Help me rank my forensic psychiatry fellowship shortlist

[Willbutrin]

Hi everyone, PGY-2 in psych and currently trying to learn as much as I can about the field of forensic psychiatry and what the programs offer. There is actually very limited information online comparing programs. I think I've read almost every post on the website, and I'm still a little lost when it comes to evaluating the quality of the training you'll get. I was hoping to only apply to a small number of places, but it's looking like I'll just apply broadly and narrow it down based on the interviews I get.

Of course, I'm internally biased towards the ivy leagues on my list, but like in all areas I'm sure it's very common to get a quality (and more relaxed) education at other institutions. I have a mental checklist of the things I should look for: shorter commutes, guaranteed supervision time with the PD and/or leading forensic names affiliated with the program, experience in psychological testing, risk assessment tools, malingering instruments, experience with more complex cases (NGRIs), etc. The following schools are all in areas where I could see myself living and/or settling down. I can tell you that I'm not interested in becoming an academic and I see myself working in outpatient/inpatient with forensics on the side.

Anyway, I'd appreciate your participation in the poll, and I'd love to hear your rationale(s).

CORRECTION: Case western is in Cleveland, not Columbus.

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[Alemo]

I’m in fellowship currently. Forensics is very different than clinical medicine. The strength of the fellowship completely depends on the director and how many opportunities they can secure for their fellows. Are you going to take call in a prison (big red flag)? Or are you going to take classes at law school, see private cases, do plenty of NGRIs, plenty of comps, policy work, etc etc. the strength is all in variety.

Case is great because the faculty are numerous and there’s a large infrastructure of criminal and civil settings and a massive pipeline of various cases. NYU on the other hand is very unidimensional and busy work heavy. Clinical care is a mandated part of the fellowship but it should be minimal. Yale and Brown are the only Ivy places with good reputations. MGH faculty will tell you to avoid the MGH program if possible. So again, don’t go by “traditional” rep.

Other good places listed here are USC, Colorado, UCSF, and Northwestern.

 

[heartsink]

Yale and Brown are the only Ivy places with good reputations.

I'm not so sure Yale has the best reputation when it comes to determining good qualities in a psychiatrist...

Technically it's the medical school that hosted her, not the residency or fellowship program - but personally I would never want to associate myself with this institution now. This kind of thinking tends to permeate, as evidenced by a Yale psychologist that actually lauded the rant.

 

[Willbutrin]

I’m in fellowship currently. Forensics is very different than clinical medicine. The strength of the fellowship completely depends on the director and how many opportunities they can secure for their fellows. Are you going to take call in a prison (big red flag)? Or are you going to take classes at law school, see private cases, do plenty of NGRIs, plenty of comps, policy work, etc etc. the strength is all in variety.

Case is great because the faculty are numerous and there’s a large infrastructure of criminal and civil settings and a massive pipeline of various cases. NYU on the other hand is very unidimensional and busy work heavy. Clinical care is a mandated part of the fellowship but it should be minimal. Yale and Brown are the only Ivy places with good reputations. MGH faculty will tell you to avoid the MGH program if possible. So again, don’t go by “traditional” rep.

Other good places listed here are USC, Colorado, UCSF, and Northwestern.

Thank you! These insights are exactly the kind I am looking for. I'm not personally interested in living in CT or RI (or the northeast in general) longterm, so I probably won't consider Yale or Brown anyway. I'm more of a west-coast type, so USC, Colorado, UCSF, Northwestern are all exciting options.

Is there any easy way to determine whether or not a program is clinical (or prison-call) heavy, or is that something I would have to grill the PD on during interviews? I haven't really been able to pick up on that nuance from the fellowship overviews on the respective websites, and I imagine it's something they try to downplay.

 

[soundnin]

i see california schools listed but no uc davis? i'm also a pgy-2 interested in forensics and from what i read, it's one of the top programs in the country.

one afternoon i had some free time and looked up some commutes to the associated state hospitals and other sites if listed on the program's websites (I can't remember how I defined sites nearby... maybe under 40 miles):

OHSU - state hospital ~50 miles, other sites nearby
UC Davis - napa state hospital ~60 miles
Tulane - east louisiana state hospital ~110 miles??
Case Western - northcoast ~15 miles, heartland ~60 miles, summit county jail ~40 miles, UH richmond ~15 miles
UMass - bridgewater state hospital ~65 miles, boston sites ~50 miles
SUNY upstate - central NY psychiatric center ~50 miles
UCLA - ?
UCSF - san quentin ~15 miles
UTSW - sites nearby
U of Virginia - western state hospital ~40 miles, fluvanna women's ~15 miles
U of Cincinnati - sites nearby
OSU - sites nearby
Brown - sites nearby
Yale - sites nearby
U Penn - sites nearby
U of Maryland - sites nearby
AECOM - sites nearby
U of Rochester - wayne county behavioral ~45 miles
U of Michigan - sites nearby
Emory - 1 site about 100 miles away but housing provided (1 week/year)
UNLV - sites nearby

 

[Willbutrin]

i see california schools listed but no uc davis? i'm also a pgy-2 interested in forensics and from what i read, it's one of the top programs in the country.

one afternoon i had some free time and looked up some commutes to the associated state hospitals and other sites if listed on the program's websites (I can't remember how I defined sites nearby... maybe under 40 miles):

OHSU - state hospital ~50 miles, other sites nearby
UC Davis - napa state hospital ~60 miles
Tulane - east louisiana state hospital ~110 miles??
Case Western - northcoast ~15 miles, heartland ~60 miles, summit county jail ~40 miles, UH richmond ~15 miles
UMass - bridgewater state hospital ~65 miles, boston sites ~50 miles
SUNY upstate - central NY psychiatric center ~50 miles
UCLA - ?
UCSF - san quentin ~15 miles
UTSW - sites nearby
U of Virginia - western state hospital ~40 miles, fluvanna women's ~15 miles
U of Cincinnati - sites nearby
OSU - sites nearby
Brown - sites nearby
Yale - sites nearby
U Penn - sites nearby
U of Maryland - sites nearby
AECOM - sites nearby
U of Rochester - wayne county behavioral ~45 miles
U of Michigan - sites nearby
Emory - 1 site about 100 miles away but housing provided (1 week/year)
UNLV - sites nearby

UC-Davis was originally off my shortlist because I didn't have much interest in living in Sacramento. Definitely have heard that it's one of the top programs though, so maybe I should reconsider.

Thanks for the list! I made a similar type of list with commutes yesterday. I'll PM it to you later today if you're interested.

 

[Jack Napier]

I’m in fellowship currently. Forensics is very different than clinical medicine. The strength of the fellowship completely depends on the director and how many opportunities they can secure for their fellows. Are you going to take call in a prison (big red flag)? Or are you going to take classes at law school, see private cases, do plenty of NGRIs, plenty of comps, policy work, etc etc. the strength is all in variety.

Case is great because the faculty are numerous and there’s a large infrastructure of criminal and civil settings and a massive pipeline of various cases. NYU on the other hand is very unidimensional and busy work heavy. Clinical care is a mandated part of the fellowship but it should be minimal. Yale and Brown are the only Ivy places with good reputations. MGH faculty will tell you to avoid the MGH program if possible. So again, don’t go by “traditional” rep.

Other good places listed here are USC, Colorado, UCSF, and Northwestern.

Does Columbia have a good reputation among Ivy League forensic programs?

 

[TexasPhysician]

What state do you want to live in?

 

[Willbutrin]

What state do you want to live in?

I haven't quite narrowed it down. I grew up in the south and went to school in the midwest. Ideally, I'd like to live on the west coast, but there are some factors (notably cost of living) which make me wary of that option. My top states to live (in no particular order) would be: Washington, Oregon, Nevada, Arizona, Colorado, North Carolina, Tennessee, Texas, Florida.

 

[Alemo]

Thank you! These insights are exactly the kind I am looking for. I'm not personally interested in living in CT or RI (or the northeast in general) longterm, so I probably won't consider Yale or Brown anyway. I'm more of a west-coast type, so USC, Colorado, UCSF, Northwestern are all exciting options.

Is there any easy way to determine whether or not a program is clinical (or prison-call) heavy, or is that something I would have to grill the PD on during interviews? I haven't really been able to pick up on that nuance from the fellowship overviews on the respective websites, and I imagine it's something they try to downplay.

You have to look at a schedule which a good program should provide. The best source of information interview is the current/immediate past fellows, though sometimes the “behind the scenes” view isn’t possible on the interview day. Usually afterwards though the fellows give you contact info and you can ask what’s was good what was bad etc.

Forensics is pretty small too so if you have a mentor who’s even somewhat active in AAPL they’ll give you good information.

I don’t know specifics about Colorado’s program but I think Richard Martinez is head of the fellowship directors org, active in AAPL, and is very involved in correctional psychiatry. USC is one of the oldest programs (older usually means better with regard to infrastructure/opportunity). UCSF sounded really cool as far as civil exposure plus rotating at San Quentin. They also do some VA work which I think is clinical. Renee Binder is an AAPL legend and past pres of APA.

 

[Alemo]

Does Columbia have a good reputation among Ivy League forensic programs?

Why are you asking questions like this year after year?

I didn’t interview there but I hear you don’t work with Applebaum that much and it’s busy work heavy. Just a rumor though.

 

[Willbutrin]

You have to look at a schedule which a good program should provide. The best source of information interview is the current/immediate past fellows, though sometimes the “behind the scenes” view isn’t possible on the interview day. Usually afterwards though the fellows give you contact info and you can ask what’s was good what was bad etc.

Forensics is pretty small too so if you have a mentor who’s even somewhat active in AAPL they’ll give you good information.

I don’t know specifics about Colorado’s program but I think Richard Martinez is head of the fellowship directors org, active in AAPL, and is very involved in correctional psychiatry. USC is one of the oldest programs (older usually means better with regard to infrastructure/opportunity). UCSF sounded really cool as far as civil exposure plus rotating at San Quentin. They also do some VA work which I think is clinical. Renee Binder is an AAPL legend and past pres of APA.

Great tips, I appreciate it. My residency program is solid for general psychiatry, but it doesn't have an in-house forensic fellowship, and we don't have any forensics attendings affiliated. That's the main reason why I'm trying to be more proactive and seek out info. I am planning to attend AAPL 2022 in NOLA though, which will be a good opportunity to network. There is a grad from my program who is currently a forensics fellow at UC-Denver, and I've heard good things about the program. UCSF also sounds like a great program if you can get over the pains of living on a fellow salary in SF for the year.

 

[Jack Napier]

Why are you asking questions like this year after year?

I didn’t interview there but I hear you don’t work with Applebaum that much and it’s busy work heavy. Just a rumor though.

I’ve been debating applying for several years, but haven’t for a variety of reasons. It’s hard to find reliable information. Is it ok that I post in an open forum regarding this topic?

 

[SmallBird]

I'm not so sure Yale has the best reputation when it comes to determining good qualities in a psychiatrist...

Technically it's the medical school that hosted her, not the residency or fellowship program - but personally I would never want to associate myself with this institution now. This kind of thinking tends to permeate, as evidenced by a Yale psychologist that actually lauded the rant.

Not being open to a good opportunity with Yale forensics because the Child Study Center made a mistake with a grand rounds speaker now two years ago seems unnecessarily cautious.

 

[TexasPhysician]

I haven't quite narrowed it down. I grew up in the south and went to school in the midwest. Ideally, I'd like to live on the west coast, but there are some factors (notably cost of living) which make me wary of that option. My top states to live (in no particular order) would be: Washington, Oregon, Nevada, Arizona, Colorado, North Carolina, Tennessee, Texas, Florida.

I know a fair share of fellowship trained psychiatrists that aren’t doing forensics at all. They claim lucrative forensic jobs aren’t sitting around and are quite rare. I assume some of what you learn will be state laws, and you’ll probably build mostly local connections. Most psychiatrists stay in the last state they train in. If you network, you’ll know where the better jobs are.

I’d start by narrowing your list to only states you could see yourself in long-term. Now what does the list look like?

 

[Zyprexa100]

Case has a good forensic fellowship.

 

[heartsink]

Not being open to a good opportunity with Yale forensics because the Child Study Center made a mistake with a grand rounds speaker now two years ago seems unnecessarily cautious.

It isn't just about self-preservation. Culture is changing and there is building resentment toward the bleeding edge of progressive racism in the name of "equity". Khilanani is an extreme example, but she is a symbol that reflects the trend; the pendulum has swung too far in one direction. It is schools like Yale that helped get us here and people are taking notice. The counterbalance is that moderate minds will not associate with their train of thought much longer. Good opportunities exist in more moderately-minded places. Ivy Leagues can't coast by on their name anymore.

 

[Alemo]

I’ve been debating applying for several years, but haven’t for a variety of reasons. It’s hard to find reliable information. Is it ok that I post in an open forum regarding this topic?

Fair enough. And re: Yale, I think in the past they've taken like 4-5 fellows which cuts into how much work you get exposed to.

Again I just started fellowship (obviously) but was pretty involved all throughout residency. My understanding is that the value of the year almost totally depends on the PD, the number of forensic faculty, volume and variety of report writing and line by line supervision you get for those reports, and the quality of the lectures.

It’s an extremely young field. People like James Knoll, Resnick, and Charles Scott are leaders that everyone looks to for the gospel truth. Their programs are good because they’re obsessed with teaching forensic psychiatry, have a huge pipeline of private cases from lawyers, and publish/promote themselves. It’s not like every other medical sub-specialty where there’s this widely disseminated body of knowledge and it’s all about hospital infrastructure, amount of pathology, and how many researchers are there are to develop cutting edge stuff. You can publish guidelines about treating bipolar disorder and everyone everywhere can follow it but it’s a lot harder to publish guidelines about how to write a comp/sanity opinion for a guy accused of child murder and rape who you think is malingering.

None of this has anything to do with the university attached to the fellowship, or how much psychiatric research they do, or how much rare pathology comes through. Re: private civil work, lawyers want solid legal thinking—not necessarily someone who “trained at prestigious medical center university.”

I think UPMC doesn’t even have a fellowship anymore. MGH doesn’t have a good one. Meanwhile, when was the last time anyone considered Case/UC Davis/SUNY Upstate/U Colorado/USC as phenomenal general residency programs? They’re probably all fine programs, but the point is forensics is a weird pseudomedical (basically non-medical) thing where the standard rules don’t apply. Conversely, if you’re just trying to get board certified, there’s plenty of fine forensic programs.

The vast majority of forensic fellowship slots don’t fill.

 

[Willbutrin]

Fair enough. And re: Yale, I think in the past they've taken like 4-5 fellows which cuts into how much work you get exposed to.

Again I just started fellowship (obviously) but was pretty involved all throughout residency. My understanding is that the value of the year almost totally depends on the PD, the number of forensic faculty, volume and variety of report writing and line by line supervision you get for those reports, and the quality of the lectures.

It’s an extremely young field. People like James Knoll, Resnick, and Charles Scott are leaders that everyone looks to for the gospel truth. Their programs are good because they’re obsessed with teaching forensic psychiatry, have a huge pipeline of private cases from lawyers, and publish/promote themselves. It’s not like every other medical sub-specialty where there’s this widely disseminated body of knowledge and it’s all about hospital infrastructure, amount of pathology, and how many researchers are there are to develop cutting edge stuff. You can publish guidelines about treating bipolar disorder and everyone everywhere can follow it but it’s a lot harder to publish guidelines about how to write a comp/sanity opinion for a guy accused of child murder and rape who you think is malingering.

None of this has anything to do with the university attached to the fellowship, or how much psychiatric research they do, or how much rare pathology comes through. Re: private civil work, lawyers want solid legal thinking—not necessarily someone who “trained at prestigious medical center university.”

I think UPMC doesn’t even have a fellowship anymore. MGH doesn’t have a good one. Meanwhile, when was the last time anyone considered Case/UC Davis/SUNY Upstate/U Colorado/USC as phenomenal general residency programs? They’re probably all fine programs, but the point is forensics is a weird pseudomedical (basically non-medical) thing where the standard rules don’t apply. Conversely, if you’re just trying to get board certified, there’s plenty of fine forensic programs.

The vast majority of forensic fellowship slots don’t fill.

Wow, I really like this summary. It really helps me to reconceptualize the scouting process. Thank you!

Another question: I've been seeing a lot of posts about how many forensic trained psychiatrists do not find enough forensic work. Do you (or anyone reading this) have any insight into whether or not that's true? If there's no guarantee for regular work (and by work I mean an additional 1-3k per month on top of my regular job), I don't know if I could justify taking the year for a fellowship.

 

[TexasPhysician]

Wow, I really like this summary. It really helps me to reconceptualize the scouting process. Thank you!

Another question: I've been seeing a lot of posts about how many forensic trained psychiatrists do not find enough forensic work. Do you (or anyone reading this) have any insight into whether or not that's true? If there's no guarantee for regular work (and by work I mean an additional 1-3k per month on top of my regular job), I don't know if I could justify taking the year for a fellowship.

This is just what I’ve seen, but those I know that are fellowship trained are either not using it at all or are quite busy in the field. This is partly why I advise doing this fellowship where you want to live. You should be networking in training (any level), and that networking can lead to opportunities.

 

[heartsink]

This is just what I’ve seen, but those I know that are fellowship trained are either not using it at all or are quite busy in the field. This is partly why I advise doing this fellowship where you want to live. You should be networking in training (any level), and that networking can lead to opportunities.

Surely states without any forensic programs need someone to be forensically trained in psychiatry though. Somehow, psychiatrists have broken into legal world to network in these states without academic affiliations guiding them. So how is that best done? Cold-calls?

 

[Alemo]

Some psychiatrists give free talks at legal conferences or to criminal law firms. Similar to how law firms or financial advisors give talks to residents/physician offices.

If you’re in a metropolitan area, you will get work. May not be totally steady all the time, but you’ll get it.

I don’t think TexasPhysician is implying that the market is saturated with forensic psychiatrists. That doesn’t mean there aren’t more psychologists who a lawyer might opt for for other reasons, but that’s another story.

 

[TexasPhysician]

Surely states without any forensic programs need someone to be forensically trained in psychiatry though. Somehow, psychiatrists have broken into legal world to network in these states without academic affiliations guiding them. So how is that best done? Cold-calls?

That’s a different debate. The majority of forensic work is not being done by forensic fellowship trained psychiatrists. I’m just saying that the easiest way to move into forensic work from fellowship is leveraging your network. Most I know are doing no forensic work.

 

[Willbutrin]

That’s a different debate. The majority of forensic work is not being done by forensic fellowship trained psychiatrists. I’m just saying that the easiest way to move into forensic work from fellowship is leveraging your network. Most I know are doing no forensic work.

I totally see the rationale for training in an area where you intend to live from the standpoint of making local connections and continuing to practice in a place where you know the legislature, jails, courtrooms, etc.

However, isn't it also true that you could also create that foundation in any place after 1-year of dedicated networking and work? On top of that, aren't you putting yourself at a disadvantage settling down in an area (like the training city) where you're invariably competing for new work with your mentors, alumni, and co-fellows who also decide to stay?

 

[splik]

I totally see the rationale for training in an area where you intend to live from the standpoint of making local connections and continuing to practice in a place where you know the legislature, jails, courtrooms, etc.

However, isn't it also true that you could also create that foundation in any place after 1-year of dedicated networking and work? On top of that, aren't you putting yourself at a disadvantage settling down in an area (like the training city) where you're invariably competing for new work with your mentors, alumni, and co-fellows who also decide to stay?

No. Doing forensic work is very connections based. Lots of people train in one place and then move somewhere else so it is doable, but it is not easy to break into a new area unless you were joining a forensic practice or had a mentor or connections in the other area. I don't think you would be competing with your mentors since no one is going to give you the kinds of cases out of training that a seasoned forensic psychiatrist will get. Your mentors may send you the cases they don't want. I am not sure that networking is that helpful. I will tell you that most of the cases I get, it is from repeat customers (i.e. attorneys who were happy with my work before), because I was recommended by an attorney or even a friend (to their lawyer friend or relative etc). You can certainly advertise, list yourself on directories, do CLE talks, make media/TV appearances etc, but almost all the money I have made from forensic work has come from personal recommendations and not from advertising/networking etc. I am in an area with lots of psychiatrists, and a large number of forensic faculty, and I have not felt I have been "competing" for work with people I trained with. And a lot of the most lucrative work is done by non forensic-trained folks.

You also have to remember for the more important (and thus high-paying) cases, attorneys will go out of area or even out of state to get the best experts. No one wants a rookie straight out of fellowship for that sort of thing. I wasn't able to get my full fee until several years out of training.

 

[TexasPhysician]

I totally see the rationale for training in an area where you intend to live from the standpoint of making local connections and continuing to practice in a place where you know the legislature, jails, courtrooms, etc.

However, isn't it also true that you could also create that foundation in any place after 1-year of dedicated networking and work? On top of that, aren't you putting yourself at a disadvantage settling down in an area (like the training city) where you're invariably competing for new work with your mentors, alumni, and co-fellows who also decide to stay?

Say you move to a preferred state where there is no fellowship. You take a regular psych job working 30-40 hours. How do you plan to build connections with judges, attorneys, etc that may hire you? You were in a position doing dedicated forensics and meeting the right people. Now you are totally outside of forensics doing Gen psych 30-40 hours with no inroads. Many counties will have a strong relationship with a psychiatrist that does the forensic stuff. He/she may not be forensic trained, but he/she is a known entity that has done the work for maybe decades (I’ve seen this). The people with power may never change their ways until this person retires. What next? Big civil cases don’t want someone fresh out of training. It’s a battle.

 

[heartsink]

And a lot of the most lucrative work is done by non forensic-trained folks.

This is very interesting to me because other posters on this subforum have explicitly cautioned against attempting this; their caveat being that the opposing counsel will grill a non-fellowship trained psychiatrist on the stand regarding their lack of fellowship training, board certifications, etc. in an attempt to discredit them.

 

[romanticscience]

This is very interesting to me because other posters on this subforum have explicitly cautioned against attempting this; their caveat being that the opposing counsel will grill a non-fellowship trained psychiatrist on the stand regarding their lack of fellowship training, board certifications, etc. in an attempt to discredit them.

Attorneys want an expert in psychiatry, especially in a particular area relevant to the case, not an expert in forensic psychiatry. They don’t care that you know landmark cases or theories of neuro-law; that’s their job. However, you need to know your role, how it’s different than a clinician, how to formulate and communicate well-reasoned opinions in your report and at trial.

There are many other ways to demonstrate credibility other than forensic boards. It hadn’t been my experience that attorneys have not asked /discussed forensic certification when they retain me. Remember, law is a totally different world compared to medicine. People are thinking differently. We’re seen differently from their eyes than how we see ourselves. A lawyer at my last deposition asked me what I majored in when I went to medical school.

 

[Jack Napier]

Say you move to a preferred state where there is no fellowship. You take a regular psych job working 30-40 hours. How do you plan to build connections with judges, attorneys, etc that may hire you? You were in a position doing dedicated forensics and meeting the right people. Now you are totally outside of forensics doing Gen psych 30-40 hours with no inroads. Many counties will have a strong relationship with a psychiatrist that does the forensic stuff. He/she may not be forensic trained, but he/she is a known entity that has done the work for maybe decades (I’ve seen this). The people with power may never change their ways until this person retires. What next? Big civil cases don’t want someone fresh out of training. It’s a battle.

What if one joins an academic program?

 

[Bartelby]

This is very interesting to me because other posters on this subforum have explicitly cautioned against attempting this; their caveat being that the opposing counsel will grill a non-fellowship trained psychiatrist on the stand regarding their lack of fellowship training, board certifications, etc. in an attempt to discredit them.

Keep in mind forensic fellowships got certified by the ACGME in 1997, so there are plenty of people who got into the practice of forensic psychiatry when fellowships were either novel or nonexistent. There is a big difference between someone with decades of experience (but no fellowship) taking their 1,500th case and in someone with no experience and no fellowship deciding to try out taking a first case.

I think it is possible to still do forensic work without the fellowship, but be mindful that there is a needed skillset that differs from the clinical skills taught in residency. As romanticscience correctly states, the lawyer should be able to explain the law and the legal questions for you, so being a pseudo-lawyer added to the case isn't what is needed. You do need to be able to handle meeting the standard for a forensic IME, maintaining ethical standards for forensic evaluation, navigating difficult situations (such as pressure from an attorney, limits on your exam, limits on what findings are admissible, writing declarations in support of motions), effective report writing, and effective deposition and courtroom testimony (to name a few). You could seek mentorship from someone who does the work while you learn the ropes, especially if you are targeting a narrow type of evaluations or are taking cases only in an area of particular subspecialist expertise for you.

 

[TexasPhysician]

What if one joins an academic program?

My experience only comes from programs that don’t have a forensic fellowship. The faculty getting the forensic cases were not fellowship trained. One knows a judge. The other is well published with Ivy credentials that does rare civil cases. Attorneys were not knocking on the door of academia to give out cases.

 

[Jack Napier]

My experience only comes from programs that don’t have a forensic fellowship. The faculty getting the forensic cases were not fellowship trained. One knows a judge. The other is well published with Ivy credentials that does rare civil cases. Attorneys were not knocking on the door of academia to give out cases.

The administrator where I did my child fellowship said they would frequently get calls looking for forensic services. Maybe there is a regional factor?

 

[splik]

The administrator where I did my child fellowship said they would frequently get calls looking for forensic services. Maybe there is a regional factor?

Definitely a regional factor. The devil is in the detail. I'm wondering who is calling and about what kinds of evaluations. In my area there is desperation for people to do child competency evaluations and juvenile waiver evals because the courts pay so terribly (it could work out as low as $30-40/hr depending on how long it takes to complete). Similarly, the courts pay a flat rate of $1200 for child custody evaluations. These are multihour evaluations requiring interviewing multiple parties, extensive record review and detailed report writing, and can be risky given parents can become murderous if they perceive you as taking their kids away from them. As you can imagine, not many psychiatrists are going to agree to do that kind of work if they get paid much, much less than they could for doing much simpler clinical work.

 

[TexasPhysician]

The administrator where I did my child fellowship said they would frequently get calls looking for forensic services. Maybe there is a regional factor?

I’ve been asked many times to do forensic work. No one has agreed to my rates. I don’t believe my rates are anything crazy, but I’m certainly asking for more than I earn in my clinic roles. For me to accept forensic work, I’d have to be willing to reschedule days of patients for court, etc.

I find it entertaining as my rate isn’t higher than what I last hired an outside attorney for, yet they call my rates high.

There is plenty of low paying forensic work available if you are ok with a pay cut.

 

[nexus73]

I’ve been asked many times to do forensic work. No one has agreed to my rates. I don’t believe my rates are anything crazy, but I’m certainly asking for more than I earn in my clinic roles. For me to accept forensic work, I’d have to be willing to reschedule days of patients for court, etc.

I find it entertaining as my rate isn’t higher than what I last hired an outside attorney for, yet they call my rates high.

There is plenty of low paying forensic work available if you are ok with a pay cut.

What’s your rate? I charge $400 for forensic work, $650 to testify. I’ve been told by other forensic psychiatrists the $400 is somewhat low.

 

[TexasPhysician]

What’s your rate? I charge $400 for forensic work, $650 to testify. I’ve been told by other forensic psychiatrists the $400 is somewhat low.

It started at $400, but recently changed to $500 as it just isn’t worth my time under that now. I don’t have a different rate for testifying. I’m strongly considering just declining to even discuss forensic opportunities though.

My most recent discussion was a personal injury attorney who tried to talk my rates down because she could bring me “volume”. She also wanted me to accept payment if and only if a settlement is reached or she wins in court. That’s left a bad taste in my mouth.

 

[Alemo]

She also wanted me to accept payment if and only if a settlement is reached or she wins in court

Lmao what could go wrong?

I think rates are very location dependent. I’ve seen a range from 200-800 an hour. Keep in mind it could also depend on the type of case (a second opinion sanity eval for a public defender would probably be quoted lower than malpractice work for a plaintiff). Physicians think money is icky but lawyers are must more comfortable with wheeling and dealing.

 

[Bartelby]

She also wanted me to accept payment if and only if a settlement is reached or she wins in court. That’s left a bad taste in my mouth.

That is explicitly unethical per AAPL guidelines. Good call passing that up.

 

[psyguru]

I do recommend OHSU. We did two forensic cases a week for 6 months with great supervision. In some programs, you would do fewer cases or only shadow cases. The didactics were solid. Having a little more clinical supervision would have been nice but I did not really miss it.

 

[psyguru]

What’s your rate? I charge $400 for forensic work, $650 to testify. I’ve been told by other forensic psychiatrists the $400 is somewhat low.

Generally speaking, a physician expert witness with some experience (i.e. 5-10 depos/testimonies) should charge at least $500/hr. Neurosurgery experts charge $2k an hour to testify to keep things in perspective. Blood splatter, police use of force experts and other non-medical experts charge $250/hr. I think forensic psychologists could charge $300 or more. Once an opposing non-forensic psychology expert witness was charging $700/hr (she was well-published in PTSD) in a sexual assault/ PTSD case. Regarding rates, I would not be surprised if they offer you $400/hr or less for court-funded competency to stand trial cases for trespassing or a McIME from one of the IME companies (they will take a cut). Many of those types of cases are done by forensic psychologists so which may depress the rates. Also, many of those cases would gross < 10 hours and the court-funded ones are capped. Many cases can go over 20 hours pre-depo. If you want to charge higher rates look into PI, med mal, will contests, multi-plaintiff multi-district cases, toxic torts, capital mitigation, select occupational IMEs, tobacco litigation, and class action. Once you get enough referrals, you can turn down cases that do not offer your rate. Another factor could be geographical. That is one reason to take cases nationally. Niche building can help as well.

 

[psyguru]

It started at $400, but recently changed to $500 as it just isn’t worth my time under that now. I don’t have a different rate for testifying. I’m strongly considering just declining to even discuss forensic opportunities though.

My most recent discussion was a personal injury attorney who tried to talk my rates down because she could bring me “volume”. She also wanted me to accept payment if and only if a settlement is reached or she wins in court. That’s left a bad taste in my mouth.

I would not accept payment on contingency. Some other specialists work as hybrid experts in personal injury clinics where they get paid, both for clinical work and expert witness work after the case settles via liens. There are plenty of attorneys in the sea so I would move on.

 

[psyguru]

Lmao what could go wrong?

I think rates are very location dependent. I’ve seen a range from 200-800 an hour. Keep in mind it could also depend on the type of case (a second opinion sanity eval for a public defender would probably be quoted lower than malpractice work for a plaintiff). Physicians think money is icky but lawyers are must more comfortable with wheeling and dealing.

I will stick to my rate but sometimes will do low-bono or pro-bono (asylum, human trafficking, VAWA cases) if it is a case I am interested in.