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UMMS Fellowship in Forensic Psychiatry

The Law and Psychiatry Program of the Department of Psychiatry, University of Massachusetts Medical School, offers an exciting, comprehensive ACGME-accredited Fellowship in Forensic Psychiatry. The program is unique in its devotion to intensive supervision and teaching by faculty who are recognized national leaders in the field. The program is accredited for three full-time positions. Applicants must have at least completed the requirements of a general psychiatry residency at the time of the commencement of the fellowship year. The fellowship is a one-year full-time program of supervised clinical, research, and courtroom experience in forensic psychiatry and the legal regulation of psychiatric practice. In addition to, and independent of, the curriculum approved by the Residency Review Committee for Psychiatry, the required participation in this training includes attendance at educational conferences, and it authorizes the resident to perform forensic examinations for the courts of the Commonwealth of Massachusetts. The overall goals of the program include training fellows in the following areas:

  1. To become familiar with sources of the law, basic legal research techniques, and the interpretation of relevant statutes, case law, and legal standards;
  2. To become knowledgeable about legal issues affecting psychiatric practice;
  3. To provide appropriate consultation to the legal system, including effective reports and testimony;
  4. To understand the role boundaries and ethical foundations of forensic practice;
  5. To become familiar with forensic research and develop skills to critically review relevant professional literature;
  6. To be effective practitioners, scholars, and teachers in the field of forensic psychiatry;
  7. To learn to provide psychiatric care for persons involved in the criminal justice system in a culturally competent manner with an emphasis on understanding levels of care and the least restrictive setting appropriate to individual treatment needs;
  8. To gain expertise in conducting forensic evaluations and formulating the treatment needs of forensic patients using an evidence-based approach, through an understanding of relevant literature;
  9. Consider careers including forensic work within the public sector.

During the training year, fellows work with a multi-disciplinary faculty with extensive forensic and academic experience in a wide range of settings where they conduct criminal and civil evaluations. Major rotation sites include the Court Evaluation Unit of the Worcester Recovery Center and Hospital, a psychiatric hospital run by the Department of Mental Health, and Bridgewater State Hospital, a secure forensic facility for the state run by the Department of Correction. At each site, fellows conduct inpatient criminal forensic evaluations such as competence to stand trial, criminal responsibility, aid in sentencing, and need for treatment of inmates. These evaluations include assessments related to whether persons involved in the criminal justice system meet standards for civil commitment. Participation in clinical treatment of persons involved with the criminal justice system takes place at Bridgewater State Hospital. During the year, fellows assess competence to make treatment decisions for some of their treatment patients. Additional rotations include placement at a juvenile court clinic site and an adult court clinic site, as well as the opportunity to work with senior faculty conducting private criminal and civil evaluations related to areas such as community risk assessments, applications for Asylum, guardianship, disability, sexual misconduct, and malpractice. The program offers other rotations (e.g., child custody evaluations and opportunities to review consultations in medical ethics and attend the Ethics and Treatment Issues Committee meetings at UMass Memorial Medical Center) to meet the interests of each fellow.

A strength of the program has been in its devotion to rigorous didactics and supervision. Educational components of the program include intensive supervision of all cases, report preparation, and court testimony. In addition, one day per week fellows attend comprehensive seminar series covering areas related to civil and criminal forensic assessment methods, research issues, mental health law, and landmark legal cases. The educational program is also attended by post-doctoral level fellows in forensic psychology, keeping with the multidisciplinary approach to training. Fellows attend statewide forensic mental health conferences and receive an educational stipend to support attendance at national forensic meetings. Fellows are also given opportunities to teach medical students, psychiatry residents and psychology trainees during the year. In addition, fellows occasionally provide lectures to law enforcement officers related to mental health issues.

During the training year, fellows work on an empirical research project or on a review of a topic relevant to law and psychiatry. The research component is conducted with significant mentoring from multi-disciplinary faculty who are considered national leaders in the fields of forensic psychiatry, forensic psychology, and mental health law. Fellows frequently present their findings at national meetings and pursue publication of their research. Opportunities also exist for fellows to become involved in ongoing faculty research projects. Supervision of academic work is provided by individual faculty members.

In addition to providing training experiences to meet the requirements for ACGME accreditation, the fellowship is designed to emphasize forensic psychiatric practice in public sector settings. The fellowship utilizes literature for all its seminars and provides an emphasis on teaching evidence-based practices in forensic psychiatry. The individuals encountered by trainees represent diverse racial and ethnic backgrounds, and the program emphasizes an approach to working with these individuals in a culturally competent way.

Methods to monitor the program and evaluate program quality and fellow performance include monitoring of patient logs, and a computerized evaluation system designed to give comprehensive feedback to fellows and faculty during the year