Answering a few questions I've received about forensic fellowships

[whopper]

New York programs: the word I heard last I was in that area was that Albert Einstein had the best program. This is from fellows from multiple programs in that area, be it NYU, Albert Einstein, Columbia etc. Reason being is that Merrill Rotter, the PD there is allegedly one of those types of teachers that makes students feel comfortable, good about their program, and piques their interest via inspiration.

NYU: when I interviewed there and it was years ago, and things may have changed, they had an odd policy of paying one fellow one amount and the other a far larger amount because one of the salaries was funded one way, the other via another method and due to red tape it had to stay this way. This led to some very odd situations including one fellow being way better than another yet making much less than the other.

What are some things programs want to see in applicants?
Interest
Previous experience in forensic psychiatry
Publications

The unfortunate truth is most general residency programs have no attendings experienced in forensic psychiatry, or have some experience but it's to the point where the guy is causing more harm than good.

E.g. I knew one guy that did jobs for the court (he had no education in the area) and did several inappropriate things such as address the evaluee as his patient. People forensically evaluated are not supposed to have a doctor-patient relationship. A resident or student, following such a person, will actually be taught several things incorrectly.

Another problem is even if there is a rather experienced psychiatrist, many of them have rather big egos and not so humble attitudes because they may be the only one in the area.

USMLE scores don't seem to matter much.

I'd put emphasis on publications because they show you can critically think but also because it shows samples of your writing. Forensic psychiatry deals with a heck of a lot of writing and doctors often stop writing in English and write in medicine.

E.g. 42 y/o AA --> w/ hx of SCZ PT brought by the CPD via the MCT to PES. Transferred to CEC due to head lx., transferred back and cleared.

In real English...
A 42 year old African American man with a history of schizophrenia chronic paranoid type was brought by the Cincinnati Police and the Mobile Crisis Team of Hamilton County to the psychiatric emergency service, transferred to the emergency room due to a head laceration, but was transferred back after he was medically cleared.

My own posts here are not a good example because I write off the top of my head and do not do grammar and word reductions to increase efficiency and be succinct. If I've ever learned anything from my PD, it's to get my own writings, and cut them apart. The finished product is much better.

From experience, I've seen residents get into fellowship follow this model. Most get in somewhere so long as they applied to enough places, but they might not have gotten into the better ones. Usually every year, there's a few programs that don't fill up. The fellowships in this area don't do the MATCH, so there's some programs that are open but applicants didn't know about it. Bottom line, if you're worried about your prospects, and you apply to enough places, you could easily get in.

The better programs, however, may want an applicant who did some work in this area. Some work that most applicants could do that is realistically available in most programs involve petitioning the court for court-ordered medications, writing 72 hour hold forms, requests for involuntary commitment, capacity evaluations for forced procedures or medications, and possibly testifying on the stand if the attending is comfortable with you doing that. in addition to this, know the court cases that established the legal foundations for the anything you do that is forensic. E.g. if you do the application for court-ordered meds, know the landmark cases that established the rules of this area.

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[LimbicResponse]

Thank you. Your posts are a true pleasure to read. Forensics is an area I'd like to further explore. I would say writing is definitely a weakness of mine, due to a combination of disinterest during college, and not having a strong foundation in the English language. Knowing this, I have always ignored the possibility of doing forensics.

I'm I being too critical by self selecting out of forensics due to my weaknesses? I'm at what most people consider a top program, there is a forensics fellowship in-house and a very well regarded faculty member in the forensics world.

 

[whopper]

If you're still a medstudent don't worry. There's plenty of time. I wouldn't even worry about the writing at this point. Fellowships tend to take applicants from their own residency programs first because the person is a known quantity.

 

[PistolPete]

Thank you so much for your post. Care to mention what the best programs are on the West coast? I've heard that UC Davis is supposed to be really good and nicely linked to Atascadero State Hospital, but other than Davis, what program would be a close second or third? Not sure I'd want to live in Ohio for a year, even if Resnick is out there!

 

[digitlnoize]

Aaaahhhhh!!!!! Whopper is back!!! We have missed you around here buddy!

Thanks for the info. I'll pass it along to my friends interested in forensics.

 

[notdeadyet]

I've heard that UC Davis is supposed to be really good and nicely linked to Atascadero State Hospital, but other than Davis, what program would be a close second or third?

I'd be very curious to hear about this too, particularly the reputation of UCSF, USC and OHSU.

btw, UC Davis has the relationship with Napa State rather than Atascadero State, unless things have changed. Napa is an hour away from Sac vs. Atascadero, which is about 4 hours away.

 

[whopper]

UC-Davis's fellowship is headed by Charles Scott. He advanced the field of forensic psychiatry in general but in particular with correctional psychiatry and the interface between child and forensic psychiatry. He's authored what many consider THE textbook for correctional psychiatry.

In AAPL, he's pushed for forensic psychiatrists to use evidenced-based data more vs simply rendering an opinion on a whim. He recently was the president.

Now all this said, impressive, but what's it qualitatively like to be in his program? I don't know. I do know for a fact that some of the top people in any field (especially forensic psychiatry) have a rep of being dreadful to their students/residents/fellows/colleagues. He seems like a nice guy, charismatic, and I don't mean to criticize him at all because everything I do know about him is good. Just that I can't give it one of those confident stamps of approval due to lack of knowledge on the other aspects such as his treatment of fellows, their hours, how much he's willing to stick his neck out for the fellows, etc.

 

[notdeadyet]

Any thoughts on UCSF or USC?

 

[whopper]

Unfortunately don't have much experience with those programs. Some programs do make some headway in the field bumping up their rep, but I haven't heard anything. Doesn't mean they're bad. Just don't know.

 

[honsano]

Unfortunately don't have much experience with those programs. Some programs do make some headway in the field bumping up their rep, but I haven't heard anything. Doesn't mean they're bad. Just don't know.

Granted I am a resident who is applying, but I have heard good things about the PD at UCSF, Binder. Outside of that not much about the program structure and interaction with faculty. I have heard great things about UC Davis. I hear you work like an animal at Davis but you come out well trained. If I'm not mistaken Scott is the current president of AAPL.

Whopper, you know anything about SE programs like Emory, UNC, Florida or the South Carolina ones? Also, was forensic pimping during interviews a regular thing or infrequent from your experience?

 

[whopper]

Pimping during interviews was infrequent but did happen somewhat more than during general residency interviews.

A tradition that I don't actually agree with going on in many programs is during mock trials, the program faculty will pimp the fellows during cross-examination. I do agree the cross-examination needs to be tough, but what I don't agree with are instead of prepping them for this dreaded phenomenon, then going at them full attack (e.g. before a marathon run, a coach conditions the athlete, then makes them run the full marathon), several faculty members stick them in the mock trial, bare, naive and then go on the full attack. Kind of like the coach putting the athlete into a marathon first day and if the guy gets killed, too bad for him.

Again, cross-examinations should be tough, but so too should the training to prepare them for the psychological shock. I've seen some fellows develop a type of PTSD like dread over this process. PTSD like because the emotional scar of being humiliated for literally over 1 hour straight and over questions that actually aren't fair in many regards from an educational standpoint.

To give an example, during the first mock trial, a fellow will act as a lawyer on the side of the fellow being cross examined. That fellow will still be green as to how and when to object to unfair questions, so during this hell, usually that fellow just keeps silent while the fellow on the stand gets his ass reamed without being given lifelines he would usually get in real life. To give another example, I've seen cases where fellows were told by their faculty to not do something (e.g. like get an extra report) that even the fellow thought was needed for the trial, then the fellow gets his ass chewed out for not getting the extra report, and the faculty member won't throw the guy a lifeline and admit the fellow did it based on his advice, even after the mock-trial is over and everyone could drop their "kill the fellow" attitude.

And another thing I've found damaging in this process is if I were to ever chew out a fellow on cross examination (because lawyers will do that to expert witnesses in real-life) when the damned exercise is over, lick the victim's wounds. Don't put salt on them, and I've seen faculty do that in several programs, being nonconstructively critical at the guy even when they stop pretending to be the cross examining lawyer.

I'm all for fellows getting their ass chewed on cross examination, but after they've been given the proper tools and basic training so it doesn't leave an emotional scar.

Getting back to the original question, reason why I bring this up is because this type of pimping is actually common during mock trials in fellowship, I believe it's created a culture that primes faculty to be a bit more open to doing it on interviews. I was pimped 3x as far as I can remember during forensic interviews though I didn't give a damn when it happened because I already got into the program I wanted. My attitude was (without saying it), "Go ahead. F-U. The more you try to intimidate me, the more I think you're pathetic because you got no fear leverage over me."

 

[whopper]

Let me tell you about one of my interviews.

I did my interview > 3 years ago so this information may no longer be valid for this program.

1) They made me pay for my room and food. Some programs paid these for me. Okay nothing against them for that because most programs won't do this. Problem though was they wanted me to rent a car because they wanted me interviewing all over town and out of town---at several hospitals and the local jail. It cost a heck of a lot more money than most other programs because they wanted this interview process to be over three days. Most programs do it all in one day. On a resident's salary, most interviews costed me somewhere between less than $50 to a few hundred. This one cost me thousands.

2) While at the interview, one of the faculty outright said he thought the program blew. Specifically saying so because they wouldn't pay for the fellow's AAPL review course among several other things and every single other fellowship did so.

3) They told me to go to (fake name inserted) Gotham Hospital. Problem there is there are two Gotham Hospitals close to each other and they didn't tell me which one. So I called them up about an hour before, not knowing which one to go to, and they told me to go to the wrong one. So I missed an interview.

4) They told me to interview at their main hospital, telling me they had a parking spot ready for me and emphasizing that it was very important i go to the exact right one because parking at that hospital is horrendous. They did not have a spot. When I got to the exact place they told me to go, the parking attendant there had no clue who I was and wouldn't allow me to park. So I spent an hour finding a place to park and missed yet another interview.

5) They had me drive out to a jail a few hours outside of town because a lot of the work is done there and wanted a doctor there to interview me. So in the rental car they made me pay for, I drove out there for about 4 hours, and guess what? That guy was on vacation. They had me drive out there 4 hours there 4 hours back for no reason! Yet another interview missed, about $30 of gas wasted. A day in a rental car, hotel room, and fast food all paid for on my end for a waste.

All this and the PD comes out and tells me he's mad at me because I missed a bunch of interviews.

So then, I'm thinking maybe I'm just some type of loser because I missed what must have been 4 out of 7-ish interviews. I'm at the AAPL convention and guess what? I hear a bunch of fellows having drinks and talking about their interviews and they're all telling me about this horrendous program where one of the faculty is telling them their own program blows, that they missed a bunch of interviews, how they were told to go to the wrong hospital and I go to them, intrude on the conversation and quickly say, "Wait a minute...Was that XXXXX!??!!?" And all of them give me this dead stare all saying yes.

We then bonded because all of us got screwed and thought it was all our own faults because no program could be so disorganized as to do this to every single applicant who interviewed there.

Now of course a program completely mishandling their interview process doesn't necessarily mean their program is bad, but IMHO it likely does. The same people coordinating the fellowship usually coordinate the interviews, so go figure. Anyways, it was years ago. Maybe things are different and better. I hope so. The PD at that particular program has a good rep in AAPL so I suspected it could be the coordinator of the program perhaps being clueless.

 

[honsano]

Whopper can you speak to choosing a program based off location when considering a part time outpatient civil practice? I have heard a couple of varying opinions on this. Some say that connections you build from the work you do at your program and who they know is invaluable if you stay in that area. Others say big name programs will give you the best training and a name for your Cv?

 

[shan564]

I've heard that the quality/reputation of a fellowship program can affect your future career/financial prospects, since lawyers like to get consultations from the guy who went to the "top" programs... is there any truth to that? If so, do you have an idea of the magnitude of the difference?

 

[whopper]

Whopper can you speak to choosing a program based off location when considering a part time outpatient civil practice? I have heard a couple of varying opinions on this. Some say that connections you build from the work you do at your program and who they know is invaluable if you stay in that area. Others say big name programs will give you the best training and a name for your Cv?

I'm somewhat confused by what you mean in "considering a part time outpatient civil practice."

I can address the rest:
Connections in this field are incredible important. In most clinical work, the patient goes to you and there is hardly any connections based on that. If a patient sees you in the hospital, there is no connection that brought them in other than their insurance or if your hospital was the closest or things to that effect.

The fact of the matter is most forensic psychiatry fellows don't end up doing much forensic work at all after graduation though I do believe that FP fellowship is still worth it because it teaches you some incredibly useful things for clinical psychiatry that are usually not taught in general psychiatry residency and should be.

In forensic psychiatry you usually use the extra training in a state forensic facility, but you also being an expert witness for the court. In the latter, the psychiatrist is hired by a lawyer or the court. Lawyers don't know much of the medical/psychiatric community on who they can use. If a psychiatrist worked as one (edit: worked with one), that psychiatrist now becomes a known quantity vs a roll of the dice.

For example, if a lawyer has a case that he finds very difficult to win, he now needs either 1-a rock solid, highly respected psychiatrist with a good rep to clear through the crap and truly show that his client is in the right. or 2- A gun-for-hire will do anything for the money, but can convince a judge and jury because this guy is really a used-car salesman in spirit but somehow ended up going to medschool and psychiatry residency.

Per the lawyer's code of ethics, they must do what they can to win for their client, and that the "real truth" will be brought about in the adversarial process of the court. They are not supposed to determine on their own if their client is right or wrong, but merely provide the best service for that client so long as they follow the law.

Getting to the point, a lawyer hiring a psychiatrist is like a director picking a lead man for a role. Directors tend to use actors they've worked with before because they are known quantities. Think of Scorsese and Deniro. Same thing with forensic psychiatrists. If the lawyer knows the FP, they develop a relationship based on respect and/or seeing how far the guy will go to support the lawyer no matter what so long as the client for the lawyer's paying everyone enough.

There are very few lawyers in a given area who can command the cases where a psychiatrist is needed. So you move into a city, and you're a FP, it's not like you can just open an office and lawyers call you up.

The connections are very similar to the cigar-smoke filled rooms where conspiracy theorists claim the real power is in the politics of those who can get into that inner circle. This in turn turns psychiatrists away from obtaining more FP experience because they can't into the circle, and the ones in the circle get more and more experience, further building the connections, and further making them aces in the profession that can't be taken down by the newer/younger docs.

The above, though it is true, it also one end of the spectrum. There will be some lawyers looking outside the connections but this is rare. I could think of ways a new guy could break into the scene but this is only after being in this profession for some time and a newer guy without the experience wouldn't have thought of that.

A factor in considering fellowship is if you decide to stay in the area, will the fellowship want you to join their inner circle? First, the fellowship will not tell you outright they want you in. They have to be convinced you are good. Then if you're good you will be asked in one form or another but this will not happen until you've been with the fellowship for some time. During an interview they might ask a question to the effect of "do you plan on staying in the area? We'd like to see that in a candidate" This will likely mean they are open to including you into the circle if you prove to them you're worth it.

 

[whopper]

I've heard that the quality/reputation of a fellowship program can affect your future career/financial prospects, since lawyers like to get consultations from the guy who went to the "top" programs... is there any truth to that? If so, do you have an idea of the magnitude of the difference?

To some degree but IMHO not as much as your question seems to imply.

UC-Davis, Case Western, Albert Einstein, are some of the top programs in the field. A judge or jury, however, will not know this. My own program, U. of Cincinnati is a top program but if I went on the stand and the other guy was at an Ivy League without a fellowship or even one that was good the judge and jury will likely be more impressed by the Ivy League name because it has more of a name-brand recognition.

Will a judge or jury care if you were taught by Phil Resnick? They probably don't know who he is though he's the most recognized name in forensic psychiatry.

Lawyers do want a guy that can get the job done on their end. If that means a top guy, then yes, but being a top guy is hardly based on the institution but the real talents of the individual. A better program will help you to become that better expert witness. IMHO a "top program" would open doors but really more based on the connection aspects. The better programs already have a solid base of connections in their area. Some are so good they even have national/federal connections. For example, one of my mentors is often doing cases out of state.

But simply going to a top program in and of itself IMHO will not make much a difference based on name alone. It's like going to an unknown residency or one from a name-brand. It depends more on you. It's more similar to general psychiatry. You could have gone to a name-brand, you might not have, but if you want a job at a hospital they usually don't care.

If I were to move, for example, to a very different area, most of that connections benefit I can enjoy now would be lost and I'd have to rebuild it up. That could take several months to years depending on how much I worked on it and the politics of the new locality.

 

[PistolPete]

Thank you very much for the candid nature of your responses whopper, something I've been waiting for a while with respect to forensic fellowships. To be honest, it's a bit discouraging though, as it seems from your post that forensic psychiatry is all about who you know, and locality based.

It seems like even after I'd finish fellowship, I'd still have to grind it out for 2, 3 or 4 years before getting any recognition or exposure to the few lawyers that have access to the good cases, and I'm not sure I'm up for that, despite having an interest in the field.

Can you comment on this? What incentive do new, young psychiatrists have to apply to forensic fellowships if the road ahead is so unpredictable?

 

[PistolPete]

And can you comment on how DO's are viewed in forensics?

 

[whopper]

as it seems from your post that forensic psychiatry is all about who you know, and locality based.

No, it's not just about who you know. You could build a base of connections on your own, especially if you are in an underserved area. Just that it'll take more time and experience. A fellowship may also include you in their connections if you prove yourself to them.

DOs? I've never seen it make any difference so far in real-life though during cross examination during a mock trial they may try to gun you down. If that's the case, don't sweat it. You're likely only do two mock trials, so if someone tries to give you grief twice a year for a few minutes, that's not a big deal.

 

[shan564]

No, it's not just about who you know. You could build a base of connections on your own, especially if you are in an underserved area. Just that it'll take more time and experience. A fellowship may also include you in their connections if you prove yourself to them.

Does that have a big impact on your job prospects? I find forensics very interesting, but what's scaring me off is the idea that job/career/salary isn't as firmly defined as it is in other areas of medicine. I've heard that forensic psychiatrists can make big money, but I'd be happy with the standard amount that'd be expected for somebody who has done a year of fellowship on top of psychiatry residency. Do you think that's a fair expectation?

 

[whopper]

If you want to work in a state forensic psychiatry facility, this is like working at a hospital after general psychiatry residency. Connections will likely not make any difference whatsoever.

If you want to do private cases, connections do matter. Good programs will open doors. They'll also teach you the politics of how these connections work because there is a culture to it. The good programs, however, will likely only open connections within their locality unless they have national level connections and usually only the top programs have that.

If you go into a brand new area, you can build up connections but this takes time and you have to make efforts to network. This could be difficult because the graduate will likely just want to get a job first and networking while working full-time is difficult. Then if you do a private case, this will have to be in addition to that full time job. You'll have to take time off or work the equivalent of two jobs at once, and if you need to testify, you have to ask your boss for time off for that.

As for money, I wouldn't go into it for it. You're opening yourself to be a hired gun and given that the alternative is a nice, stable, 6-figure salary, I don't see any excuse for someone to *****, er, cough cough, sell themselves in that manner. I can think of avenues with as much if not even more profit vs forensic psychiatry if you really just want the money.

A fair expectation in forensic psychiatry is to make at least as much as anyone else in general psychiatry. As I've mentioned, most forensic fellow graduates don't do much if any forensic psychiatry at all. That said, their talents are often highly respected by psych departments because there will be cases here and there where a dept chair or colleague may ask for your help. Your skills in forensic will greatly assist you if you choose to just be a general psychiatrist by trade. A buddy of mine is a forensic fellowship graduate and is sometimes interviewed by the local news on forensic psych issues but works as a general psychiatrist otherwise.

 

[Chimed]

If you want to work in a state forensic psychiatry facility, this is like working at a hospital after general psychiatry residency. Connections will likely not make any difference whatsoever.

If you want to do private cases, connections do matter. Good programs will open doors. They'll also teach you the politics of how these connections work because there is a culture to it. The good programs, however, will likely only open connections within their locality unless they have national level connections and usually only the top programs have that.

If you go into a brand new area, you can build up connections but this takes time and you have to make efforts to network. This could be difficult because the graduate will likely just want to get a job first and networking while working full-time is difficult. Then if you do a private case, this will have to be in addition to that full time job. You'll have to take time off or work the equivalent of two jobs at once, and if you need to testify, you have to ask your boss for time off for that.

As for money, I wouldn't go into it for it. You're opening yourself to be a hired gun and given that the alternative is a nice, stable, 6-figure salary, I don't see any excuse for someone to *****, er, cough cough, sell themselves in that manner. I can think of avenues with as much if not even more profit vs forensic psychiatry if you really just want the money.

A fair expectation in forensic psychiatry is to make at least as much as anyone else in general psychiatry. As I've mentioned, most forensic fellow graduates don't do much if any forensic psychiatry at all. That said, their talents are often highly respected by psych departments because there will be cases here and there where a dept chair or colleague may ask for your help. Your skills in forensic will greatly assist you if you choose to just be a general psychiatrist by trade. A buddy of mine is a forensic fellowship graduate and is sometimes interviewed by the local news on forensic psych issues but works as a general psychiatrist otherwise.

Thanks, whooper, for you posts and insights.

Not sure how true it is, but I've been told that having forensic training is also great if you want to go into administration.

Whooper, what are your thoughts about the job market for dual child and forensic trained psychiatrists? Someone posted previously that it is very hard to find any work in this area. However, at least where I am and the city I'll likely move to, those with dual training are in very high demand. Is this just a fluke that of my location?

I'm about to start my forensic fellowship on Monday!!! I'm pretty excited about it, but not 100% sure what I'll do when I'm finished. I'm also starting to become increasingly interested in ethics and may use this to branch into more academic areas with my background.

 

[whopper]

Not sure how true it is, but I've been told that having forensic training is also great if you want to go into administration.

Whooper, what are your thoughts about the job market for dual child and forensic trained psychiatrists? Someone posted previously that it is very hard to find any work in this area. However, at least where I am and the city I'll likely move to, those with dual training are in very high demand. Is this just a fluke that of my location?

Administration: Yes, and a lot of it has to do because in administration you need to know what the laws are concerning your practice.

Child psych and forensic psych:
This is a highly specialized but also potentially highly lucrative field because there's so few dual forensic and child fellowship graduates. Interviewing children after being sexually assaulted, doing custody evaluations, seeing a minor with mental illness in the system for committing a crime, these things happen.

Word of warning, I've been told by people to think more than twice when doing child custody evals. In such cases you're likely going to have to pick one parent vs the other, and you're touching upon a trait on someone's most highly prized evolutionary product, their children. A good analogy is akin to stepping into a mother bear's lair. She will fight back.

A colleague of mine has told me he records every single moment he ever works on a child custody case, and when you start getting enough info that doesn't go the way one parent wants, expect them to fight back mean and dirty. You're messing with their ability to see their kids. I'm talking death threats, false accusations or rape, etc. When I say record, I mean with a recording device, not just writing what happened down.

And that's another reason why this could be so lucrative--because it could be dangerous. It wasn't forensic psych related but whenever you mess with someone's access to their kids, expect blowback. A buddy of mine, his dad is an Ob-Gyn, delivered a stillborn baby, and while it wasn't his fault, the father blamed my buddy's dad. A few days later, that Ob-Gyn was driving on the highway, the father of the stillborn drove right next to him and sprayed the guy's car with a hail of bullets fired from an Uzi. I'm not joking. Thankfully my buddy's dad was not hit, that other guy was arrested, though his car was toast.

Since it is so specialized, yes, it could be hard to break in. Again connections help, particularly with courts and lawyers that work with minors. If you do enough work with a court, you might become their go-to guy for assistance.

Odd case, I've had to testify in one particular county a few times, and that county's court's go to guy (or in this case woman) did a lot of things wrong. For example you're not supposed to do an insanity evaluation and competency evaluation at the same time because if the person is not competent, they don't have the capacity to choose an insanity defense and you're not supposed to do that evaluation unless the person has the capacity to allow you to do so. Landmark cases mentioned if you do one type of eval, you're not supposed to use that data and extrapolate into into a different type of eval.

But that lady did it, did it often (cause it makes more money and it's less work) and there I was, being cross-examined on why I wouldn't do both reports at once. I mentioned how it's not appropriate, and this court used this lady to do that inappropriate stuff for years. Everyone in the court is looking at me uncomfortably including the judge because he's used her for years because the more I spoke, the more I was exposing bad practices they allowed for years, and it's all on record.

This is not uncommon. Judges and lawyers know the law better than us forensic psychiatrists but we usually know mental health laws better than them. It's like a psych nurse vs a non-psych M.D. That M.D. may be an M.D. but they don't know psychiatry as well as someone that does it all the time, even if a nurse is considered lower on the totem pole.

 

[Chimed]

Just an unsolicited update: I've only finished about a month of my forensic fellowship, but I can say that so far I really love this. I suppose it's difficult to know what kind of things suit your personality before really doing it and I neve would have envisioned myself in forensics when I started residency, but this suits my personality far more then I could have anticipated. Hmmm, funny how things turn out. I'll admit that the idea of being able to make a bit more income through forensics was initially part of the appeal. But at this point, I'd rather take a pay cut and do this.

 

[PistolPete]

Glad to see you're enjoying your fellowship and found a good fit!

 

[Slikateer]

First of all, many thanks for starting this forum! I found this very informative as I am considering the next move of my psychiatric career.

During my training, I did have some limited experience on the inpatient units to attend court hearings for extended 3-month involuntary psychiatric holds and medication over management cases. I've had some limited experience also going to family court to observe child custody cases for mentally ill parents as well. However I found myself asking to go as it was not heavily promoted in my residency program.

But Whopper does make a good point about training in forensic psychiatry, as I have gone to these court cases where I saw psychiatrists having no clue how to present in a court of law. I find it stunning that most regular psychiatry programs don't train their residents enough to do this.

My question is to Whopper. I will continue to stay in NYC where I did my training, and there is some demand for forensic psychiatrists, namely because we have an extensive AOT program that requires the forensic psychiatrist to review these cases. Would a forensic fellowship would go into the details of dealing with AOT cases? And is Albert Einstein pretty good at training in this aspect of forensic psychiatry? Or are all NY fellowships do an adequate job on AOT issues?

Also my PD actually did a fellowship in forensic psychiatry as well. Is it too risky to ask further questions about it as it may appear that I may be encroaching on "his turf?"

 

[whopper]

AOT? Assisted outpatient?

NY is one of the only states to have a Kendra's Law type law. It's AOT is one of the most extensive in the country. Would a NYC fellowship help with this? It should.

How is Albert Einstein in this? I'm not specifically sure. I have had several friends go through that program but now I've lost contact with them.

I can say, however, that forensic psychiatry, is the field where you're going to deal with AOT patients the most and get the most training in terms of preventing them from attacking someone else or being able to operate as much as you can within the law.

The biggest pros I got for Albert Einstein, and this was coming from fellows and graduates from NYC programs even outside of it, were that the PD was phenomenal, made you feel respected, and he was passionate about what he did. All of the fellows from the other programs couldn't say this about their own PDs. Many of them told me they were envious of the fellows in Einstein, and my buddies in Einstein told me they absolutely loved working with Merril Rotter.