men when examining obstacles present at various career stages.

Scholarly activities by gender

Table 4 reflects the number of peer-reviewed publications and conference presentations by gender and career stage. In the overall sample and within the advanced career stage, men authored or co-authored significantly more publications and conference presentations than women.

Table 4. Scholarly activities: Peer-reviewed publications and conference presentations by gender and career stage.

	Number of authored or co-authored peer-reviewed publications					Number of authored or co-authored conference presentations
	n	Mean	Median	SD	Range	n	Mean	Median	SD	Range
Women	834	11.2^a	5.0	19.5	0.0 − 197.0	816	19.4^c	10.0	30.8	0.0 − >201.0
Early career women	449	6.7	4.0	8.1	0.0 − 60.0	436	15.5	10.0	18.1	0.0 −   175.0
Middle career women	219	14.1	6.0	22.3	0.0 − 142.0	217	23.1	10.0	37.4	0.0 − >201.0
Advanced career women	165	19.3^b	6.0	30.1	0.0 − 197.0	163	24.7^d	5.0	44.0	0.0 − >201.0
Men	548	25.8^a	8.0	43.2	0.0 − >201.0	543	36.2^c	12.0	54.3	0.0 − >201.0
Early career men	160	8.6	5.0	9.7	0.0 − 54.0	159	20.4	13.0	25.0	0.0 − >201.0
Middle career men	124	18.4	5.5	31.6	0.0 − >201.0	124	27.6	10.0	41.3	0.0 − >201.0
Advanced career men	261	39.9^b	12.0	54.6	0.0 − 201.0	257	50.1^d	12.0	68.2	0.0 − >201.0

Note. Includes all licensed and non-licensed respondents; excludes those who indicated they are not neuropsychologists.

Survey response option range was from 0 − >200. Mean, median, and standard deviations were calculated with >200 recoded to 201.

a Men authored or co-authored significantly more peer-reviewed publications than their female counterparts, t = 7.5, p < .001, d = 0.4.

b Advanced career men authored or co-authored significantly more peer-reviewed publications than their female counterparts, t = 5.0, p < .001, d = 0.5.

c Men authored or co-authored significantly more conference presentations than their female counterparts, t = 6.6, p < .001, d = 0.4.

d Advanced career men authored or co-authored significantly more conference presentations than their female counterparts, t = 4.6, p < .001, d = 0.4.

Scholarly activities by gender: funded research

Funded research activity deserves separate consideration. When examining rates of funded research among neuropsychologists, which included 187 women and 144 men, both groups spend approximately 11 hours per week in this role. However, funded male researchers produced significantly more publications (M=56.7, SD=60) and conference presentations (M=78, SD=71.2) than their female counterparts (M=24.8, SD=30.2; M=39.2, SD=44.2), t=5.8, p<.001, d=0.7; t=5.7, p<.001, d=0.7, respectively. There was a significant gender by career stage interaction for number of funded research publications, F (2, 318)=6.9, p=.001, and conference presentations, F (2, 313)=8.8, p<.001. ACP men produce significantly more funded publications (M=87.9, SD=63.7) and conference presentations (M=112.6, SD=74) than ACP women (M=46.3, SD=45.3; M=51.7, SD=57.8), t=3.9, p<.001, d=0.9; t=4.7, p<.001, d=0.8, respectively. All three subgroups spend similar amounts of time conducting funded research each week.

Income

Income: the gender gap across time

As depicted in Table 5 and Figure 3, over the last 15 years, male neuropsychologists have reported larger salaries than female neuropsychologists. In 2005, men made an average of $34,000 more than women. The gender income gap increased in 2010 to approximately $48,000, and it remained at approximately $48,000 in 2015. The gender income gap increased again from 2015 to 2020, such that the difference became statistically significant for the first time, with male neuropsychologists (M=212.4, SD=145.6) reporting higher incomes than their female counterparts (M=139.5, SD=91) by almost $73,000, t=9.0, p<.001, d=0.6.

Figure 3. Gender differences in neuropsychologist income across time.

Table 5. Income: Gender differences from 2005 to 2020.

2005		2010		2015		2020^a
Women (n = 255)	Men (n = 309)	Women (n = 534)	Men (n = 597)	Women (n = 590)	Men (n = 529)	Women (n = 584)	Men (n = 423)
Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)
83.4 (39.4)	117.4 (76.6)	103.7 (50.9)	151.9 (98.3)	120.2 (52.5)	168.8 (101.9)	139.5 (91.0)	212.4 (145.6)

Note. Income values are in thousands of dollars. Includes licensed clinicians who are currently practicing full-time or more; excludes those who indicated they are not ­neuropsychologists. Using 1SD above the mean for current second-year postdoctoral trainees, those earning <$55,000 annually were excluded.

a In 2020, the annual mean salary for men was significantly greater than the annual mean salary for women, t = 9.0, p = <.001, d = 0.6.

Income: the gender gap by professional identity

Table 6 depicts differences in salaries across gender regarding professional identity. Across all three professional identities, men report higher incomes than women, though this difference is only statistically significant for adult (M=196.7, SD=128.3 vs. M=135.8, SD=99.5) and lifespan (M=260.4, SD=176.4 vs. M=154.5, SD=78.6) neuropsychologists.

Table 6. Income: professional identity.

					Percentile					Significance testing
	n	Mean	Median	SD	25	75	95	99	Min–Max	t	p	d
Pediatric										1.9	.06	0.4
Women	152	136.9	120.0	79.2	103.3	145.0	203.5	694.0	68.0–800.0
Men	43	173.9	126.0	118.3	115.0	192.0	530.0	–	72.0–600.0
Adult^a										6.3	<.001	0.5
Women	321	135.8	120.0	99.5	105.0	140.0	209.0	408.5	60.0–1550.0
Men	257	196.7	150.0	128.3	120.0	221.5	473.0	742.0	55.0–970.0
Lifespan^b										5.9	<.001	0.8
Women	105	154.5	134.0	78.6	104.5	180.0	310.5	500.0	75.0–500.0
Men	118	260.4	210.0	176.4	150.0	300.0	600.4	1,203.6	64.0–1286.5
Not a neuropsychologist^c										0.01	1.0	0.0
Women	6	124.7	118.0	45.8	83.8	161.8	–	–	80.0–197.0
Men	5	125.0	110.0	62.8	85.0	172.5	–	–	80.0–235.0

Note. Income values are from 2020 and are expressed in thousands of dollars. Includes licensed clinicians who are currently practicing full-time or more. Using 1SD above the mean for current second-year postdoctoral trainees, those earning <$55,000 annually were excluded. Min–Max = minimum–maximum.

a Adult men earn significantly more than adult women, t = 6.3, p < .001, d = 0.5.

b Lifespan men earn significantly more than lifespan women, t = 5.9, p < .001, d = 0.8.

c A self-designation indicating identity as a psychologist, but not as a neuropsychologist.

The SPSS statistical algorithm (HAVERAGE) is undefined for percentiles beyond a certain point at which case numbers are low. As percentiles based on small or under-represented samples are unstable/arbitrary, these ranges were marked as missing.

Income: the gender gap by professional identity and career stage

Additional comparisons between women and men regarding professional identity and the three career stages can be seen in Table 7. With the exception of early career pediatric neuropsychologists, men earn more than women in all other groups and across all professional identities. Among pediatric neuropsychologists, there was a significant main effect for career stage; ACPs (M = 202.4, SD = 149.5) and MCPs (M = 166.0, SD = 93.2) earn significantly more than ECPs (M = 115.5, SD = 24.3). For the adult neuropsychologist group, a two-way ANOVA revealed a significant interaction effect; ACP men (M = 261.3, SD = 165.9) earn significantly more than ACP women (M = 175.9, SD = 116), and ECP men (M = 134.1, SD = 53.4) earn significantly more than ECP women (M = 114.3, SD = 18.9). Among lifespan neuropsychologists, there was a significant main effect for gender; men (M = 260.4, SD = 176.4) earn significantly more than women (M = 154.5, SD = 78.6). There was also a significant main effect for career stage, with advanced career lifespan neuropsychologists (M = 276.3, SD = 183.4) earning significantly more than middle career lifespan neuropsychologists (M = 179.3, SD = 82.4) and early career lifespan neuropsychologists (M = 142.3, SD = 88.2).

Table 7. Income: professional identity by career stage.

					Percentile
	n	Mean	Median	SD	25	75	95	99	Min–Max
Pediatric^a
Early career women	93	116.0	110.0	25.7	100.0	126.5	159.8	–	68.0–235.0
Early career men	16	112.3	118.5	13.9	100.1	123.3	–	–	91.3–134.0
Middle career women	32	153.9	144.5	52.2	130.0	168.5	276.5	–	90.0–400.0
Middle career men	15	192.0	127.0	152.3	115.0	172.0	–	–	72.0–600.0
Advanced career women	27	188.6	135.0	161.8	110.0	178.0	720.0	–	92.0–800.0
Advanced career men	12	233.5	197.5	117.3	173.8	257.6	–	–	100.0–550.0
Adult^b
Early career women	183	114.3	115.0	18.9	103.0	126.0	146.6	165.8	60.0–170.0
Early career men	92	134.1	121.0	53.4	105.0	143.7	237.3	–	57.0–385.0
Middle career women	81	156.0	130.0	163.6	110.0	148.5	259.8	–	60.0–1550.0
Middle career men	63	183.6	162.0	77.6	126.3	205.0	390.0	–	98.0–450.0
Advanced career women	57	175.9	150.0	116.0	130.0	182.5	357.5	–	87.0–900.0
Advanced career men	102	261.3	200.0	165.9	149.8	328.8	592.5	964.9	55.0–970.0
Lifespan^c
Early career women	41	122.3	110.0	41.9	93.0	139.0	199.0	–	75.0–290.0
Early career men	22	181.1	130.5	132.7	103.5	220.0	583.5	–	64.0–607.0
Middle career women	37	161.4	150.0	82.4	112.4	192.5	379.2	–	80.0–500.0
Middle career men	26	204.7	186.5	77.0	149.5	256.0	377.6	–	100.0–400.0
Advanced career women	27	193.9	170.0	96.5	120.0	250.0	460.0	–	100.0–500.0
Advanced career men	69	308.3	250.0	200.5	184.0	350.0	760.0	–	100.0–1286.5

Note. Income values are from 2020 and are expressed in thousands of dollars. Includes licensed clinicians who are currently practicing full-time or more. Using 1SD above the mean for current second-year postdoctoral trainees, those earning <$55,000 annually were excluded. Min–Max = minimum–maximum.

a For pediatric neuropsychologists, there was a significant main effect for career stage, F (2, 195) = 17.9, p < .001; advanced career neuropsychologists and middle career neuropsychologists earn significantly more than early career neuropsychologists.

b For adult neuropsychologists, there was a significant interaction effect, F (2, 572) = 4.8, p = .009; advanced career men earn significantly more than advanced career women, and early career men earn significantly more than early career women, t = 3.8, p < .001, d = 0.6; t = 3.4, p = .001, d = 0.5, respectively.

c For lifespan neuropsychologists, there was a significant main effect for gender; men earn significantly more than women, t = 5.9, p < .001, d = 0.8. There was also a significant main effect for career stage, F (2, 221) = 20.8, p < .001; advanced career neuropsychologists earn significantly more than middle career neuropsychologists and early career neuropsychologists.

The SPSS statistical algorithm (HAVERAGE) is undefined for percentiles beyond a certain point at which case numbers are low. As percentiles based on small or under-represented samples are unstable/arbitrary, these ranges were marked as missing.

Income: the gender gap by work setting

Table 8 shows salaries by gender with regard to work setting. Private practitioners earn more than individuals working solely in institutions and those who work in institutions plus private practice settings. Across all three work settings, men report significantly higher incomes than women.

Table 8. Income: general work setting.

					Percentile					Significance testing^a
	n	Mean	Median	SD	25	75	95	99	Min–Max	t	p	d
Institution										4.5	<.001	0.5
Women	364	120.4	115.0	28.3	103.0	134.8	171.7	198.1	60.0–400.0
Men	171	138.4	124.5	48.0	107.0	154.0	244.0	351.8	57.0–400.0
Private practice										5.5	<.001	0.8
Women	126	174.8	140.0	123.4	105.8	200.0	388.0	873.0	60.0–900.0
Men	97	299.8	240.0	196.2	152.5	392.5	702.0	–	60.0–1286.5
Institution + private practice										3.5	.001	0.5
Women	88	167.8	135.0	160.3	120.0	167.3	316.1	–	60.0–1550.0
Men	150	240.1	200.0	140.9	149.5	280.0	533.5	908.8	55.0–907.6

Note. Income values are from 2020 and are expressed in thousands of dollars. Includes licensed clinicians who are currently practicing full-time or more; excludes those who indicated they are not neuropsychologists. Using 1SD above the mean for current second-year postdoctoral trainees, those earning < $55,000 annually were excluded. Min–Max = minimum–maximum.

a Across all three work settings, men report significantly higher incomes than women: institutions (t = 4.5, p < .001, d = 0.5), private practice (t = 5.5, p < .001, d = 0.8), and institution plus private practice (t = 3.5, p = .001, d = 0.5).

The SPSS statistical algorithm (HAVERAGE) is undefined for percentiles beyond a certain point at which case numbers are low. As percentiles based on small or under-represented samples are unstable/arbitrary, these ranges were marked as missing.

Income: the gender gap by work setting and career stage

Regarding work setting and the three career stages, gender comparisons can be seen in Table 9. Across all career stages and general work settings, men report higher incomes. There was a significant main effect for career stage in each group. Among those who work in institutions, ACPs (M = 158.6, SD = 57.8) earn significantly more than MCPs (M = 138.6, SD = 33.2) and ECPs (M = 113.3, SD = 21.5), and MCPs earn significantly more than ECPs. Among those who work in private practice, ACPs (M = 289.9, SD = 201.5) earn significantly more than MCPs (M = 196.9, SD = 118.3) and ECPs (M = 149.6, SD = 85.9). In the institution plus private practice setting, ACPs (M = 262.8, SD = 157.7) earn significantly more than ECPs (M = 145.5, SD = 61.1).

Table 9. Income: general work setting by career stage.

					Percentile
	n	Mean	Median	SD	25	75	95	99	Min–Max
Institution^a
Early career women	238	112.1	110.0	18.9	100.0	121.6	145.3	165.0	60.0–200.0
Early career men	82	115.1	112.0	23.6	101.8	129.3	153.4	–	57.0–215.0
Middle career women	85	131.3	130.0	25.0	112.0	145.0	180.0	–	80.0–210.0
Middle career men	44	149.7	134.0	42.4	120.5	174.3	222.5	–	105.0–333.0
Advanced career women	41	146.3	140.0	49.6	118.5	161.0	196.8	–	90.0–400.0
Advanced career men	45	169.8	155.0	62.9	122.1	197.5	280.7	–	89.0–400.0
Private practice^b
Early career women	44	126.6	128.0	34.5	101.1	144.8	196.3	–	75.0–235.0
Early career men	19	203.0	150.0	135.2	120.0	235.0	–	–	60.0–607.0
Middle career women	35	176.8	150.0	98.3	106.0	220.0	420.0	–	60.0–500.0
Middle career men	15	243.7	183.0	149.0	117.0	336.0	–	–	98.0–600.0
Advanced career women	47	218.4	175.0	170.1	120.0	250.0	720.0	–	87.0–900.0
Advanced career men	63	342.3	300.0	209.4	200.0	450.0	784.0	–	100.0–1286.5
Institution + private practice^c
Early career women	35	128.3	122.0	37.5	110.0	135.0	210.0	–	60.0–290.0
Early career men	29	166.3	140.0	76.7	121.5	202.5	378.8	–	84.0–450.0
Middle career women	30	206.0	151.0	259.2	128.8	192.5	871.9	–	70.0–1550.0
Middle career men	45	211.7	200.0	86.8	140.0	250.0	414.0	–	72.0–450.0
Advanced career women	23	177.9	150.0	79.8	130.0	187.9	404.0	–	98.0–425.0
Advanced career men	75	286.9	218.0	168.3	180.0	350.0	612.0	–	55.0–970.0

Note. Income values are from 2020 and are expressed in thousands of dollars. Includes licensed clinicians who are currently practicing full-time or more; excludes those who indicated they are not neuropsychologists. Using 1SD above the mean for current second-year postdoctoral trainees, those earning <$55,000 annually were excluded. Min–Max = minimum–maximum.

a Within an institutional setting, there was a significant main effect for career stage, F (2, 538) = 76.5, p < .001; advanced career neuropsychologists earn significantly more than middle career neuropsychologists and early career neuropsychologists, and middle career neuropsychologists earn significantly more than early career neuropsychologists.

b Within a private practice setting, there was a significant main effect for career stage, F (2, 221) = 17.0, p < .001; advanced career neuropsychologists earn significantly more than middle career neuropsychologists and early career neuropsychologists.

c Within an institution plus private practice setting, there was a significant main effect for career stage, F (2, 238) = 12.9, p < .001; advanced career neuropsychologists earn significantly more than early career neuropsychologists.

The SPSS statistical algorithm (HAVERAGE) is undefined for percentiles beyond a certain point at which case numbers are low. As percentiles based on small or under-represented samples are unstable/arbitrary, these ranges were marked as missing.

Income: the gender gap by private practice

As can be seen in Table 10, men earn more than women in every role of private practice. Specifically, men (M = 323.1, SD = 207.3) who are sole proprietors earn significantly more than women sole proprietors (M = 189.5, SD = 131.9). Following up on the possibility that these gender-based differences might be accounted for by other variables, female sole proprietors were significantly younger than male sole proprietors (M = 50.3, SD = 10.5 vs. M = 59.6, SD = 10.2) and had been practicing fewer years (M = 18.4, SD = 10.7 vs. M = 27.1, SD = 10.7), t = 5.6, p<.001, d = 0.9; t = 5.1, p<.001, d = 0.8, respectively. Forensic hours per week were significantly different between women and men sole proprietors (women: M = 10.3, SD = 13.6 vs. men: M = 17.6, SD = 14.5), t = 3.2, p=.002, d = 0.5, as were the overall number of work hours per week (women: M = 36.3, SD = 9.3 vs. men: M = 41.4, SD = 9.4), t = 3.2, p=.002, d = 0.5.

Table 10. Income: private practice roles.

	Women					Men						Significance testing
Private practice role	n	%	Mean	Median	SD	n	%	Mean	Median	SD	Total n	t	p	d
Sole proprietor^a ^,b	78	49.4	189.5	150.0	131.9	80	50.6	323.1	268.5	207.3	158	4.8	<.001	0.8
Early career	18	23.1	117.1	115.0	32.4	6	7.5	264.3	287.5	115.9	24	3.1	.03	1.7
Middle career	20	25.6	209.7	200.0	111.1	13	16.3	272.1	250.0	146.2	33	1.3	.20	0.5
Advanced career^c	40	51.3	211.9	176.5	157.2	61	76.3	339.7	270.0	223.6	101	3.4	.001	0.7
Partner	7	38.9	168.9	140.0	74.1	11	61.1	304.9	300.0	184.8	18	2.2	.05	1.0
Employee	34	69.4	131.7	130.0	35.6	15	30.6	185.2	150.0	116.0	49	1.8	.10	0.6
Outside contractor	10	66.7	111.5	111.0	26.5	5	33.3	173.8	175.0	53.6	15	2.5	.06	1.5
Other^d	5	–	–	–	–	–	–	–	–	–	6

Note. Income values are from 2020 and are expressed in thousands of dollars. Includes licensed clinicians who are currently practicing full-time or more in private practice and licensed clinicians who are currently practicing full-time or more in an institution plus private practice setting, with at least 80% of their time at the private practice; excludes those who indicated they are not neuropsychologists. Incomes reflect the private practice portion only. Using 1SD above the mean for current second-year postdoctoral trainees, those earning <$55,000 annually were excluded. Some percentages do not total 100% due to rounding.

a Male sole proprietors earn significantly more than women sole proprietors, t = 4.8, p < .001, d = 0.8.

b The percentages in the shaded boxes reflect the proportion of early, middle, and advanced career sole proprietors.

c Advanced career men earn significantly more than advanced career women, t  = 3.4, p = .001, d = 0.7.

d Those in the other group consisted primarily of individuals who held positions within two different private practices. Given the small number of individuals in this group, statistics were not calculated, nor were comparisons across the two groups made.

Income: the gender gap by private practice and career stage

When examining differences in private practice incomes across the three career stages, ACP men (M = 339.7, SD = 223.6) earn significantly more than ACP women (M = 211.9, SD = 157.2).

Hourly fees: clinical and forensic by gender

Table 11 examines gender with regard to clinical and forensic hourly fees across general work settings. Men (M = 357.9, SD = 92) charge a significantly higher hourly fee than women (M = 334.2, SD = 84.4) for forensic work. Although the numbers reported by men across work settings appear higher per hour for clinical and forensic work, the differences are not statistically significant.

Table 11. Fees: gender comparisons of clinical and forensic hourly fees.

	Women					Men					Significance testing
	n	Mean	Median	SD	Min–Max	n	Mean	Median	SD	Min–Max	t	p	d
Hourly fee 2020
Clinical	384	246.0	250.0	85.4	100.0–500.0	358	259.2	250.0	98.3	100.0–500.0	1.9	.05	0.2
Forensic^a	208	334.2	325.0	84.4	190.0–575.0	286	357.9	350.0	92.0	190.0–575.0	3.0	.003	0.3
General work setting
Institution
Clinical	136	265.1	250.0	103.8	100.0–500.0	96	266.4	250.0	105.1	100.0–500.0	0.1	.92	0.02
Forensic	51	348.6	350.0	73.4	200.0–500.0	46	363.5	350.0	86.3	200.0–500.0	0.9	.37	0.2
Private practice
Clinical	149	230.9	230.0	67.3	100.0–450.0	114	244.0	225.0	95.9	100.0–500.0	1.2	.21	0.2
Forensic	79	328.5	300.0	91.1	200.0–575.0	94	357.3	350.0	92.5	200.0–575.0	2.1	.04	0.3
Inst. + Priv. Prac.
Clinical	76	238.8	225.0	82.9	100.0–500.0	124	260.7	250.0	91.8	100.0–500.0	1.7	.09	0.3
Forensic	60	328.4	300.0	82.8	190.0–550.0	121	355.8	350.0	95.2	190.0–550.0	2.0	.05	0.3

Fee values are from 2020 and are expressed in hundreds of dollars. Includes all licensed clinicians who are currently practicing; excludes those who indicated they are not ­neuropsychologists. Clinical and forensic hourly fees exclude presumptively erroneous numbers (e.g. zeros) and extreme statistical outliers (i.e. tails trimmed at 5th and 95th percentiles).

Inst. + Priv. Prac. = institution plus private practice; Min–Max = minimum–maximum.

a Men charge a significantly higher hourly fee than women for forensic work, t = 3.0, p = .003, d = 0.3.

Forensic activities by gender

Regarding the number of hours women and men spend performing forensic activities each week, Table 12 shows that men (M = 11.5, SD = 11.4), on average, spend approximately two more hours in forensic practice each week than women (M = 9.7, SD = 10.8), which is not statistically significant. There was a significant main effect for career stage; ACPs (M = 13.9, SD = 13.5) spend significantly more time in forensic practice activities than MCPs (M = 8.8, SD = 8.5) and ECPs (M = 7.2, SD = 7.3).

Table 12. Forensic: gender and forensic activity hours per week.

	Women			Men
	n	Mean	SD	n	Mean	SD
Entire sample	241	9.7	10.8	276	11.5	11.4
Career stage^a
Early career	93	7.1	7.8	54	7.4	6.3
Middle career	70	9.1	9.2	70	8.7	7.9
Advanced career	78	13.4	13.9	150	14.1	13.4

Note. Includes all licensed clinicians who are currently practicing full-time or more; excludes those who indicated they are not neuropsychologists. Entries of >60 h per week were excluded.

a There was a significant main effect for career stage, F (2, 521) = 20.0, p < .001; advanced career neuropsychologists spend significantly more time performing forensic activities than middle career neuropsychologists and early career neuropsychologists.

Number of positions held as a neuropsychologist and perceived unfairness/mistreatment by gender

As can be seen in Table 13, a majority of women (89.3%) and men (78.6%) have held one to three positions as a neuropsychologist. Fewer than one in five of the respondents reported experiencing perceived unfair treatment in the workplace, with women reporting slightly higher rates. Among individuals reporting mistreatment, men reported a much higher rate of general problems with administration or an employer. Women were much more likely to report having experienced abusive employers or colleagues, with sexism being the most common problem and much more frequently experienced by women. Problems related to unethical/exploitative practice environments and pay scale/salary were experienced relatively equally by approximately one in six to seven women and men. Among all respondents, reports of racism and cultural discrimination were infrequent. There were no significant gender differences in perceived unfairness or mistreatment associated with career stage.

Table 13. Career satisfaction: number of positions as a neuropsychologist and perceived unfairness or mistreatment.

	Women		Men
	Frequency	%	Frequency	%
Number of positions held as a neuropsychologist^a (n = 1535)	(n = 930)		(n = 603)
1	410	44.1	168	27.9
2	264	28.4	169	28.0
3	156	16.8	137	22.7
4	40	4.3	54	9.0
5	38	4.1	43	7.1
6	3	0.3	12	2.0
7	9	1.0	8	1.3
8	4	0.4	2	0.3
10	1	0.1	3	0.5
11	0	0.0	1	0.2
13	1	0.1	0	0.0
14	0	0.0	1	0.2
15	1	0.1	1	0.2
20	1	0.1	0	0.0
>20	2	0.2	4	0.7
Have you ever changed jobs related to perceived unfairness or some type of mistreatment? (n = 1550)	(n = 940)		(n = 610)
Yes	174	18.5	88	14.4
No	766	81.5	522	85.6
Perceived unfairness or mistreatment that led to changing positions (n = 223)	(n = 147)		(n = 76)
Problems with administration/employer	28	19.0	23	30.3
Abusive employer/colleagues	27	18.4	13	17.1
Sexism	22	15.0	1	1.3
Racism	2	1.4	0	0.0
Cultural discrimination	2	1.4	1	1.3
Unethical/exploitative practice environment	22	15.0	13	17.1
Pay scale/salary	21	14.3	13	17.1
Perceived discrimination against neuropsychologists	7	4.8	7	9.2
Budget cuts/unrealistic billing or RVU expectations	7	4.8	3	3.9
Deficient benefits/poor opportunity for growth	3	2.0	2	2.6
Disclosed or undisclosed legal reasons	3	2.0	0	0.0
Choose not to disclose	3	2.0	0	0.0

Note. Includes all licensed and non-licensed respondents. Some percentages do not total 100% due to rounding.

a No respondents indicated they had held 9, 12, 16, 17, 18, or 19 positions.

Career satisfaction

Table 14 examines career satisfaction relative to general work settings and professional identities.

Table 14. Career satisfaction: general work setting and professional identity.

	Income satisfaction^a				Job satisfaction^c				Work-life balance satisfaction^c
	Women		Men		Women		Men		Women		Men
	n	Mean (SD)	n	Mean (SD)	n	Mean (SD)	n	Mean (SD)	n	Mean (SD)	n	Mean (SD)
Entire sample	673	73.5 (23.4)^a	451	78.3 (21.3)^a	675	79.9 (18.8)	450	81.4 (19.0)	667	69.6 (25.1)	445	71.1 (24.6)
General work setting
Institution	439	72.3 (23.2)	199	75.9 (20.6)	441	79.3 (17.2)	198	80.3 (17.9)	435	70.5 (24.4)	195	73.1 (23.7)
Private practice	136	77.4 (22.5)	103	81.8 (23.1)	136	86.7 (16.7)	103	86.9 (17.2)	134	70.2 (25.0)	101	73.5 (23.4)
Inst. + Priv. Prac.	98	73.1 (24.7)	149	79.1 (20.7)	98	73.1 (24.7)	149	79.1 (20.7)	98	64.4 (27.5)	149	66.8 (26.0)
Professional identity
Pediatric	178	75.3 (21.8)	49	76.6 (23.5)	177	80.6 (17.6)	49	78.3 (20.0)	176	66.4 (25.9)	49	61.2 (27.3)
Adult	373	72.7 (23.9)^b	283	78.2 (20.8)^b	376	78.6 (19.3)	283	80.3 (18.9)	369	71.0 (24.4)	278	73.5 (23.0)
Lifespan	122	73.1 (24.0)	119	79.2 (21.8)	122	82.9 (18.6)	118	85.4 (18.1)	122	69.6 (25.9)	118	69.5 (25.9)

Note. On a 0–100 scale. Includes all respondents who are licensed and currently practicing full-time or more; excludes those who indicated they are not neuropsychologists.

Inst. + Priv. Prac. = institution plus private practice.

a Women reported significantly lower mean income satisfaction than men across the entire sample, t = 3.6, p < .001, d = 0.2.

b Women employed as adult neuropsychologists reported significantly lower income satisfaction than men who identified as adult neuropsychologists, t = 3.1, p = .002, d = 0.2.

c Regarding mean job and work-life balance satisfactions, there were no significant differences between women and men in the overall sample. There were also no significant differences between the genders when examining general work setting and professional identity specifically.

Career satisfaction by gender

When examining the entire sample, women reported significantly lower income satisfaction, which is not surprising considering their incomes are significantly lower than men’s incomes. This was particularly relevant for ACP women who reported significantly lower income satisfaction than ACP men.

Career satisfaction by gender and career stage (not presented in tables)

There were no statistically significant main effects for gender. However, there were significant main effects for career stage for both income satisfaction and job ­satisfaction, F (2, 1134)=33.0, p<.001; F (2, 1135)=21.1, p=<.001, respectively, which revealed that ACPs (income: M = 82.2, SD = 18.9; job: M = 85.9, SD = 16.5) are significantly more satisfied than MCPs (income: M = 73.9, SD = 23.2; job: M = 78.4, SD = 19.6) and ECPs (income: M = 71.9, SD = 23.6; job: M = 78, SD = 19.1). The overall interaction between gender and career stage regarding work-life balance satisfaction was not significant, and there were no significant main effects.

Career satisfaction by gender, career stage, and work setting (not presented in tables)

Regarding career satisfaction ratings across work settings, there were no statistically significant interactions between gender and career stage for any of the three satisfactions, and there were also no statistically significant main effects for gender.

Career satisfaction by gender, career stage, and work setting: institution (not presented in tables)

There was no significant main effect for career stage.

Career satisfaction by gender, career stage, and work setting: private practice (not presented in tables)

With regard to private practice and income satisfaction, there was a significant main effect for career stage, F (2, 238)=9.9, p<.001, which revealed that ACPs (M = 84.9, SD = 18) are significantly more satisfied than MCPs (M = 69.4, SD = 30).

Career satisfaction by gender, career stage, and work setting: institution plus private practice (not presented in tables)

Regarding institution plus private practice settings and income satisfaction, there was a significant main effect for career stage, F (2, 247)=9.5, p<.001, which revealed that ACPs (M = 84.1, SD = 17.2) are significantly more satisfied than MCPs (M = 72.6, SD = 24.6) and ECPs (M = 71.2, SD = 24); the same significant results were found when examining institution plus private practice settings and job satisfaction.

Career satisfaction by gender, career stage, and professional identity

With regard to career satisfaction across professional identity, there were no statistically significant interactions between gender and career stage for any of the three satisfactions.

Career satisfaction by gender, career stage, and professional identity: adult neuropsychologists (not presented in tables)

Regarding income satisfaction and job satisfaction among adult neuropsychologists, there were significant main effects for career stage, F (2, 660)=8.6, p<.001; F (2, 663)=5.7, p=.004, respectively, which revealed that ACPs (income: M = 80.4, SD = 20.4; job: M = 83.1, SD = 18.9) are significantly more satisfied than ECPs (income: M = 71.9, SD = 23.6; job: M = 77.2, SD = 19.3). There was also a significant gender difference when examining income satisfaction among adult neuropsychologists, which revealed that women (M = 72.7, SD = 23.9) have significantly lower income satisfaction than men (M = 78.2, SD = 20.8), t = 3.1, p=.002, d = 0.2. There was a significant main effect for career stage and work-life balance satisfaction, F (2, 650)=6.0, p=.003, which revealed that ECPs (M = 75.3, SD = 22.7) are significantly more satisfied than ACPs (M = 67.8, SD = 26.1).

Career satisfaction by gender, career stage, and professional identity: pediatric neuropsychologists (not presented in tables)

Related to the identify of pediatric neuropsychologist, there was a significant main effect for career stage and job satisfaction, F (2, 226)=9.0, p<.001, which revealed that ACPs (M = 88.6, SD = 11.7) are significantly more satisfied than MCPs (M = 73.9, SD = 21.6).

Career satisfaction by gender, career stage, and professional identity: lifespan neuropsychologists (not presented in tables)

Finally, regarding income satisfaction and job satisfaction among lifespan neuropsychologists, there were significant main effects for career stage, F (2, 241)=15.1, p<.001; F (2, 240)=10.8, p<.001, respectively, which revealed that ACPs (income: M= 84.8, SD=16.2; job: M=90.1, SD=12.3) are significantly more satisfied than MCPs (income: M=69.1, SD=26.4; job: M=80, SD=20), and ECPs (income: M=69.5, SD=24.2; job: M=79, SD=21.3).

Career satisfaction by gender: personal/family and work environment obstacles by work setting

Table 15 shows that across all three work settings, the greatest specific personal/family obstacle to attaining greater income satisfaction and job satisfaction is establishing and maintaining family life. Although consistently numerically higher for women in each instance, the differences are not statistically significant.

Table 15. Career satisfaction: personal/family and work environment obstacles within the last five years by general work setting.

	Institution
	Obstacles to income satisfaction^a ^,c				Obstacles to job satisfaction^b ^,d
	Women (n = 459)		Men (n = 201)		Women (n = 459)		Men (n = 201)
	n	%Yes	n	%Yes	n	%Yes	n	%Yes
Personal/family	119	25.8	50	24.9	159	34.6	63	31.3
Establishing and maintaining family life	93	78.2	37	74.0	139	87.4	48	76.2
Personal health	13	10.9	11	22.0	36	22.6	18	28.6
Family member’s health	30	25.2	18	36.0	54	34.0	23	36.5
Major psychosocial stressors	16	13.4	14	28.0	27	17.0	19	30.2
Dual career family	69	58.0	21	42.0	111	69.8	26	41.3
Other	8	6.7	8	16.0	7	4.4	11	17.5
Work environment	292	63.6	112	55.7	355	77.3	143	71.1
Is this because of a hostile work environment?	23	7.9	12	10.7	79	22.8^e	28	19.6
	Private Practice
	Obstacles to income satisfaction^a ^,c				Obstacles to job satisfaction^b ^,d
	Women (n = 137)		Men (n = 104)		Women (n = 137)		Men (n = 104)
	n	%Yes	n	%Yes	n	%Yes	n	%Yes
Personal/family	42	30.7	16	15.4	41	29.9	17	16.3
Establishing and maintaining family life	33	78.6	11	68.8	32	78.0	12	70.6
Personal health	10	23.8	6	37.5	12	29.3	5	29.4
Family member’s health	11	26.2	2	12.5	15	36.6	1	5.9
Major psychosocial stressors	10	23.8	2	12.5	12	29.3	1	5.9
Dual career family	21	50.0	5	31.3	24	58.5	5	29.4
Other	3	7.1	2	12.5	0	0.0	3	17.6
Work environment	71	51.8	41	39.8^f	69	50.4	47	45.2
Is this because of a hostile work environment?	6	8.5	3	7.3	11	15.9	5	10.6
	Institution plus Private Practice
	Obstacles to income satisfaction^a ^,c				Obstacles to job satisfaction^b ^,d
	Women (n = 100)		Men (n = 152)		Women (n = 100)		Men (n = 152)
	n	%Yes	n	%Yes	n	%Yes	n	%Yes
Personal/family	26	26.0	41	27.0	29	29.0	39	25.7
Establishing and maintaining family life	21	80.8	29	70.7	25	86.2	28	71.8
Personal health	4	15.4	7	17.1	5	17.2	12	30.8
Family member’s health	10	38.5	10	24.4	11	37.9	10	25.6
Major psychosocial stressors	3	11.5	10	24.4	5	17.2	9	23.1
Dual career family	12	46.2	24	58.5	18	62.1	22	56.4
Other	0	0.0	3	7.3	1	3.4	4	10.3
Work environment	68	68.0	72	47.4	72	72.0	101	66.4
Is this because of a hostile work environment?	11	16.7^g	9	12.7^h	24	33.3	16	15.8

Note. Includes all respondents who are licensed and currently practicing full-time or more; excludes those who indicated they are not neuropsychologists.

a Respondents were initially asked, “Are there aspects of your personal or family life that create obstacles to attaining greater income satisfaction?” If they answered “yes,” they were then instructed to select all obstacles that applied to them.

b Respondents were initially asked, “Are there aspects of your personal or family life that create obstacles to attaining greater job satisfaction?” If they answered “yes,” they were then instructed to select all obstacles that applied to them.

c Respondents were asked, “Are there aspects of your professional work or the practice environment in which you work (i.e., not personal or family factors) that create obstacles to attaining greater income satisfaction?” If they answered “yes,” they were then asked about whether this was due to a hostile work environment.

d Respondents were asked, “Are there aspects of your professional work or the practice environment in which you work (i.e., not personal or family factors) that create obstacles to attaining greater job satisfaction?” If they answered “yes,” they were then asked about whether this was due to a hostile work environment.

e Only 347 of the 355 respondents answered this follow-up question.

f Only 103 of the 104 respondents answered this question.

g Only 66 of the 68 respondents answered this follow-up question.

h Only 71 of the 72 respondents answered this follow-up question.

Percentiles based on small or under-represented samples are unstable/arbitrary. This is particularly true for items having fewer than ten respondents.

Career satisfaction by gender: personal/family and work environment obstacles in institutions

Regarding income satisfaction in an institutional work setting, there were no statistically significant gender differences. Regarding job satisfaction in institutions, having a dual career family was identified by women as significantly more of an obstacle (69.8% vs. 41.3%; χ²[1] = 15.6, p=<.001), and more men than women identified “other” as being an obstacle (17.5% vs. 4.4%; χ²[1]=10.3, p=.004).

Career satisfaction by gender: personal/family and work environment obstacles in private practice

Within a private practice setting, with regard to attaining greater income satisfaction, significantly more women reported that there are aspects of personal or family life that create obstacles (30.7% vs. 15.4%; χ²[1] = 7.5, p=.006). There were no significant differences between women and men regarding obstacles related to job satisfaction.

Career satisfaction by gender: personal/family and work environment obstacles in institution plus private practice

For those who combine employment in an institution with private practice, significantly more women indicated that there are aspects of their work environment that create obstacles to attaining greater income satisfaction (68% vs. 47.4%; χ²[1]=10.4, p=.002). There were no statistically significant gender differences regarding obstacles related to job satisfaction.

Career satisfaction by gender: personal/family and work environment obstacles by work setting and career stage

Not shown in Table 15 are data addressing the three career stages across general work settings.

Personal/family and work environment obstacles in institutions by career stage

Regarding employment in institutions, significantly more ECP women indicated that having a dual career family is an obstacle to attaining greater job satisfaction (70.3% vs. 39.4%; χ²[1]=10.2, p=.002). Significantly more ECP men than women identified “other” as being an obstacle to attaining greater job satisfaction (24.2% vs. 3%; χ²[1]=14.9, p=.001).

Personal/family and work environment obstacles in private practice by career stage

There were no significant differences between women and men in any of the three career stages who are employed in private practice settings.

Personal/family and work environment obstacles in institutions plus private practice by career stage

For respondents who combine employment in an institution with private practice, significantly more MCP women indicated that when they experience obstacles in their work environment that prevent greater job satisfaction, it is due to a hostile work environment (42.3% vs. 9.4%; χ²[1]=8.5, p=.005).

Career satisfaction: personal/family and work environment obstacles by professional identity

Table 16 shows that within the last 5 years, across all three professional identities, the greatest specific personal/family obstacle to attaining greater income and job satisfaction is establishing and maintaining family life.

Table 16. Career satisfaction: personal/family and work environment obstacles within the last five years by professional identity.

	Pediatric Neuropsychologists
	Obstacles to income satisfaction^a^,^c				Obstacles to job satisfaction^b^,^d
	Women (n = 186)		Men (n = 50)		Women (n = 186)		Men (n = 50)
	n	%Yes	n	%Yes	n	%Yes	n	%Yes
Personal/family	55	29.6	16	32.0	76	40.9	21	42.0
Establishing and maintaining family life	39	70.9	12	75.0	66	86.8	13	61.9
Personal health	10	18.2	3	18.8	19	25.0	6	28.6
Family member’s health	12	21.8	4	25.0	26	34.2	3	14.3
Major psychosocial stressors	2	3.6	6	37.5	12	15.8	9	42.9
Dual career family	27	49.1	5	31.3	55	72.4	6	28.6
Other	3	5.5	2	12.5	3	3.9	4	19.0
Work environment	112	60.2	30	60.0	134	72.0	33	66.0
Is this because of a hostile work environment?	7	6.3^e	3	10.0	26	19.8^f	6	18.2
	Adult Neuropsychologists
	Obstacles to income satisfaction^a^,^c				Obstacles to job satisfaction^b^,^d
	Women (n = 386)		Men (n = 285)		Women (n = 386)		Men (n = 285)
	n	%Yes	n	%Yes	n	%Yes	n	%Yes
Personal/family	95	24.6	66	23.2	111	28.8	76	26.7
Establishing and maintaining family life	79	83.2	51	77.3	94	84.7	62	81.6
Personal health	14	14.7	13	19.7	29	26.1	21	27.6
Family member’s health	25	26.3	18	27.3	36	32.4	23	30.3
Major psychosocial stressors	17	17.9	15	22.7	22	19.8	15	19.7
Dual career family	54	56.8	35	53.0	72	64.9	36	47.4
Other	6	6.3	8	12.1	4	3.6	10	13.2
Work environment	238	61.7	137	48.2^h	283	73.3	189	66.3
Is this because of a hostile work environment?	27	11.4^g	16	11.8^i	74	26.6^j	36	19.0
	Lifespan Neuropsychologists
	Obstacles to income satisfaction^a^,^c				Obstacles to job satisfaction^b^,^d
	Women (n = 124)		Men (n = 122)		Women (n = 124)		Men (n = 122)
	n	%Yes	n	%Yes	n	%Yes	n	%Yes
Personal/family	37	29.8	25	20.5	42	33.9	22	18.0
Establishing and maintaining family life	29	78.4	14	56.0	36	85.7	13	59.1
Personal health	3	8.1	8	32.0	5	11.9	8	36.4
Family member’s health	14	37.8	8	32.0	18	42.9	8	36.4
Major psychosocial stressors	10	27.0	5	20.0	10	23.8	5	22.7
Dual career family	21	56.8	10	40.0	26	61.9	11	50.0
Other	2	5.4	3	12.0	1	2.4	4	18.2
Work environment	81	65.3	58	47.5	79	63.7	69	56.6
Is this because of a hostile work environment?	6	7.4	5	8.6	14	17.7	7	10.1

Note. Includes all respondents who are licensed and currently practicing full-time or more.

a Respondents were initially asked, “Are there aspects of your personal or family life that create obstacles to attaining greater income satisfaction?” If they answered “yes,” they were then instructed to select all obstacles that applied to them.

b Respondents were initially asked, “Are there aspects of your personal or family life that create obstacles to attaining greater job satisfaction?” If they answered “yes,” they were then instructed to select all obstacles that applied to them.

c Respondents were asked, “Are there aspects of your professional work or the practice environment in which you work (i.e., not personal or family factors) that create obstacles to attaining greater income satisfaction?” If they answered “yes,” they were then asked about whether this was due to a hostile work environment.

d Respondents were asked, “Are there aspects of your professional work or the practice environment in which you work (i.e., not personal or family factors) that create obstacles to attaining greater job satisfaction?” If they answered “yes,” they were then asked about whether this was due to a hostile work environment.

e Only 111 of the 112 respondents answered this follow-up question.

f Only 131 of the 134 respondents answered this follow-up question.

g Only 237 of the 238 respondents answered this follow-up question.

h Only 284 of the 285 respondents answered this question.

i Only 136 of the 137 respondents answered this follow-up question.

j Only 278 of the 283 respondents answered this follow-up question.

Percentiles based on small or under-represented samples are unstable/arbitrary. This is particularly true for items having fewer than ten respondents.

Career satisfaction: personal/family and work environment obstacles of pediatric neuropsychologists

Regarding both types of satisfaction, significantly more male pediatric neuropsychologists indicated that major psychosocial stressors contribute to decreased satisfaction (income satisfaction: 37.5% vs. 3.6%; χ²[1]=14.5, p=.001; job satisfaction: 42.9% vs. 15.8%; χ²[1]=7.1, p=.008). Significantly more female pediatric neuropsychologists indicated that establishing and maintaining family life is an obstacle to attaining greater job satisfaction (86.8% vs. 61.9%; χ²[1]=6.8, p=.009). Female pediatric neuropsychologists also differed significantly from men with regard to frequency of reporting that a dual career family creates an obstacle to attaining greater job satisfaction (72.4% vs. 28.6%; χ²[1]=13.5, p=<.001).

Career satisfaction: personal/family and work environment obstacles of adult neuropsychologists

Among adult neuropsychologists, significantly more women indicated that there are obstacles present within their work environments that prevent them from attaining greater income satisfaction (61.7% vs. 48.2%; χ²[1]=13.5, p=.001). There were no statistically significant gender differences regarding job satisfaction.

Career satisfaction: personal/family and work environment obstacles of lifespan neuropsychologists

Among lifespan neuropsychologists, significantly more women indicated that aspects of their personal or family life create obstacles to attaining greater job satisfaction (33.9% vs. 18%; χ²[1]=10.8, p=.005). There were no statistically significant gender differences regarding income satisfaction.

Career satisfaction: personal/family and work environment obstacles by professional identity and career stage

Not shown in Table 16 are data related to career stage across professional identities.

Personal/family and work environment obstacles of pediatric neuropsychologists by career stage

For pediatric neuropsychologists, regarding attaining greater job satisfaction, significantly more ECP women indicated that establishing and maintaining family life (94.1% vs. 57.1%; χ²[1]=9.1, p=.003), as well as having a dual career family (76.5% vs. 14.3%; χ²[1]=11.1, p=.001) are obstacles to attaining greater job satisfaction, relative to ECP men. Significantly more ECP men identified “other” as being an obstacle for attaining greater job satisfaction (42.9% vs. 2%, χ²[1]=16.0, p<.001). With regard to attaining greater income and job satisfaction, significantly more ECP men indicated that personal health is an obstacle (income satisfaction: 66.7% vs. 2.7%; χ²[1]=20.6, p<.001; job satisfaction: 71.4% vs. 17.6%; χ²[1]=9.7, p=.002).

Personal/family and work environment obstacles of adult neuropsychologists by career stage

Among adult neuropsychologists, significantly more ACP women reported that aspects of their personal or family life create obstacles to attaining greater income satisfaction (64% vs. 37.5%; χ²[1]=12.6, p<.001). Regarding job satisfaction, significantly more ECP men identified “other” as being an obstacle to attaining greater job satisfaction (20.6% vs. 1.6%; χ²[1]=10.2, p=.001). Significantly more MCP women indicated that when they experience obstacles in their work environment, the effect on job satisfaction is due to a hostile work environment (28.8% vs. 8%; χ²[1]=7.9, p=.005).

Personal/family and work environment obstacles of lifespan neuropsychologists by career stage

Related to lifespan practitioners and career stage, there were no significant gender differences across career stages regarding either satisfaction.

Part 2: Ethnic/racial diversity results

Characteristics of the 2020 sample by ethnic/racial diversity: age and years in practice

Table 17 shows age and years in practice of the different ethnic/racial groups. Men (M=51.5, SD=12.6) are significantly older than women (M=43.2, SD=10) across all ethnic/racial groups. Individuals who Chose not to disclose ethnicity/race (M=53.2, SD=11.3) are significantly older than African American/Black (M=41.5, SD=8.8), Asian or Pacific Islander (M=40.7, SD=7.1), Hispanic/Latino(a) (M=43.3, SD =11.5), and Biracial/Multiethnic/Multiracial (M=41.9, SD=10.2) individuals; Whites (M=47.2, SD=12) are significantly older than the Asian or Pacific Islander group, F (6, 1646)=8.8, p<.001. Regarding years in practice, men (M=19.1, SD=12.7) have been in practice significantly longer than women (M=10.9, SD=9.2) across all ethnic/racial groups. Individuals who Chose not to disclose ethnicity/race (M=19.6, SD=13.1) have been in practice significantly longer than Asian or Pacific Islander (M=7.7, SD=6.2), Hispanic/Latino(a) (M=10.3, SD=10.3), and Biracial/Multiethnic/Multiracial (M=9.7, SD=10.1) individuals; Whites (M=14.9, SD=11.6) have been in practice significantly longer than the Asian or Pacific Islander group, F (6, 1552)=9.3, p<.001.

Table 17. Age and years in practice by ethnicity/race.

	Age^b				Years in practice^c
Ethnic/racial group^a	n	Mean	SD	Min–Max	n	Mean	SD	Min–Max
African American/Black	25	41.5	8.8	30.0–64.0	23	9.1	8.6	1.0–35.0
Asian or Pacific Islander	77	40.7	7.1	28.0–58.0	74	7.7	6.2	0.50–27.0
Hispanic/Latino(a)	74	43.3	11.5	28.0–72.0	66	10.3	6.2	0.50–42.0
Biracial/Multiethnic/Multiracial	35	41.9	10.2	30.0–66.0	32	9.7	10.1	0.50–37.0
Chose not to disclose ethnicity/race	40	53.2	11.3	33.0–75.0	38	19.6	13.1	0.50–49.0
White	1400	47.2	12.0	28.0–78.0	1324	14.9	11.6	0.50–50.0

Note. Includes all licensed and non-licensed respondents. Some percentages do not total 100% due to rounding.

Min–Max = minimum–maximum.

a As there were only two individuals in the American Indian/Alaskan Native group, they were excluded from analyses.

b Men (M = 51.5, SD = 12.6) are significantly older than women (M = 43.2, SD = 10) across all ethnic/racial groups, t = 13.9, p < .001, d = .07.

c Men (M = 19.1, SD = 12.7) have been in practice significantly longer than women (M = 10.9, SD = 9.2) across all ethnic/racial groups, t = 13.7, p < .001, d = .07.

Characteristics of the 2020 sample by ethnic/racial diversity: highest degree, work environment, and work status

Table 18 examines the highest degree, work environment, and work status of the various ethnic/racial groups. Across all groups, an overwhelmingly large percentage of individuals have attained a Ph.D. (percentages across groups range from 68 to 81%), rather than a Psy.D. (percentages range from 14 to 32%). Similarly, an overwhelming majority of respondents practice in urban settings (percentages range from 80 to 91.7%), followed by individuals who practice in both urban and rural settings (percentages range from 6.5 to 20%), and those who practice solely in rural settings (percentages range from zero to 7.7%). Across all ethnic/racial groups, most individuals work full-time (percentages range from 75 to 87.8%), followed by full-time plus part-time (percentages range from 6.8 to 15%), and those who hold only part-time jobs (percentages range from zero to 10%).

Table 18. Degree, work environment, and work status by ethnicity/race.

	Highest degree				Work environment						Work status
	Ph.D.		Psy.D.		Urban		Rural		Both		Full-time		Part-time		Full-time plus
Ethnic/racial group^a	Freq.	%	Freq.	%	Freq.	%	Freq.	%	Freq.	%	Freq.	%	Freq.	%	Freq.	%
African American/Black	17	68.0	8	32.0	22	91.7	0	0.0	2	8.3	21	87.5	0	0.0	3	12.5
Asian or Pacific Islander^b	63	79.7	15	19.0	66	89.2	2	2.7	6	8.1	65	87.8	4	5.4	5	6.8
Hispanic/Latino(a)^c	56	74.7	19	25.3	56	83.6	5	7.5	6	9.0	55	82.1	4	6.0	6	9.0
Biracial/Multiethnic/Multiracial	25	71.4	10	28.6	27	87.1	2	6.5	2	6.5	25	80.6	3	9.7	3	9.7
Chose not to disclose ethnicity/race^d	34	81.0	6	14.3	32	80.0	0	0.0	8	20.0	30	75.0	4	10.0	6	15.0
White^e	1099	77.9	305	21.6	1061	80.0	102	7.7	164	12.4	1127	84.8	106	8.0	91	6.8

Note. Includes all licensed and non-licensed respondents. Some percentages do not total 100% due to rounding.

Freq. = frequency; Full time plus = full time plus part-time.

a As there were only two individuals in the American Indian/Alaskan Native group, they were excluded from analyses.

b One respondent (1.3%) selected “Other” for highest degree.

c For work status, two respondents (3%) are retired.

d Two respondents (4.8%) selected “Other” for highest degree.

e Five respondents (0.4%) selected Ed.D., and one respondent (0.1%) selected “Other” for highest degree. For work status, four respondents (0.3%) are retired, and one respondent (0.1%) is disabled.

Characteristics of the 2020 sample by ethnic/racial diversity: career stage, professional identity, and practice environment

Table 19 examines the career stage, professional identity, and practice environment of the various ethnic/racial groups, excluding the two individuals in the American Indian/Alaskan Native group. The majority of the members of the remaining four ethnic/racial minority groups depicted in the table have entered the field of neuropsychology relatively recently and are still in the “early” career phase (percentages range from 56 to 62.9%), a pattern not seen for White neuropsychologists (42.3%) and those who Chose not to disclose ethnicity/race (19.5%). White neuropsychologists and those who Chose not to disclose ethnicity/race are more likely to be in the middle or end phases of their careers. Regarding professional identity, adult practitioners predominate, especially within the African American/Black (70%) and Asian or Pacific Islander (62.1%) groups. The Hispanic/Latino(a) group has a much higher percentage of pediatric practitioners (34.5%) compared to the other five groups (percentages range from 14.8 to 22.6%). The Chose not to disclose ethnicity/race group (35.5%) is more heavily represented by lifespan neuropsychologists than the other ethnic/racial groups (percentages range from 14.5 to 29.6%). Apart from those in the Chose not to disclose ethnicity/race group (29%), most individuals in the remaining five groups, including African American/Black, Asian or Pacific Islander, Hispanic/Latino(a), Biracial/Multiethnic/Multiracial, and White, practice primarily in institutions (percentages range from 54.5 to 75%). Again, with the exception of those in the Chose not to disclose ethnicity/race group, those in the remaining five ethnic/racial groups depicted split their time approximately evenly between private practice and institution plus private practice settings.

Table 19. Career stage, professional identity, and practice environment by ethnicity/race.

Ethnic/racial group^a	Career stage						Professional identity						Practice environment
	Early		Middle		Advanced		Pediatric		Adult		Lifespan		Institution		Priv. Prac.		Inst. + Priv. Prac.
	Freq.	%	Freq.	%	Freq.	%	Freq.	%	Freq.	%	Freq.	%	Freq.	%	Freq.	%	Freq.	%
African American/Black	14	56.0	7	28.0	4	16.0	3	15.0	14	70.0	3	15.0	15	75.0	2	10.0	3	15.0
Asian or Pacific Islander	48	60.8	27	34.2	4	5.1	11	19.0	36	62.1	11	19.0	39	68.4	8	14.0	10	17.5
Hispanic/Latino(a)^b	40	57.1	15	21.4	15	21.4	19	34.5	28	50.9	8	14.5	34	61.8	12	21.8	9	16.4
Biracial/Multiethnic/Multiracial	22	62.9	7	20.0	6	17.1	4	14.8	15	55.6	8	29.6	20	74.1	4	14.8	3	11.1
Chose not to disclose ethnicity/race	8	19.5	13	31.7	20	48.8	7	22.6	13	41.9	11	35.5	9	29.0	13	41.9	9	29.0
White^c	590	42.3	341	24.5	463	33.2	219	19.2	682	59.9	238	20.9	618	54.5	271	23.9	245	21.6

Note. Includes all licensed and non-licensed respondents. Some percentages do not total 100% due to rounding.

Freq. = frequency; Priv. Prac. = private practice; Inst. + Priv. Prac. = institution plus private practice.

a As there were only two individuals in the American Indian/Alaskan Native group, they were excluded from analyses.

b One man and one woman (3.5%) indicated they were not neuropsychologists and were therefore excluded.

c Six women and seven men (1.5%) indicated they were not neuropsychologists and were therefore excluded.

Figure 4 shows career stage by ethnicity/race, excluding the two individuals in the American Indian/Alaskan Native group. In the other four ethnic/racial minority groups, including African American/Black, Asian or Pacific Islander, Hispanic/Latino(a), and Biracial/Multiethnic/Multiracial, the vast majority of members are early in their careers, followed by MCPs and ACPs, respectively. The reverse is true for those in the Chose not to disclose ethnicity/race group who are primarily ACPs, followed by MCPs and ECPs, respectively. Finally, although the highest percentage of the White group is in the ECP stage, compared to the ethnic/racial minority groups, a much larger percentage of the White group is in the ACP stage.

Figure 4. Career stage by ethnicity/race. Note. Analyses do not include the two individuals who identified as American Indian/Alaskan Native; excludes those who indicated they are not neuropsychologists. Some percentages do not total 100% due to rounding.

Characteristics of the 2020 sample by ethnic/racial diversity: percentage comparisons of White and ethnic/racial minority groups across career stage

Figure 5 shows percentages of respondents who are either White or in one of the five ethnic/racial minority groups across the three career stages. Individuals who identify as being ethnic/racial minority members are primarily ECPs, followed by MCPs and ACPs, respectively. Though many Whites are also early in their careers, the percentage is much smaller compared to the ethnic/racial minority groups. Within the White group, ACPs are the second-largest career stage group, followed by MCPs.

Figure 5. Percentage comparisons of White and ethnic/racial minority groups across career stage. Note. Those in the Chose not to disclose ethnicity/race group were not included in these analyses. Analyses include individuals from all five ethnic/racial minority groups; excludes those who indicated they are not neuropsychologists. ECP = Early Career Psychologist; MCP = Middle Career Psychologist; ACP = Advanced Career Psychologist; E/R diverse = Ethnically/Racially Diverse. Some percentages do not total 100% due to rounding.

Characteristics of the 2020 sample by ethnic/racial diversity: percentage comparisons of ethnic/racial groups within each career stage

Figure 6 shows an alternative way of viewing the information presented in Figure 5 by examining the percentage of respondents who are either White or in one of the five ethnic/racial minority groups within each career stage. Similar to Figure 5, a majority of ethnic/racial minority individuals are ECPs, followed by MCPs and ACPs, respectively. Within the White group, ECPs dominate, followed by ACPs and MCPs, respectively.

Figure 6. Percentage comparisons of White and ethnic/racial minority groups within each career stage. Note. Those in the Chose not to disclose ethnicity/race group were not included in these analyses. Analyses include individuals from all five ethnic/racial minority groups; excludes those who indicated they are not neuropsychologists. ECP = Early Career Psychologist; MCP = Middle Career Psychologist; ACP = Advanced Career Psychologist; E/R diverse = Ethnically/Racially Diverse. Some percentages do not total 100% due to rounding.

Scholarly activities by ethnicity and race

Scholarly activities by ethnicity/race are reported in Table 20. Overall, the publication counts range from 5.9 (Biracial/Multiethnic/Multiracial group) to 18.3 (White group). All groups appear to be producing high numbers of conference presentations, ranging from 16.2 (Biracial/Multiethnic/Multiracial) to 27.2 (White).

Table 20. Scholarly activities: peer-reviewed publications and conference presentations by ethnicity/race.

	Number of authored or co-authored peer-reviewed publications					Number of authored or co-authored conference presentations
	n	Mean	Median	SD	Range	n	Mean	Median	SD	Range
Ethnicity/race
African American/Black	21	10.2	2.0	23.4	0.0 − 95.0	21	20.1	5.0	46.8	0.0 − >201.0
Asian or Pacific Islander	61	11.0	6.0	13.0	0.0 − 65.0	60	22.0	13.5	24.5	0.0 − 110.0
Hispanic/Latino(a)	59	9.8	4.0	20.2	0.0 − 125.0	58	16.3	6.5	31.0	0.0 − >201.0
Biracial/Multiethnic/Multiracial	28	5.9	4.0	6.3	0.0 − 25.0	26	16.2	10.0	21.2	0.0 − 100.0
Chose not to disclose ethnicity/race	33	11.2	7.0	14.5	0.0 − 55.0	33	20.0	3.0	28.9	0.0 − 114.0
White	1193	18.3	6.0	34.0	0.0 − >201.0	1174	27.2	10.0	44.2	0.0 − >201.0

Note. Includes all licensed and non-licensed respondents; excludes those who indicated they are not neuropsychologists.

Survey response option range was from 0 to >200. Mean, median, and standard deviations were calculated with >200 translated to 201.

For both publications and conference presentations, one-way ANOVAs were not statistically significant, F (5, 1389) = 2.5, p = .03; F (5, 1366) = 1.4, p = 0.23, respectively.

Income by ethnicity and race

Table 21 shows salaries by ethnic/racial group. Although the range of reported values appears substantial, there were no statistically significant group differences.

Table 21. Salary by ethnicity/race.

					Percentile
Ethnicity/race^a^,^b	n	Mean	Median	SD	25	75	95	99	Min–Max
African American/Black	14	139.1	138.9	36.8	109.0	177.0	–	–	85.0–200.0
Asian or Pacific Islander	43	145.1	125.0	69.9	106.0	160.0	282.0	–	80.0–500.0
Hispanic/Latino(a)	42	177.0	124.7	124.2	107.5	192.5	527.5	–	72.0–660.0
Biracial/Multiethnic/Multiracial	18	134.8	125.5	46.0	104.0	151.0	–	–	75.0–250.0
Chose not to disclose ethnicity/race	24	249.8	164.0	296.3	120.0	220.0	1287.5	–	85.0–1550.0
White	865	170.8	131.3	117.7	110.0	180.0	400.0	706.8	55.0–1286.5

Note. Income values are in thousands of dollars. Includes licensed clinicians who are currently practicing full-time or more; excludes those who indicated they are not neuropsychologists. Using 1 SD above the mean for current second-year postdoctoral trainees, those earning <$55,000 annually were excluded.

Min–Max = minimum–maximum.

a As there were only two individuals in the American Indian/Alaskan Native group, they were excluded from analyses.

b There were no significant differences between any of the groups when examining annual mean salaries, F (5, 1000) = 2.9, p = .013.

The SPSS statistical algorithm (HAVERAGE) is undefined for percentiles beyond a certain point at which case numbers are low. As percentiles based on small or under-represented samples are unstable/arbitrary, these ranges were marked as missing.

Perceived unfairness/mistreatment by ethnicity/race and gender

Table 22 examines unfairness/mistreatment by ethnicity/race and gender. Although not statistically significant, a higher number of minority women than minority men have changed jobs related to perceived unfairness or some type of mistreatment. The two primary reasons that women and men have left jobs involve unethical/exploitative practice environments and problems with administration/employer.

Table 22. Career satisfaction: perceived unfairness or mistreatment by ethnicity/race.

	Women		Men
	Frequency	%	Frequency	%
Have you ever changed jobs related to perceived unfairness or some type of mistreatment? (n = 189)	(n = 128)		(n = 59)
Yes	29	22.7	8	13.6
No	99	77.3	51	86.4
Perceived unfairness or mistreatment that led to changing positions (n = 33)	(n = 26)		(n = 7)
Problems with administration/employer	8	30.8	3	42.9
Abusive employer/colleagues	1	3.8	0	0.0
Sexism	1	3.8	0	0.0
Racism	1	3.8	0	0.0
Cultural discrimination	0	0.0	0	0.0
Unethical/exploitative practice environment	11	42.3	3	42.9
Pay scale/salary	2	7.7	1	14.3
Perceived discrimination against neuropsychologists	0	0.0	0	0.0
Budget cuts/unrealistic billing or RVU expectations	0	0.0	0	0.0
Deficient benefits/poor opportunity for growth	2	7.7	0	0.0
Disclosed or undisclosed legal reasons	0	0.0	0	0.0
Choose not to disclose	0	0.0	0	0.0

Note. Includes all licensed and non-licensed respondents; excludes those who indicated they are not neuropsychologists. Some percentages do not total 100% due to rounding.

Career satisfaction by ethnicity and race

Table 23 examines income, job, and work-life balance satisfaction ratings among the various ethnic/racial groups, excluding the two individuals who identify as American Indian/Alaskan Native. Although none of the career satisfaction ratings are significantly different between the groups, individuals who identify as African American/Black (M=85.8, SD=11.9) reported an appreciably higher income satisfaction compared to the other groups (i.e. mid-80s vs. mid-70s). Those in the Chose not to disclose ethnicity/race group and African Americans/Blacks reported low job satisfaction (M=72.9, SD=24.7; M=73.1, SD=29.1, respectively) compared to the other groups (percentages range from 78.8 to 81.6%). Work-life balance satisfaction ratings are consistently lower than income and job satisfaction ratings for all groups but are particularly low for those in the Chose not to disclose ethnicity/race group (M=57.3, SD=29.6) and the Biracial/Multiethnic/Multiracial group (M=61.4, SD=29), and are highest for those who identify as Asian or Pacific Islander (M=74.3, SD=23.2).

Table 23. Career satisfaction by ethnicity/race.

Ethnic/racial group^a	African American/Black		Asian or Pacific Islander		Hispanic/Latino(a)		Biracial/Multiethnic/Multiracial		Chose not to disclose E/R		White
Satisfaction	n	Mean (SD)	n	Mean (SD)	n	Mean (SD)	n	Mean (SD)	n	Mean (SD)	n	Mean (SD)
Income	18	85.8 (11.9)	50	75.3 (22.1)	49	77.4 (23.1)	23	75.8 (20.7)	28	73.0 (22.7)	968	75.3 (22.7)
Job	18	73.1 (29.1)	49	78.8 (21.4)	49	79.8 (20.1)	22	81.6 (14.2)	28	72.9 (24.7)	971	80.8 (18.4)
Work-life balance	18	69.4 (29.5)	47	74.3 (23.2)	48	70.7 (25.8)	22	61.4 (29.0)	28	57.3 (29.6)	961	70.4 (24.6)

Note. On a 0–100 scale. Includes all respondents who are licensed and currently practicing full-time or more; excludes those who indicated they are not neuropsychologists.

Chose not to disclose E/R = Chose not to disclose ethnicity/race.

a As there were only two individuals in the American Indian/Alaskan Native group, they were excluded from analyses.

There were no statistically significant differences among the six groups regarding income, job, and work-life balance satisfactions.

Obstacles to career satisfaction by ethnicity and race

Responses pertaining to personal/family and work environment obstacles within the last 5 years by ethnicity/race are presented in Table 24.

Table 24. Career satisfaction: personal/family and work environment obstacles within the last five years by ethnicity/race.

	African American/Black		Asian or Pacific Islander		Hispanic/Latino(a)		Biracial/Multiethnic/Multiracial		Chose not to disclose ethnicity/race		White
Job satisfaction	(n = 19)		(n = 52)		(n = 50)		(n = 23)		(n = 28)		(n = 993)
	n	%Yes	n	%Yes	n	%Yes	n	%Yes	n	%Yes	n	%Yes
Personal/family^a	5	26.3	15	28.8	9	18.0	7	30.4	9	32.1	255	25.5
Establishing and maintaining family life	4	80.0	11	73.3	5	55.6	5	71.4	6	66.7	196	77.5
Personal health	1	20.0	2	13.3	2	22.2	–	–	4	44.4	42	16.6
Family member’s health	1	20.0	6	40.0	2	22.2	1	14.3	4	44.4	68	26.9
Major psychosocial stressors	–	–	3	20.0	2	22.2	–	–	2	22.2	48	19.0
Dual career family	3	60.0	8	53.3	5	55.6	4	57.1	1	11.1	133	52.6
Other	1	20.0	–	–	–	–	1	14.3	1	11.1	22	8.7
Work environment^b	9	47.4	25	48.1	26	52.0	15	65.2	18	64.3	569	57.4^f
Is this because of a hostile work environment?	4	44.4	3	12.0	3	11.5	0	0.0	1	5.9^e	53	9.3^g
Job satisfaction	(n = 19)		(n = 52)		(n = 50)		(n = 23)		(n = 28)		(n = 993)
	n	% Yes	n	% Yes	n	% Yes	n	% Yes	n	% Yes	n	% Yes
Personal/family^c	3	15.8	16	30.8	14	28.0	7	30.4	7	25.0	304	30.6
Establishing and maintaining family life	3	100.0	15	93.8	10	71.4	6	85.7	5	71.4	247	81.3
Personal health	2	66.7	3	18.8	4	28.6	2	28.6	5	71.4	73	24.0
Family member’s health	2	66.7	5	31.3	4	28.6	2	28.6	2	28.6	99	32.6
Major psychosocial stressors	1	33.3	3	18.8	3	21.4	2	28.6	2	28.6	63	20.7
Dual career family	1	33.3	10	62.5	9	64.3	5	71.4	1	14.3	181	59.5
Other	1	33.3	–	–	1	7.1	–	–	1	14.3	24	7.9
Work environment^d	14	73.7	40	76.9	35	70.0	17	73.9	19	67.9	672	67.7
Is this because of a hostile work environment?	8	57.1	10	25.6^h	7	20.6^i	2	11.8	1	5.3	135	20.3^j

Note. Includes all respondents who are licensed and currently practicing full-time or more; excludes those who indicated they are not neuropsychologists.

a Respondents were initially asked, “Are there aspects of your personal or family life that create obstacles to attaining greater income satisfaction?” If respondents answered “yes,” they were then instructed to select all obstacles that applied to them.

b Respondents were asked, “Are there aspects of your professional work or the practice environment in which you work (i.e., not personal or family factors) that create obstacles to attaining greater income satisfaction?” If they answered “yes,” they were then asked about whether this was due to a hostile work environment.

c Respondents were initially asked, “Are there aspects of your personal or family life that create obstacles to attaining greater job satisfaction?” If they answered “yes,” they were then instructed to select all obstacles that applied to them.

d Respondents were asked, “Are there aspects of your professional work or the practice environment in which you work (i.e., not personal or family factors) that create obstacles to attaining greater job satisfaction?” If they answered “yes,” they were then asked about whether this was due to a hostile work environment.

e 17 of 18 respondents answered this follow-up question.

f 992 of 993 respondents answered this question.

g 567 of 569 respondents answered this follow-up question.

h 39 of 40 respondents answered this follow-up question.

i 34 of 35 respondents answered this follow-up question.

j 666 of 672 respondents answered this follow-up question.

Percentiles based on small or under-represented samples are unstable/arbitrary. This is particularly true for items having fewer than ten respondents.

Obstacles to career satisfaction by ethnicity and race: income satisfaction

Regarding income satisfaction and personal/family obstacles, establishing and maintaining family life is the number one obstacle endorsed by every group (percentages range from 55.6 to 80%), with the exception of individuals in the Hispanic/Latino(a) group who rated this obstacle as being equally as challenging as having a dual career family (both 55.6%). Maintaining a dual-career family is rated as the second-largest obstacle to attaining income satisfaction for those who identify as White (52.6%), Asian or Pacific Islander (53.3%), Biracial/Multiethnic/Multiracial (57.1%), and African American/Black (60%). Those in the Chose not to disclose ethnicity/race group reported personal health and family members’ health (both 44.4%) as being tied for the second most problematic obstacle for attaining greater income satisfaction. All groups have a near majority or greater number of members who reported experiencing obstacles in their work life that create lower-income satisfaction (percentages range from 47.4 to 65.2%). However, only those in the African American/Black group reported a substantially higher level of hostility within their workplace (44.4%); the percentages for the other five groups ranged from zero to 12%.

Obstacles to career satisfaction by ethnicity and race: job satisfaction

Regarding job satisfaction, with the exception of those in the Chose not to disclose ethnicity/race group who reported that establishing and maintaining family life and personal health are equally difficult (both 71.4%), every group indicated that establishing and maintaining family life is the number one obstacle (percentages range from 71.4 to 100%), followed by having a dual career family for White (59.5%), Asian or Pacific Islander (62.5%), Hispanic/Latino(a) (64.3%), and Biracial/Multiethnic/Multiracial (71.4%). African Americans/Blacks ranked personal health and family members’ health as being tied for the second most challenging obstacle (both 66.7%) to attaining greater job satisfaction. It appears that for all groups, work environment obstacles are more problematic with regard to job satisfaction than income satisfaction (percentages range from 67.7 to 76.9%). As was the case with income satisfaction obstacles, individuals in the African American/Black group reported high levels of hostility within the workplace (57.1%), compared to the other five groups (percentages range from 5.3 to 25.6%).

Discussion

Large-scale survey data can be used to provide summaries and insights into two of the timeliest topics related to careers in clinical neuropsychology. The status of women practitioners has received increasing attention, which is understandable and appropriate given that, at present, approximately 60% of all respondents are women, and 53.8% of these women are early career entrants. This current over-representation of women, which is increasing across time, has numerous implications. Our second focus pertaining to survey data addresses a topic that can be viewed as nearly the opposite in terms of sheer numbers of under-representation in the form of ethnic/racial diversity, a topic of equal or greater interest that is heightened by recent US events pertaining to racism and social justice. When subsets of survey respondents in the various ethnic/racial minority groups were under-represented (e.g. a response rate less than 10%), detailed analyses may have been limited or even precluded. For this reason, some important questions related to differences among the various ethnic/racial groups were difficult to address (e.g. board certification by ethnicity/race, academic rank and position titles in institutions by ethnicity/race, hourly fees by ethnicity/race, forensic activities by ethnicity/race). We will discuss the findings related to gender and ethnic/racial diversity separately.

Gender

Gender: overall sample characteristics

Based on survey data collected in 2010 (Sweet et al., 2011), women neuropsychologists were noted to have become the majority. The size of that majority is increasing over time, which is consistent with national trends in education. According to the National Center for Education Statistics, the majority of bachelors, masters, and doctoral-level degrees conferred by postsecondary institutions are awarded to women, regardless of the field of study. When examining the discipline of psychology as a whole, approximately 78.9% of bachelor’s degrees, 80.2% of master’s degrees, and 73.7% of doctoral degrees are awarded to women (U.S. Department of Education et al., 2019).

Within the field of neuropsychology, the prototypical neuropsychologist tends to be a White, middle-aged woman who is employed full-time, providing services to adults in an institution. Importantly, there is a significant difference in age and years in practice between female and male neuropsychologists – women are approximately six and a half years younger, and they have also been in practice approximately six and a half fewer years than men. A majority of women and men in the overall sample identify as adult practitioners, 55.8% and 62.1%, respectively, and are working full-time or more. Interestingly, 80% of pediatric neuropsychologists are women, which mirrors a decades-long over-representation of female psychologists in U.S. primary education systems (American Psychological Association [APA], Committee on Women in Psychology, 2017). According to the Bureau of Labor Statistics, in 2019, the second most common position held by a woman was as a teacher in an elementary or middle school setting (Bureau of Labor Statistics, 2020a); these trends also appear in educational systems across the world (Drudy, 2008). Future surveys of pediatric neuropsychologists may find relevant questions pertaining to career choice to be informative. At some point, if trends continue, male pediatric neuropsychologists may become a rarity.

The percentage of individuals who identify as adult neuropsychologists has remained relatively stable across time, whereas the percentage of individuals who identify as pediatric neuropsychologists has increased, and the percentage of individuals who identify as lifespan neuropsychologists has decreased. Given these trends, it appears that some lifespan neuropsychologists may have transitioned to pediatric neuropsychology. It also appears that as younger professionals are entering the field, they opt to specialize in either adult or pediatric neuropsychology. Finally, as lifespan neuropsychologists are primarily older men, it is very likely that as these professionals retire, the number of lifespan neuropsychologists will continue to decrease over time.

Both women and men tend to work in institutions on a full-time basis. While some women work in private practice (either solely in private practice or in an institution plus private practice setting), a much larger percentage of men can be found performing private practice work. It is unclear why more men gravitate toward private practice than women, especially in their early and middle careers, but perhaps job security, with known benefits, is more important for women during child-raising years. ACP women outnumber ACP men in exclusively private practice settings.

Gender: academic rank and position titles

Gender differences can also be seen when examining academic rank and position titles within institutional settings. Although similar percentages of women and men hold academic titles (approximately 63% of those working in institutional settings), women hold the title of assistant professor and “other” more often than men, whereas men hold the title of professor more often than women. Interestingly, in 2015, men held the title of associate professor more often than women, which is a title held almost equally by women and men as of 2020. One might envision that in the 2025 version of the salary survey, approximately equal percentages of women and men will hold the title of professor. Women are more likely to hold institution position titles of staff neuropsychologist/psychologist, as well as clinical training director, and they are less likely to hold administrative titles of Division Head and some form of Chair (e.g. assistant, associate, vice, department).

Sachs et al. (2018) examined historical perspectives, present trends, and future directions of women’s leadership in neuropsychology. In this study, there were relatively equal numbers of women and men who were members of the Society for Clinical Neuropsychology, Division 40 of the APA and the National Academy of Neuropsychology. The number of women who were board certified by ABPP/ABCN, and those who served as directors of internship and postdoctoral training programs were similar to the relative proportion of women in neuropsychology. Increasing numbers of women were identified as serving on the board of directors for the American Academy of Clinical Neuropsychology and the International Neuropsychology Society. Gender disparities were found regarding the proportion of women who had been elected and appointed to upper-level leadership positions in neuropsychological organizations and on editorial boards.

Gender: scholarly productivity

Scholarly activities vary by gender, with men producing a greater number of conference presentations and peer-reviewed publications during their careers. As represented by current ACPs, by the end of one’s career, men have been significantly more productive in these scholarly activities than women. Although female and male funded researchers reported engaging in approximately the same number of funded research hours per week, men were again more productive. These findings mirror those of other academic career settings (e.g. academic medicine: Raj et al., 2016; academic surgery: Mueller et al., 2017). However, in this study, because current ECPs and MCPs do not differ in scholarly productivity, perhaps by 2025, the interim effect of cohort retirement may result in more similar ACP scholarly productivity.

Recent relevant publications offer a compatible viewpoint of change across time. For example, within psychology, a gender publication’s gap persists in most subfields, although reducing over time (Odic & Wojcik, 2020). Specifically, within neuropsychology, Matchanova et al. (2020) examined gender disparities in authorship trends from 1985 to 2019 across six widely read journals in clinical neuropsychology. Despite women being under-represented as authors across the six neuropsychology journals, the rate at which they published articles across time increased, and their articles were cited as frequently as men’s. In a study conducted by Rohling et al. (2022), examining gender trends over five decades, in the 40 years prior to 2008, women attained less research productivity than men. The opposite was true for the youngest cohort, which slightly favored women, suggesting there may be a trend within neuropsychology toward gender equality regarding research productivity.

McCutcheon and Morrison (2016) examined potential barriers to research productivity reported by women faculty, finding that regardless of parental status, women had significantly lower research output than men. One possibility is that men choose specialties that have greater rates of research output. Also, parental status may not be significant because these authors did not investigate the age of children, with young children being more burdensome of time. Notably, mothers spent significantly more time on childcare, and reported significantly more work-family conflict than men. The McCutcheon study found no significant differences between women and men regarding number of hours spent on housework and workplace tasks. While this study did not examine specific obstacles preventing women and men from producing higher rates of scholarly work, it seems intuitive that establishing and maintaining family life not only has a negative impact on attaining greater income and job satisfaction, but also likely carries over to other areas of one’s professional life (e.g. having adequate time to conduct research and publish findings).

Gender: board certification

Based on 2020 survey data, ECP and MCP women have attained ABCN board certification at higher rates than their male counterparts, and ECP and MCP women who have not yet attained ABCN board certification appear to have a higher interest in completing the process than men. Despite having a higher interest, and within a broad context of high support for and pursuit of board certification, women reported more obstacles to attaining board certification, which include prohibitive time commitment and cost. This is especially true of women who are early in their careers. ACP men have attained a higher rate of board certification than early and mid-career men, as well as women in any of the three career stages. This undoubtedly reflects the fact that in 2005 and earlier, there were more men in the field of neuropsychology than women.

Gender: the income gap

Excluding part-time workers, the gender income gap was significant in general, as well as when broken down by identity or work setting in the direction of women earning less money. Among the many mean and median income listings, whether statistically significant or not, the dollar values are nearly all lower for women.

The phenomenon of women earning less than men is not unique to the field of neuropsychology. The gender income gap is pervasive, and it is found in almost all professions. According to the Bureau of Labor Statistics, in 2019, women who were full-time wage and salary workers had median usual weekly earnings that were 82 percent of the earnings of male full-time wage and salary workers. The gender income gap can also be found in all states of the United States (Bureau of Labor Statistics, 2020a), and internationally. According to the Organization for Economic Co-operation and Development (OECD), as of 2019, women in all 37 countries that compose the OECD earned less than their male counterparts (the income gap ranged from 4.86% (Denmark) to 32.5% (Korea) (Szmigiera, 2021).

There has been great interest and research investment regarding understanding the gender income gap. Converging lines of evidence indicate that one of the primary factors is establishing and maintaining family life. According to the Bureau of Labor Statistics, in 2017, married women with a spouse present and married women with a spouse present with children under 18 earned 78.5% and 79.2% of men’s median income, respectively. Women who were single (e.g. never married, divorced, separated, or widowed) with no children under 18 made 94.2% of men’s median income. Women ages 16-24 and women who were single and never married earned 91.2% and 91.3% of men’s median weekly income, respectively (Bureau of Labor Statistics, 2018). Multiple international studies have supported the hypothesis that the burden of establishing and maintaining family life is disproportionally placed on women and has a significant negative effect on income (e.g. Kleven et al., 2019).

Specific to neuropsychology, many more women are employed in an institution, at all stages of their careers, rather than in private practice or in an institution plus private practice setting, where the potential to earn a higher salary has consistently been found to be greater. When examining the annual mean salary of sole proprietors of a private practice, there are approximately equal numbers of women and men in this role. Of those who devote at least 80% of their time to performing clinical and forensic evaluations, women earn significantly less annually than men by almost $134,000. An almost identical pattern is found for those who identify as partners in a private practice. However, women are less likely to be partners and more likely to be employees in a private practice, earning much less than sole proprietors or partners. Moreover, collapsing across all work settings, male neuropsychologists are more likely to hold full-time employment plus a part-time position, thus likely earning a larger mean annual salary than women who do not augment full-time employment. This finding is consistent with that of Harvard economist Claudia Goldin (2014) who believes that a portion of the gender income gap stems from men investing a greater number of additional work hours beyond those defined as full-time.

Finally, what explains the fact that female neuropsychology private practice owners earn less money? In our sample, there is not a statistically significant difference in the number of work hours between male and female sole proprietors. Researchers who study venture capital funding have found that there is a gender income gap among entrepreneurs regarding the salaries women and men choose to pay themselves, with women paying themselves 77% relative to male counterparts (Gonzalez, 2018). Possibly related, in a series of experiments, Exley and Kessler (2019) found that women subjectively describe their abilities and performances to potential employers less favorably than their similarly achieving male counterparts. In other words, women may perceive that they are worth less than their male counterparts, which, in the instance of neuropsychologists, can be reflected in their billing schedules (e.g. female neuropsychologists charge significantly less per forensic work hour). As noted previously with regard to the entire survey sample, given that sole proprietors determine their own income through billable activities and control of expenses, there may also be a gender-based differential of additional work hours among solo private practitioners.

Gender: career satisfaction

Women have lower income satisfaction than men, which is not surprising considering they are earning significantly less than men. Income satisfaction is lowest for women with the identity of adult practitioner relative to pediatric and lifespan practitioners. Related to income satisfaction and job satisfaction, overall ratings of personal/family obstacles are generally comparable for women and men, with the number one obstacle being establishing and maintaining family life, followed by being part of a dual career household, regardless of work setting or professional identity. Generally speaking, although a relatively large percentage of individuals report obstacles in their work environments that are preventing them from attaining greater income and job satisfaction, with the exception of women who work in an institution plus private practice setting, few women and men are reporting that this is due to a hostile work environment. Not surprisingly, those who are experiencing hostile work environments are experiencing greater job dissatisfaction than income dissatisfaction.

Diversity

Diversity: overall sample characteristics, career satisfaction, and perceived unfairness/mistreatment

Of all respondents who answered the question regarding ethnicity/race, 12.9% of the sample was comprised individuals from one of the five ethnic/racial minority groups, including African American/Black, American Indian/Alaskan Native, Asian or Pacific Islander, Hispanic/Latino(a), or Biracial/Multiethnic/Multiracial. Looking specifically at the percentage of ethnic/racial minorities within the three career stages over time, one of the most exciting findings we see is that within the last 15 years, the influx of ethnic/racial minority individuals into the field has substantially increased. Of all respondents, approximately 59% of ethnic/racial minorities are in the early career stage. As more individuals from ethnic/racial minority groups have entered the field of clinical neuropsychology, the ratio of White practitioners and White postdoctoral residents to practitioners and postdoctoral residents in ethnic/racial minority groups has changed, causing the percentage of White individuals to decrease (Sweet et al., 2021a, 2021b). In particular, individuals who identify as either Asian or Pacific Islander or Hispanic/Latino(a) are entering the field of clinical neuropsychology at increasing numbers, compared to African Americans/Blacks, American Indians/Alaskan Natives, and Biracial/Multiethnic/Multiracial individuals. Overall, given the steady influx of ethnic/racial minorities into the field in the last 15 years, this pattern is promising and is very likely to continue over time.

When examining career satisfaction, those who identify as African American/Black report the lowest job satisfaction of any of the ethnic/racial minority groups, which may, in part, be related to the high rates of hostility they report within their workplace. Specifically, the rate at which African Americans/Blacks report dissatisfaction within their workplace, which they attribute to a hostile work environment, is more than double that of the next highest ethnic/racial minority group. Conversely, African Americans/Blacks report the highest income satisfaction of any of the ethnic/racial minority groups. Similar to the entire 2020 sample, the number one obstacle to attaining greater income and job satisfaction is almost always establishing and maintaining family life for all ethnic/racial minority groups.

With regard to discrimination in the workplace, approximately one in five individuals have left a job because of perceived unfairness or some type of mistreatment. Very few women and no men reported leaving a position because they experienced discrimination. Most individuals left because of problems with their administration/employer or because they perceived working in an unethical/exploitative practice environment.

Diversity: income

Although the annual mean salary was not significantly different between any of the ethnic/racial groups, Hispanic/Latino(a) and White neuropsychologists reported earning approximately $32,000–$43,000 and $25,000–$36,000 more than those who identify as African American/Black, Asian or Pacific Islander, and Biracial/Multiethnic/Multiracial. This is not unlike the discipline of medicine in which there are substantial differences in incomes between women and men, and also substantial differences in incomes between White physicians and ethnic/racial minority physicians. In 2018, the difference in salaries between White and African American U.S. physicians was approximately $50,000, favoring White physicians (Larkin, 2018). According to the Bureau of Labor Statistics, national data on all individuals who identified as Hispanic or Black earned considerably less than Asians and Whites. Asian men earned the highest median weekly salary, followed by White, Hispanic, and Black men (78%, 58%, and 56%, respectively, of the earnings of Asian men). A similar pattern was found for women – White, Black, and Hispanic women earned 82%, 69%, and 63%, respectively, of the earnings of Asian women. This may be due, in part, to Asian and White individuals attaining higher levels of education. Among individuals 25 years and older, Asians were the most likely of the groups to hold a bachelor’s degree or higher (65%), followed by 41% of Whites, 32% of Blacks, and 22% of Hispanics (Bureau of Labor Statistics, 2020b).

Final comments

Regarding gender, the topic that has predominated in this article, there is little more to say than that there are obvious implications for women who strive to balance time- and energy-consuming professional career challenges with establishing and maintaining family life, the latter of which, according to experts from various disciplines, continues to fall disproportionately to women. Readers are referred to the excellent review and recommendations specifically pertaining to attaining work-life balance as a clinical neuropsychologist (Feigon et al., 2018). Also, the history of seminal events related to women’s legal rights in the U.S. and the “herstory” of women in psychology is an informative treatise from the APA, Committee on Women in Psychology (2017).

Regarding ethnicity/race, building upon prior works within neuropsychology to promote accurate multicultural assessment (e.g. Byrd et al., 2008; Romero et al., 2009; Byrd et al., 2010; Rivera Mindt et al., 2010; Aghvinian et al., 2021; Franzen et al., 2021), since 2015, AACN’s Relevance 2050 initiative has promoted the critical importance of keeping pace with the changing diversity of the U.S. population. Diversity issues have amplified considerably and have sharpened in focus for the specialty of clinical neuropsychology in the last two years, almost entirely because of widely publicized events within the U.S that have underscored social injustice, racism, and violence toward citizens who are black, indigenous, and people of color (BIPOC). There are two very different neuropsychological practice perspectives related to diversity: (1) factors related to patient care (normative data, brain-behavior relationships, and assessment strategies), and (2) ethnicity/race of practitioners. Both are critically important to the future of the specialty.

With regard to the perspective of patient care, the factors worthy of consideration are numerous and multifaceted. The availability and application of appropriate normative data appear to be the most salient factor, and as such, has been receiving the bulk of attention in published literature. In fact, prior survey data indicated that approximately two-thirds of U.S. and Canadian practicing neuropsychologists perceived their greatest challenge in assessing ethnic/racial minority patients to be lack of appropriate normative data (Elbulok-Charcape et al., 2014). In their roles as co-editors of TCN’s Department of Culture and Gender in Neuropsychology, Hilsabeck and Rivera Mindt (2021) inventoried the recent contents of TCN, reporting that in 2020, of ten relevant articles, 60% addressed normative testing values related to cultural and linguistic diversity. These published contents in 2020 resembled the TCN contents of 2019, when 55% of diversity articles reported normative data. The issue of having appropriate normative data available to neuropsychology practitioners might be understated if only referred to as broadly relevant to patients who are BIPOC. More explicitly, the selection of appropriate normative data requires much greater attention to language(s) and language competence, education and its comparability to the requirements (most often U.S.-based education) of an individual test, cultural/multicultural background broadly and specifically regarding an understanding and comfort level with formal evaluation processes, and ethnicity/race (see Fujii, 2018 for review and recommendations). Readers are also referred to the comprehensive textbook edited by Irani (2022), for detailed review of these and other relevant topics from multiple international practice perspectives, as well as examples of applications using very specific international normative data.

Beyond the increasing attention and professional energy invested in producing and applying normative data that match up to the diversity of patients, there is also increasing attention being given to diversity-related underlying health and brain conditions, such as differential predictors of Alzheimer’s disease and cognitive decline (Johnson et al., 2022), incidental brain MRI findings in the Hispanic/Latino(a) population (Ivanovic et al., 2021), and prevalence of depression due to cerebrovascular disease (Bogoian & Dotson, 2022). And, more broadly, long-held traditional assessment strategies are being reconsidered to reflect that (1) test instruments may contain insensitive stimuli or questions (e.g. Salo et al., 2022), (2) prior experience with racism may affect symptom reporting (e.g. Hill-Jarrett & Jones, 2022), and (3) prior negative examination experience or lack of formal examination experience among BIPOC patients may produce “stereotype threat” that negatively impacts test results (see VanLandingham et al., 2022 for review and recommended strategies).

Regarding the second perspective related to ethnic/racial diversity of practitioners themselves, neuropsychologists find themselves considering that we may or may not reflect the increasingly diverse ethnic/racial mix of our patients. Questions regarding the status and trajectory of neuropsychology’s ethnic/racial identity require more than comparisons within our specialty across time, which we have now updated. Overall, the percentage of White respondents has declined from 92.9% in 2005 to 84.5% in 2020 (Sweet et al., 2021b).

Comparisons to the broader discipline of psychology and to U.S. citizenry may also be instructive. In the latest available data that include diversity information (APA, Committee on Women in Psychology, 2017), of 79,000 APA members, approximately 65% were women and approximately 15% belonged to ethnic/racial minority groups. By comparison to the overall 2020 neuropsychology survey data, 60% of respondents are women and 12.9% are members of ethnic/racial minority groups. Readers will note that the numbers provided by APA are not that discrepant from our specialty data. However, the most appropriate comparisons would be specifically to individuals soon to enter the specialty from postdoctoral training programs and early career practitioners, as the composition of these cohorts provides an up-to-date view of neuropsychology’s current ethnic/racial diversity. The APA’s Committee on Women in Psychology (2017) estimated that there are approximately 3000 psychology doctorates awarded each year to individuals who provide some form of health service. Approximately 74% of these new doctoral-level psychology practitioners are women and approximately 22% belong to ethnic/racial minority groups. Among clinical neuropsychology postdoctoral trainees, in 2020, approximately 23% belonged to ethnic/racial minority groups (Sweet et al., 2021a). Additionally, suggesting an accumulation of change, in 2020, among ECP respondents, 72.3% are women, and of all ethnic/racial minority survey respondents, approximately 59% are ECPs.

Although neuropsychology specialty data and broader discipline data from APA are relatively comparable, both are distinctly different from U.S. census data. A comparison between U.S. census data and neuropsychology specialty data indicates that White neuropsychologists are over-represented (61.6% vs. 84.5%, respectively), whereas individuals in all ethnic/racial groups are under-represented (e.g. the Black or African American U.S. population is 12.4% (vs. 1.5%), the American Indian/Alaskan Native U.S. population is 1.1% (vs. 0.1%), the Asian U.S. population is 6% (vs. 4.7%), the Hispanic or Latino U.S. population is 18.7% (vs. 4.5%), and the Multiracial U.S. population is 10.2% (vs. 2.1%) (Jones et al., 2021). It is important to note that a comparison between neuropsychology specialty data and U.S. census data proves difficult due to the small sample sizes of the ethnic/racial minority groups in the present sample. In addition, U.S. census relabeling of categories and U.S. census-taker changes in self-identification preferences also make comparisons across ethnic/racial minority groups in the present sample and those in the U.S. census challenging. However, despite these caveats, for the moment, and likely for foreseeable years to come, clinical neuropsychologists as a group do not appear to resemble their U.S. patient base.

Impact of the COVID-19 pandemic on women and ethnic/racial minority individuals

While the negative effects of the pandemic have been widespread, they have been more prevalent for women and ethnic/racial minorities. According to the U.S. Labor of Bureau Statistics, the COVID-19 recession has been more challenging for women than men. One reason women have experienced greater hardship is that they are more likely to work in industries that have been affected most by the pandemic (e.g. restaurants and other retail establishments, hospitality, and health care). Second, compared to men, when schools and daycares around the country closed, women acquired childcare responsibilities at disproportionate rates. Third, fewer women than men have jobs that allow them to telecommute, 22% and 28%, respectively. Finally, in situations where both spouses are employed full-time, mothers provide approximately 60% of the childcare (Karageorge, 2020).

Certain ethnic/racial minority members have also experienced greater hardship during the pandemic, compared to their White counterparts. The disproportionate effects may relate to the long-standing inequalities in education, employment, housing, and health care that the global pandemic has exacerbated. The Center on Budget and Policy Priorities continually tracks the effects the global pandemic has had on individuals’ abilities to attain food, housing, and employment. Updated data as of 10 September 2021 (see https://www.cbpp.org/research/poverty-and-inequality/tracking-the-covid-19-economys-effects-on-food-housing-and), suggest that Black and Latino adults were more than twice as likely as White adults to report that their household sometimes or often did not have enough food to eat in the last seven days, and taken together, adults who identify as American Indian, Alaskan Native, Native Hawaiian, Pacific Islander, or multiracial were twice as likely as White adults to report their household did not have enough to eat. Compared to 10% of Whites, 22% of Blacks, 19% of Asians, 18% of Latinos, and 18% of the combined group comprised of American Indian, Alaskan Native, Native Hawaiian, Pacific Islander, or multiracial individuals, were behind paying their rent. When examining the difficulty adults have covering their expenses, compared to 22% of Whites and Asian adults, the rates were higher for Black (41%), Latino (37%), and adults who identify as American Indian, Alaskan Native, Native Hawaiian, Pacific Islander, or multiracial, taken together (34%). The data on unemployment also show disproportionate rates between ethnic/racial minority individuals and Whites. Specifically, 8.8% of Black and 6.4% of Latino workers are unemployed, compared to 4.5% of Whites, and workers who were born outside of the U.S., including individuals who are now U.S. citizens, have experienced larger job losses than U.S.-born workers (Center on Budget and Policy Priorities, 2021).

In this study, 82.6% of respondents completed the survey prior to the official declaration in the U.S. of the COVID-19 pandemic. The annual psychology incomes reported in 2020 were unaffected by the pandemic, as they reflected income from 2019 (Sweet et al., 2021b). The 2025 neuropsychology professional practice and “salary survey” will have the opportunity to capture the unique effects the pandemic has had on all individuals, including women and ethnic/racial minority groups, with the expectation that some of the national trends reported above may be mirrored in the answers provided by respondents or, by then, hopefully resolved.

Limitations and future directions

We acknowledge that this study has some limitations. First, there are inherent limitations of conducting survey research that relies on self-report. These include respondents having difficulty assessing themselves accurately, resulting in biased responding; interpreting questions in an idiosyncratic manner; providing socially acceptable answers, rather than being fully forthcoming; encountering survey fatigue; not fully reading questions before responding; and leaving questions unanswered. Second, those who opt to complete surveys may have different qualities and characteristics than those who elect not to complete surveys. Third, those who identify as ethnic/racial minority neuropsychologists represented a much smaller number of individuals than those who identify as White, limiting the number of comparisons that could be made between groups (e.g. some analyses that examined differences between women and men could not be conducted with the various ethnic/racial groups because the group sizes were too small).

Finally, although we have tried to be as inclusive as possible in this survey, we fully recognize that some of our labels and terminology will require modification in future surveys, including providing additional options for colleagues who do not identify as either female or male and refining the labels we have used for the various ethnic/racial groups. In future survey work, our goal will include consideration of qualitative studies on gender identity and ethnicity/race, in an attempt to answer some important questions, such as unique challenges faced by individuals who do not identify as either female or male. In addition, we hope to rely on the resources provided by various neuropsychology groups, such as the Hispanic Neuropsychological Society (https://hnps.org), the Asian Neuropsychological Society (https://the-ana.org), the Society for Black Neuropsychology (https://soblackneuro.org), and the Queer Neuropsychological Society (https://www.queerneuro.org), to ensure that we can consider and appreciate the full range of diversity issues and that all of our colleagues have the opportunity to provide valuable insight into the ever-growing field of clinical neuropsychology.

The current article has only begun to examine diversity factors within the field of clinical neuropsychology. Importantly, the field has taken major strides in recognizing the value of advocating for racial justice and ethnic/racial and cultural diversity, as evidenced by all four major neuropsychological organizations publishing statements to the effect. It is our hope that in the coming years, the number of individuals who enter the field as ethnic/racial minorities will continue to increase, allowing more sophisticated examination of these topics, including the intersection of ethnicity/race and gender (e.g. Hill-Jarrett & Jones, 2022). In conclusion, we hope readers are left with two important messages. First, despite some of the differences between genders and ethnic/racial minority groups noted above, there are benefits to pursuing a career in clinical neuropsychology, including having the opportunity to engage in research and clinical work in tandem; conducting both clinical and forensic evaluations in which the referral questions can be multifaceted and intellectually stimulating; having the opportunity to work in different settings across one’s career, all with relatively high income; and working in a profession in which income and job satisfactions are relatively high, and mistreatment is perceived to be relatively low. Second, the trends we have seen over the last 15 years support the notion that the field of neuropsychology is gradually becoming more diversified. While this may not be occurring at the same rate as the general population, even slow change is encouraging.

Acknowledgments

The authors thank the American Academy of Clinical Neuropsychology, the National Academy of Neuropsychology, and the Society for Clinical Neuropsychology (Division 40 of the APA), for their financial support and assistance in recruiting survey participants. We also extend our gratitude to the numerous additional regional, state, and local neuropsychology organizations which assisted in recruiting participants, particularly the International Neuropsychological Society, the Association of Postdoctoral Programs in Clinical Neuropsychology, and the NPSYCH listserv. Finally, we offer a special thank you to all of the respondents who allocated time to participate.

Disclosure statement

The authors report no potential conflict of interest.

Additional information

Funding

The majority of financial support for the 2020 survey was provided equally by the American Academy of Clinical Neuropsychology, the National Academy of Neuropsychology, and the Society for Clinical Neuropsychology (Division 40 of the American Psychological Association). Additional funding was provided by the American Psychological Association Office of HealthCare Finance.