Forensic Psychiatry - Fellowship & Future

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PistolPete

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Hello everyone,

Haven't had any residents from my program go into forensics in recent years, and I wanted to get some input from senior residents, fellows and attendings: how difficult would it be to land a forensic fellowship at either USC, UCSF or UCSD, coming from a psych residency in California (not one of the above three)? Which one of these has best reputation for allowing fellows the appropriate experience in writing documents, and testifying? I know that Dr. Resnick is in Ohio but I have no intention in moving there for a year.

Furthermore, I've heard varying views on the utility of doing a forensic fellowship, especially since not all are top quality. I know several psychiatrists that work in the state hospital system, and occasionally testify in court, but they're not really acting as "forensic psychiatrists" per se, that is, not going out of their way to market themselves as forensic experts that are hired for complex cases. How viable is it to spend 50% of my time purely as a forensic expert, evaluating patients/writing reports/testifying?

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I'm just a psych resident but have interests in forensics and am in California. Since no one else is answering you...

UCSF is probably the best know of the three. Binder is a big name, and forensic programs tend to bear a lot of resemblance to their program leaders. UCSF has particularly strong civil experience, which is often a weak point at less well rounded programs. USC would be viewed by most as a fair step down from UCSF. I know little about UCSD, as it's a very new program.

You're leaving out what most anyone would consider the strongest of the California forensic fellowship programs, which is UC Davis. Hard to not consider it one of the best in the country. Run by Charles Scott, who rocks. Very well rounded and great experience. They work their fellows hard, but come out with great experience.

But for what you're talking about doing, a fellowship in the geographic area you hope to practice would probably not be a bad strategy. I wouldn't discount the perks of building a reputation locally as you train.

I would wager that 99% of your folks who do forensic fellowships spend less than 50% of their time evaluating/testifying.
 
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Hello everyone,

Haven't had any residents from my program go into forensics in recent years, and I wanted to get some input from senior residents, fellows and attendings: how difficult would it be to land a forensic fellowship at either USC, UCSF or UCSD, coming from a psych residency in California (not one of the above three)? Which one of these has best reputation for allowing fellows the appropriate experience in writing documents, and testifying? I know that Dr. Resnick is in Ohio but I have no intention in moving there for a year.

Furthermore, I've heard varying views on the utility of doing a forensic fellowship, especially since not all are top quality. I know several psychiatrists that work in the state hospital system, and occasionally testify in court, but they're not really acting as "forensic psychiatrists" per se, that is, not going out of their way to market themselves as forensic experts that are hired for complex cases. How viable is it to spend 50% of my time purely as a forensic expert, evaluating patients/writing reports/testifying?

I'm going to be starting a forensics fellowship in July. Sorry, I can't say anything about the California programs. But I would beg to differ about questioning the utility of doing a forensic fellowship at all vs. not going to ANY program because you're concerned it might have as good of a reputation. My reasoning is that if you're going to be testifying in court and want to be a forensics expert, you're better off being board certified.
 
Thanks a lot for the replies, guys. I really had no idea that UC Davis was such a strong program, so that goes to show just how much I know! Not sure I'd want to live in Sacramento, but that's still a while away, so maybe my mind will change.

Chimed, I'm wondering what tips you can provide for those of us that may be wanting to do a forensics fellowship... was the interview the most important part of the application process? LORs? Connections? Your writing sample?
 
Thanks a lot for the replies, guys. I really had no idea that UC Davis was such a strong program, so that goes to show just how much I know! Not sure I'd want to live in Sacramento, but that's still a while away, so maybe my mind will change.

Chimed, I'm wondering what tips you can provide for those of us that may be wanting to do a forensics fellowship... was the interview the most important part of the application process? LORs? Connections? Your writing sample?

Sorry I can't be of more help, but I only applied to my current institution. I've been here for 5 and a half years, so they know me pretty well. The interview and application process was more a formality.

I'm not sure if they still visit this site, but whooper and anasazi both completed a forensic fellowship and have knowledge about the application process. But, in general, all the things you mentioned--LORs, connections, and writing samples--are probably important. If you can find a way to write up a case and get a publication in a forensic journal, I'm sure that would help. Because forensics can be lucrative, I would imagine that some programs might try to weed out those who have a genuine interest in the field from those who just want to pad their income. At least, that was the sense I got from the folks where I am.

Best of luck.
 
Because forensics can be lucrative,

I've heard this phrase a lot, but still haven't been able to figure out what people mean on a concrete level.
 
I had a mentor who did a case every month or so. Was flown to Ohio while I was there for 4 days, all expenses paid, and billed $700/hr.
 
Interesting. You probably have to get "in good" with lawyers though which is hard to "learn." Seems that connections matter more than your academic prowess? I wonder what the learning curve is and how long it takes to amass cases consistently?
 
I had a mentor who did a case every month or so. Was flown to Ohio while I was there for 4 days, all expenses paid, and billed $700/hr.

I know a fellowship trained doc that can't find forensic opportunities that pay more than her child hours.

Everyone is fighting for the forensic positions/hours now which is making it increasingly hard to make it worthwhile.
 
I know a fellowship trained doc that can't find forensic opportunities that pay more than her child hours.

Everyone is fighting for the forensic positions/hours now which is making it increasingly hard to make it worthwhile.

Hmmm....You're saying that the field for dual trained child and forensics is over saturated? I'm not sure where you are, but that is highly unlikely in the majority of locations. Regardless, doing something just for the money is likely not going to be "worthwhile" if that your goal.
 
Hmmm....You're saying that the field for dual trained child and forensics is over saturated? I'm not sure where you are, but that is highly unlikely in the majority of locations. Regardless, doing something just for the money is likely not going to be "worthwhile" if that your goal.

I'm saying that all of forensics is tough to get into even with a fellowship. Non-fellowship psych docs with historic inroads with attorneys/judges are hard to displace.

My friend even offered to undercut the prices of a non-fellowship psych doc and the judge told her no-thanks. His reasoning was he knew the current doc did good work and trusted him. The judge refers all county cases to 1 guy. This is one of multiple cases I'm aware of.

Forensics requires significant self promotion, networking, and time to build even a part-time private practice forensics practice in many locations from what I've seen. Either that or have published 100s of articles or be the recognized expert in a certain niche.
 
His reasoning was he knew the current doc did good work and trusted him. The judge refers all county cases to 1 guy.

I think this is true in general, and what I'm afraid of. Even if you're an average to slightly above average psychiatrist after forensics, it's still gonna take a long time to build up a forensics practice, so I'm trying to weigh whether or not this is practical and will be worth my time to do the fellowship (I don't know any lawyers), even though I do have an interest in forensics. I'll have to mull on this for a while.
 
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I think this is true in general, and what I'm afraid of. Even if you're an average to slightly above average psychiatrist after forensics, it's still gonna take a long time to build up a forensics practice, so I'm trying to weigh whether or not this is practical and will be worth my time to do the fellowship (I don't know any lawyers), even though I do have an interest in forensics. I'll have to mull on this for a while.

My two cents is that if you're really interested in forensics, you should do the fellowship even if it takes time to build a practice for all the above reasons. If you're just looking to make extra money, then I wouldn't bother for multiple reasons. Forensics is a great way to diversify your practice. Even if it paid less then seeing patients, I'm looking to do something in psychiatry besides just cranking out patients from 8 to 5, Mon through Friday. I love psychiatry and I enjoying seeing patients, but I just can't do it all the time. I thought I'd end up in academics, and I still might. But the research thing just isn't for me. Forensics is still an intellectual area of psychiatry, but there are NO grants! :D
 
JMC Marine should be able to weigh in on this topic, not sure he's frequenting this forum lately, though. If not, you might PM him.

Another missing person who did forensics is whooper (also anasazi). He has been so active on this forum in the past, I'm surprised he's not around. He would likely be a great resource.
 
Would it be feasible or possible to have a forensics only type of practice?
 
Would it be feasible or possible to have a forensics only type of practice?

The idea of being an expert in the field requires that you continue to see patients. You could theoretically fill your schedule with forensics clients with enough connections, but eventually cross-examination would question your abilities as you have no recent clinical experience.
 
Forensics is a relatively non-competitive fellowship, but a cutthroat business in the real world. Many small to mid size markets (in terms of population size) are controlled by 2-3 forensic psychiatrists that own the market. It's nearly impossible to compete with these guys on the big cases, unless you are willing to risk your integrity and potentially your license (unfortunately, there are forensic psychiatrists that will jump when the attorney says jump and run when the attorney says run). Also, in tort cases, likability factor (due to dealings with a jury) is huge and should not be under-estimated. In terms of clinical practice, almost all of the forensic guys keep a very small private practice (some see just a few a day) so that on cross exam, they don't get harassed. Things that I have seen on cross exam...so you didn't go to medical school in the US?....so you are a DO (I'm a DO)?....so how much do you charge an hour?....nothing is off limits unfortunately.

The idea of being an expert in the field requires that you continue to see patients. You could theoretically fill your schedule with forensics clients with enough connections, but eventually cross-examination would question your abilities as you have no recent clinical experience.
 
I know a fellowship trained doc that can't find forensic opportunities that pay more than her child hours.

Everyone is fighting for the forensic positions/hours now which is making it increasingly hard to make it worthwhile.

Yikes, where I am from dual fellowship CAP & forensic docs are so hard to come by the saying is that they just take a dump truck full of money and pour it onto your house to get services.
 
Yikes, where I am from dual fellowship CAP & forensic docs are so hard to come by the saying is that they just take a dump truck full of money and pour it onto your house to get services.
You'd better like doing custody evals. Ugh... And demand doesn't always equate cost when it comes to the court. Out my way, evals are a flat fee set by the county for a lot of them.
 
CAP is the way to go these days.

Yikes, where I am from dual fellowship CAP & forensic docs are so hard to come by the saying is that they just take a dump truck full of money and pour it onto your house to get services.
 
Yikes, where I am from dual fellowship CAP & forensic docs are so hard to come by the saying is that they just take a dump truck full of money and pour it onto your house to get services.

just because something is hard to come by doesn't mean that the supply/demand curve associated with that matches up with salaries.

If you read all these statistics like "there are only 3 child psychiatrists serving this area of 16 billion people" and assume that means people will be throwing money at you, you're wrong.
 
and assume that means people will be throwing money at you, you're wrong.

and assuming that there aren't places where they do throw money at you is wrong too. just do your research before you settle down in a particular place. the folks that do this stuff around my way charge by the hour and do quite well.
 
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