Print this page

Forensic Psychiatry Residency Program

Clinical Rotations

Residents receive clinical training at three major sites in four major settings: inpatient treatment units at the Center for Forensic Psychiatry; the Outpatient Evaluation Unit of the Center for Forensic Psychiatry; the University of Michigan Medical Center; and the Scott Correctional Facility, a state prison for women located about 20 minutes from the medical center.

Center for Forensic Psychiatry-- Inpatient

Most inpatients at the Center have been found not guilty by reason of insanity or incompetent to stand trial. Residents function both as treating psychiatrists for their own patients, and as forensic examiners for the patients of other clinicians. They receive ongoing supervision in the management of forensic patients with particular emphasis on clinical problems such as suicide, malingering, amnesia, self-injurious behavior, violence, psychosis, substance abuse, and antisocial behavior. Residents prepare psychiatric reports and provide testimony for the courts, particularly competency to-stand-trial evaluations and clinical certificates for continued, involuntary hospitalization. Other important forensic issues encountered on inpatient units include the right to treatment, the right to refuse treatment, informed consent, and confidentiality/privilege. Typical case loads of 2-3 patients are carefully monitored to provide exposure to a variety of diagnostic groups, legal issues, and offenses.

6 MONTHS

6 MONTHS

Inpatient Forensic

(Center for Forensic Psychiatry)

65%

Outpatient Forensic

(Center for Forensic Psychiatry)

15%

Inpatient Forensic

(Center for Forensic Psychiatry)

20%

Outpatient Forensic

(Center for Forensic Psychiatry)

30%

Correctional Psychiatry

(Scott Correctional Facility))

30%

Legal Regulation and Civil Forensic Psychiatry

(University of Michigan Health Systems and
Private Practice Settings)

20%

 

Center for Forensic Psychiatry-- Outpatient Evaluation Unit

In order to obtain certification as Consulting Forensic Examiners under Michigan law, residents observe at least five competency to stand trial evaluations and five criminal responsibility evaluations in the outpatient unit. They then conduct five supervised competency evaluations and five criminal responsibility evaluations; the final evaluation regarding each issue is supervised by the Director of Training and Research. Residents observe court testimony, participate in a mock trial, and provide testimony when required in cases they have examined. Other forensic issues arising in the evaluation unit include Miranda rights, competency to be sentenced, juvenile waiver, and pre-sentencing recommendations.

University of Michigan Health System-- Legal Regulation and Civil Forensic Psychiatry

The University of Michigan Health System and the practices of faculty forensic psychiatrists on serve as the venues for this rotation. Residents consult to a general psychiatric service on issues related to the legal regulation of psychiatric practice, such as civil commitment, confidentiality, refusal of treatment and the "right to die," emergency treatment, decision-making competence, guardianship and conservatorship, etc. They gain experience in psychiatric aspects of civil litigation such as malpractice, disability, sexual harassment, psychic injury related to trauma, and child custody, and in administrative aspects of forensic psychiatry. The rotation includes three major components. First, residents attend a monthly conference including faculty from the forensic psychiatry program and from the consultation-liaison service of the University of Michigan Department of Psychiatry, where cases and questions pertaining to the law/psychiatry interface are presented for consultation and educational purposes. Second, residents meet regularly with the hospital attorney for the University of Michigan Health System to discuss matters relating to the legal regulation of psychiatry, with particular reference to active problems, law suits, and policy issues at the hospital. Third, residents observe and assist experienced forensic psychiatrists, both in private practice and at the Child and Adolescent Psychiatric Hospital, engaged in the full range of civil controversies.